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Human Resources Department recommending the Board take the following actions regarding Health Plan Programs and Ancillary Employee Benefit Programs for the 2026 Plan Year:
1) Approve the proposed 2026 Retiree and COBRA (which includes countywide Employee Assistance Program rates) health plan rate cards (Attachment A) based on the cost sharing of health premiums in the current Memoranda of Understanding with all bargaining units, the Salary and Benefits Resolution for unrepresented employees, and in accordance with Consolidated Omnibus Budget Reconciliation Act; and
2) Grant Human Resources the authority to correct any minor clerical errors or adjustments, if necessary, to the approved health plan rate cards for the 2026 health benefits plan year, as needed.
FUNDING: Countywide cost, shared between the County Departments (General Fund and Non-General Fund) and employees.
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DISCUSSION / BACKGROUND
On August 19, 2025, with Legistar file 25-1360, the Board of Supervisors adopted the 2026 health plan rate cards for active employees, outside agencies whose benefits are administered through the County, and Operating Engineers, Local 3 (OE3)’s Health Trust plans for their members in our Trades and Crafts (TC) and Corrections (CR) bargaining units.
Medicare Retirees who are 65 or older are eligible to purchase Medicare Advantage supplement health plans through UnitedHealthcare (UHC) and Kaiser Permanente Senior Advantage (KPSA); the rates for the KPSA plan were not yet available to be presented to the Board on that date. As the KPSA rates have since been received, Human Resources is returning to the Board for the adoption of the 2026 Retiree rate card.
For the 2026 plan year, the following retiree Medicare Advantage supplement plans are scheduled to renew as follows:
KPSA 9.8% Increase
UnitedHealthcare 21.0% increase
Industry-wide, Medicare Advantage supplement plans have continued to see larger rate increases the last few years both due to the general upward medical cost trend and as a result of Medicare payment adjustments and the Inflation Reduction Act (IRA) of 2022. Medicare’s lower payment rates to insurers (which make the primary Medicare plans more affordable) resulted in significant Medicare Advantage supplement plan rate increases.
As a summary from the August 19, 2025, Board item, for the 2026 plan year, health and retiree-relevant ancillary benefit programs are scheduled to renew as follows:
Blue Shield PPO 200 Standard 13.9% increase
Blue Shield PPO 1700 ABHP Low 13.9% increase
Blue Shield PPO 2000 ABHP High (ACA Compliant Plan) 13.9% increase
Kaiser HMO Standard 13.9% increase
Kaiser 1700 ABHP 13.9% increase
Delta Dental 3.7% increase
VSP Vision 25.4% increase
On April 9, 2024, with Legistar file 24-0502, the Board of Supervisors newly approved the County’s participation in the “ConcernPlus” Employee Assistance Program (EAP) for first responders through the County’s current EAP provider, Concern EAP. ConcernPlus gives first responders generally the same benefits otherwise provided through our EAP to eligible employees, including emotional health and substance abuse, parenting and childcare needs, financial coaching, legal consultation, and eldercare resources, while providing law enforcement first responders with specific culturally competent short-term counselors. The designation of eligible “first responders” is determined on a department-by-department basis by their respective appointing authorities. Benefit-eligible employees not designated as first responders access our traditional EAP.
The EAPs have monthly Per Enrolled Participating Member (PEPM) rates, in addition to Critical Incident Stress Debrief (CISD) hours that can be purchased at $450/hour on a fee-for-service (FFS) basis as needed. The County now has the option to renew the ConcernPlus program through the term ending December 31, 2026; 2026 EAP renewal PEPM rates are as follows:
EAP Concern PRISM $3.56 PEPM (No change)*
EAP ConcernPlus PRISM $14.35 PEPM (20.0% increase)
*The County’s traditional EAP provider, Concern EAP, has a three-year rate guarantee period ending June 30, 2026. Should the renewal rates change for coverage after that date, staff would return to the Board at that time.
The EAP is an employer provided benefit for benefit-eligible County employees. When an employee terminates coverage (i.e., due to change in employment status or benefit eligibility), they and any covered dependents have the ability to enroll in a continuation of coverage (COBRA) at their own cost, including the EAP. As the COBRA rate card is the only rate card that reflects the EAP cost, it is recommended that the Board approves the 2026 COBRA health plan rate card.
ALTERNATIVES
The Board could choose to override the recommendation to renew the 2026 Employee Benefits Insurance Program Renewal as recommended; however, if the Board chooses to not approve the recommendations as listed herein, the County would not meet the deadlines required by the vendors for the plan year.
If ConcernPlus is not renewed, the program offering will end with a final date of coverage December 31, 2025; effective January 1, 2026, benefit eligible “first responder” employees will transition back to the County’s traditional EAP through Concern EAP.
PRIOR BOARD ACTION
02/15/2011 Legistar file 11-0121: County joined CSAC-EIA Health program (now PRISM Health).
04/09/2024 Legistar file 24-0502: Board initially authorized ConcernPlus EAP program for first responders.
08/19/2025 Legistar file 25-1360: Board adopted 2026 health plan rate cards for active employees and outside agencies, and authorized Human Resources to execute administrative health and benefit program plan renewals for the 2026 health benefits plan year.
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Approve as recommended.
FINANCIAL IMPACT
The total percentage change from the 2025 rates is 13.7%. The overall increase in annual premium from last year is approximately $5,545,524 for all listed benefit programs and ancillary benefits including long term disability and life insurance. Costs are shared between employees and salary and benefits budgets for each County department. It is anticipated that most departments can cover the six months of increased costs with Salaries and Benefits savings from vacancies. Departments will assess these costs with the mid-year budget report and request a budget transfer to address any increases that cannot be covered with savings.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
Workforce Excellence
Priority: Focus on Employee Development & Well- Being
Action Item: Continue to implement wellness initiatives and activities for El Dorado County employees
CONTACT
Joseph Carruesco, Director of Human Resources