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Monmouth County votes Thursday on $243.9M Horizon health plan contract; county projects medical costs up 10% a year
On the agenda: nothing in this report has been voted on. Jersey Intel will report the outcome from the county’s official record.
Monmouth County, N.J.’s commissioners are scheduled on Thursday, Oct. 22, to vote on a three-year contract with Horizon Blue Cross Blue Shield of New Jersey to run the county’s self-funded employee health plan. The estimated cost is $243,923,950.98 for 2027 through 2029. The county’s own figures project medical costs rising 10% a year.
Image: Jersey Intel infographic. Photo: Monmouth County Hall of Records, Freeholdman12 / Wikimedia Commons (CC BY-SA 4.0).
- What we know: Agenda item 71 would authorize the contract (RFP P-4-2027), with two one-year renewal options. About $3,746,345.88 is listed as “administrative fees and profit to be paid to Horizon.” The rest is budgeted for medical costs.
- Why it matters: It’s the largest dollar item on Thursday’s agenda. The county’s budget lines climb from $72.6 million in medical costs in 2027 to $87.8 million in 2029.
- What’s next: The posted agenda lists the regular meeting for 12:30 p.m. Thursday at the Hall of Records, One East Main Street, Freehold. The public can comment on agenda items before the votes.
What the resolution says
According to the draft resolution posted with the agenda, the county advertised a request for proposals under its “Fair and Open Process,” and two proposals were opened on Aug. 25, 2026. The contract would be awarded without competitive bidding under the state law exception for insurance contracts, following the procedures for “extraordinary unspecifiable services.”
The resolution breaks the cost into three plan years:
- 2027: $72,561,210 in medical costs plus $1,179,361.32 in administrative costs, for $73,740,571.32
- 2028: $79,817,331 plus $1,247,603.52, for $81,064,934.52
- 2029: $87,799,064.10 plus $1,319,381.04, for $89,118,445.14
Each year’s medical line is exactly 10% higher than the year before. The resolution doesn’t explain the assumption. Under a self-funded plan, the county pays its employees’ claims and pays the administrator to run the plan, so the medical figures are estimates, not a fixed price. No money can be spent until the county’s chief financial officer certifies that funds are available in each year’s budget, the resolution says.
The recommendation
A certification dated Oct. 19 from Iris Dullavin, the county’s director of benefits and workforce wellness, says the county’s benefits consultant, Alliant Insurance Services Inc., reviewed the medical administration proposal from Aetna, “determined there was no significant differential in network discounts and recommended the quotations submitted by Horizon.” It says Horizon “has successfully provided these Services to the County in the past.”
The certification describes the cost as “$243,923,950.98 for two (2) years.” The resolution and the budget lines cover three plan years, 2027 through 2029, and the three yearly totals add up to that figure.
Questions before the vote
- What does the county pay Horizon now, and how do the new administrative fees compare?
- Why does the county project medical costs rising 10% a year, and what would hold them down?
- How did Aetna’s proposal compare on administrative fees, not just network discounts?
- Will the certification’s “two (2) years” wording be corrected before the vote?
Also on Thursday’s agenda
The commissioners are also set to consider an $8,977,185.77 contract with Benefit Plan Administrators of Eau Claire, LLC to administer the county’s self-funded retiree indemnity health plan for 2027 through 2029, including about $540,152.30 in administrative fees. They’re also scheduled to act on county guarantees, on first reading, of Monmouth County Improvement Authority bonds for 11 local projects, from $700,000 for Freehold Township Fire District No. 1 to $23,181,661 for Wall.
Be there, or send us what you have
If you attend Thursday’s meeting in Freehold, record the discussion and send it to us. If you have the proposals, Alliant’s evaluation or the current contract terms, email jerseyintel@gmail.com.
