Bulloch County officials in last Tuesday’s budget workshop heard reports of soaring costs in the county employee health insurance program and that department heads have requested hiring 28 more employees to jobs paid from the general fund and 29 more paid from the fire fund.

So the county commissioners – including some elected last year on anti-tax-increase platforms – face challenges to maintaining what some called a “budget neutral” stance.

Mark Browder, vice president of Mark III Employee Benefits, the broker or advisor to the county on its mostly self-insured employee health benefits plan, was the first presenter during the April 1 budget work session. His firm has served the county in this capacity since 2023 and last year recommended a change in the contracted medical and dental plan administrator from the previous 90 Degree Benefits program through IBG (Industry Buying Group) to Cigna. The county made the change to Cigna last July 1.

$2.3M in old claims

A ransomware attack on Change Healthcare detected Feb. 21, 2024 had affected the healthcare industry and IBG’s processing of claims, Browder stated in his summary slideshow. This lag time in claims impacted Bulloch County in a significant way that didn’t fully reveal itself until “2024-2025,” he said, meaning during the county’s July 1-June 30 current fiscal year.

“The runout claims represent an incredible 59% of prior Medical Claims spend, or $2,295,271,” one slide stated.

Bulloch County’s government has had to pay these unbudgeted late claims from the current, FY 2025 revenue, confirmed Chief Financial Officer Kristie King. But a similar continuing increase in the county’s claim payments under its self-insurance program must now be budgeted for FY 2026, she said. The new fiscal year begins July 1.

A separate company, Optum Rx, serves as benefits manager for the county’s pharmacy plan, but pharmacy claims have remained stable since a previous effort to control these two years ago, Browder reported.

However, in two years, the combined medical and pharmacy claims have more than doubled, from (rounded here) $5.34 million in fiscal year 2023 to $6.14 million in fiscal 2024 and now, a projected $11.87 million in fiscal 2025.

Again, of that $11.87 million, almost $2.3 million was for “runout” or previous-year late-processed claims, according to his report. He stated that the most recent year’s increase was “driven by a significant claims catch-up, and historical under-reporting.”

Mark III Employee Benefits recommended that the county renew its current arrangement, with Cigna as its third-party medical and dental benefits administrator.

$3.5M increase

But the advisory firm also calculated the 2025-2026 total plan cost as $11,717,808, up from the current year’s county-budgeted amount of $8,197,213.

“For ’24-’25, we’re on track for almost $12 million,” Browder told the commissioners. “And just so you understand, what’s going on is as these claims come in, because you’re self-funded, Finance (the county finance office) is having to cover those claims. So that claims explosion is being covered today, but has to be addressed going into the ’25-’26 plan year.”

So the $11.7 million figure, a $3.53 million or 43% increase, is the recommended health plan funding for the county’s fiscal year 2026 budget.

“The County has to fund the increase,” a slide stated, indicating that this is something where the commissioners really have no choice.

As of February, the county had 395 employees eligible, according to the health insurance advisor’s charts. This also provides context for a budgeting factor the county CFO, King, reported later in the work session.

Third budget day

The April 1 afternoon work session was for key staff members to discuss budget priorities with commissioners and review input from the March 17-18 “budget retreat.” During those two days in the Gene Bishop Field House at Paulson Stadium, leaders of more than 20 county departments and funded agencies had given presentations about needs and wants.

Then last week, outgoing interim County Manager Cindy Steinmann reviewed needs and issues identified at the 2024 budgeting retreat more than a year earlier and progress as of the mid-March 2025 retreat and since. Speaking of growth in the county workforce, Steinmann noted that the county added 34 general-fund paid positions in fiscal year 2024. Then last year, a county workforce needs study was completed, for “future implementation … in small phases.”

How many added positions have been requested by the various departments during and since the March retreat?

“I’ve had 27 full-time employees requested in the general fund, and one part-time, and rural fire has requested 17 additional full-time and 12 part-time,” King told the commissioners.

Those, for fiscal 2026, would be in addition to the 37 full-time firefighter positions of various ranks the commissioners recently approved adding to the fiscal 2025 budget. Hiring is now underway in preparation for the Bulloch County Fire Department’s pending July 1 takeover of service to the five-mile district previous served by the Statesboro Fire Department. Until now, the BCFD had a maximum of 30 full-time firefighters.

But the BCFD’s salaries are funded from a special fire fund with its own tax millage, and the county department now stands to receive the $2.5 million to $3 million in revenue the county previously sent to the city for service by the Statesboro Fire Department.

Still, the department’s leaders know they will not get all of the additional 17 full-time and 12 part-time personnel in the next budget, King said Friday.

“The Fire Department I need to negotiate with a little bit because I think they know that we can’t fund all of those positions this year,” she said.

All have needs

Needs for new or expanded buildings and additional “rolling stock” such as more fire trucks were also discussed, with the Special Purpose Local Option Sales Tax being one long-term funding source for some of these. The possibility of an across-the-board raise or merit raises was also mentioned. But commissioners’ comments reflected a realization that they can’t do it all.

“The one thing I do kind of want to focus on is maintaining where our departments are now. I don’t want to rob Peter to pay Paul … because every department has needs,” said Commissioner Toby Conner.

After someone mentioned a “budget neutral” approach, Public Safety Director Randy Tillman, who will serve as interim county manager after Steinmann’s resignation takes effect Wednesday, said the county cannot be “neutral” in paying for things it must have whose costs it cannot control.

“On top of that, some of the things you heard were about the growth and how that’s going to affect emergency services, public safety, recreation and all that moving forward,” Tillman said. “So it’s going to be a task to look at ‘budget neutral’ plus providing for growth.”

Steinmann asked commissioners at one point, if they could not yet identify what priorities they want to fund, to talk about what items they don’t.

“I think it’s not as much a matter of what we don’t want to fund as what we can’t fund right now,” said Chairman David Bennett.