MANSFIELD — Skyrocketing costs of health insurance for county general fund employees are not sustainable — even in a county in good financial shape — according to Commissioner Tony Vero.
“I would say health insurance costs increasing 70 percent over five years is not sustainable, regardless of the financial position of any employer,” he said.
His comments came after commissioners met Thursday with Cindi Herring, a benefit specialist with the County Employee Benefit Consortium of Ohio, to review the period from April 2025 to May 2026.
Richland County joined CEBCO, a 48-county pooled health insurance organization, in 2017. The county’s current contract, which began in 2026, expires in 2028.
CEBCO is a member-owned, not-for-profit, self-insured purchasing pool. It was launched by the County Commissioners Association of Ohio in 2004.
Herring told commissioners the county had an “overall loss ratio” of 120.3 percent during the period, comparing paid claims versus paid premiums.
“Your paid claims are almost $14 million. Your premiums were at 11 million, so there is quite a difference there, hence the 120 percent loss ratio,” she said.
She said medical claims were $10.4 million, a 37 percent increase from the previous period. Herring said prescription medication claims were $3.1 million, an 8.8 percent increase over the previous period.
The CEBCO representative said the county had 13 “high-cost claimants” during the period, including four cancer claims.
Looking at the cost increases, Vero told Herring the price hikes “are staggering.”
“I’m not laying blame of anything, other than just looking at the actual dollars. If we hit $6.6 million at the end of 2027, it will be a 70 percent increase in health insurance costs from what the taxpayers paid in 2022 to what they would paid in 2027,” he said.
CEBCO will conduct its annual group review at the end of July and will then meet with individual counties to go over actual cost increases.
Richland County has 284 general fund employees participating in the health insurance plan through CEBCO. That number rises to 586 people when covered family members are included.
That number does not include employees using the insurance who work at other agencies, such as Richland Public Health and Richland County Children Services.
According to CEBCO, 48 of the state’s 88 counties participate in the plan, which offers “group purchasing and superior programs in health insurance and wellness advocacy,” according to its website.
Herring said CEBCO “shops” for its insurance carriers.
“We just did that last year. We put out a request for proposals and Anthem won that,” she said.
Vero said the county doesn’t have all the needed information yet in terms of making a decision on whether to continue its contract with CEBCO past 2028.
“Our claims and experience drive the health insurance cost increase. We have to understand that in more detail and then we will look at all options,” he said.
“We are in a self-insured pool right now. We could stay with CEBCO. We could look at being full self-insured on our own. I don’t think we have all those answers yet,” he said.
He said the county would also look at what’s happening in the private sector with regards to insurance costs.
“Health insurance costs in all sectors are going up substantially,” Vero said. “Is 70 percent normal or is our experience just significantly worse than other employers?”
In April, a state auditor’s report urged Madison Local Schools to get its health insurance costs under control. The auditor urged the district to negotiate a less generous health insurance plan for its teachers and staff.
The report found Madison Local Schools’ current plans are more costly than those of average school districts in the region. The audit recommended aligning the district’s employer insurance costs with the regional average for school district employees.
Vero said that’s easier said than done in terms of changing collectively bargained benefits with unions that represent county employees.
“It’s quite difficult. These are collectively bargained and there are caps on insurance premiums. The plan itself is part of bargaining. That’s something we will discuss with HR as we move forward,” Vero said.
“CEBCO has been a really good partner. This isn’t a ‘Hey, you guys, we don’t like what you’re doing.’ The service is fantastic.
“But the caveat is certainly when you have a 70 percent increase potentially over five years, I think you at least got to look at all options. We will look after this meeting and get a better sense what the renewal will actually be,” he said.
“This is certainly not a sign of displeasure with CEBCO. I want to make that very clear.”
(Below is a PDF of the CEBCO first quarter report for 2026 provided to the Richland County Board of Commissioners on Thursday.)
