Memorandum
Date: September 29, 2026
To: The Honorable Lake County Board of Supervisors
From: Susan Parker, County Administrative Officer
Pam Samac, Human Resources Director
Subject: Consideration of Update on Employee Health Benefits
Executive Summary:
Background
Health care costs continue to rise, and this remains a nationwide challenge driven by factors such as higher prescription drug prices, increased use of specialty care, and rising provider costs. The County of Lake contracts with the PRISM Health Insurance Program to provide health coverage for its employees and eligible dependents. PRISM is a joint powers authority that allows public agencies across California to purchase health coverage together as a group.
To ensure the County is receiving the best value, staff conducted a market review of available alternatives. No more competitive options were identified. The results were as follows:
1. Aetna: Declined to quote
2. Anthem: Declined; not competitive
3. Cigna: Declined; not competitive
4. Blue Shield: Declined; not competitive
5. UnitedHealthcare: Declined; not competitive
As a result, PRISM remains the most cost-effective option for the County. Because PRISM is a pooled program, risk is spread across many participating counties, which helps insulate the County from sharp cost increases that a single employer might face on its own. A single large claim or a difficult claims year has less impact on the County's rates than it would under a stand-alone plan, which also makes premiums more stable and predictable for budgeting.
2027 Open Enrollment (September 14 - October 9, 2026)
In preparation for the 2027 plan year, Human Resources has taken the following steps:
• Returned to in-person open enrollment meetings so employees can ask questions directly and get help choosing the plan that best fits their needs
• Increased awareness of lower-cost health care options, such as telehealth, urgent care instead of the emergency room for non-emergencies, and generic prescriptions, so employees can make better use of available services while reducing costs for both themselves and the County
• Conducted a cost-share survey of management, elected, and confidential staff to gather input on how premium costs are shared between the County and employees
• Researched alternative health care options to confirm the County's current program remains the best available choice
Next Steps
Human Resources, Alliant, and PRISM will continue to closely monitor health care options and costs, and staff will return to the Board with updates or recommendations as needed.
If not budgeted, fill in the blanks below only:
Estimated Cost: ________ Amount Budgeted: ________ Additional Requested: ________ Future Annual Cost: ________
Purchasing Considerations (check all that apply): ☒ Not applicable
☐ Fully Article X. <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI>- and/or Consultant Selection Policy <http://lcnet.co.lake.ca.us/Assets/Intranet/Policy/Policies+$!26+Procedures+Manual/Ch4_2021v2.pdf>-Compliant (describe process undertaken in “Executive Summary”)
☐ Section 2-38 <https://library.municode.com/ca/lake_county/codes/code_of_ordinances?nodeId=COOR_CH2AD_ARTXPU_S2-38EXCOBI> Exemption from Competitive Bidding (rationale in “Executive Summary,” attach documentation, as needed)
☐ For Technology Purchases: Vetted and Supported by the Technology Governance Committee <http://lcnet.co.lake.ca.us/Assets/Intranet/Intranet+Forms/Information+Technology/AdvPlan.pdf> (“Yes,” if checked)
☐ Other (Please describe in Executive Summary)
Consistency with Vision 2028 <http://www.lakecountyca.gov/Government/Directory/Administration/Visioning/Vision2028.htm> (check all that apply): ☐ Not applicable
☐ Well-being of Residents ☐ Public Safety ☐ Disaster Prevention, Preparedness, Recovery
☐ Economic Development ☐ Infrastructure ☒ County Workforce
☐ Community Collaboration ☐ Business Process Efficiency ☐ Clear Lake
Recommended Action: Presentation only.