Mayor Pike and the Jeffersontown City Council voted to approve first reading of a resolution to switch the city's employee medical insurance from Anthem to Cigna, citing a costly Anthem renewal. "We're gonna go from Anthem to Cigna," Mayor Pike said, noting Anthem's renewal request would have increased the city's cost by roughly $162,754.

Chip, the benefits consultant working with the city, told council members Cigna's pricing was the most competitive in the marketplace and that the broker negotiated several benefit changes. Chip said Cigna's proposal came in about 0.5% below the city's current cost and about an 11.5% premium spread versus Anthem's renewal. Under the Cigna proposal, the city would move to a level-funded contract: "written on self insured paper, but it works and operates like a fully insured program," Chip said, explaining the arrangement fixes monthly funding and caps exposure at roughly 110% of expected claims.

Chip described specific benefit modifications negotiated with Cigna: coverage for certain weight-loss medications without requiring a diabetes diagnosis; an increase in annual physical therapy visits from 20 to 30; and a reduction in the specialty medication (tier-4) cap from $350 to $300 while maintaining a 25% cost share. He also warned that the plan's reinsurance/specific-limit structure would change: the city's pooling level would drop from $150,000 under Anthem to $50,000 under Cigna, meaning reinsurance would begin paying amounts above $50,000 for an individual claimant.

Council members raised operational concerns about timing, prior authorizations and employee costs. Deductibles and out-of-pocket limits accumulate on a calendar-year basis; councilmember questions focused on whether employees who had already met their calendar-year deductibles would receive credit if the city changed carriers with a Dec. 1 effective date. Chip said Cigna agreed to provide deductible and out-of-pocket credit for December for employees who can document they have met those amounts with an Anthem explanation of benefits (EOB), and the broker's office can process individual EOBs earlier than waiting for the December report from Anthem.

Chip also noted that prior authorizations (for prescriptions, outpatient procedures and therapies) do not automatically transfer to a new carrier and that physician offices would typically need to request new authorizations under Cigna.

Council discussed operational alternatives, including paying one month of the Anthem renewal (Chip estimated about $16,000) to remain on Anthem for December and make Cigna effective Jan. 1 to avoid calendar-year credit complications. Chip said he would ask Cigna whether a 13-month contract or other timing options might be available. He also told the council the city's claims experience is concentrated: six catastrophic claimants have accounted for about 70% of the city's total paid claims, which affects how likely it is that most employees have met deductibles.

At the meeting, Councilmember (speaker 5) moved for first reading of resolution 839, series 2025, approving the city's change to Cigna for medical insurance; Councilmember Mark (speaker 4) seconded. The motion for first reading by title only passed among members present.

Next steps: personnel and enrollment meetings are scheduled (Chip said meetings are set Monday afternoon at 2:00 p.m. and Tuesday at 8:00 a.m. and 2:00 p.m., to finalize enrollment and answer employee questions). The resolution advanced on first reading; further council action will be required for final approval.