Cigna would still run the health plan. Sandy Springs would fund the claims.

Sandy Springs’ proposed health-plan switch would keep Cigna and the current provider network—but move responsibility for funding eligible claims to the city’s plan. Council is scheduled to consider the change Oct. 20, ahead of a proposed Jan. 1 start.⁠[1]

The trade is more control over spending, with more direct financial risk. The proposal includes insurance to reimburse high-cost claims, generally above a $200,000 individual threshold. But it also leaves the city with roughly $700,000 in additional liability for known high-cost claims before that protection applies, according to staff’s accompanying questions-and-answers document.⁠[1]

Staff projects an expected 2027 medical-program cost of $10.65 million and recommends budgeting a maximum projection of $12.73 million, including both city and employee contributions. Neither is a fixed insurance premium: the memo says actual costs can vary with enrollment, claims, reimbursements and drug rebates.⁠[1]

Those rebates are part of the math, not just a potential bonus. The comparison table incorporates an estimated $446,000 in pharmacy rebates into Cigna’s self-funded projections. The Q&A says Cigna has offered to pass through 100% of eligible rebates—but staff will seek contract language defining what qualifies and capturing all applicable manufacturer-related revenue. Some rebates attributable to 2027 may not arrive until 2028.⁠[1]

Staff also says it is seeking audit rights over pharmacy payments, fees and rebate reporting. That does not mean unrestricted access to every underlying invoice: the Q&A acknowledges that confidentiality or proprietary restrictions may prevent the city from receiving every manufacturer invoice unredacted. These are the protections staff describes pursuing, not verified terms of an executed agreement.⁠[1]

Employees would also pay more. Staff recommends a 20% increase in medical-plan contributions—the first increase since 2021—while retaining fully city-paid employee-only coverage under the HSA Base Plan.⁠[1]

The financial documents still do not line up completely. While the memo recommends appropriating the $12.73 million maximum projection, the draft ordinance uses an estimated $11,344,016.55 for the self-funded arrangement. The packet does not reconcile those amounts.⁠[1]

The Oct. 20 agenda lists the proposal as unfinished business, and the accompanying memo requests authorization rather than documenting a completed council approval. The meeting begins at 6 p.m. in the Studio Theatre at City Hall, 1 Galambos Way.⁠[1]