The Palm Coast City Council received a detailed presentation on employee health insurance Tuesday, hearing that the city’s health plan — which covers about 512 employees and more than 1,000 total members — is currently running about $384,000 under budget for the 2025-26 plan year. The early positive performance sets the stage for a projected renewal increase of only about 3.8 percent heading into FY 2026-27, compared to a 10 percent increase the year before.
Brown & Brown Senior Account Executive Brandon Savage presented the data, noting that total medical and pharmacy claims grew by 10 percent this plan year — a cost of about $932,000 — with the city absorbing roughly $800,000 of that and employees covering the remainder. One claimant has already exceeded the $175,000 individual stop-loss threshold, meaning the city’s insurance backstop is now in effect for that person. Three large claimants combined account for about 17 percent of all claims spending so far this year.
Staff is recommending a transition to a new third health plan option for FY 2026-27: a Blue Care HMO plan that would sit between the existing PPO and the High-Deductible Health Plan (HDHP). The HMO would require members to select a primary care provider but would not require referrals for specialist visits. Employees currently enrolled in the PPO would be allowed to stay on that plan indefinitely. New enrollees, however, would only be offered the HMO and HDHP options. Claims data suggests the HMO plan saves about 4 percent on medical spend versus the PPO, primarily by using a smaller but still widely available network.
Council members asked pointed questions about access to specialty care under the HMO, particularly for serious diagnoses that might require facilities like Moffitt Cancer Center or MD Anderson. Savage confirmed that employees would not be left without options but acknowledged some disruption in the provider network, noting that about 85 percent of current claimants would find their existing providers covered under the new Blue Care network. Mayor Norris asked directly whether employees would “get hung out to dry” under the HMO plan. Savage replied: “Will not.”
The council reached consensus — with Councilman Gambaro as the lone voice of hesitation — in favor of the staff recommendation to close the PPO to new enrollees while allowing current members to stay. The decision on plan design changes will be formalized ahead of the October 1, 2026 renewal. More information about the city’s health benefits is available at www.palmcoastgov.com.
Palm Coast’s City Council heard a second health presentation Tuesday from My Health On-Site, a Florida-based company that operates 25 employee health and wellness centers statewide — including one already serving Flagler County employees. The city is exploring whether to partner with the county’s existing clinic or open its own location, potentially saving close to half a million dollars in the first year alone.
Brian Branham, My Health On-Site’s account executive, told the council the county’s clinic has an 86 percent utilization rate, with 75 percent of eligible county employees using it and 76 percent of those returning three or more times per year. He projected that a city clinic operating at 32 hours of provider time per week — sized for Palm Coast’s roughly 512 employees — could produce a net savings of about $489,000 in year one after all operating costs are paid. The savings come largely from shifting primary care visits, lab work, and prescription fills away from Florida Blue’s fee-for-service claims and into a controlled-cost environment.
The clinic model would provide services to employees at no cost, including primary care, chronic disease management, prescription dispensing, lab draws, flu shots, and occupational health services like pre-employment physicals and drug screens. Branham said the city currently spends about $40,000 per month on occupational health through its existing MediQuik contract, costs that could potentially be absorbed by a clinic. He said early detection is one of the biggest returns on investment. “Time after time, we’ve found folks who haven’t been to the doctor in five or six years, and we’ll find things in those labs that they have no idea they have,” he told the council.
Council members were supportive of exploring the concept further, with Vice Mayor Pontieri pushing for a survey of city employees to gauge interest and Mayor Norris comparing the idea to the medical clinic he had access to while working at the White House. Councilman Sullivan referenced the concept of a “troop medical clinic” familiar to military personnel. One complication discussed was that the Flagler County Sheriff’s Office recently left the county’s shared plan, which freed up clinic capacity but also reduced the pool of shared costs. The council directed staff to return with more information in roughly two months, including a formal employee survey and deeper cost analysis. The Flagler County Human Resources team was acknowledged as currently being stretched thin due to the county administrator search, and the council agreed to give them time before pressing further.
