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West Virginia County Ditches Group Health Plan for Tech-Driven ICHRA Model
Monongalia County, West Virginia becomes the first U.S. local government to replace its traditional group health plan with a tech-driven ICHRA model.
Key Points
- Monongalia County, West Virginia becomes the first U.S. local government to replace its traditional group health plan with a tech-driven ICHRA model.
- The move gives approximately 260 employees tax-free funds to choose their own coverage from over 30 plans, aiming for a 3% premium savings for the county.
- This shift serves as a potential model for other public sector employers seeking alternatives to rising group insurance costs.
Monongalia County, West Virginia is the first local government in the U.S. to move its employees from a traditional group health plan to an Individual Coverage Health Reimbursement Arrangement (ICHRA), a tech-driven model managed by Take Command. The move is a direct response to rising premium costs and signals a potential new path for public sector benefits.
Governing differently: For 2026, the county will shift its roughly 260 employees off their Highmark Blue Cross Blue Shield plan. The plan was detailed in the county's October commission agenda, formalizing the replacement of its long-standing group coverage.
Commanding control: ICHRA administrator Take Command will manage the new arrangement. The model gives employees tax-free funds to shop for their own coverage from a marketplace offering more than 30 different plans, giving them significantly more choice than the previous single-carrier model.
The switch is primarily a financial decision. "Of the savings that we are seeing in premiums, the county would recognize a 3% savings on what we are currently paying,” Commissioner Sean Sikora told local news outlet WAJR. The decision marks a break from the traditional employer-sponsored insurance model, though the county is still committing to fund the bulk of employee premiums.
By moving to an ICHRA, Monongalia County is serving as a test case for other local governments grappling with unsustainable healthcare costs, trading the simplicity of a group plan for the potential savings and flexibility of a marketplace model.
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