Commissioners approve new insurance administrator as legal challenges loom over Mayor Daniella Levine Cava’s proposal
For the first time in nearly two decades, Miami-Dade County is switching the company that oversees health insurance for its employees. In a 7-2 vote, county commissioners approved a contract with Aetna, a national insurance provider owned by CVS Health, ending AvMed’s 18-year run as administrator of the county’s health care plan.
The change, recommended by Mayor Daniella Levine Cava, comes at a critical moment as the county faces a budget crunch. Aetna has promised Miami-Dade savings of roughly $40 million a year compared to AvMed’s rates, but AvMed has mounted a legal challenge that could delay or derail the transition just weeks before open enrollment begins in late October.
(This report cites original reporting by Douglas Hanks of the Miami Herald, published August 13, 2025.)
Aetna promises big savings, AvMed disputes the numbers
The Miami Herald reported that Aetna, which charges the county $15 million annually in administrative fees, pitched its nationwide network and purchasing power as a way to deliver steep discounts on prescriptions, medical procedures, and hospital stays. Two consultants hired by the county backed Aetna’s claims, estimating the new deal could save Miami-Dade about $40 million per year.
Carladenise Edwards, chief administrative officer for Levine Cava, told commissioners the administration is focused on bending the cost curve. “We’re going to try and reduce the cost curve,” Edwards said. “As we do that, the county will save money over time.”
AvMed, which charges $10 million in annual fees, disputed those numbers, arguing the analysis was flawed. The Doral-based insurer has administered the county’s health plan since 2007 and says it offers competitive rates that were overlooked in the county’s rush to award the new contract.
Commissioners divided as legal battle unfolds
The commission debate revealed divisions over the process and the timing of the decision. Commissioners Roberto Gonzalez and Danielle Cohen Higgins opposed the switch. Gonzalez criticized the mayor’s handling of the rollout, saying it fueled anxiety among county workers.
“I don’t trust the mayor — and I want to trust the mayor,” Gonzalez said during the meeting.
Cohen Higgins raised concerns that commissioners didn’t have enough time or information to make such a significant decision. “I need more,” she said, suggesting the board was asked to make a choice on an accelerated timeline without clear explanations of the financial impact.
In contrast, Commissioner Oliver Gilbert, who sponsored the resolution, defended the process. “I’m left with the people we pay to analyze that,” Gilbert said. “This is theater at this point.”
Four commissioners—Marleine Bastien, Juan Carlos Bermudez, Eileen Higgins, and Micky Steinberg—did not attend the vote.
Meanwhile, AvMed has filed a lawsuit alleging that Levine Cava’s administration violated bidding rules. The county denies the allegation. If a judge intervenes, the switch to Aetna could be delayed, raising uncertainty for the county’s 29,000 employees and retirees.
What it means for Miami-Dade employees
For employees, county officials emphasized that insurance fees will not change, regardless of who administers the plan. Namita Uppal, Miami-Dade’s procurement director, said Aetna has already been assisting employees with questions and provider coverage.
“I haven’t found an example where Aetna came back and said: ‘It’s not covered,’” Uppal told commissioners.
Still, the timing poses a challenge. The county’s open enrollment period begins in just weeks, meaning the transition must be implemented quickly unless the legal dispute stalls the process.
The decision marks the first time since the Bush administration that Miami-Dade has changed its health care administrator—a significant shift for one of South Florida’s largest workforces, with nearly $600 million in annual claims at stake.
The bigger picture
The commission’s decision highlights both the financial pressures facing Miami-Dade and the political risks for Levine Cava. While the Aetna deal offers the promise of major savings, AvMed’s legal fight could complicate implementation and spark further tensions within the county workforce.
For now, the board’s vote has set the county on a new course—one that employees, retirees, and taxpayers will be watching closely as the legal and logistical battles unfold in the weeks ahead.
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