Saint Louis Public Schools human resources staff presented recommended benefit renewals the board will vote on at the October business meeting, asking the board to approve no plan design changes for medical coverage, to renew the district's relationship with UnitedHealthcare for medical and Express Scripts for pharmacy, and to continue several wellness and ancillary programs.

Why it matters: the district projects higher benefit costs for the 2026 plan year driven primarily by a steep rise in prescription drug spending, notably GLP-class medications (used for diabetes and weight management). The district's proposed funding model estimates the district's share at roughly $45 million and total plan costs (district plus employees) near $50 million for the coming year.

Key details from the presentation:

- Medical and pharmacy structure: staff said the district is fully insured on the medical side and self-insured on pharmacy. Broker Michael Duffy explained the district's long-term choice of fully insured medical coverage has provided budget predictability and was financially advantageous over the past nine-year period.

- Renewal cap and plan design: HR said a proposed renewal cap of 12.9% had been negotiated down to 11.9% for the medical renewal; staff recommended no plan-design changes for the 2026 medical benefit with UnitedHealthcare and no plan changes for ancillary carriers (dental, vision, life/long-term disability). HR also said they will go to market for broker services in 2027.

- Pharmacy trends and rebates: staff reported pharmacy costs rose from about $12 million to an expected $14 million year-to-date; the district expects roughly $5'$6 million in rebates under current arrangements, which help offset pharmacy costs. HR noted there are no rate caps under the pharmacy plan.

- GLP drugs and the encircle program: staff said GLP-class medications (used for diabetes and for newer weight-loss indications) are a major driver of pharmacy cost increases. The district said it saw a large rise in weight-loss GLP spend (district reporting showed that weight-loss GLP claims more than doubled and represented a substantial percentage of recent increase). Staff proposed adding an "encircle" program through Express Scripts to manage eligibility and monitoring for weight-management GLP prescriptions. Eligibility described in the presentation requires a BMI under 32 or BMI 25'32 with two comorbidities; the program adds clinical monitoring, coaching, tracking, and enrollment steps intended to limit inappropriate prescribing and ensure safety.

- Cost and impact estimates: HR projected the district share near $45 million and total plan costs near $50 million (based on roughly 3,200 employees used for the model). HR said the business health coalition provides a small pool (about $20 per member) that helps cover administrative costs for some specialty programs and that participation in programs such as inReach and encircle should not add direct cost to the district for administration.

- Retiree requirement: HR reminded the board that Missouri law requires urban school districts to offer the same rates to pre-65 retirees (retirees cannot receive the $0 base plan and are limited to buy-up options).

During Q&A board members asked about wellness rooms, alternative or "natural" health providers, and whether the district could use building space (including vacant properties) for staff wellness centers. Staff responded that some schools already have wellness rooms created with federal ESSER funds and that network/contractual constraints make enrollment of many alternative-health providers difficult because they are often out-of-network.

Quotes: broker Michael Duffy summarized plan-choice drivers: "Being fully insured has been a better option for the St. Louis public schools over this time period." HR also summarized plan structure: "We are fully insured on our medical side, but we are self insured on our pharmacy side."

Ending: Human resources asked the board to approve the renewal recommendations at the October meeting and said open enrollment is expected to run tentatively Oct. 21'Nov. 2025; HR said they will bring broader plan options to market for the 2027 academic year.