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Board hears 2026 benefits renewal: 11.9% medical cap negotiated; pharmacy costs and GLP drugs drive increases
Summary
Human resources proposed a medical renewal for January 2026 with no plan changes, an 11.9% negotiated premium cap, and continued self-funded pharmacy coverage; staff described rising pharmacy spending, rebates, and a proposed encircle program to manage GLP (weight-loss/diabetes) drug use.
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…
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