Treasurer reports medical claims up 30%; district watching $4 million fund balance

Treasurer Missus Roberts told the Fairfield Union Local School District board on Oct. 20 that the district’s medical insurance claims have been higher this fiscal year and that staff are evaluating plan funding and future premium strategies.

Roberts said the district had collected roughly $1.3 million in health-plan revenue so far this year but had paid about $1.6 million in claims to date, an increase of approximately 30% compared with the same period last year. “We have had some very high claims this year,” Roberts said, noting that plan premiums for Plan A increased 10% and Plan B 3% in the district’s recent rate-setting cycle.

Roberts said the district currently holds a medical fund balance just under $4,000,000 and that the board had previously elected to absorb roughly $360,000 of the recent premium increases from that fund. She said dental program figures remain essentially flat compared with the prior year.

Why it matters A sustained uptick in high-cost medical claims can reduce the reserve balance the district uses to smooth premium changes and cover unexpected expenditures. Roberts said the district is in a healthy position now but that ongoing high claims will require monitoring and potential plan design decisions.

Details and next steps Roberts said staff are analyzing claims and evaluating whether changes to plan structure or premium-sharing are necessary. She described a stop-loss arrangement that mitigates very high claims above $100,000 per individual, and said the stop-loss mechanism yields credits when reimbursements apply. The treasurer urged continued monitoring and indicated future recommendations could include plan adjustments or alternative funding approaches.

Provenance The treasurer presented the financial and insurance reports during the consent/financial part of the agenda.