District presents benefits, wellness results and proposed medical-plan changes ahead of open enrollment

Sarasota County Schools presented an annual benefits and wellness update and a set of proposed medical-plan changes during a work session, including a plan to move to a new benefits platform, proposed premium changes for 2026 and the removal of GLP-1 medications for weight loss from the pharmacy benefit.

Erin Singerman of the district's risk-management/benefits team summarized the wellness program and data underpinning it. "Our district's wellness philosophy is built on five interconnected dimensions that support both personal and professional well-being," she said, listing physical, financial, nutritional, emotional and social wellness and citing a staff survey with 737 responses that identified physical wellness (exercise and preventive screenings) as employees' top priority.

Staff and consultants discussed medical-trend pressures driven by specialty and GLP-1 drugs, and presented projections prepared by Gallagher Benefits Services, which the district selected after an ITN and has contracted for five years with two one-year renewals. Staff said Gallagher projected a calendar-2026 medical trend that would produce an increase near 13.5 percent under existing plan designs; after plan design changes the district proposed an 8.5 percent premium increase for 2026 and expects some savings from other steps.

Key measures presented and staff proposals

- Gallagher contract: staff said Gallagher Benefits Services was selected after the ITN and awarded a five-year contract with two one-year renewals; district staff said Gallagher provided actuarial projections and plan change modeling.

- Cost drivers: presenters highlighted specialty drugs and GLP-1 medications (for diabetes and weight loss) as major cost drivers. The district reported pharmacy spending of about $3.2 million for GLP-1 drugs from January through June, with approximately $1.6 million for diabetes indications and $1.5 million for weight-loss indications (rounded figures provided during the presentation). Staff said specialty drugs represented about 43 percent of pharmacy spend ($12 million) during the same period.

- Plan design changes and bargaining: staff said they worked with the Sarasota Classroom Teachers Association on allowed plan-design changes. The district will reduce four plans to three (combining two HMO options), adjust maximum out-of-pocket and deductible features on remaining plans, add some copay alignment changes, implement a 30-day waiting period for new hires to enroll in benefits, remove the GLP-1 weight-loss benefit while retaining GLP-1 coverage for diabetes, and discontinue some wellness vendor programs; staff estimated those changes would yield about $4.7 million in savings.

- Premiums and open enrollment: staff said they will propose an 8.5 percent premium increase for 2026 to cover projected costs and maintain reserves. Open enrollment was announced for Oct. 10 through Nov. 3; employees will have multiple enrollment supports and on-site enrollment events across the district.

Board reaction and next steps: Board members asked for comparables and transitional support for employees affected by the GLP-1 weight-loss removal. Board member Ziegler praised the prevention and wellness work but asked whether the district is an outlier in plan generosity; staff responded that the district's actuarial value is higher than many peers and noted the district is one of a few in the state offering all core benefits at no employee premium for single coverage. Board member Edwards asked staff to explore transition options for employees who use GLP-1 medications; staff said they would review potential transition or partial-cost options and that employees would receive notice and transition-time information once decisions are finalized.

Why this matters: The proposed plan-design changes, broker selection and premium recommendations affect employee benefits, district finances and open-enrollment decisions for hundreds to thousands of staff. District staff said the changes are intended to reduce an unsustainable trajectory of double-digit increases while preserving preventive programs and some wellness services.

No formal board vote was taken on benefits at the workshop; staff marked action items for the September 16 board meeting where some changes will come before the board for formal approval.