District committee recommends $50/month surcharge for adults without annual physicals to curb rising claims

The Topeka Public Schools health insurance committee recommended a physician‑engagement incentive that would require covered adults on district insurance to obtain an annual preventive screening or face a $50 per‑month premium surcharge, committee members told the Board of Education.

Under the committee recommendation, the program year would run July 1 through June 30. Any covered adult (employee and/or spouse) who does not complete an annual preventive visit during that period would incur an additional $50 per month on the district premium; two adults on a family plan would face $100 per month. A committee member summarized the annual exposure as “$1,200 a year” in a two‑adult family scenario.

Why it matters: District staff presented loss‑ratio data showing several years of unfavorable claims experience: the district’s loss ratio had been near 140% in a recent year and was about 124% year‑to‑date through March. The insurance broker and committee framed the proposal as a preventive‑care incentive to lower long‑term claims and stabilize premiums. The superintendent and board members said the program is intended to encourage preventive care rather than to be punitive.

Committee rationale and coverage: Miss Sharp and committee members said the broker (USI) recommended the $50‑per‑month starting point as a level strong enough to “move the needle” but mindful of retention risk. Miss Schmidt, a committee member, said the intent is “to get people to see their primary care provider and get in for routine exams…if anything is amiss, we catch it sooner.” The district noted that preventive services covered under the Affordable Care Act should be fully covered and that there should be no cost barrier to the preventive exam itself.

Operational questions and next steps: Board members raised operational issues including access to primary care providers and using district health clinics or Topeka High’s clinic for appointments and PD‑day scheduling. The committee asked the board to authorize moving forward with outreach to staff, setting program details and planning pilot communications; board members indicated support for prompt staff notification ahead of the program year.

Outcome: The committee presented the recommendation as a discussion item; there was no formal board vote recorded. Administrators said they would finalize implementation details, coordinate with district clinics, and provide further communication and follow‑up reporting to the board.