Pulaski board hears in-depth review of district self-funded health plan and cost trends

District staff and Brown & Brown presented a detailed update on the Pulaski Community School District’s self-funded health insurance plan, telling the board the program has produced substantial cost avoidance compared with broad fully insured market offers but still requires continued management to hold down trend.

Mark, a district staff member leading the budget discussion, summarized the financial picture and said the decision to move to a self-funded model in 2022 produced a large cost avoidance compared with the 30%-plus renewals the district faced under a limited set of fully insured bidders.

“We were able to negotiate that 30% over 2 years. So we received a 12% with an 18% pending,” Mark said as he explained the district’s path into self-funding and later said the district is tracking an approximate 1% loss ratio year to date through February.

A Brown & Brown representative presented monthly claims and utilization slides showing an improvement in January and February and an updated “loss ratio” (plan cost versus expected premium equivalents) of about 1% year to date. The Brown & Brown presenter said targeted interventions — including a specialty pharmacy carve-out, a physical-therapy contract and a charitable “Samaritan Fund” program — together accounted for material savings, and that the Samaritan Fund alone has mitigated roughly $1.5 million of plan liability annually.

“Things like the physical therapy, specialty savings...has yielded a hundred and 47,000 just on the specialty carve out piece alone,” the Brown & Brown presenter said. “That Samaritan Fund...has saved over $1,500,000 annually for the district.”

Board members asked about the details and frequency of monitoring, stop-loss marketing, administrative fees and employee education. Lindsay, identified as the PEA vice president, told the board the benefits advisory committee provides staff feedback across buildings and that Brown & Brown has been responsive in committee meetings. Jackie, a Brown & Brown representative, said the vendor meets monthly to review trends and that some stop-loss quotes had been favorable in preliminary marketing.

The presentation included a preliminary actuarial projection showing a possible premium-equivalent increase in the ballpark of 8% if current trend assumptions hold, with Brown & Brown noting January–February improvement could reduce that figure when the stop-loss market is finalized. Presenters said stop-loss was marketed annually and preliminary responses included flat or slightly negative quotes in some cases.

Board discussion also covered spousal-surcharge and cash-in-lieu options for employees: presenters outlined industry benchmarks (about 13% of employers use a spousal surcharge) and said the district has about 272 spouses currently on the plan; presenters warned that surcharges and cash-in-lieu programs can reduce participation among healthier spouses and can carry upfront costs.

No formal action was taken on benefits at the meeting. District staff told the board the formal renewal and any required employee-premium decisions will be returned to the board at a future meeting (the district indicated a renewal vote is being planned for April 30 in board materials). Board members asked Brown & Brown and staff to provide stop-loss firming and final premium-equivalent numbers in time for open-enrollment and premium-notice timelines.

Why it matters: Employee health insurance is the district’s largest non-personnel budget item, and choices about self-insurance, stop-loss and plan design affect district budgets, employee premiums and long-term financial risk.

What’s next: Brown & Brown and district staff will finalize stop-loss marketing results and return to the board with a formal renewal proposal and recommended employee-premium splits ahead of open enrollment.