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Springfield SD 186 board approves split-vendor health plan strategy, selects Aetna network, Consociate Health TPA and Smith Rx PBM
Summary
After months of committee work and an expedited RFP, the board approved a “best‑in‑class” approach that separates third‑party administration, health network and pharmacy‑benefit management. The change is intended to increase transparency of discounts and rebates and reduce long‑term costs.
The Springfield School District 186 board on April 7 approved a change to the district’s employee health‑benefit strategy, moving away from a single “one‑stop‑shop” vendor toward a split‑vendor “best‑in‑class” model. The board adopted three resolutions to accept Aetna as the health network (with a Springfield Clinic Advantage option and access to Barnes‑Jewish care), Consociate Health as the third‑party administrator (TPA), and Smith Rx as the pharmacy benefits manager (PBM) for the contractual year beginning June 1, 2025.
Board documents and presenters said the district issued separate RFPs for the TPA, network, PBM and stop‑loss coverage, received multiple proposals (11 vendor proposals in total), and conducted committee review and vendor presentations in March. The district’s insurance committee — which included representatives from the district’s bargaining groups and administration — voted unanimously to recommend the three vendors presented to the board. The committee members and the district consultant said the accelerated timeline (about three months for what they said is normally a 9–12 month process) was a compressed effort but produced viable vendor options.
How the model will change: rather than buying a bundled plan in which a single vendor handles network, PBM, TPA and stop‑loss, the district will contract separately for the TPA, health network and PBM and will run a separate RFP for stop‑loss insurance. Presenters said that approach will produce itemized reports on negotiated discounts and rebates returning more value to the district rather than allowing a single vendor to retain portions of those savings.
Plan options and employee impact: The district will continue to offer Gold and Silver PPO plan options and will add a high‑deductible health plan coupled with a health savings account (HSA) option. Presenters said district premiums will not increase this year; the HSA option will have lower employer‑paid premium contributions but the district will contribute toward employees’ HSAs. Presenters said Memorial Choice will remain available for two more years under its existing contract.
Consultant Mike Allwood, who advised the district and helped run the RFP process, summarized the expected benefits of the split model: "With these guys, you guys are gonna be a really big fish in a smaller pond. And the responsiveness for management, for getting the bills paid, for getting reporting for your memorial refunds is going to all be streamlined." He also said separating functions will allow negotiated rebates and discounts to be visible and returned to the district.
The board voted on three related resolutions during the business meeting: approval of Aetna for the district’s self‑funded medical insurance recommendation (resolution 12.4), approval of Consociate Health as the district TPA (resolution 12.5), and approval of Smith Rx as the PBM (resolution 12.6). Each resolution passed; the roll calls recorded six ayes and one present on each of the three insurance resolutions.
Next steps: Open enrollment will run from April into May. The district’s benefits manager, insurance broker Troxell, the consultant, and the chosen vendors will run employee education sessions about plan options, the HSA, and new provider access (including Springfield Clinic Advantage and Barnes‑Jewish). The district said it will run a separate RFP for stop‑loss insurance and bring a stop‑loss resolution to the board in May.
Ending: District officials said the goal is to stabilize the self‑insurance fund (which currently carries a deficit in the Education Fund), generate savings for the plan, and eventually pass savings along to employees or to slow premium growth.
