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Chesapeake Public Schools projects 7% health-cost trend; proposes premium adjustments for 2026
Summary
Director of employee benefits Christina Warren told the School Board the district forecasts a 7% medical cost trend for 2026, with total projected plan costs of $88.6 million and targeted premium changes to limit district exposure while preserving coverage options.
Christina Warren, director of employee benefits and risk management for Chesapeake Public Schools, told the School Board that the district is forecasting a 7% medical cost trend for 2026 and projects total plan costs of about $88,600,000 for the coming plan year.
Why it matters: the district operates a self‑insured plan and pays employee claims directly; higher medical trends could increase the district’s fiscal exposure and lead to premium increases for employees and/or changes in plan design.
Warren said the district offers two Anthem options: an HMO (selected by 82% of eligible employees in 2025) and a PPO (18%). For the employee‑only HMO tier, she reported a 2026 annual cost per covered employee of $12,402.58, with the district contributing $11,782.45 and the employee share $620.13. She said net pharmacy claims were about $30,000,000 in 2024 and that specialty drugs and diabetes medications are major drivers of pharmacy spending.
Warren described plan design and utilization details: musculoskeletal conditions affect about 27% of members and account for 13% of spend; cardiovascular conditions affect roughly 16% and account for 10% of spend; cancer affects about 3% of members but 8% of total cost. She noted that generics comprise about 88% of prescriptions while brand and specialty drugs make up 12% of fills but more than half of pharmacy cost.
On GLP‑1 drugs (commonly discussed for weight loss), Warren said the district’s Anthem plan requires strict clinical criteria and the district does not cover the GLP‑1 injectables for non‑diabetic weight‑loss use because of their potential to significantly increase plan costs. The district continues to offer weight‑management resources at its clinics, including dietitian support and wellness coaching.
To mitigate rising costs, Warren said most premium tiers will increase for 2026; spousal tiers will see a more modest increase. She reminded employees that completing the online health risk assessment and biometric screening will continue to earn a $400 annual premium reduction (spread over 24 pay periods under the district’s 2026 payroll schedule). Warren also described planned initiatives: a financial wellness program, an added health coach, increased preventive screening participation, relocation of the Nell’s Ridge clinic to campus clinic space at the School Administration Building by fall 2025, and expanded retiree plan information in late summer ahead of fall open enrollment.
Chair Angie Swigert clarified a logistics detail after Warren’s presentation: "The clinic is moving, but not the pharmacy," noting the pharmacy at Nell's Ridge will remain in its current location.
Warren closed by saying the benefits team will continue monitoring claims trends and return with retiree plan details and open enrollment materials. No board action was required; the item was presented for information and discussion.
