Lubbock ISD health-plan update: claims trending, projected premium scenarios and an $855,000 projected shortfall if only prior premium commitments applied

Lubbock ISD health-plan staff delivered a status update on district medical, dental and prescription coverage and presented preliminary premium scenarios for 2026.

Lisa (benefits staff) reported claims through April show a maximum claims loss ratio of about 83.9% (goal under 87%). Projected paid-claim totals presented were roughly $27 million for 2025 and $29 million for 2026. The district conducted a request-for-proposal process and issued best-and-final offer letters to competing vendors; responses are pending and staff said they would bring firm fee proposals and recommendations to the board in July.

Using existing commitments (including a premium deferral previously approved for employees), staff said the plan would still produce a roughly $855,000 deficit under current projections. Options to address the gap discussed during the workshop included raising employee premiums, changing plan designs, restricting some coverages, or additional cost-sharing measures.

Staff emphasized certain employee-facing features that distinguish the plan locally: a district wellness credit ($50), zero co-pay clinics, zero co-pay prescription options and other member supports. The districtcontributes about $391 per covered employee per month, staff said.

Timeline and next steps: Staff said final vendor fee proposals are expected in July; the board must make decisions by August to allow open enrollment setup in October for January 1 plan renewals. Trustees and staff pledged continued outreach and education to employees; staff will return with firm recommendations and modeled premium options.