Holmen administrators recommend benefit changes as health-plan renewal arrives; board to approve on consent

Holmen School District administrators presented recommended changes to employee benefit plans at the April 28 meeting and put the proposal on the consent agenda for approval.

Julie Coleman, executive director of finance and operations, outlined the district's transition last year from a fully funded plan to a self-funded cooperative model through Ticket Health and reported year-to-date claims and utilization data. Coleman said the district has about 370 employees on the plan and 938 total members (employees plus dependents). Claims and average cost-per-visit in the district exceed benchmarks, in part because local care costs are higher, she said. Coleman identified Neighborhood Family Clinic as a lower-cost provider option and encouraged plan members to use that clinic when appropriate.

Coleman said the recommended 2025–26 plan design would reduce the district’s initial renewal request (about 13%) down to a net 5.18% increase by changing deductibles, max out-of-pocket levels and some copay amounts, and by removing the option for retirees to remain on the district plan going forward. The proposal would raise the single in-network deductible from $2,000 to $3,000 and the family in-network deductible from $4,000 to $6,000; in-network family max out-of-pocket would rise from $8,000 to $10,000. The recommendation also includes a new pharmacy benefit manager (Rightway) and added screening services for breast cancer (MRI, ultrasound and thermography) and other care-coordination improvements through Ticket Health.

Coleman and staff noted the district will continue its Health Savings Account (HSA) employer contributions. The district currently contributes roughly $762,000 annually to HSAs and the alternate benefit plan (cash in lieu), which covers about 155 employees and costs roughly $774,000 annually. About 352 employees participate in the HSA; 86 are receiving the maximum employer contribution tied to the district wellness incentives.

Coleman further explained the district will offer COBRA and other options for retirees affected by the change; roughly 13 retirees currently remain on the plan. Board members asked clarifying questions about benchmark comparisons and retiree transitions. A board member identified the benchmark source as Allegiance, the plan administrator.

Because administration placed the renewal on the consent agenda, the benefit changes were approved as part of the board's consent vote on April 28.

Administration said the recommended design balances near-term cost containment with continued access to care and that the changes are intended to keep plan increases closer to the market trend while preserving wellness incentives and HSA support.