Committee recommends Group Health Trust renewal after competing bids, with plan design changes and direct‑bill clinic arrangement

The district’s employee health insurance renewal for the 2025–26 plan year was recommended unanimously by the committee for placement on the full board agenda, with administration authorized to finalize a direct‑billing arrangement with Neighborhood Family Clinic.

Leah Hauser, presenting the renewal, said the district originally budgeted for a 10% increase and received an initial renewal at +7%. Marsh McLennan Agency, the district’s broker, negotiated further; Hauser said competing offers from Quartz (a Gundersen‑only option) helped produce counteroffers. “They were able to come back with a 3% increase,” Hauser said, and then with further negotiation the district could reach a 4.6% decrease if it accepted two plan‑design changes: removing the local Mayo buy‑up (the PPO option) and adding a nationwide PHCS wraparound network to the base plan.

Under the recommended package, Group Health Trust would remain the carrier and the district would move to the lower premium with some design changes. Hauser said some employees (42, she said) are on the current Mayo buy‑up plan; those employees would lose local Mayo network coverage in the local buy‑up but would have access to the nationwide wraparound network and to the district’s proposed separate direct‑billing arrangement for Neighborhood Family Clinic services.

Hauser told the committee the direct billing arrangement would keep Neighborhood Family Clinic’s free access for covered employees and families while routing payments from the district directly to the clinic rather than through the insurer. She described initial figures from the insurer indicating about $35,000 was charged to the insurance plan last year for Neighborhood Family Clinic visits; Hauser said the district would add back roughly $35,000 to its budget if it implemented direct billing.

The insurance committee recommended the option that produced a 4.6% premium decrease and authorized administration to finalize a Neighborhood Family Clinic arrangement; the motion to forward the recommendation to the full board was moved by Mr. Burnett and seconded by Mr. Wells and recorded moving to the full board (4–0, three absent).

Presenters emphasized consumer‑education steps that supported the lower renewal, including staff training on primary‑care use, promotion of the clinic and telehealth, and enrollment outreach. Hauser and others said deductibles, copays and out‑of‑pocket levels would not change under the recommended option; employees who currently pay the buy‑up premium would see lower take‑home costs, while those who rely on Mayo locally would be offered support to transition.

The committee’s recommendation and the request to finalize the direct‑bill arrangement will appear on the full board agenda for formal approval.