Benecon explains how Keystone Central's self-funded school health plan works; stop-loss set at $100,000

Cathy Cook, a Benecon representative, told the Keystone Central School District finance committee that the district has participated in a Public School Health Insurance Cooperative (PSHIC) since 2009 and that the district’s stop‑loss per person is currently set at $100,000.

The PSHIC model, Cook said, pools claims funding from member districts into a single operating account, keeps each member’s accounting separate, and returns surplus dollars to members when the cooperative’s claims experience permits. “We do not give lasers,” Cook said, describing Benecon’s approach to avoid singling out and excluding high‑cost plan members from reinsurance coverage.

Cook walked board members through the cooperative’s layers: a member claims fund (the “green box”) that pays claims below the stop‑loss point; a spec‑share account contributed to by all members that pays a majority share of specific high‑cost claims above the stop‑loss point; and a reinsurance (stop‑loss) policy that covers the remaining…