Lawmakers on the Select Committee on School Finance heard detailed briefings Aug. 25 on how the current funding model allocates health insurance dollars to school districts and on what it would mean for districts to join the state employee group insurance plan.

Matthew Wilmar, senior school‑finance analyst with the Legislative Service Office, told the committee the recalibration model bases the health‑insurance allocation on state employee premium rates and a statewide weighted participation mix (employee only, employee plus spouse, family, split contracts, etc.). For the 2025‑26 model year he said the model’s per‑FTE health‑insurance allocation is approximately $17,596.

“We aggregate that at the statewide level and then apply that to each district,” Wilmar said, describing the present calculation method. He also showed that districts on aggregate spend a portion — roughly 75–80% in recent years — of the health‑insurance funds the model allocates; the remainder is available for districts to use on other local priorities.

Why it matters: health insurance is a major component of total compensation. How the model computes employer health contributions and which employees are eligible affects district budgets and the state’s fiscal exposure.

Key points from the briefings

- How the model allocates premiums: The model uses the state employee premium schedule (rates set for the state plan) and a statewide weighted participation rate to produce a per‑FTE health allocation that is incorporated into each district’s foundation amount.

- Participation and carryover: Wilmar showed districts have had 75–95% participation rates in their plans depending on the employee group and year; some employees are ineligible or opt not to participate (for example, spouse coverage through other employers). Districts keep unspent health allocation dollars and may use them for other compensation or operating needs.

- Reimbursements outside the block grant: Health claims for positions funded entirely outside the block grant (for example, special‑education transportation positions) are 100% reimbursed separately; those sums were shown as roughly 16–19% of total health expenditures in recent analyses.

- Options and policy levers: Wilmar outlined policy options discussed in prior recalibration cycles, including excluding summer‑school and extended‑day positions from the health allocation, applying district‑level participation weights instead of a statewide aggregate, or requiring districts to join the state plan.

State plan (EGI) perspective

Patricia Bach and Karen Williams of Wyoming Employees Group Insurance (EGI) briefed the committee on program structure and the operational implications should all districts opt in. EGI is a self‑funded, community‑rated plan that covers state employees and a variety of employer groups; it currently serves about 21,900 eligible employees and retirees with about 18,000 actively enrolled in health or dental plans.

EGI officials said their eligibility rules differ from some district plans: EGI’s baseline eligibility is 20 hours per week (80 hours a month), lower than some districts’ 30‑hour rules. They described the state plan as community rated — the same premium structure applies whether a group has 10 members or thousands — and said employers who join must reconcile split arrangements when spouses work for different participating employers.

EGI warned that onboarding all districts would require increased staff and budget authority to manage enrollment and claims. Officials said adding several thousand lives would increase claim dollars initially and would require operational expansion, although a larger pool could eventually stabilize the program. EGI emphasized vendor procurement cycles (benefits vendors are selected via RFP at least every five years) and network adequacy as part of planning for scale.

Committee questions and fiscal context

Committee members pressed for more granularity. Senator Rafales and others asked whether adding districts would lower premiums through better purchasing leverage; EGI said more members could improve negotiating power with vendors but added many variables determine whether per‑capita costs decline. Wilmar noted that the model builds additional non‑health benefit percentages into the employer compensation calculation; combined with health allocations, the weighted “compensation” per model FTE approaches roughly $95,875 under current model assumptions (this figure includes salary, retirement, Social Security/Medicare, employer benefit contributions and the per‑FTE health allocation).

Ending

No policy decisions were made on Aug. 25. The committee asked for follow‑up details, including district‑level participation comparisons and scenario estimates showing the fiscal impact of any requirement that districts join the state plan. EGI officials said they would provide additional operational cost and staffing estimates if the committee asked them to do so.