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Ashwaubenon committee backs 2026 plan-design changes, keeps employee premium contribution at 7.5% with wellness incentive
Summary
The committee approved proposed 2026 changes to medical, dental and vision plan design — modest increases in deductibles and out-of-pocket maximums intended to reduce premium increases — and maintained a 7.5% employee premium contribution with a 2.5% reduction for completing wellness requirements.
The Village of Ashwaubenon Finance and Personnel Committee voted to adopt staff-recommended plan-design changes for the 2026 medical, dental and vision benefits program and to maintain the employee premium contribution at 7.5% with a 2.5% reduction for participants who complete the wellness requirements.
Village staff member Joel described the recommended changes as adjustments intended to lower the overall premium-equivalent increase for both employees and the village. Joel said the proposal would raise the in-network individual deductible by $250 and the family deductible by $500; it would increase the in-network out-of-pocket maximum for individuals by $300 to $6,800 and for families by $600 to $13,600. Joel told the committee those changes would reduce an estimated worst-case premium-equivalent increase from "just over 11%" to about 7.3%, subject to stop-loss negotiation outcomes.
Joel explained that the village operates a fully self-funded plan with UMR as plan administrator and that stop-loss insurance caps the village's liability for catastrophic claims. Joel discussed the stop-loss cap and negotiation levers, noting the village currently has an $85,000 per-claim stop-loss attachment point and that negotiating different terms (including so-called "lasering" of very high-cost claimants) can lower premium costs but shifts some risk back to the village.
On employee engagement and incentives, Joel said an internal health committee of line employees from several departments and Brown & Brown representatives review plan options and comparables with private and public employers. The committee heard that the village covers roughly 95% of the overall premium-equivalent on average and employees contribute about 5%; staff proposed maintaining the 7.5% employee premium contribution with a 2.5% reduction for participants who complete the wellness requirements (a wellness certificate or annual preventive visit and labs). Joel described a shift from an externally run health risk assessment (HRA) to a "wellness certificate" process that allows employees to meet the requirement through their primary care provider or via the village's A+ clinic; Marissa, the village licensed nurse practitioner, can perform annual physicals and lab draws at the A+ clinic.
Dental plan changes are limited to a 3% premium increase to rebuild a reduced dental fund balance after transfers to the health fund. Joel said staff is budgeting for a conservative (worst-case) estimate while negotiating stop-loss and that updated numbers will be reflected in the Nov. 11 joint committee/board budget meeting.
Tracy Flucke moved to maintain the 2026 employee medical and prescription premium contributions at 7.5% with a 2.5% reduction if participants complete the wellness requirements; Tom Silk seconded. The motion carried on voice vote.
No formal roll-call tallies were recorded in the transcript for the motions; staff emphasized that final premium equivalents and stop-loss terms remain subject to negotiation and will be finalized for the upcoming budget meeting.
