Emporia board opens review of 2026 health insurance renewal, explores partially self‑funded option

The Emporia Board of Education began a multi‑meeting review of the district’s 2026 health insurance renewal, directing staff to continue exploring a partially self‑funded plan that staff said could substantially reduce the projected premium increase.

Interim Assistant Superintendent for Business and Operations Josh Schwartz led the presentation with staff member Kate Cape and described a proposed timeline that would return to the board for a decision in October. Schwartz told the board the district’s fully insured renewal showed a large increase — a “sticker‑shock” number when first received — and that a partially self‑funded approach being discussed with broker and consultant IMA could cut the district’s projected rate increase roughly in half if projections hold.

What staff presented: the district currently offers three plan options and pays a portion of premiums; staff illustrated how a fully insured renewal would increase premiums by roughly 26% on an apples‑to‑apples basis for some plans, while a partially self‑funded model showed a smaller increase (staff cited an approximate mid‑single‑digit increase for the modeled partially self‑funded option). The presentation explained the main technical differences between fully insured and self‑funded arrangements — including the role of pharmacy benefit managers (PBMs), third‑party administrators (TPAs), and stop‑loss insurance (both individual and aggregate stop‑loss) that limit the district’s exposure to extremely large claims.

Staff said two Kansas districts working with the same consultant (Osawatomie and Leavenworth) reported positive multi‑year experiences with a partially self‑funded model; staff described those districts as having three to four years of experience and gave generally favorable feedback about long‑term cost control. Board members raised questions about administrative workload, required cash flow to start a self‑funded plan, stop‑loss limits and the risk of catastrophic claims. Staff said one model would use a district bank account to collect premiums and pay claims, with weekly ACH activity and modest additional transaction entries; administrators told the board they had not identified a need to add staff for the partially self‑funded option but acknowledged a launch learning curve.

Board members repeatedly raised questions about retiree coverage and the district policy that allows exiting employees to remain on the district plan by paying the full premium. Several trustees asked staff to research whether other districts on self‑funded plans allow departing employees to retain coverage and whether that practice raises additional risk in a self‑funded arrangement.

Timeline and next steps in the presentation: staff said the health insurance committee would meet again before the board’s planned October decision (staff referenced an October 8 decision target) and that open enrollment would begin on Oct. 20 (as presented). Staff also said the committee would work with IMA to refine stop‑loss numbers and model cash‑flow requirements.

Board reaction: several members expressed frustration with recurring large premium increases and emphasized the importance of protecting employees from steep out‑of‑pocket changes. Trustees asked staff to return with more detailed questions for IMA, comparative data from districts that tried self‑funding and scenarios showing worst‑case stop‑loss outcomes. No formal vote or policy change occurred during the discussion; the item was presented as an initial informational discussion with follow‑up planned.

Evidence and consultant involvement: staff identified IMA as the consultant providing modeling and comparative district contacts. District staff described contacting similar districts and returning positive feedback but emphasized the need for more detailed analysis and stop‑loss negotiation.