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District pursues insurance cost‑savings: Samaritan Fund pilots and prescription sourcing change
Summary
Riverside staff described a planned insurance‑carrier change and a Samaritan Fund program to help high‑cost employees access coverage off the district’s rolls; the committee also reviewed a planned move to TrueRx for prescription sourcing to lower drug costs.
Riverside Local staff told the Finance & Personnel Committee the district is moving forward with an insurance arrangement through DCW and has rolled out a cost‑saving option called the Samaritan Fund for high‑use employees.
The administration described the Samaritan Fund as an opt‑in program for employees with high medical costs. Eligible employees volunteer to apply; if accepted the fund helps the employee secure coverage via a different arrangement and provides prepaid debit support that can cover co‑pays, deductibles and premiums. The presenter said eight applicants had applied at the time of the meeting and that union leadership has helped share information about the option with members.
Staff also said the district is pursuing a different prescription drug sourcing mechanism (TrueRx) to reduce pharmacy costs for employees and the district; DCW and the consortium are evaluating plan options and shopping for competitive rates. The presenter said the district’s proposed stop‑loss level is $250,000 for high‑cost claims.
Why it matters: health‑plan design and stop‑loss terms materially affect the district’s budget and employees’ out‑of‑pocket costs. The Samaritan Fund was presented as a voluntary, year‑to‑year alternative that can reduce the district’s exposure to very high claims while maintaining coverage for participating employees.
Clarifying note: committee discussion included dollar figures for Samaritan Fund donations; the transcript contains inconsistent numeric phrasing. District staff should be asked to provide a written summary of Samaritan Fund eligibility rules, exact donation amounts, and enrollment limits before the board takes formal action or publishes program guidance.
Ending: staff said they will continue to work with DCW and the consortium and provide updated premium and plan information to the board as shopping concludes.
