Board hears detailed health‑insurance renewal briefing; Innovia clinic to open in November with trial month in October

District administrators and the broker provided an update on the 2026 health insurance renewal and plans to open a direct primary care clinic operated by Innovia.

Jen Corti of the district's broker (M3) said the district's rolling medical loss ratios were about 117% for July 2023–June 2024 and about 119% for July 2024–June 2025, producing a combined two‑year loss ratio near 118%. Corti said Aspirus Health Plan's paid claims exceeded collected premiums over these periods and that prescription drug costs were a significant driver.

Because of those losses, Aspirus declined to offer a 'not to exceed' cap for the next renewal year. The broker and administration described strategies to reduce claim costs, including adding a district‑run Innovia direct primary care clinic, starting member incentives tied to clinic use and adjusting plan design (adding $250 emergency‑room and $75 urgent‑care co‑pays after the deductible). The proposed plan changes would lower the signature plan renewal percentage and reduce projected employer costs compared with an uncapped renewal.

The Innovia clinic property purchase was confirmed (address reported as 2811 Eighth Street, suite 2, near the Public Defender's building and south of Culver's). Innovia will open Nov. 3; employees on the district health plan may use Innovia services at no district cost during October (the district will be billed for labs and certain services incurred in October). The board discussed timing for tying employer HSA contributions to clinic use: administrators proposed keeping the January HSA contribution as usual but making the September contribution contingent on the employee (and spouse, if applicable) having an in‑person clinic visit in the district's initial measurement window (October 1 to July 31 for the first year). The administration discussed a proposed employer HSA contribution structure (presented in the meeting as $1,000 on family plans with $500 attributed to the spouse, split roughly two‑thirds employee/one‑third spouse for the employer contribution in the first year) and noted further details would be finalized before bringing recommendations back to the board.

The administration also presented a proposed spousal surcharge to discourage spouses from remaining on district coverage when they have access to other employer coverage; the sample level discussed was $125 per month for eligible spouses. The broker cautioned that spousal surcharges are permitted only when the spouse has other employer‑sponsored coverage and cannot be applied to government coverages like Medicare or VA benefits or to dependents aged 18–26 under ACA rules.

Board members asked about prior denials of coverage for members who needed care at Marshfield Clinic and were told the carrier will consider prior‑approval requests; district staff said they have worked with Aspirus representatives to secure approvals in necessary cases. Administrators said they'll continue outreach to staff, hold an Innovia kickoff on Sept. 24 and bring a formal recommendation to the board next month.