Lynchburg schools consider Anthem 'HealthKeepers' network to limit premium increases

Lynchburg City Schools’ Finance & Facilities Committee on Tuesday reviewed a proposal from benefits consultant Mark 3 and Anthem to change the district’s in‑state provider network from Anthem’s PPO to Anthem’s HealthKeepers network as the district negotiates its plan year 2026 renewal.

Mark 3 consultant Heath Thomas and Anthem representative Carl Laferney told the committee they are seeking a network change so the district can “make no changes to the benefit design and no changes to the employee contributions” for the next plan year. Laferney said HealthKeepers is only different for Virginia providers and is “very comparable” to the PPO, with Anthem’s data showing a 98.29% match between the providers the district’s employees use now and those in HealthKeepers.

The committee was told the change could produce roughly 5% lower claim costs — projected at about $600,000 based on recent experience — which Anthem said could offset a recommended 6.5% premium increase if the district remains on the current PPO. Laferney said LabCorp and Quest would remain preferred reference labs and that clinical policy, referrals and pharmacy formularies would not change under the proposed network move. He also said Rehab Associates is expected to join HealthKeepers before Jan. 1, which would further increase the provider-match percentage.

Committee members pressed for concrete employee premium figures before making a decision. At least one committee member said they would not support moving networks without knowing how much employees would pay after any change. Thomas said the firm would calculate employee-cost impacts once the committee signaled a direction and provide those figures to the committee. He confirmed the district’s open enrollment window requires a decision in coming weeks.

No formal vote was recorded on a network change. A committee member moved to bring the topic and full information to the full board; other members said the finance committee should review the detailed numbers first and that staff would provide the requested premium comparisons and provider disruption lists. The committee agreed to obtain the specific cost and provider-comparison data and to consider a special finance‑committee meeting or to include the item on the next work session agenda.

Clarifying details discussed included the roughly $600,000 projected annual claim savings (approximate, based on recent experience), Anthem’s estimate that about 98–99% of current provider claims would be in‑network under HealthKeepers once Rehab Associates is added, and staff’s prior recommendation that staying with the current PPO could require an approximate 6.5% increase to maintain plan funding. Committee members asked the administration to provide per‑plan dollar amounts (employee only, family, etc.) and an explicit list of any local providers that would be out of network under HealthKeepers.

The discussion closed with staff agreeing to provide a provider-by-provider disruption list and premium impact calculations to the finance committee and to attempt to produce those numbers in time for open enrollment materials.