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Benefits committee recommends plan design changes to lower premium increase to 6.6%; board to act next meeting
Summary
District insurance committee recommended lowering the FY25–26 medical premium increase from an expected 9.5% to 6.6% by adjusting base plan cost‑sharing, adding massage to the base plan and removing a costly out‑of‑network “plus” rider; the board will consider the recommendation as an action item at the next meeting.
The District 11 benefits insurance committee recommended changes to the FY2025–26 employee benefits plan that district staff said would reduce a proposed premium increase from 9.5% to about 6.6%.
Jessica (benefits presenter) told the board Kaiser Permanente proposed a 9.5% increase under the district’s contract cap. The committee recommended several design changes intended to lower the overall premium increase while enhancing benefits for employees on the base plan: lower the base plan deductible and out‑of‑pocket maximum; add massage therapy to the base plan at a $30 copay (20 visits per contract year); increase emergency‑room copay from $250 to $500 (waived if admitted); and remove a 20‑visit “plus rider” that allowed limited out‑of‑network access. Staff said removing the rider would save about $750,000 annually.
Under the committee’s preferred structure, the buy‑up plan (Kaiser 1500) and the base plan (Kaiser 5000 with the committee’s enhancements) would produce a 6.6% premium increase. The committee also recommended moving to a flat dollar district contribution for the base plan to improve budget predictability, which slightly increases the district’s annual cost (committee‑estimated $1,580,000 annual district increase in that model) while lowering some employee premiums for family coverage.
Benefits staff reported most members were enrolled in the buy‑up plan (about 86%); the committee noted the district would contact a small number of members who had used out‑of‑network options to help them find in‑network providers. Dental, vision and life insurance rate guarantees are unchanged in the recommendation. The committee said staff will bring the formal plan and premium motion as an action item at the next board meeting.
Ending: The board received the recommendation and asked staff for follow‑up scenarios (including keeping the percentage split unchanged) before voting; staff will return with a formal action item and materials for board consideration.
