Coventry School Committee votes to move school health plan to fully insured trust, citing near-term savings

The Coventry School Committee voted 6-0 on Feb. 27 to accept the evaluation team’s recommendation to move the district’s employee health benefits — medical, pharmacy and dental — to a fully insured Trust rather than remain in the WB Community Health self-insured pool.

Superintendent Cowart summarized the evaluation, saying the committee’s recommendation was based on proposals, binders and a scoring rubric completed by an evaluation team that included the assistant superintendent, the finance director, an account senior accountant, the HR manager and a town reviewer. ‘‘The recommendation based on what I just went through in that analysis is, for the public schools to move to the trust for health care, pharmacy and dental,’’ Cowart said.

Why it matters: The Trust’s quoted premiums were lower than the WB Community Health working rates presented to the district; the district’s analysis estimated an annual difference of roughly $924,000 between the two proposals when comparing the most populous plan tiers. Committee members and staff emphasized that the Trust’s fully insured premium model reduces the district’s exposure to unexpectedly large claims, while the WB model would retain self-insurance stop-loss risk.

The evaluation team and scoring: Cowart said the team scored proposals against a rubric published in the RFP. The Trust received 77.6 points under the committee’s weighted rubric (out of 106), while WB Community Health received 64.2 points. The rubric weighted overall cost most heavily (50%), then comparability, network disruption and a multiyear guarantee.

Cowart explained differences in structure between the two offers: WB’s working rates include stop-loss insurance and are a self-insured working rate that can vary; the Trust’s fully insured premiums are fixed for the contract period, making year-to-year costs more predictable for budgeting. Cowart noted both plans offered comparable copays and deductibles but that the Trust’s pharmacy manager (CVS Caremark under the Trust proposal) had slightly different retail-network coverage than the WB pharmacy network; the district’s review found only two very low-usage out-of-state pharmacies that would be affected.

Union review and legal approval: Cowart said union leadership has received the proposals and that review by district counsel would be required before final contracting. ‘‘We did share the RFPs with union leadership, and Kelly is still in the process of reviewing it,’’ she said. She added any final agreement would be contingent on legal review.

Committee motion and vote: A motion to approve the RFP recommendation was made, seconded and carried 6 to 0.

What the district said about budget impact: Cowart presented sample calculations comparing the most-used plan tiers and said the Trust’s fixed premiums were lower than the WB working rates; when applied to current employee counts and employer shares the district estimated hundreds of thousands of dollars in potential annual savings. Cowart also cautioned that conversion-related adjustments and transitional details (including pharmacy tier mapping) would require follow-up before savings could be finalized.

Next steps: The district will continue union review and legal review; staff said they would return with the final contract for attorney review and to address pharmacy formulary and network questions before the change becomes effective.