District outlines plan to curb rising health costs, ties HSA incentive to new Innovia clinic

At its Sept. 8 meeting, Wisconsin Rapids School District administrators presented board members with options to rein in rising health-insurance costs, including a direct primary-care arrangement with Innovia, new copays for emergency and urgent care, a proposed $125-per-month spousal surcharge and an incentive tying part of employer HSA contributions to in-person visits at the Innovia clinic.

The district’s broker, Jen Corte of M3, told trustees the plan’s rolling medical-loss ratios were concentrated above 100 percent: 117% for July 2023–June 2024 and 119% for July 2024–June 2025, a combined 118% across the two-year window. Corte said Aspirus Health Plan paid out about 18% more in claims than it collected in premium dollars during the most recent period and that shortfalls were driven in part by prescription drug costs she estimated at roughly $2 million–$2.5 million for the year.

Those figures, Corte said, produced a modeled renewal that would otherwise be “uncapped” for 2026; last year the district negotiated a not-to-exceed (NTE) increase capped at 9.5% for the “signature” network but the carrier is not offering an NTE for 2027. To reduce utilization and make the plan more marketable, the district is opening a direct primary-care clinic with Innovia and proposing changes to plan design and incentives.

Why it matters: the district’s fully insured premiums must cover claims to keep renewal increases manageable. With claims outpacing premiums, administrators said the district risks larger increases unless utilization changes or plan contributions change.

Key proposals and projected effects

- Innovia clinic: The district plans to open an Innovia clinic (2811 Eighth Street, Suite 2) on or about Nov. 3. Corte said Innovia will allow employees to use other Innovia locations at no charge to the district during October; labs and imaging would still be…