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Eau Claire board hears health-insurance update as district weighs rebate use, stop-loss options
Summary
The Eau Claire School Board on Tuesday evening received a detailed briefing on the district's employee health insurance from Dr. Elworthy and consultants with Marsh McLennan Agency (MMA), who said a recent spike in high-cost claims ' especially specialty pharmaceuticals and cancer cases ' has pushed projected plan costs well above prior expectations and created pressure on next year's renewal.
The Eau Claire School Board on Tuesday evening received a detailed briefing on the district's employee health insurance from Dr. Elworthy and consultants with Marsh McLennan Agency (MMA), who said a recent spike in high-cost claims ' especially specialty pharmaceuticals and cancer cases ' has pushed projected plan costs well above prior expectations and created pressure on next year's renewal.
Dr. Elworthy told the board the district has a self-funded plan and that plan-design changes since 2016, including separating active employees and retirees in 2022, shaped current liabilities. Matt Robertson of MMA said the district's current carrier and third-party administrator arrangement has limited exposure through a specific stop-loss of $150,000 per member, but a small number of very large claims this year have driven carrier payments above premiums collected.
The consultant outlined recent utilization trends: roughly 1,000 members were identified as eligible for care…
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