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Board approves 2026 health‑plan changes, conditions part of HSA deposit on Innovia clinic visits
Summary
The board approved plan design changes for 2026 that include new urgent‑care and ER co‑pays, higher out‑of‑pocket maximums, a 2025 cap on the district’s Freedom plan contribution, and a $1,500 annual spousal surcharge where spouses have employer coverage available.
The board approved several modifications to the district’s employee medical benefits for the 2026 plan year after a presentation by M3 consultant Jen Corte.
Corte reported the district’s 12‑month medical loss ratio remained elevated (about 120 percent) and outlined a multi‑part recommendation intended to stabilize future renewals while encouraging use of the district’s new Innovia direct‑primary‑care clinics. The board approved the recommendations by roll call votes that together: (1) preserved the Signature plan benefit structure with the district/employee premium split intact; (2) capped the district contribution to the Freedom (Marshfield) network at 2025 dollar amounts with employees covering the remaining increase; (3) added $75 urgent‑care and $250 ER co‑pays that count toward the plan’s out‑of‑pocket maximum (raising signature annual OOP to $2,500 single/$5,000 family, and Freedom OOP to $3,500 single/$7,000 family); and (4) added a $1,500 annual spousal surcharge for spouses who have employer‑sponsored coverage available but decline it and remain on the district plan.
In a separate, subsequent motion the board approved maintaining the HSA deposit amounts ($1,500 single; $3,000 family) but making the September half of the HSA deposit contingent on the employee and, if applicable, the spouse completing an in‑person physical/clinic visit at Innovia Health by July 31, 2026. The district framed the contingency as an incentive to use Innovia and to encourage early diagnosis and primary‑care management.
Why this matters: The combined changes reduce the district’s renewal exposure and encourage members to use Innovia’s no‑copay primary‑care services; they also shift some near‑term premium pressure to employees on the Freedom network and introduce a spousal surcharge commonly used by other employers to encourage spouses to take employer coverage when available.
Roll calls: The motions passed on roll calls recorded in the transcript. The consultant noted early Innovia utilization (appointments scheduled and completed) and invited board members to an Innovia open house on Nov. 11.
Speakers quoted are named in the speakers section below.
