Germantown committee backs 2026 self-funded health, dental and vision plan, forwards recommendation to full board

The Germantown School District finance committee voted to recommend that the full board approve the district’s proposed 2026 health, dental and vision benefits, including UMR-administered medical coverage and Delta Dental and Delta EyeMed for dental and vision, after a consultant presentation on plan performance.

Michelle, a consultant from R and R, told the committee the district’s shift to self-funding and changes to plan design have helped contain what otherwise would be steep trend increases in health-care spending. "We have been able to put an administrator, a TPA, and a network in that has driven a lot of savings," Michelle said, and she added the district is "not looking at people having to make any changes" to the plan design for 2026.

Why it matters: School districts nationwide face rising medical and pharmacy costs driven by specialty drugs and high-cost catastrophic claims. The committee was presented with analysis showing self-funding gave Germantown more control over stop-loss and claims management and, according to the consultant, produced savings that the district can reallocate to classrooms and staffing.

Key details from the briefing and committee discussion: - Plan design and network: Michelle said the district added a "Nexus" tier in 2025 to steer members toward higher-discount, higher-quality providers; she said more than 80% of members already use tier‑1 providers. The consultant stressed the design preserves member choice while using incentives to encourage top-tier providers. - Pharmacy and coupons: The district’s pharmacy benefit manager (listed in the presentation as CVS) integrates with GoodRx to apply available coupons, reducing out‑of‑pocket pharmacy costs for some prescriptions, Michelle said. - Dental recommendation and cost impact: The consultant reported the self‑funded dental plan was running over budget with a cited plan loss ratio of 115%. After working with Delta Dental, she recommended adding "CheckUp Plus" (so routine cleanings do not count toward the annual maximum) and suggested a roughly 5–5.5% dental rate increase. The recommendation presented to the committee was that the district absorb the dental increase for 2026 so employees and members would not see higher rates. - Cost projections: During discussion, a committee member cited a 2026 per‑employee projection for the district’s self‑funded program of $24,001.95 and contrasted that with a higher fully insured projection (the presentation cited an amount in the low‑to‑mid $30,000s), yielding an estimated per‑employee savings of roughly $9,300 to reallocate elsewhere in the district.

Motion and vote: Committee member Speaker 6 moved "to approve the proposed UMR options for health insurance, Delta Dental, and Delta EyeMed coverage for the 2026 plan year to include the enhancement to the Delta Dental coverage and the associated cost increase to be covered by the district with all costs noted in the Germantown School District 2026 benefit rate sheet that was provided." Speaker 1 seconded. The committee conducted a voice vote; Speaker 3 called the vote and the motion carried.

What’s next: The finance committee forwarded a positive recommendation to the full Germantown School District board; the board will consider the 2026 benefit rate sheet and the recommended dental enhancement at its next scheduled meeting. The consultant and staff said they will continue monthly monitoring of claims and benefits performance.

Quotes: "We have been making some really good improvements," Michelle said, arguing the district’s self‑funded approach gives it more control over claims and stop‑loss arrangements. "No increase in any kind of costs to the district or the members for 2026," she also stated during the presentation.

Ending: The committee’s recommendation formalizes staff and consultant recommendations to keep the current plan design, add the CheckUp Plus dental enhancement and have the district absorb the modest dental increase for 2026; final adoption requires full board approval.