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Lee's Summit district forecasts 10.66% rise in health claims, will shift stop‑loss to Symetra
Summary
District finance staff told the Finance Committee the self‑funded insurance plan expects about a 10.66% increase in claims next plan year, the district plans to cover roughly 80% (about $2.3 million) of that rise while employees would absorb roughly $725,000, and staff recommended switching stop‑loss coverage to Symetra to reduce administrative costs.
Dr. Herzog, the district finance presenter, told the Finance Committee on Sept. 22 that the Lee's Summit R‑VII self‑funded health plan is projecting "about a 10% little over 10%, 10.66% increase" in claims for the upcoming plan year and that the district has accounted for much of that cost in current budgets.
"Of that increase, the district is planning and and has budgeted for funding 80% of that increase," Herzog said, citing roughly $2.3 million the district would absorb and noting employees would see the remainder — about $725,000 — through higher plan costs. Herzog also said the district will continue to fund health savings accounts at the same monthly levels as the prior insurance year.
To limit the budget impact, Herzog told the committee staff pursued bids for stop‑loss coverage and recommended switching from Blue Cross Blue Shield's stop‑loss service to Symetra, saying the district would save "about $280,000" over staying with the incumbent. "We are changing our stop loss provider to Symetra," Herzog said, and added that staff did not expect the change to affect employee benefits.
Committee members asked how much of the increase was already built into the district's budget and whether the six‑month overlap with the fiscal year changed the effective rate. Herzog said most of the cost for the second half of the plan year was included in current budgets and that additional adjustments could be considered during the next fiscal year if claims run higher than anticipated.
Staff emphasized the district is in an early stage of self‑funding and has roughly $7 million in reserve for the plan. Herzog said the stop‑loss contract being proposed carries an individual attachment point of $250,000 and also triggers if aggregate claims exceed 125% of expected claims.
No formal board vote was recorded in the committee meeting; the insurance and related items will appear on the full board consent agenda for Thursday's meeting.
