Arlington ISD examines on-site clinics, wellness incentives as health-care costs climb
Loading...
Summary
Trustees heard staff point to 20 high-cost claimants that account for about $11 million of $45 million in annual claims, and discussed options including a TRS ActiveCare pilot, on-site employee clinics (estimated $2.5M'$3M/year) and enhanced wellness incentives to reduce long-term claims.
Arlington ISD trustees on April 9 received a follow-up briefing on the district's teacher-health coverage and potential steps to curb rising costs, including a TRS ActiveCare pilot, stronger wellness incentives and on-site clinics.
Scott Kale, who presented the analysis with Holly Stambaugh, said the district's claims picture is driven by a small number of very expensive medical cases: “We do have about 20 high cost claimants. And those 20 high cost claimants are $11,000,000 of our $45,000,000, claims,” Kale said, noting the district takes in roughly $40 million in premiums and is currently running at a claims-to-premium ratio above 100%.
The presentation outlined several options. One is a self-insured model discussed with a health system that could show payback after several years; another is a partnership or pilot with TRS ActiveCare that staff said could be imminent and might include tiered networks inside the same plan. Holly Stambaugh, the district's director of compensation, described on-site clinic models and estimated operating costs between $2.5 million and $3 million per year if implemented with fidelity. She also described an enhanced wellness tier that could raise employer contributions for family coverage while offering deeper premium incentives for employees who complete biometric screenings and health assessments.
Trustees pressed staff about likely return on investment and timing. Trustee Mike asked whether the clinic model's cited 1-to-1 ROI applied to the clinic alone or to the broader package; Stambaugh said the 1-to-1 figure applied to the clinic model and that combining clinic access with stronger wellness incentives could increase the impact. Trustees also asked about the pilot with TRS ActiveCare and whether the district would be invited; staff said TRS was considering a pilot for two districts and that Arlington ISD had been told it was likely to be invited.
Why it matters: district staff said reducing the claims ratio below 100% would increase the district's options, including the possibility of a self-funded plan. Until then, Arlington ISD remains pooled with other districts in a high-claims region, which limits district-level control.
Next steps: staff said they will continue modeling options, monitor TRS board decisions on the pilot and return with more detailed financial analysis before any recommendation to change the district's plan.
Sources: presentation and Q&A with Scott Kale and Holly Stambaugh at the April 9 board meeting.
