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USI briefed assembly on health‑plan performance and renewal; stop‑loss exposure discussed
Summary
USI presented combined borough‑district health‑plan performance through March 2026 (≈103.5% of budget), stop‑loss renewal negotiations and plan‑design options; consultants warned run‑out exposure if the district leaves self‑funding and urged careful review of plan design alternatives.
USI consultant Matt Lewis presented a review of the borough and school district’s combined health insurance plan, reporting year‑to‑date combined claims at roughly 103.5% of budget through March and outlining stop‑loss renewal outcomes obtained earlier this spring.
Lewis said the plan produced a surplus in the prior full policy year and Sun Life was retained as the stop‑loss carrier after negotiation. He highlighted that current year performance through March was driven by many smaller claims rather than very large specific‑stop claims, described the mechanics of a paid run‑out stop‑loss contract, and outlined options for plan‑design changes to reduce future cost (deductible increases, adjusted out‑of‑pocket maximums, emergency‑room copays) with illustrative annual savings estimates.
Assembly members asked about run‑out liability if either partner left the combined arrangement and whether the USI recommendations had budgetary ramifications; USI estimated a conservative run‑out exposure for the school district near $2.19 million and about $771,000 for the borough under certain scenarios. The consultant also described monthly reporting on claims and urged continued monitoring and collaborative planning between the borough and the district before any structural changes.
What’s next: Staff will continue monthly monitoring, provide updated April data when available, and discuss strategic plan‑design options for 2027 renewals and long‑term liability management.
