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Board reviews Curative-backed insurance renewal amid higher short-term claims and heavy early utilization
Summary
Volusia County staff and brokers presented renewal data for Curative medical coverage and ancillary plans; Curative reported high early utilization and a medical loss ratio above 100% while negotiating a 5% increase cap, and the board discussed provider-network changes, member experience and options for absorbing or passing costs.
At a May 12 workshop, Volusia County School District staff, broker Brown & Brown and Curative representatives reviewed 2026 renewals across medical, dental, vision, life and disability lines.
Curative: medical performance and utilization Curative and the broker reported an elevated medical loss ratio (claims-to-premium) following high early utilization as members completed baseline visits and used preventive benefits. The plan’s medical loss ratio was reported at about 118% through March and noted to have risen further with April data. Curative said the high ratio reflects members pursuing needed care after the plan’s launch; the vendor argued that upfront investment in preventive care should reduce long‑term catastrophic claims and overall trend.
Negotiations and proposed terms Brokers said they negotiated the vendor’s initial 9.5% cap down to 5% for the district’s renewal discussions. Presenters showed scenarios for the board to either absorb the increase or pass some costs to employees; staff also described optional wellness and implementation funds Curative will maintain as part of the arrangement.
Network and member experience Curative acknowledged early disruption after switching to a direct provider network and said it has secured direct contracts with major local systems and thousands of providers; the company reported strong pharmacy satisfaction and said steering certain surgeries to lower‑cost facilities has produced identified savings of about $628,000 to date. Curative reported high engagement metrics—about 98% baseline visit completion and substantial follow‑up engagement via care navigators.
Board questions and next steps Trustees pressed on prior‑authorization coordination, why some members saw passes expire earlier than expected, and where wellness or optional funds might be directed. Staff noted the district will continue to evaluate whether to absorb the negotiated increase and will return proposed renewal actions in the June agenda. No final rate decisions were made at the workshop.
Representative quote: "About 98% of members did ultimately complete the baseline visit," a Curative representative said, citing early engagement that the company said explains elevated short‑term claims.
