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R&R consultant proposes health‑plan redesign that would lower premiums and reduce employee out‑of‑pocket costs
Summary
Chris Kramer of R&R Insurance presented health‑plan performance data and an alternative trust plan that he said would reduce gross premiums by about 4.5% (roughly $150,000) and cap in‑network individual out‑of‑pocket spending at $5,000 while keeping $20 office‑visit copays.
Chris Kramer, the district’s employee‑benefits consultant from R&R Insurance, told the Brown Deer School Board that the district’s health plan is performing well this year but that market headwinds mean employers should seek sustainable options. Kramer presented rolling 12‑month data showing roughly $3.5 million in premiums against about $1.9 million in medical claims and approximately $455,000 in prescription claims — a current loss ratio of about 67 percent.
Kramer said the district participates in the Wisconsin Counties Association Group Health Trust (WCA GHT), which smooths large year‑to‑year swings for public employers. He described an alternative plan design offered through the trust that would (per his presentation) reduce the district’s gross premium by about 4.5 percent and cap an in‑network individual out‑of‑pocket at $5,000. The redesign would preserve $20 primary‑care office‑visit copays and a 90/10 coinsurance split for major medical services, and Kramer estimated the change represented roughly $150,000 in gross premium savings for the district.
On claims timing, Dr. Beetle asked why past high claims spiked in August; Kramer explained a processing lag when procedures performed in June or July are billed and posted in August or September. On dental, Kramer proposed an optional Check‑Up Plus enhancement for the self‑funded dental plan that would prevent routine cleanings from being deducted from the annual $1,000 dental maximum. He said that option would cost about $7,200 annually (roughly a 4.7 percent increase) but would help employees who currently use a large share of the dental cap.
Kramer described value‑added services that will be communicated at open enrollment — including telehealth and a weight‑management/wellness program — and offered a virtual presentation for staff. He said he would confirm specific Gallagher details with the district the following day and that administration would incorporate the recommended materials into open‑enrollment communications.
No formal board vote was recorded on the health‑plan design at this meeting; Kramer’s presentation concluded with staff follow‑up and opportunities for additional information requests.
