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Hernando negotiators consider switching to self‑insured health plan amid projected 23% premium increase
Summary
District staff told negotiators the fully insured plan is projecting a 23% increase; the district is scheduled to meet Aug. 5 with Blue Cross to examine options and staff argued that moving to a self‑insured model would let the district own data and reduce long‑term costs, though upfront planning and reinsurance remain issues.
District staff raised insurance costs and a possible move from a fully insured health plan to self‑insurance as a potential way to limit future premium growth.
"The raise at the meeting was 23," said Matt Goldrick, referring to the proposed 23% increase on fully insured plans; he said the district will hold a meeting on Aug. 5 with Blue Cross to explore fully insured versus self‑insured options and to refine cost projections. Staff said switching to self‑insurance could reduce the year‑to‑year increase because the district would ultimately own claims data and could negotiate formularies and reinsurance more effectively.
Staff described the district’s recent claims experience as 107% over the prior 12 months and said an increase in the district’s high‑cost patients (from about 29 to roughly 50 people) is a major driver of premium growth. Goldrick said, "Blue Cross Blue Shield owns our data. Next year, for 2027, we'll start owning our data and really know it," and argued that owning claims data would let the district better target steps such as reinsurance or risk‑sharing to limit the cost impact of a small number of very expensive claims.
Union representatives said employees worry about upfront costs and potential changes to plans. Staff said the district’s goal in year one is to shift to self‑insurance while keeping employee experience constant and to use years two and three to evaluate real claims data; they cautioned that self‑insurance is not an immediate fix for this year's increase but could save money over time if established and funded correctly.
No plan change was adopted at the session. Parties agreed to reconvene after the Aug. 5 insurance meeting with more precise numbers and a clearer picture of employee premium impacts.
