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Consultant tells Taylor County board self-funded plan has saved district tens of thousands
Summary
A Gallagher consultant reviewed Taylor County School District's long-running self-funded health plan, saying pharmacy renegotiations, stop-loss bidding and PACE group purchasing reduced costs and that fully insured quotes would be substantially higher.
Anne Edenfield, a consultant with Gallagher, told the Taylor County School Board the district has run a self-funded health plan for "25 plus" years and that the arrangement has produced net savings for the district. "So these are it's a huge savings," Edenfield said, noting renegotiated pharmacy terms and a 15% reduction on the district's stop-loss policy saved the plan roughly $91,000 and tens of thousands more on pharmacy rebates.
Edenfield explained the mechanics of self-funding and why switching to a fully insured model would likely be more expensive. She said she requested fully insured quotes from Florida Blue and Capital Health Plan (CHP) for comparison and that the fully insured proposals were "a significant increase in the cost to cover y'all." She described the district's participation in a quasi-PACE consortium that lowers administrative fees while allowing the district to pay claims independently.
Board members pressed staff about how employee contributions were shown on the rate sheets and about the change from a 10-pay to a 12-pay distribution; staff clarified the annual cost is the same and is merely spread over more pay periods. Edenfield also described stop-loss mechanics: the district would pay claims up to the stop-loss attachment point and Symetra would cover catastrophic costs above that threshold. "Anything above 175,000, boom, that goes to Symmetra," she said.
The presentation concluded with board members asking for follow-up details, including who fills various roles in the PACE pool and how comparable nearby counties handle contributions. Edenfield offered to provide underwriting and pool information as a follow-up.
