--- ## title: Microsoft PowerPoint - Board Meeting.pptx ## author: George Vander Weit date: D:20260402150136-05'00' --- ## Work session: Insurance Plan Review April 9, 2026 Stacey Sovine, executive director of administrative services George Vander Weit, One Digital Insurance Representative. Believe, Belong, Build and Become. ## Burnsville Eagan Savage School District #191 2025-2026Medical and Dental Plan Review and 2026-2027funding recommendations ## 2025–2026Self Funding Medical (Through March2026) Actual –3/2026Projected ## $13,207,456$23,727,495Medical Plan Claims ## (Net Stop Loss Violations) $671,941$2,388,214Fixed Costs ## $13,879,397$25,814,721Total Plan Costs $17,158,122$27,947,622Internal Funding ## $14,004,717$12,600,369Total Running Reserve Estimate 54.2%48.7%Reserveas % of annual costs •Target Reserve: 55% of annual costs ## 2025–2026Self Funding Medical: Reserve Estimate •Prior Reserve represents the estimated reserve position at the end of 6/30/25 •Projected Reserve At Expected is what the reserve projection is given current funding levels had claims been exactly equal to expected medical claim projections •Actual Total Reserve is our reserve position plan year to date •Target Reserve is 55% of annual costs ## Reserve $10,725,991 $14,640,538 ## Feb-26, $14,004,717 $13,088,150 ## K ## $ 5.M ## $ 10.M ## $ 15.M ## $ 20.M ## $ 25.M ## $ 30.M ## Prior ReserveProjected Reserve At Expected ## Actual Total Reserve55% of Total Costs History of Reserve balance •Net ending position of self funded health plan per District Financial statements: TargetChange in valueBalanceFiscal Ending $8,405,544$9,066,555June 302020 $8,649,470($610,924)$8,455,631 June 302021 $9,309,463($1,105,171)$7,350,460June 302022 $10,907,833($1,914,409)$5,436,051June 302023 $11,457,917$2,200,196$7,636,247June 302024 $12,002,450$1,340,626$8,976,873June 302025 •Pharmacy represents 25% of the health plan spend at $195 PMPM •Mental health claims continue represent over $1.1 million of spend, up 9% •3 high cost claimants with each over $1 million in spend in the past 12 months •High-cost claimants continue to represent over 18% of spend over the past 3 years. The severity of the claims in number and dollar value over stop loss are improving but this has created higher stop loss premiums over the past few years •With the continued rising costs of medical and prescription drugs not slowing, the need to adjust rates to cover expenses is what drives the recommendation for an increase to funding of 5% Health plan observations and funding recommendation for 2026-27 ## 2026–2027Self Funding Medical Projection of Costs ## Projected ## $25,031,467Medical Plan Claims ## (Net Stop Loss Violations) $1,927,805Fixed Costs ## (Less Pharmacy Rebates) ## $26,959,272Total Plan Costs $27,428,758Internal Funding ## $14,940,538Total Running Reserve Estimate 55.4%Reserveas % of annual costs •Target Reserve: 55% of annual costs •BCBS administrative rate will remain at current rate. •Stop premiums will increase by 17% thanks to the stop loss premium cap •Plan has a $250k individual deductible with a 115% aggregate contract •OneDigital consulting fee is a fixed annual fee of $75,000 and will not be changing ## 2026–2027Self Funding Year Medical Projection •Prior Reserve represents the projected reserve position for claims incurred through 6/30/26and paid through 12/31/26 •Projected Reserve At Expected is what the reserve projection is given renewal funding levels if claims are exactly equal to expected medical claim projections for plan year 7/1/26–6/30/27 •Minimum Reserve is 11% of annual costs •Target Reserve is 55% of annual costs ## 2025–2026Self Funding Dental (Through February2026) Actual –2/2026Projected ## $602,993$904,489Dental Plan Claims $40,617$60,925Fixed Costs ## $643,610$965,415Total Plan Costs $587,559$881,339Internal Funding ## $446,113$418,088Total Running Reserve Estimate 46.2%43.3%Reserveas % of annual costs •Target Reserve: 25% of annual costs ## 2026–2027Self Funding Dental Projection of Costs ## Projected ## $940,492Dental Plan Claims $65,367Fixed Costs ## $1,005,859Total Plan Costs $925,405Internal Funding ## $337,634Total Running Reserve Estimate 33.5%Reserveas % of annual costs •Target Reserve: 25% of annual costs •Delta administrative rate will increase by 5.9% History of Reserve balance, claims and 2026-27funding recommendation •Net position of self funded dental plan per District Financial statements –June 302020: $449,155 –June 302021: $460,555 –June 302022: $497,197 –June 302023: $525,883 –June 302024: $514,893 –June 302025: $481,786 –Claims are stabilizing –Funding recommendation is to increaserates 5% for 2026-27