School board to review self-funded insurance plan

Clay Today | By Nick Blank | May 4, 2022

FLEMING ISLAND – The Clay County Schools District received an overview of what potentially adding self-funded insurance would look like at a recent workshop.

Former state Rep. Travis Cummings, The Bailey Group’s vice president of benefits, called the discussion exciting and said self-funded insurance is meant to curb the volatility of the market.

“The goal all along from the insurance committee and the superintendent … and all the stakeholders was to make a transition that was not burdensome clearly to the employees in terms of change or disruption,” he said. “It’s still United Healthcare. It’s still the same plan designs.”

Senior account executive Allison Profitt provided details on the firm’s support, funding specifics and the district’s position.

In a self-funded model, premiums would be split between claims, an administration fee, stop loss insurance and pharmacy benefits the district pays. She compared it to an a la carte system. “Really what we’re going to do is take that premium and split it up,” she said. Profitt presented numerous advantages and disadvantages to self-funded insurance. It offers the elimination of some taxes and operational costs, gives access to more data and provides flexibility. However, it assumes certain risks, adds more administration and depends on a fluctuating claims market. Profitt said the Bailey Group has to monitor relationships with benefit and insurance providers.

Stop-loss insurance, a key factor in insurance discussions, has two forms: specific and aggregate. Specific stop-loss coverage places a cap on the amount that the employer pays for any one individual claim, while aggregate stop-loss coverage places a ceiling on the figure a self-insured employer must pay across an entire plan year.

“Anything above that stop-loss deductible is going to be reimbursed,” Profitt said.

During the board member discussion, board member Janice Kerekes asked for a recommendation on plans. Profitt and Cummings said the Bailey Group could hone in on what the district’s claims are and complete valuations based on district data. Cummings presented the district with a projected $1,898,158 cost savings if it went self-funded from October 2022-September 2023 fiscal year.

“We just feel good about the position of the school district,” Cummings said.

The insurance portion of the meeting concluded with Superintendent David Broskie telling board members the process to bring insurance information before the board could take months. It will resume at a future meeting.

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