The Insurance Committee met on April 28 to review the current state of our health plans and begin planning for the 2026–2027 school year. Overall, the committee examined financial trends, upcoming rate adjustments, and new wellness initiatives that may impact members.
From a financial standpoint, the medical plan reported a loss ratio of 93% for the February 2025 through January 2026 period, with total net claims nearing $6.8 million. Dental claims exceeded expected levels with a 116% loss ratio, while vision remained closer to target at 98%. The reserve fund continues to be a concern, with a current balance of approximately negative $1.73 million after required margins are applied.
Looking ahead, the committee approved a 10% increase to medical and prescription plans for the 2026–2027 plan year. Based on current estimates, this would result in a monthly increase of about $15.76 for single coverage and $39.27 for family coverage. The committee also reviewed proposals for stop-loss coverage as part of ongoing efforts to manage risk and control large claim exposure.
Several updates were shared related to wellness and benefits. The committee is exploring biometric screenings through BeWell Solutions for Fall 2026, potentially scheduled around opening day or a professional development day. Additionally, Delta Dental has expanded coverage to include pulp caps (once per tooth per lifetime), effective January 1, 2026. Members who complete a preventive care visit between June 1, 2025, and May 15, 2026, will also be entered into a raffle for an Apple Watch or other fitness trackers, with the drawing scheduled for May 22.
Medical Mutual continues to expand its digital tools, including updates to the mobile app and “My Health Plan” portal. New features allow members to track prior authorizations, claims, and healthcare expenses more easily. There is also an ongoing push to encourage members to switch to paperless Explanation of Benefits (EOBs) for added security and convenience.
Finally, the committee reviewed utilization data and health trends. While overall costs per member decreased by 12.3%, usage of MRI and CT scans remains higher than expected benchmarks. A relatively small group—97 members—accounts for over half of total claims costs. The most common chronic conditions among members continue to be high cholesterol, high blood pressure, and asthma.
👉 Members are strongly encouraged to review the full report for complete details and context here.
The next Insurance Committee meeting is scheduled for September 22, 2026. As always, please reach out to an EEA representative with any questions.