The Clay County School Board transitioned to a self-insured health program effective October 1, 2022. As part of the program, the district is required to maintain reasonable stop-loss insurance for claims over $300,000.

In conjunction with the Bailey Group, the District’s third-party administrators, and the Stealth Partner Group, the health insurance underwriting firm, an RFP was submitted for Stop Loss Insurance. At least four carriers submitted their interest under the specific terms and agreements. Accordingly, it is their professional opinion that we renew with WellPoint as the District’s Stop Loss Carrier. The annual fixed premium is $1,661,355, based on a total of 2,867 employee participants. The coverage supports claims over $300,000. The coverage will also include a Gene Therapy Rider, GTS-5, which will protect members in need of five specific gene therapies. The premium for GTS-5 is included in the renewal increase.

The board has maintained the same stop loss level ($300,000 per individual) and stop loss carrier (Sun Life) for the past two plan years of being self-insured. This year, the recommendation is to maintain the individual stop loss level of $300,000 but change the carrier to Wellpoint due to their competitive offer. This is a financial recommendation to save dollars for the health plan. 

The Board to approve the district recommendation to renew the stop loss carrier, Wellpoint with the current deductible level of $300,000 per individual for the 2024-2025 plan year. The board is to approve the renewal of the current Gene Therapy protection at the current $1.99 PEPM rate, which is also included in the annual premiums. 

Approve the district to renew at the current $300,000 stop loss level with a new stop loss carrier, Wellpoint, for the 2024-2025 plan year. Approve to renew the current Gene Therapy protection.

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