Dodgeland board weighs self-funded health plan as premiums jump 26%

The Dodgeland School District Board of Education spent more than an hour on April 27 reviewing options to absorb a 26% renewal on the district's employee health insurance. Administrators presented a self-funded alternative offered by Cell Fund Health that pairs direct primary care and nurse "navigators" with stop-loss insurance and said the proposal could limit exposure to very large claims while preserving access to major in-network hospitals.

The district administrator explained the two paths before the board: renew with the current broker (a guaranteed 26% increase, estimated at about $1.35 million) or move to a self-funded design with an estimated maximum exposure near $1.33 million but with a chance of savings if high-cost claims are contained. "With the self-funded option there's a potential it would be cheaper, but it's not guaranteed," the district administrator said, noting a recommended individual stop-loss at $50,000 and aggregate protection that would cap catastrophic costs.

Administrators cautioned that the self-funded plan would not be HSA-eligible. They proposed using funds currently earmarked for HSA contributions to buy down premiums if the district adopted the new model. Board members also heard that employees would be assigned a direct primary care provider and that nurse navigators would help guide members to lower-cost providers for imaging, prescriptions and specialty referrals so that some services could effectively be provided at no out-of-pocket cost if the employee remained on the "paved path" the vendor advocates.

Board members pressed for examples and operational detail. One board member asked when a decision would be required for a July 1 implementation; administrators said open‑enrollment timing makes the coming weeks critical. Several trustees emphasized the need for direct employee engagement: they requested a presentation from the vendor and a staff Q&A session before any vote so employees could evaluate how the model would affect access, continuity with existing specialists and take-home pay when premiums and deductible changes are considered.

Administrators warned that, under the brokered renewal, a planned $1,200 return for returning teachers could be largely consumed by the higher premiums. "My biggest concern is employees will essentially feel like they're paying to come to work," one trustee said, noting the risk that raises may be offset by insurance cost increases.

The board did not take a final vote but directed staff to arrange vendor presentations, provide employee-facing examples (for instance, imaging or specialty‑care paths), and gather references from other employers who have been using the model. The district will revisit the decision before open enrollment and will weigh timelines to avoid surprising staff during benefits selection.