Polk Schools Health Plan Will Become Solvent Three Years Ahead of Schedule

Polk County Public Schools' self-funded health plan is on track to become solvent in 2020 - three years ahead of schedule.

"Every PCPS employee should be very proud of what we have achieved, because we did it together," said Superintendent Jacqueline Byrd. "We were facing multimillion-dollar shortfalls. The district and the unions took action together, and because we did, the health plan is healthier than it's been in a long time."

The work done to stabilize the health plan means that, for the foreseeable future, employees will not incur any additional costs for coverage.

A combination of high-dollar claims and insufficient funding over time had pushed the school district's health plan far into the red. In 2019, the gap between anticipated claims and available funding exceeded $17 million.

"Two years ago, I brought to your attention that our health plan had major problems ... and that we had to make some major changes," said Chief Financial Officer Michael Perrone at the April 28 School Board work session.

Those changes included increasing the school district's contributions to the health plan by $60 per person, per month. To make that possible, both the Polk Education Association and AFSCME - the unions that represent teachers, paraeducators, bus drivers and bus attendants; as well as clerical, school nutrition, custodial and maintenance personnel - agreed to freeze salaries for the 2019-20 school year.

"When the PEA bargaining team dug into the district's budget before negotiations last year, we knew if there was salary movement that the same money would be eaten up by insurance premium and deductible increases. That's why our bargaining team, along with the AFSCME team, agreed to put $9 million into digging out our health plan," said PEA President Stephanie Yocum.

Additionally, PCPS switched insurance carriers, from Florida Blue to Blue Cross and Blue Shield of Alabama, and in the process made a number of changes to its coverage.

Employee deductibles increased from $750 to $900 annually. Co-pays went from $40 to $50. After extensive research - which even involved mapping store locations and their proximity to district worksites - PCPS dropped the CVS pharmaceutical network, opting for Walgreens and Publix exclusively.

"When you're working with fewer companies, those companies know they're going to fulfill more orders. It helped us in negotiating better prices," Perrone said.

The district also adopted two significant changes related to prescription medications: Drugs that are available over the counter are no longer covered, and health plan participants must try generic forms of drugs before receiving brand-name medications.

"If the generic works, why pay for the brand name?" said Linda King, PCPS' director of risk management and employee benefits.

Increasing the district's contribution, employee deductibles and co-pays; and making changes to the pharmaceutical coverage, combined with better-than-expected claims in 2019, cut the projected deficit from more than $17 million to just over $4 million.

That set the health plan on its current trajectory to become solvent this year. If no changes had been made, the health plan wouldn't have gotten out of the hole until 2023.

Moving forward, King said she and her staff are working to increase employees' use of the district's two free health clinics as well as participation in the district's wellness program. These strategies will allow PCPS to provide the most effective preventative care possible, reducing health plan costs over time.

The district is also wrapping up an audit to ensure only eligible dependents are receiving benefits.

In addition to stabilized health care costs for employees, solvency also means that in future budget years, the district will be in a better position to provide pay increases, though Perrone cautioned the financial impact of the pandemic on the district remains to be seen.

The heads of both unions are hailing the outlook for the health plan - and employees.

"With a failing health plan, the cost would only go up more and more to the employee," said Larry Milhorn, president of AFSCME Local 2227. "I'm proud of our negotiating teams for doing the hard thing this year to make it better in the future. Remember, every dollar that we can save in health care can go to raises."

"A solvent, financially stable health plan benefits every single employee and dependent on our insurance," added Yocum. "The changes that were made to our plan are paying off in dividends right now. A solid health plan means more salary dollars for employees, and that's a win for everyone."