At a meeting of the Lafayette Parish School System Insurance and Finance Committee, committee members reviewed Gallagher's stop-loss (specific reinsurance) renewal proposal, discussed its impact on the district's Fund 85 budget and received an update on open-enrollment transitions to the Humana Medicare Advantage plan.

Melanie, a Gallagher presenter, told the committee that specific reinsurance (often called stop loss) is purchased to protect a self-funded plan from catastrophic individual claims and to stabilize premiums. "The reinsurance, the stop loss, we we use those terms interchangeably, is to cover anything over a certain amount. Currently, as of yesterday, it was a half a million dollars," she said.

Melanie described a proposed renewal design that would raise the individual specific deductible to $600,000 and add a separate $325,000 layer that must be satisfied before reinsurer reimbursement. She said the change is intended to reduce the district's premium and limit the compounding effect of premium increases year to year: if the market experiences a 10% increase on a lower premium base, the actual dollar increase is smaller.

Committee members asked for retrospective modeling. One member, Jeremy, asked staff to apply the proposed $600,000 attachment and the aggregate layer to last year's claims to show how the district would have fared; Melanie said the analysis had been done previously but the specific figures were not at the podium and that staff would provide the retrospective analysis to the board.

On budget impact, committee members and staff said the higher stop-loss costs were anticipated and were included in the Fund 85 budget adopted by the board in the spring for fiscal 2026. "When you adopted the board adopted Fund 85 budget in the spring for the fiscal 26 year, which we're we already built in an increase because we knew stop loss was predicted to go up," a staff member said. The presenter reiterated that the proposal, as presented, would not require additional Fund 85 dollars.

The presentation used example claim scenarios to illustrate how the $600,000 deductible and the $325,000 layer would work in practice. Melanie warned that the district has seen individual claims in the $2 million to $3 million range and that specialty drugs and gene-based therapies can quickly produce very large, unpredictable costs.

Separately, Trish and other benefits staff updated the committee on open enrollment processing. They said open enrollment remains in progress with ongoing data entry into Meritain and pharmacy systems. Staff provided counts of member transactions: roughly 375 total member changes this cycle (including additions and cancellations), 93 members moved from the district's Blue Cross plan to the Humana Medicare Advantage plan during this transition, and staff reported earlier 2025 transitions of about 236 members. Staff estimated Humana membership approaching roughly 1,000 members after the current transitions and said two members had moved back from Humana to the self-funded plan for noncoverage reasons.

Superintendent (identified only by role in the record) thanked staff and Gallagher for the work and said he expects the new Rx plan and network changes to begin producing savings after Jan. 1 that will help the district build a dedicated fund balance for the health plan.

Votes at a glance

- Motion: Approve minutes from the Board Insurance and Finance Committee meeting of Oct. 15, 2025. Outcome: approved. Vote call noted Mister Edmond and Mister Hidalgo present and voting; Mister Bajoran absent. (See provenance.)

What remains open

Committee members requested a retrospective, claim-level analysis applying the proposed $600,000 specific deductible and $325,000 aggregate layer to last year's claims; staff said that analysis exists and will be circulated to board members. Staff also said open-enrollment data entry is ongoing and final counts will be reported when processing completes.

(Reporting note: this account is based on the committee meeting transcript. Where the transcript provided unclear numeric strings or incomplete figures those items are noted in provenance and clarifying details.)