“I don’t find myself speechless very often” ` – Chris Bomberger,
” The Texas School Health Benefits program sent out the distress signal to districts that had pulled out of the state’s benefits system for educators: their reinsurer had pulled out of covering 51 Texas school districts who had negotiated their own benefits to find better cover coverage, better prices or both.”
Denton ISD has a short window of time to get new health care benefits for employees after the Texas School Health Benefits reinsurer opted not to continue coverage for more than 50 Texas school districts in the program.
Chris Bomberger, the executive director of child nutrition, benefits and risk management for the district, was the bearer of bad news for the school board on Tuesday night.
The reinsurer, a company that gives financial protection to insurance companies, won’t continue coverage for the school district and the 51 districts in the TSHB program for the coming school year because of the cost of reinsuring, according to Bomberger’s presentation. Bomberger is on the TSHB Board of Trustees, along with six trustees who work in other Texas school districts.
WHAT IS A REINSURER?
Open enrollment had long ended and Denton ISD employees were all set to see their health benefits start as usual on Sept. 1.
But then the Texas School Health Benefits program sent out the distress signal to districts that had pulled out of the state’s benefits system for educators: their reinsurer had pulled out of covering 51 Texas school districts who had negotiated their own benefits to find better cover coverage, better prices or both.
But what is a reinsurer, anyway? Well, it turns out its a insurance policy for insurance companies. It might sound like a financial plan devised by Rube Goldberg, but its a customary part of company finance profiles.
“Reinsurance providers offer ‘stop gap’ insurance to insurance third party administrators,” said Chris Bomberger, the Denton ISD Executive Director of Child Nutrition, Benefits & Risk Management. “The company that assumes liability from the primary insurer is known as the reinsurer. Primary companies are said to ‘cede’ business to a reinsurer.”
When he delivered the bad news to the Denton School Board this week, Bomberger reported that the reinsurer based it’s decision to stop coverage on 10 months of utilization data as well as the cost to reinsure.
Utilization data is information about actual consumer behavior, and in the healthcare industry, it is used to evaluate everything from the cost and quality of care, medical practice patterns and outcomes of health care treatment.
As of now, eligible district employees don’t have health benefits secured for Sept. 1, the beginning of the year for coverage. There are 5,000 employees eligible for health coverage through the district currently. Within the district, employees who work 16 hours a week or more are eligible for healthcare coverage.
“I don’t find myself speechless very often, but this topic has me a little bit speechless,” he said. “On May 25, just a couple of weeks ago, I was contacted by our consortium that we’re partners with in TSHB and was notified that our reinsurance carrier had basically pulled our policy moving forward into next year.”
Bomberger and Denton ISD Superintendent Jamie Wilson said there is only one thing to do: Spend the next few weeks hustling to secure benefits.
Trustees also passed a resolution to fully authorize Wilson to approve health insurance coverage for the district.
How the district got here
Like a lot of employers across the country, Denton ISD has faced rising health care coverage costs in recent years. For public schools, health care benefits are an especially crucial part of employee compensation. Administrators across the state have been hard at work to make their districts the most attractive destination in a state with a growing number of students and a shrinking number of teachers.
Denton ISD is among the districts serving some of the fastest-growing communities in the state.
And it isn’t just teachers the district needs to recruit and retain. With new campuses opening over the next five years, Denton ISD is on the hunt for specialists, including administrators, counselors, bilingual and special education instructors and other key personnel.
The district’s benefits have changed in the last few years — by financial necessity, leaders said.
From September 2020 through August 2022, Denton ISD offered benefits through Texas School Health Benefits. Then, starting in September 2022, the district opted to leave TRS-ActiveCare, the health care benefits vended through the state’s teacher retirement system.
At the time, Bomberger led his department in a risk that other public schools in the state have considered and taken — leaving the state health benefits system in search of more affordable coverage.
The sting of leaving TRS-ActiveCare?
Once a district opts out, you can’t get back in for four years, even if the system has better rates than other options on the market.
Bomberger said that during the 2021-22 school year, 2,700 employees chose the district’s healthcare. During the 2022-23 school year, 2,750 district employees opted for coverage through their workplace. Employees may choose to be covered by other plans, Bomberger said, saying it’s most likely that those who choose another plan are carried by another family member or a spouse.
The Affordable Healthcare Act requires Denton ISD to offer healthcare benefit. It wasn’t until the 87th Texas Legislative session that districts were legally allowed to seek insurance outside of TRS-ActiveCare. To date, most districts with 500 or fewer employees are required to participate in the state’s insurance system.
Compounding problems
The district learned the reinsurance provider wouldn’t renew just four days before the 88th Texas Legislative session ended and came up short on bills that would have given teachers a raise and increased the state’s allotment for students, which is funded on average daily attendance numbers instead of enrollment.
Not only did Denton ISD meet the end of the session disappointed in a scant $4 billion available in the state budget for public schools, but it quickly moved to shutter the K-8 Virtual Academy and cut costs across campuses because of gridlock over school funding.
The situation looks grim: Denton ISD is considering giving employees raises out of its own savings, with nothing else on the horizon if Gov. Greg Abbott doesn’t call a special session to address school funding. Board members were still fuming Tuesday night about the state’s austerity program for schools in spite of the legislature’s $37 billion “rainy day fund.”
Place 3 Trustee Amy Bundgus cast the sole vote against the resolution to authorize Wilson to secure benefits for workers, but not because of a lack of trust in the superintendent, she said.
“Given the unusual circumstance that we are in with this sudden and concerning shift in our options, for me as a trustee accountable to our community — this situation has elevated to one of the most urgent matters on the table,” Bundgus said. “I believe that as a trustee I have the responsibility to treat the situation as urgent and approach with an ‘all hands on deck’ attitude to ensure little to no impact for district employees.”
Bundgus said she knows the uncertainty about next year’s benefits wasn’t caused by the school district.
“I feel obligated to find the absolute best remedy for all district employees and ensure zero gaps in this critical benefit,” she said.
Place 5 Trustee Charles Stafford told his peers on the board that they shouldn’t “micromanage” the process of securing coverage, and that they can trust Wilson and Bomberger to do so.
favor, given that that an insurer could offer cost-effective options that require quick decisions.
“It may accelerate our timeline and help alleviate any undue stress or worry this short-term inconvenience may cause for our staff,” he said. “Our team is very transparent with our Board of Trustees, sharing information with them continually, and ultimately — if having a special-called meeting to address the needs of our employees is what needs to happen — our trustees we will most certainly do so.”
Bundgus said she’d like the board included in the process.
“My vote to be included in this critical decision was no reflection on the administration or staff at Denton ISD,” Bundgus said. “Rather, there is a reason there are seven trustees that have been elected by the community to serve and oversee this school district.”
Bundgus said her peers can bring their expertise and interest to bear on the process to the benefit of district employees.
“Each board member should be more than a ‘yes vote’ to a final presentation,” Bundgus said. “Otherwise why are we all there? We should question, provide input, present a ‘new way’ and really impact change when change is needed. Given the criticality of this situation, and the importance of getting this right for all district employees, this is not a decision that should be abdicated.”
What’s next for the district?
Bomberger and Wilson said the plan is to secure coverage for employees. The district directed TSHB to enter discussions with Baylor Scott & White and Blue Cross Blue Shield, but Baylor Scott & White Health declined a partnership, and TSHB declined to vote on the Blue Cross Blue Shield option. The district directed TSHB to explore a narrow network option with Texas Health Resources. Generally, narrow network options keep costs down but constrain providers to local, community-based providers. Conversations with UnitedHealthcare haven’t produced options yet, either, Bomberger said.
Ultimately, Wilson and Denton ISD risk management will communicate with the board as they work through a new plan, Wilson said.
“This is what happens whenever you want the flexibility to do it yourself,” Wilson said. “It’s … just doing the business and working through getting the very best plan for employees. It’s not clean. … It’s a little sticky as you work through it all.”
Wilson said the district spends a part of each summer finishing employee benefts coverage.
“We are still within the normal window as far as our enrollment period is concerned,” he said. “I have every confidence that our team will solve this challenge since it is the responsibility of our staff to negotiate contracts like this for employees, bring the information to me and ultimately make the recommendation to our Board of Trustees.”
The team doing the work are covered by the same benefits, “so everyone has a vested interest in making the best decision for our community,” Wilson added.
Will the sprint to find new coverage cost the district more?
“Denton ISD will provide a fully funded plan,” Bomberger said. “Any plan considered must meet certain financial expectations to keep Denton ISD from future claims risk.”
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