2027 Medical Insurance Premium Rate Information

Emily

Employee Only Coverage

Current Enrollment: BSP HDHP

2026

• Monthly Cost: $0

2027

• Monthly Cost: $0

Message

Emily is early in her career, generally healthy, and likes contributing to her HSA for future healthcare expenses. She is able to keep the same plan and continue paying no monthly premium for employee-only coverage.

Key Takeaway

✅ Affordable employee-only coverage remains available.

Michael

Employee + Family

Current Enrollment: BSP HDHP

2026

• Monthly Cost: $1,160

2027

• Monthly Cost: $887

Difference

• Savings: approximately $273/month
• Annual Savings: approximately $3,276

Message

Michael was concerned about healthcare changes. When he reviewed the new rates, he discovered his family's monthly cost actually decreased under his current plan.

Key Takeaway

✅ Not every employee experiences an increase.

Sarah

Employee + Family

Current Enrollment: PCB PPO

2026

• Monthly Cost: $2,306

2027

• Monthly Cost: $3,002

Difference

• Increase: approximately $696/month

Message

Sarah values predictable copays and broader coverage before meeting a deductible. She decides the PPO still best fits her family's healthcare needs and chooses to remain enrolled.

Key Takeaway

✅ Employees still maintain plan choice. ✅ Richer plans remain available.

David

Employee + Spouse

Current Enrollment: HMO

2026

• Monthly Cost: $1,314

2027

• Monthly Cost: $1,763

Difference

• Increase: approximately $449/month

Message

David and his spouse frequently use healthcare services. Although his premium increases, he decides the value of the HMO still matches his medical needs.

Key Takeaway

✅ Healthcare decisions should be based on total healthcare needs, not just premiums.

Jennifer

Employee Only Coverage

Jennifer rarely visits physicians outside annual preventive appointments.

Current Plan

HMO

2026 Cost

• $112/month

New Option

BSP HDHP

2027 Cost

• $0/month

Savings

• $112/month
• $1,344 annually

Message

After reviewing her healthcare usage, Jennifer realized she primarily used preventive services. By moving to the BSP HDHP, she eliminated her monthly premium and retained access to preventive care while building HSA savings.

Key Takeaway

✅ Sometimes changing plans creates significant savings.

Mark & Lisa

Family Coverage

Current Plan

HMO Family

2026 Cost

• $2,352/month

New Plan

BSP HDHP Family

2027 Cost

• $887/month

Difference

• Savings of approximately $1,465/month
• Savings of approximately $17,580 annually

Message

Mark and Lisa carefully examined their healthcare spending over the previous two years. Although moving to the HDHP required more planning around deductible expenses, the premium savings were substantial.

Key Takeaway

✅ Total healthcare costs matter more than premium costs alone.

Andrea

Employee + Children

Current Plan

PCB PPO

2026 Cost

• $1,067/month

New Plan

BSP HDHP

2027 Cost

• $269/month

Difference

• Savings of approximately $798/month
• Savings of approximately $9,576 annually

Message

Andrea's children receive regular preventive care but have few ongoing medical needs. After attending an enrollment meeting and comparing costs, she decided the BSP HDHP better aligned with her family's healthcare utilization.

Key Takeaway

✅ A plan comparison can uncover significant opportunities to reduce costs.

Kevin

Employee + Spouse

Current Plan

HMO

2026 Cost

• $1,314/month

New Plan

BSP EPO

2027 Cost

• $1,328/month

Difference

• Approximately $14/month increase

Message

Kevin wanted to avoid the higher cost associated with the HMO but preferred a traditional plan structure over a high deductible plan. The BSP EPO provided a middle-ground solution.

Key Takeaway

✅ There are options between an HDHP and the highest-cost plans.

Ryan

Family Coverage

Current Plan

PCB PPO

2026 Cost

• $2,306/month

New Plan

BSP HDHP

2027 Cost

• $887/month

Difference

• Savings of approximately $1,419/month
• Savings of approximately $17,028 annually

Message

Ryan initially focused on the deductible difference. Once he reviewed the annual premium savings, he realized those savings alone could offset a significant portion of the additional out-of-pocket risk.

Key Takeaway

✅ Employees should compare annual healthcare costs, not just deductibles.

Option A

Remain in HMO Family

• 2027 Cost: $3,156/month

Option B

Move to BSP HDHP Family

• 2027 Cost: $887/month

Difference

• Monthly Savings: $2,269
• Annual Savings: $27,228

Message

Every family's healthcare situation is different. Open enrollment is the ideal time to compare plans and determine whether another option could better fit your needs and budget.

A: Healthcare costs continue to rise each year, and the cost increases are not equal across all plans. The updated premium structure helps the district maintain affordable coverage options, continue offering multiple plan choices, and ensure the long-term sustainability of the benefits program. The new structure also provides a path to provide lower health care premium costs for dependents and families which was a goal of the District benefits committee.  Finally, the district is increasing its monthly contribution toward employee health insurance from $982 to $1,030.  

A: No. The district is increasing its monthly contribution toward employee health insurance. The changes reflect how costs are shared among different plan options, not a reduction in the district's overall commitment to employee benefits.

A: Different plans have different overall costs. Plans with lower deductibles and richer benefit designs generally cost significantly more than High Deductible Health Plans (HDHPs). The new structure better aligns employee contributions with the actual cost of each plan.  The new structure also provides a path to provide lower health care premium costs for dependents and families which was a goal of the District benefits committee.

A: The district contribution increase helps offset rising healthcare costs. However, for some plans, particularly higher-cost plans, healthcare inflation and claims experience have increased faster than the district's contribution increase.  Additionally, some plans will now be considered a “buy-up” plan and will have an additional cost associated with them.  The new structure provides a path to provide lower health care premium costs for dependents and families which was a goal of the District benefits committee.

A: During open enrollment, employees should review:

• Monthly premiums
• Deductibles
• Out-of-pocket maximums
• Prescription costs
• Provider networks
• Expected healthcare utilization

The plan with the lowest premium is not always the lowest overall healthcare cost, and vice versa.

A: Employees may continue to select any plan for which they are eligible. The district is maintaining multiple plan options so employees can choose the coverage that best meets their needs.

A: No. Employees remain free to select any available plan. However, HDHPs generally have lower overall premium costs, allowing the district to provide stronger premium support while preserving access to multiple coverage options.

A: Every situation is different. Employees should compare annual premium costs, HSA contributions, expected healthcare usage, and potential out-of-pocket expenses before making a decision.

A: A Health Savings Account (HSA) allows eligible employees enrolled in an HDHP to save money tax-free for qualified healthcare expenses. Funds belong to the employee and can roll over from year to year.

A: Unused HSA funds remain in your account and continue to be available for future healthcare expenses.

A: The cost of providing family coverage is significantly higher than employee-only coverage. The updated structure reflects the actual differences in healthcare costs associated with each coverage tier.

A: The changes are not based on an individual's healthcare usage. Premiums are determined by the cost of the plan selected, not how often an individual accesses healthcare services.

A: The district evaluated multiple approaches. The selected model was designed to help preserve affordable options for employees while continuing to offer higher-cost plans for those who prefer them.

A: Employees are not being penalized for their plan selection. The updated structure better reflects the cost differences among available plans while maintaining employee choice.  The new structure also provides a path to provide lower health care premium costs for dependents and families which was a goal of the District benefits committee.

A: Healthcare costs are influenced by many factors, including:

• Hospital costs
• Prescription drug expenses
• Advances in treatment
• Increased utilization of services
• Inflation in healthcare delivery

These trends are affecting employers and employees nationwide.

A: Health plan rates are developed using numerous factors, including overall plan costs, claims trends, demographic data, and projected future expenses. Individual employee claims do not determine an employee's premium.

A: Health plans are evaluated annually. Future premium changes will depend on healthcare costs, vendor pricing, utilization trends, and district budget considerations.

A: The best plan depends on your family's healthcare needs, anticipated medical expenses, prescription usage, and financial goals. Employees are encouraged to attend enrollment meetings and review plan comparison tools before making a decision.

A: Employees managing chronic conditions should carefully compare:

• Deductibles
• Coinsurance
• Prescription coverage
• Provider access
• Annual out-of-pocket maximums

Healthcare usage patterns should be an important consideration when selecting a plan.

A: Not necessarily. Employees should review provider network information for each plan to confirm provider participation before enrolling.

A: The District benefits committee, District administration, benefits consultants, and insurance partners reviewed plan performance, healthcare cost trends, premium projections, and long-term sustainability factors before recommending changes.

A: Yes. Multiple funding and premium-sharing scenarios were evaluated before selecting the model that balanced affordability, choice, and long-term sustainability.

A: The goals are:

• Decrease health care premium cost for dependents and families
• Preserve employee choice
• Protect affordable coverage options
• Increase the district contribution
• Better align premiums with plan costs
• Sustain a strong benefits program over time

A: We understand that any increase can be difficult. While healthcare costs have increased significantly, the district is increasing its monthly contribution and continuing to provide multiple plan options. We recognize that employees will evaluate these changes differently based on their healthcare needs, and we want to help each employee understand all available options before making a decision.

A: District leadership evaluated several approaches before selecting the proposed model. The goal was to create a sustainable funding structure while continuing to offer meaningful employee choice.

A: No. There is no expectation that employees must switch plans. The district's goal is to provide options and information so employees can select the plan that best fits their individual circumstances.

A: That depends on the plan design and your specific healthcare needs. Employees should compare annual premiums, deductibles, HSA contributions, and out-of-pocket maximums to determine which option provides the best overall value for their situation.

A: Please contact one of our benefit coordinators

Andrew Staum, 913-993-6354, AndrewStaum@smsd.org

Jennifer Lumley, 913-993-6497, JenniferLumley@smsd.org