'Strange' scenario haunts school district budget

By FRANK SCHULTZ ( Contact )   Wednesday, Aug. 20, 2008
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— They call it "The Gap."

They also call it a mystery.

The Gap is about $3 million this year. That's the amount the Janesville School District over-estimated the cost of its self-funded employee health insurance plan last year.

The overage was the biggest in 10 years.

The money gets plowed back into the district's coffers. Having extra money is a good thing, but teachers have complained.

Teachers point out that The Gap cuts into funds that could be boosting their salaries, because of the way the state requires that teacher pay and benefits be bargained.

The Gap has been an open sore in recent contract negotiations, so school board member Tim Cullen asked the administration to explain what's happening.

That's what Tuesday's meeting was about. Members of the teachers union as well as school board and administration were at the table to hear from the district's health-coverage consultants.

The consulting company is Mortenson, Matzelle and Meldrum, also known as M3. The district pays M3 $36,000 a year for its services.

M3 sent three men to explain The Gap. These are men used to actuarial tables and statistical analyses. They used words such as "phenomenal," "startling" and "astounding" to describe the situation.

"A confluence of very strange things occurred," said risk manager Robert Karp.

One of those strange things was unusually large savings from discounts through The Alliance, a health-care buying cooperative the district belongs to. No one is sure why.

The teachers and district have worked for five years on improving employees' health, teacher Jim Reif said. Could that be the reason?

Employee health programs work, but they don't account for one of the biggest factors creating The Gap: the fact that employees had so very few high-cost health catastrophes, Karp said.

M3 asked The Alliance and the health plan administrator, URM, to analyze the situation. Neither could explain the dearth of high-cost claims.

M3 account executive Kevin Clougherty said one factor could be an active district-employee committee that shares information about costs with employees. That effort results in employees becoming wiser consumers of health care, saving on costs, he said.

But that can't totally explain The Gap.

Could it be the exodus of older staff being replaced by younger people, asked school board member Lori Stottler.

That has an impact, but it doesn't explain the $1.4 million in claims that the insurance administrator declared ineligible for payment in the last year, Karp said.

Employees don't appear to be absorbing those ineligible claims, so they're being absorbed by the providers, are being deemed medically unnecessary or are being paid by Medicare or Medicaid.

In the end, the consultants couldn't promise that The Gap wouldn't appear again a year from now. But their projections are based on the two previous years' claims experience, they said, so the recent dip in claims should reduce their projection.

The district already has dialed down its insurance estimate for the coming year, and there's a proposal on the table to cut $300,000 more from the insurance budget in an effort to ease the tax burden.

One thing is sure, the M3 consultants said: If the district bought insurance rather than set up a self-insured plan, and if the employees' good health delivered millions of dollars in savings, the district would never see a penny of it.

Instead, the over-estimates have kept district finances in great shape.

The Gap, Clougherty said, "has been a gold mine for this district for over three years."







reader COMMENTS (22)
rocksolid
Aug 28, 2008 at 10:32 a.m.
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Why Teach: The board did approve a "Insurance Reserve Fund" of about 3.5 million dollars a couple of months ago. This amount is part of the "fund balance". We also approved percentage guidelines as to how much is prudent to keep in the fund balance to avoid borrowing and keep our bond ratings strong etc. I hope that answers yor question.

Bill Sodemann

caddyshack243
Aug 24, 2008 at 9:05 p.m.
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Rocksolid: with all due respect:

1. When one of your daughters comes home stoned, drunk, or you catch her in a compromised position with her boyfriend, let us know how the “Everybody else is doing it” defense plays out.
2. Ownership. The JSD already budgets $1300+ per month per JEA member for insurance, and this year it will grow to $1500+ per month. This money comes from the salary and benefits package, which by law, must be combined. Since the JSD has overcharged the JEA $3 Million alone this past year, money which could have been contributed to the salary schedule, I believe I have plenty of ownership already.
3. The wellness plan, which sounds like you have a big concern for my overall well-being, at this point merely consists of a basic health risk assessment. The District has no plan, no effort to meet my individual needs. Many JEA members, due to the lack of trust towards the JSD, fear the only concern the JSD has for the health assessment is to use the results of the health risk assessment against the JEA in future bargaining sessions.
4. True statement. Employees may as well use the District insurance because the money is taken out of our package anyways. Now, if JSD initiated a program like some surrounding districts where spouses can receive that insurance premium in the form of a TSA or even a cash payment, then you may see some employees opting out of the JSD insurance.
5. True statement. Our salaries are higher. However, the insurance premiums have further opened a door to higher premiums (which mystifies even your own consultants) and further resentment towards the JSD and Board of Education. We will again be at the bargaining table this school year, and I fear the JSD will most likely follow its own history of offering a contract with further concessions and a hardball take-it-or-leave-it attitude.

Why_Teach_in_Janesville
Aug 23, 2008 at 9:50 a.m.
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Rocksolid,
I was hoping I could get a response from you about the insurance account that was set up. Please refer to my previous post. Thanks

Bealab
Aug 22, 2008 at 11:53 p.m.
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Yikes-After reading your comment again, I think you misunderstood my comment about the recent college grad who was making $50,000 plus benefits a year right out of school with only a bachelor's degree. If you read it again, I'm comparing that person to a teacher who would have to work MANY years and get a master's degree before he/she would be making a similar salary.

Bealab
Aug 22, 2008 at 10:31 p.m.
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Yikes,unfortunately there are very few teachers who have the summer off. Many have to teach summer school or take another job to make ends meet. If they aren't doing one of these two things, many teachers spend their entire summer AND THEIR OWN MONEY taking college courses to either keep their certification or to attempt to go up on the pay scale. When it comes right down to it, however, perhaps we should examine the amount of TIME put into the job during those nine months. I guarantee you that most teachers in those nine months put in so many extra hours that it would surely equal an additional three months if not more. Let's just think about June, July, and August as well earned comp. time.
P.S. - It's not a full three months by the way. More like two months with the late finish in June and the fact that most teachers go into their classrooms in mid-August, if not sooner, to prepare for the upcoming year.

Why_Teach_in_Janesville
Aug 22, 2008 at 10:01 p.m.
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yikes,
I agree with you, what I am saying is teachers understand this and can deal with the lower pay if the benefits are good. Take away the benefits and you will start losing good teachers, present and future.

yikes
Aug 22, 2008 at 9:44 p.m.
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No matter what their reason for teaching is, time off is an incredible benefit - it should be treated as such when determining pay.

Why_Teach_in_Janesville
Aug 22, 2008 at 9:32 p.m.
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Yikes,
You are correct, time is a valuable thing. That is why I said one of obvious reasons "some" teach is for the summers off. But they know going in that they aren't going to have the greatest pay but they are under the impression the benefits (insurance) are good and that they can live with the low wages as long as there are good benefits. That is why I said if schools start taking away the benefits the ambitious teachers will leave and college students will not take up the proffession.

yikes
Aug 22, 2008 at 9:21 p.m.
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Bealab - your comparison isn't a good one, unless of course that college grad has 3 mos. vacation a year. I don't know of many companies that do that...
*
Time is a very valuable thing, so you can't compare someone's salary who works all year to one who doesn't. If that teacher worked full time all summer then you have a better comparison.

Bealab
Aug 22, 2008 at 8:49 p.m.
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One final comment. Teachers are tax payers in this city too. Rock Solid, you seem to forget that fact.

Bealab
Aug 22, 2008 at 8:41 p.m.
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I agree with Why Teach on this one. Compare the salary of someone with a master's degree and 30+ credits to a teacher with the same amount of education. BIG DIFFERENCE! I met a recent college graduate with just a bachelor's degree who was making $50,000 dollars a year plus benefits. Do you know how many years it takes teachers to make that amount of money? And, that's after they PAY for all the credits needed to go up on the pay scale THEMSELVES. For years, teachers have taken lower salary increases to maintain decent health insurance. Now, that is even being threatened. Furthermore, Rock Solid, you challenge Why Teach to leave the profession if he/she is not happy. I would challenge you to leave the school board if you have that much animosity towards teachers. It's quite clear by all your statements, your voting record, etc. that developing a positive relationship with teachers is not one of your priorities.

Why_Teach_in_Janesville
Aug 22, 2008 at 7:21 p.m.
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rocksolid,
Never did I say I was unhappy in my position. I like my job and the students. The handle, Why teach, is in reference to the public opinion of teachers in general in this town and the disrespect of teachers by the district personel.
As for your reference to spouses jumping on the insurance plan. Why wouldn't they? Teachers haven't had the option to opt out of the insurance plan if thier spouses had better coverage at their employer.
You are right the raise does cover the cost of the premium and not much more.
As for the insurance fund that was set up. How much was put in it? Are you dumping the 3 million from this year into that and is that money available in case of a shortfall or will the teachers be frozen again?
AS for ownership, I think the teachers have shown a pretty good example of ownership considering the consultants can't even explain why the claims have been so low.
One last thing I would like people to know. Teachers teach for one main reason, they want to positively affect the future of the students they teach. Secondary reasons are, excellent benefits and obviously time off in the summer. As you start to take these secondary things away you are going to lose good teachers who can leave this district and enter the business world and make more money. More than enough to pay more for benefits such as insurance. So while comparing the rest of the working world to teachers, why don't you compare apples to apples. Compare people with the same education level and their pay. Then you will see that they can more than afford to pay premiums.

rocksolid
Aug 22, 2008 at 6:26 p.m.
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why teach: FYI - We did establish an insurance reserve that is part of our fund balance.

rocksolid
Aug 22, 2008 at 6:24 p.m.
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Why Teach: I will give you a few reasons.

1. Why not? The rest of the world does, why not teachers?

2. Ownership. By paying a portion, hopefully the value of the insurance becomes more apparent.

3. Method to encourage people to partake in the wellness plan. If you partake in the wellness plan, your pay 3% versus 8% of the premium. If insurance is always given to you for nothing, there is no financial incentive to partake in the wellness plan. The more who partake in the wellness plan, the healthier we are which results in lower costs.

4. Chance that some employees will choose their spouses plan instead. As it was, if anyone is married to a teacher, they are going to forego the insurance that is offered by their own employer because they know that the coverage will not be as good as the districts and it is free as compared to what their employer is making them pay (my employees pay 10%$-20% of their premiums). Perhaps in the future (as plans become more comparable) not all spouses will jump on the districts insurance plan.

5. It is better for the teacher because we provided an additonal raise that more than covers the cost of the premium. This means that you have a larger salary than what you would have had. This means that more money is put into your retirement account (by the taxpayers) so your pension will be higher. Why wouldn't you want that?

If I can make a sincere comment. If your name implies that you can think of no good reason to teach in Janesville, perhaps you should do some soul searching and find a career or a district that does not offend you. Life is too short to be so unhappy in your job. Are you not able to find anything positive about your work and the people you work for? When times are tough like they are now, we should think about what is good about our jobs, lives, family etc. and be thankful.

Hoping you have a fulfilling year.

Bill Sodemann

Why_Teach_in_Janesville
Aug 22, 2008 at 5:25 p.m.
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Mr. Sodeman,
So why is it that the teachers need to pay premiums? Why should they pay out of pocket to add to the huge insurance surplus which then adds to the "general fund"? Yes I do agree that there should be some extra at the end of the year but shouldn't that money be rolled over into a seperate account to compensate for the "few" years that there has been a deficit instead of "freezing" the teachers on the payscale to make up the money? I believe this happened 5-6 years ago. Last time there was a deficit.

rocksolid
Aug 21, 2008 at 11:29 a.m.
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whoops - typo - meant "lately" not "lateley"

rocksolid
Aug 21, 2008 at 11:23 a.m.
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Let's keep in mind some of these facts.

1. The premium rate that we charge ourselves for our plan is much less than what it would be if we were not self insured. If it were higher, then I would admit that JEA has a gripe.

2. If we were not self insured, we (the district and taxpayers) would not have any claim to the savings. The insurance company would keep it in the form of profits and say "thank you very much" to us.

3. The premium rates are set using industry standards that take into account our claim history. It would be illegal for the district to set false premium rates. Where my company saw a 16% increase last year, the district rates were virtually unchanged.

4. The rates that were set by the district were BELOW the recommendations from the consultants!

You would think that we would be joyous over such information because it means that our teachers are healthier, taht we have had very few major medical issues and that the taxpayers can catch a break as well.

Let's not turn good news into bad news. We have had enough bad news in Janesville lateley.

Sincerely,

Bill Sodemann

garyprimer
Aug 21, 2008 at 9:31 a.m.
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It's no mystery. You are just seeing how much money health insurance companies make.

Bealab
Aug 21, 2008 at 12:22 a.m.
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Perhaps this is the reason that 42% of the teacher's union voted against the current contract. Perhaps this is also the reason that teachers' trust in the district is at an all time low - year after year...surplus after surplus...interest upon interest. Yet, teachers will be paying part of their insurance this year even though it is clearly NOT needed. I hope this ongoing deception will be remembered by the teachers and the public when negotiations begin again this year.

Why_Teach_in_Janesville
Aug 20, 2008 at 9:13 p.m.
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Good thing the teachers agreed to add to this "Gold mine" by paying premiums this year. Now the district can lower its insurance estimate and still make up the difference by charging the teachers. Surprise, surprise they are going to cut $300,000 from the estimate yet will make $400,000 on premiums payments from the teachers. They are just trying to pull the wool over the eyes of the public again and make it look like they are doing what is in everyones (except teachers) best interest. Can't wait until the next contract to see what excuse the district uses when it tries to raise the premiums. Oh wait, they won't need an excuse except that "everyone else is doing it". The same rationale they used when convincing the union to start paying them this past round of "negotiations".

MooShoo
Aug 20, 2008 at 7:22 p.m.
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An ode to M3 based on an old nursery rhyme.
*
Three blind men. Three blind men.
See how they run. See how they run.
They all ran after they caused such strife
The school board cut off their tails with a carving knife.
Did you ever see such a thing in your life
As three blind men?
*
I can just imagine the three stooges up in front of the school board. When asked to explain "the gap" Moe responds:
"its freaking ASTOUNDING, what do you think Dr Curly?"
"Why Dr. Moe, its more PHENOMENAL than virgin birth! Anything to add Dr. Larry?"
"Why of course Dr. Larry, we all deserve a poke in the eye, a boink on the head, and a kick in the goin, this is a STARTLING revelation! Have we cashed the consulting check yet?"
*
There is absolutely nothing I can add to the closing comment in this story by the consultant. The Gap, Clougherty said, "has been a gold mine for this district for over three years".
*
This folks, will cost the School Board a fortune in good will with its teachers for a long, long time.

kivsquest
Aug 20, 2008 at 10:11 a.m.
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Maybe the district should get rid of the consulting firm and do the addition themselves

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