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2026 - 2027

Insurance Open Enrollment

Chippewa Falls Area Unified School District

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Health Insurance

Chippewa Falls Area Unified School District

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Premium (Monthly Cost of the Plan)� The premium is the total cost of the insurance each month. Both you and the district share this cost.

Family Plan: $1,725 per month total�

Employee pays $320/month�
District pays $1,405/month�

Single Plan: $726 per month total�

Employee pays $178/month�
District pays $548/month�

Deductible� The deductible is the amount you must pay for covered medical services before the insurance starts paying.

The CFSD deductible runs January through December each year.

This plan has three deductible levels, which means the amount you pay depends on which provider you see.

Embedded Deductible (Family Plans)�If you are on a family plan, each individual does not have to meet the full family deductible.

Once one person meets half of the family deductible and half of the out-of-pocket maximum, the insurance will begin paying for that individual.

Co-Insurance (Your Share After the Deductible)� After you meet your deductible, you and the insurance share the cost of covered services until you reach your out-of-pocket maximum.

In-Network Providers: You pay 10%�
Out-of-Network Providers: You pay 20%�

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Self-Funded Insurance 101

The Chippewa Falls School District health insurance plan is self-funded. This means the district takes on the financial responsibility for employee health care costs instead of paying a fixed premium to an insurance company.

In a self-funded plan, the district and employees contribute to a shared fund each month. Medical claims, prescriptions, and other health-related expenses are paid directly from this fund as they occur.

This is different from a fully insured plan, where fixed premiums are paid to an insurance company, and that company assumes all risk and pays all claims and keeps all profits or excess funds.

A helpful way to think about our plan is as a bucket of money. Employees contribute through premiums, and the district contributes significantly more on behalf of each participant. From that bucket, we pay for:

Medical and prescription claims
HSA contributions
Stop-loss insurance
Administrative services (Point C)
Programs like the Cardinal Healthy Primary Care Clinic, Teladoc, Solarte and other cost-saving services

If that bucket runs low—which has been happening—we must get funding from Fund 10. Fund 10 is what pays staff wages, so using those dollars for insurance impacts the district’s ability to fund salaries.

Because we are self-funded, we are required to carry stop-loss insurance and use a third-party administrator. Stop-loss insurance protects the plan from extremely high-cost claims. Once an individual’s claims reach $150,000 in a year, the stop-loss coverage takes over and pays additional costs. Our third-party administrator, Point C, helps manage the plan, ensure compliance, and provide guidance.

There are important advantages to being self-funded. For example, the district was able to go 11 years without increasing premiums. In a fully insured plan, rates typically increase every year regardless of actual costs. With self-funding, when claims are lower, we can keep savings in the fund to offset higher-cost years.

Another advantage is flexibility. We can offer programs that help employees access affordable care. These include the Cardinal Healthy Primary Care Clinic, Teladoc, and partnerships that provide lower-cost options for services like imaging and prescriptions.

Using these options benefits everyone. It reduces out-of-pocket costs for employees and helps preserve the shared fund. For example, a visit to the clinic is $25, compared to several hundred dollars elsewhere, and lab work there is free.

When these cost-saving options are not used, expenses increase significantly. Last year alone, nearly $196,000 was spent on visits that could have been handled at no cost through the clinic. Similarly, some procedures—like colonoscopies—can vary dramatically in cost depending on the provider, even when they are covered for the individual.

While these choices may not impact the individual immediately, they do affect the overall plan. Higher costs lead to increased premiums and deductibles for everyone.

Health insurance is one of the few areas where we can directly influence costs as a group. With declining student enrollment and reduced funding, we must be more mindful of how we use our health care dollars. The plan is currently facing a $2 to $2.5 million deficit. Recent changes will help reduce that, but long-term improvement depends on all of us making cost-conscious decisions.

By using the cost-effective options available, we can reduce the need to borrow from Fund 10, help stabilize premiums, and preserve resources for staff wages.

If you have questions or need help finding the best care options, the Human Resources team is here to help. You can reach us at humanresources@chipfalls.org or by phone at 715-738-2660, extensions 1902, 1901, or 1804.

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Insurance Rates June - December 2026

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Insurance Rates January - May 2027

Effective January 1, 2027, when deductibles reset, participants will see increases at all tier levels:

Tier 1 (Marshfield Clinic/Solarte Providers) – $500 increase per year for single/individual plans and $1,000 per year for family plans. These providers offer the largest discounts to CFSD participants. �
Tier 2 (Mayo & Oak Leaf Providers) – $1,000 increase for single plans and $2,000 for family plans. These providers offer moderate discounts.�
Tier 3 (Out-of-Network Providers) – $1,500 increase for single plans and $3,000 for family plans. No discounts apply for these providers.�

Important: Our deductibles are embedded, meaning if one person on a family plan has medical expenses, they only pay the individual deductible. The remaining family members share the rest, if applicable.

CFSD also offers multiple healthcare options to help participants manage or avoid meeting the full deductible.

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Performance Review & Opportunities

check_circleKeep Doing Great Things

87%

Clinic Utilization

High engagement shows employees are actively using the Cardinal Healthy Clinic.

trending_up49% Annual Wellness Visits

Strong trend in preventive care helps identify health issues early.

arrow_downwardReduced ER & Urgent Care Visits

Successful shift towards utilizing the Clinic and Teladoc, avoiding expensive emergency costs.

error_outlineRoom for Improvement

Primary Care Leakage

$196,000

Spent on office visits at Mayo Clinic that could have been handled at Cardinal Healthy Clinic.

$276,297 in Labs completed at Mayo/Oak Leaf

$218,400 in X-Rays, CT’s and MRI’s completed at Mayo/Oak Leaf

Specialty Care Cost Comparison

Colonoscopy Costs:

Going to Local Tier 1 and Tier 2 Providers is much more costly than going to MNGI!

$2,500 - $3,000 — MNGI

Keep Doing Great Things

Clinic utilization is at 87%, which is outstanding. This shows that employees are actively using Cardinal Healthy Primary Care Clinic, our most efficient and cost-effective option for care.
Wellness visits are also trending in the right direction, with 49% of individuals completing their annual physicals. This is important because preventative care helps identify health issues early, leading to better outcomes and significantly reducing the likelihood of high-cost claims. Our incentive program, including the wellness drawing, is helping drive that engagement.
We’re also seeing a positive shift in how care is being accessed. Urgent care and emergency room visits are down, which indicates that more individuals are choosing Cardinal Healthy Primary Care Clinic and Teladoc for their care needs instead of defaulting to higher-cost settings.
These are strong indicators that our current cost-saving methods are not only effective but are improving overall health outcomes. Continuing to utilize these options will help us maintain quality care while managing costs responsibly for everyone.

Room For Improvement

Last year, our plan spent nearly $196,000 on office visits at Mayo Clinic—services that could have been provided at Cardinal Healthy Primary Care Clinic at a significantly lower cost.
When we compare providers, the difference is substantial. Care at Mayo Clinic costs about 38% more than Marshfield Clinic and nearly 100% more than Cardinal Healthy Primary Care Clinic. These higher costs directly impact the overall health plan and its long-term sustainability.
To put this into perspective, a colonoscopy at OakLeaf Medical Network can cost around $25,000. The same procedure is available for approximately $2,500 at MNGI Digestive Health or $3,000 through Solarte providers. While preventative services like colonoscopies are covered at no cost to the patient, choosing a higher-cost provider results in an additional $22,500 expense to the plan for a single procedure.
By utilizing the cost-saving options available to us, we can significantly reduce unnecessary spending while still receiving high-quality care. These savings allow us to better manage our resources and maintain strong, sustainable benefits for everyone.
At the same time, improving the overall health of our population remains a priority. We strongly encourage consistent preventative care visits, as early detection and treatment lead to better outcomes and lower costs over time.
Making informed choices about where we receive care benefits not only the plan, but all of us who rely on it.

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Why You Should Use the Cardinal Healthy Primary Care Clinic

The clinic was created to help control healthcare costs while providing convenient, high-quality care for all district insurance participants. By using the clinic, you help the district save money—and more usage means even greater savings for everyone.

The clinic provides all primary care services, including doctor visits, lab work, and carried medications, all for a low copay that counts toward your deductible and out-of-pocket maximum. Preventive visits are always free.

CFSD covers the clinic’s operating costs and the service fees, so the clinic is available to all eligible employees, whether you use it or not. Currently, 87% of eligible participants are using the clinic, which has already saved the district millions in lab costs.

Using the clinic is an easy way to get care, save money, and help the district keep healthcare costs down for everyone.

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Preventive care is one of the most effective ways to maintain your health and reduce overall healthcare costs. Early detection through annual physicals and routine blood work often prevents more serious medical issues later, which can help limit the need for higher-cost interventions and, in turn, reduce the likelihood of insurance rate increases.

We strongly encourage all participants to complete their annual physical and blood work. To make this even more rewarding, CFSD offers an incentive program: each quarter, participants who complete their preventive care at the clinic are entered into a drawing for $1,000. Last year, only about 42% of participants had their physical at the clinic—so your odds of winning are excellent! Spouses with CFSD insurance who complete their preventive care at the clinic are also eligible for the drawing.

These incentives aren’t just about money—they save lives. For example, Dr. Joles was able to identify and intervene on several serious, previously unknown medical conditions for participants who completed their preventive care thanks to the incentive program.

Don’t wait—schedule your preventive care today. Your health matters, and taking action now can make a real difference for you and our participants.

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Programs to Help Reduce Deductibles

CFSD participants have access to programs that can help lower out-of-pocket costs and provide financial incentives:

Solarte – Covers secondary care such as MRIs, CTs, ultrasounds, X-rays, surgeries, and specialty care (OB/GYN, orthopedics, podiatry, etc.).�
MD Direct – Required consultation for any non-emergency orthopedic procedures.�

These programs help participants avoid meeting their deductible for diagnostic care and offer financial incentives to offset costs when surgeries or additional procedures are needed.

Remeber Solrate works differently than Alithias, you can go to the solarte site and view the providers and schedule your appointment directly with them, just let them know at the time of service that you are with Solarte, if an order is necessary any doctor can send the order to the Solarte provider directly it is not required to be sent to Solarte. This is recommended to expedite the process. You do not need to do anything after the visit to receive the incentive. Solarte will bill you directly.

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Health Insurance Shopping Tips

How much will your annual premiums cost? CFSD family plan = $3,840 a year and the single plan = $2,136 a year.

How much is your annual out of pocket maximum? CFSD family plan $8,500 ($4,500 for an individual) $4,500 for single plan. (This is the most you pay in a year for covered expenses, if you have large medical expenses and are seeing a Tier 1 in-network provider.)

How much is the health savings account contribution per year? CFSD family plan = $2,314.80 single plan = $902.64

Compare how likely or what tools the plan offers to help you avoid meeting the deductible and how likely you are to meet the deductible with or without the tools.

Compare the plan(s)to see which would cost the most in a year where you have many medical expenses: Annual Premiums ($3,840) + Out of Pocket Maximum ($9,000) - HSA contributions ($2,314.80) = Total Maximum Annual Cost $9,121.20 if you were to have two or more family members with major medical issues in a year.

**Examples are for Tier 1 2026 calendar year Click here for the insurance rate sheet.

Click here for a plan comparison tool

Click here for a video on how to use the plan comparison tool.

We know this is a lot of information, and it can feel overwhelming or frustrating. You may even be thinking about dropping CFSD insurance. That’s okay—we want you to make the choice that’s best for you. Our goal is to help you make an informed comparison if you’re looking at other plans, whether it’s a spouse’s plan, a plan on Healthcare.gov, BadgerCare, or another option.

To help, we’ve created a worksheet and a short video to guide you through comparing plans. You’ll need to make a copy of the worksheet in your Google account to use it. If you need help logging in, contact the Help Desk at 715-738-2660 ext. 5555 (or dial 5555 from a district phone).

Things to consider when comparing plans:

Annual premiums: How much will the plan cost you for the year?�

CFSD: $3,840 for family / $2,136 for single.�

Deductibles: How much do you have to pay before insurance starts helping?�
Out-of-pocket maximums: What’s the most you could pay in a year if something serious happens?�
Employer contributions to your HSA: How much is CFSD putting in to offset costs?�
Likelihood of meeting deductibles or out-of-pocket maximums: Are there tools to save money?�

CFSD offers:�

Cardinal Healthy Primary Care Clinic – all visits just $25, even for stitches.�
Teladoc – 24/7 virtual care.�
Solarte – low-cost diagnostic care.�

Timing: Have you already met your deductible or are close? Switching plans mid-year could mean meeting two deductibles in one year. Keep in mind:�

Spouse’s open enrollment is a qualifying event—you can switch during their period.�
Most employers’ open enrollment is in October/November for January coverage. CFSD’s is in May for July coverage.�

Using this guide, you can compare “apples to apples” and make the choice that works best for your family.

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Dental Insurance

Chippewa Falls Area Unified School District

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Dental rates:

Family Plan - $82/month - $41/check

Single PLan - $26.50/month - $13.25/check

Dental Insurance Shopping Tips:

How much will the plan cost for a year? CFSD $984 for family and $318 for single.

How much is the annual maximum coverage? $1,000

Does preventative care count towards your annual maximum? No

Click here for Enrollment Resources

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Vision Insurance

Chippewa Falls Area Unified School District

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Vision Rates

Family Plan - $16.34/month - $8.17/check

Single Plan - $6.58/month - $3.29/check

Vision Insurance Shopping Tips:

How much will the plan cost for a year? CFSD $196.08 for family and $78.96 for single.

Annual Exam Coverage? CFSD plan has a $20 copay

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Short-Term Disability

Chippewa Falls Area Unified School District

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Short-Term Disability

Rates

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