Frequently Asked Questions

The Bucks and Montgomery County Health Care Consortium is comprised of 11 school entities within Bucks and Montgomery counties. These school entities have joined together in a unique self-funded arrangement as a large group purchaser of medical insurance, prescription drugs and other employee benefits. The purpose of the arrangement is for consortium members to group together to get the best price possible for health care and employee benefits while also focusing on collectively improving employee health and wellness, potentially leading to even greater cost savings.

Our mission is to manage and control the rising health care costs while maintaining quality health care.

Our guiding principles are:

• Attract new members and retain BMCS members
• Develop new and innovative health plan designs
• Achieve greater cost savings
• Meet member needs
• Engage members and develop innovative health and wellness programs
• Target the specific needs of BMCS members
• Institute aggressive wellness and disease management programs
• Ensure programs are being managed effectively and efficiently
• Monitor and address the Patient Protection and Affordable Care Act (ACA)
• Minimize the adverse impacts of the ACA

School entities that decide to join the consortium may join with the health plans they currently offer. Within 120 days, if not sooner, of joining the Consortium, the school entity must migrate to the four preferred medical plans.

In future years, recognizing that significant changes to the health care industry are on the horizon, the trustees will collectively determine if new and/or different medical plans should be offered. The goal will be for the Consortium to consistently offer three or more medical plan options for its participants.

Through collaboration between Labor and Management, BMCS has achieved over $81 million in health care savings based on decisions made since BMCS's inception. While savings for individual school entities vary, all members have received some savings over their previous health insurance programs. Savings are achieved from: self-insurance funding; collective purchase of stop-loss insurance; reduced retention (carrier expenses), streamlined collection of premiums and reconciliation of accounts, as well as our partnership with Aetna for medical administration and Capital Rx for prescription administration.

Continued future savings are expected to be achieved by Labor and Management working jointly together to educate employees and develop inventive health and wellness programs targeted at the specific needs of consortium members; developing new and innovative health plan designs that achieve greater cost savings while still meeting member needs; and maintaining control over health plan reserves enabling maximization of investment income.

The Consortium is self-insured for stop-loss retention on individual medical and pharmacy claims up to $1M. Each participating school entity is able to select from one of three individual stop-loss deductibles. Budget/renewal increases will be blended between the school entity and the Consortium thereby mitigating wide budget fluctuations from year to year. The claims experienced above this deductible up to $1M is pooled across the Consortium (e.g., self-insured). Additionally, as a safeguard for the school entities, stop-loss protection is purchased for individual health insurance claims above $1M.

Monthly premium equivalent rates will be developed for each participating school entity based on their enrollments, risk, and claims experience plus their shared portion of administrative fees and stop-loss insurance premiums.

Each school entity that participates in the consortium and has all consortium documents signed and approved by their Board by the deadline, will be guaranteed a management trustee seat. The school entity may appoint one Management representative or a School Board member to the consortium trustee board. For each school entity that participates in the Consortium there is a designated labor seat on the board as well.

Labor and management (union and employers) have equal voting strength at all trustee and committee meetings.

Please contact us for more information.