SchoolCare ordered to continue covering Dover school employees

A recent court ruling ensures Dover School District employees will have their health claims paid through the end of the school year, despite an ongoing legal battle over a $1.7 million bill to the district.

On Thursday, a Strafford County Superior Court judge ordered the health insurance risk pool SchoolCare to continue providing health coverage to district employees through June 30.

The Dover School District and its superintendent, Christine Boston, sued SchoolCare in April for requiring its members to pay a surprise assessment or face a lapse in coverage.

Anthony Carr, the attorney representing Boston, said the court order “clearly shows the merit of our case against SchoolCare” and shows the other 89 SchoolCare member entities may be able to recoup money from the assessments issued in October.

“SchoolCare forced towns and school districts across this state to pay an almost 30-million-dollar ransom — just to ensure our educators and other district personnel could maintain the health care coverage that they were already guaranteed under contract,” Carr said.

Organizations put money into risk pools so they can afford to cover all their employees’ medical claims, even the more expensive ones.

SchoolCare members typically add money to the pool through premiums due at the beginning of the month. But in October, they were all issued an unexpected additional assessment. Some of the bills were higher than $2 million.

In the aftermath of the COVID-19 pandemic, SchoolCare needed another $30 million to avert a $4.5 million deficit in the risk pool and replenish the organization’s cash reserves.

The $30 million cost was shared among the 90 school districts and municipalities in the SchoolCare network based on their health insurance expenses, with the Dover School District receiving the third-highest individual assessment at $1.7 million.

The unexpected costs from SchoolCare caused budget crises across the state, Carr said, and many teachers and staff were laid off as a result.

If member entities refused to pay their share of the assessment, the risk pool said it would deny their health care claims starting May 1, according to court documents.

The Dover School District is the only SchoolCare member entity that hasn’t paid or agreed to pay. The Dover School Board said it had insufficient funds at its April 2 meeting and described the assessment as “unlawful” and “coercive.”

In an April 30 ruling, Superior Court Justice John A. Curran granted the school district’s and Boston’s request for an injunction preventing SchoolCare from denying individuals’ claims before the end of their contract with the district on June 30.

“If SchoolCare institutes a claims hold or begins outright denial of claims, covered individuals will face an uncertain situation in which they may have to decide between risking paying for a procedure, appointment, or medication out of pocket, or forgoing this medical care altogether,” Curran said.

Approximately 380 Dover School District employees and 113 retirees are enrolled on district health plans, plus many of their spouses and children, according to a Friday news release.

The court order will continue their coverage and prevent them from having to pay their medical costs out of pocket.

The injunction doesn’t end the legal battle, however. The school district and Boston are still challenging SchoolCare’s authority to impose the October assessments in the first place.

The Dover School District will not renew its membership with SchoolCare in July. Instead, it will switch to HUB International, a Chicago-based insurance brokerage, which will continue district employees’ health plans through Cigna.

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