Who pays if a plan’s claims exceed what was collected?
It depends on the plan documents, the funding arrangement and the law that applies. In the Idaho case, the participating districts were required to share the shortfall. Before joining or staying in any pooled or self-funded arrangement, ask who bears an overrun and read the documents that say so.
It depends on the documents and the law
The answer sits in the plan documents, the funding arrangement and the law that applies. In the Idaho case, the participating districts were required to share the shortfall.
Before joining or staying in any pooled or self-funded arrangement, ask who bears an overrun and read the documents that say so.
Where to go from here
Plan stop-loss alongside the change
How specific and aggregating deductibles behave when a plan changes.
Consider level-funded and self-funded options
When a different funding arrangement is worth testing.
Send us your renewal
Share the renewal and plan documents and we will tell you what to test.
More questions on this topic
What happened with the Idaho School Benefit Trust?
The Idaho Department of Insurance said the trust told districts on August 20, 2026 of a funding shortfall for the 2025-2026 plan year, which it attributed to higher-than-expected medical and dental claims.
Is this an example for private employers?
The Idaho trust served public school districts, which are outside our work.
What should I ask before choosing a self-funded or level-funded plan?
Ask what stop-loss attaches and at what level, how claims and reserves are reported to you, what happens in a bad year, and who is responsible for an overrun.
Where these details come from.
Facts on this page come from these public sources.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.