SOUTH BEND -- These days, South Bend schools bus driver Linda Frick feels like she's working primarily to buy health insurance.
She's paying more than $300 every two weeks for the nine months she's employed for coverage for herself and her husband for the year.
Fellow bus driver Betty Kolacz is in a similar position.
She recently stopped taking one of her prescription medications because it went from costing $4 a month under her old health insurance plan to $30 a month under the new one.
"With gas prices going up, the cost of living going up, no raises," said Carolyn Miller, another driver, "it's getting to the point where it doesn't pay to work."
This fall, the school corporation overhauled its health care benefits.
Premiums went from about $150 to $210 a month for a single employee.
The family plan, which was roughly $350 a month, is now nearly $600, though an optional plan, which has a higher deductible, is available for less.
School district officials say the changes were unavoidable.
Curt Novotny, human resources director, pointed for one, to a new law -- HEA 1260 -- which puts a cap on the amount school districts can pay toward employee health insurance.
In addition, he said, the school corporation, which is self insured, experienced an increase in the number of very high -- more than $250,000 -- medical claims last year.
The decision to switch plans and add different tiers of coverage -- for an employee plus children, but not spouse, for example -- was made by a committee of 13 administrators and members of various unions that represent district employees.
In the end, the committee voted on the carrier option of its choice after reviewing several.
Novotny said the new premiums are admittedly higher, but employees will have help from the insurance company shopping for health care services.
"On our old plan," he said, "there was no incentive to do that ... It's a different mindset."
Another new benefit that's coming is one that employees might actually look forward to.
The district is in the process of reviewing bids to hire an operator for an on-site or near-site medical clinic it expects to open this spring.
It'll provide primary care services, including physical exams and immunizations, as well as generic prescriptions, all for free to covered employees.
Novotny said it's possible it could also open to employees who don't carry the district's health insurance and in the future, even to the community, on a fee-for-service-based system.
The clinic will likely result in the district lowering its medical costs, Novotny said, by potentially decreasing the number of emergency room visits employees make.
Providers at the clinic will also focus on wellness-related services, which ultimately bring down health care costs, too.
The insurance committee received seven bids from organizations that wish to run the clinic. Those were narrowed down to two, Novotny said.
A representative from one of the bidding companies -- Novia CareClinics -- participated in some of the insurance committee's meetings.
"He wasn't in on every meeting," Novotny said.
The Novia representative provided information to the committee about how an on-site clinic would work with the insurance company.
"We had to have an idea," Novotny said.
A recommendation on a specific provider to run the clinic will be made to the school board next month, he said.
After the board chooses an operator, it'll likely take three to four months before the clinic will open.
As for HEA 1260, meanwhile, the new legislation that requires that school districts' costs for health insurance not exceed the state of Indiana's health plan costs by more than 12 percent, State Rep. Tom Dermody, R-LaPorte, was a sponsor.
In a phone interview last week, he said the legislature had been considering in recent years mandating that all schools join the state plan.
Dermody said he didn't agree with that, but he does believe that many schools in the state have struggled to pay for health care.
"It's taxpayer money," Dermody said, "so let's stay competitive. But within that, let's give them as many options as possible," he said his philosophy has been on the issue.
When told of the premium rate increases in South Bend, Dermody wondered, "Are they being as competitive as possible? Have they looked at everything possible?"
On the east side of St. Joseph County, Penn-Harris-Madison School Corp. was over the allowable limit on health insurance costs by 3 percent in 2011, Teresa Carroll, a spokeswoman, said.
District officials are aware of the timeline associated with law, she said, and may have to make changes to the health insurance plan in the future.
In Mishawaka schools, a spokesman said the district is already compliant with the law as it relates to health insurance costs.
In South Bend schools, employees will have until the end of the day on Tuesday to make their new health insurance elections.
Novotny said there currently are not credits available to reduce premiums for those who are non-smokers or who participate in wellness programs.
"But at some point," he said, "we'd like to do that if we have money available."
Staff writer Kim Kilbride: