ECISD medical plan committee proposes vendor changes and about 7% average premium increase
Summary
The benefits committee recommended switching medical administration back to Blue Cross and replacing a local pharmacy manager with a national pharmacy manager called in the presentation "Lucy," and proposed an average 7% increase in premiums; trustees heard staff Q&A on diabetic drugs, CT/MRI copays and outreach to high‑cost patients.
Ector County Independent School District officials presented recommended changes to the district employee medical plan for 2026, telling trustees the plan faces rising costs driven by a small number of very large claims and that committee members voted to seek new vendors and modest premium increases to stabilize the trust.
The district’s benefits director, Yolanda Gordon, and medical consultant Eric Smith summarized committee recommendations: an approximately 7% overall increase in health plan premiums, moving the district’s medical administrator from Aetna back to Blue Cross Blue Shield (presenters said that carrier offers greater provider discounts), and replacing the district’s current pharmacy manager with a national pharmacy manager the presentation identified as "Lucy." The committee recommended keeping the district’s HSA option (the tax‑deferred plan) available at no monthly cost to enrolled employees.
Presenters said pharmacy administration will be separated operationally from medical administration, which will produce distinct pharmacy and medical out‑of‑pocket maximums rather than a single combined cap. The pharmacy manager change includes an outreach program: staff said Lucy will contact members on high‑cost therapies to pursue lower‑cost fulfillment options, prior‑authorizations or copay‑assistance programs and noted the district will provide bilingual outreach where needed.
Trustees and members of the public asked for details during a question‑and‑answer period. District staff confirmed that CT scans and MRIs are covered under plan benefits and historically have not been subject to a flat copay; those services are subject to coinsurance after any applicable deductible. Presenters also emphasized the district’s on‑site and virtual care programs (primary‑care clinic and telemedicine), Virta (a diabetes management vendor) and other supports that the committee said reduce avoidable utilization.
Why it matters: the district pays medical claims from a self‑insured trust. Trustees were presented with vendor and benefit changes intended to control rising claim costs while preserving access. Staff said the pharmacy transition and targeted outreach are designed to lower net drug spend and assist employees who require costly medications.
Ending
The benefits committee’s recommendations will be implemented for the 2026 plan year if the board accepts the plan as presented; open enrollment was scheduled to begin October 27 and run through Nov. 21. Staff said in‑person and telephonic enrollment assistance will be made available to employees at district campuses.
