McAllen ISD staff propose single health plan, deductible increases and 340B mail-order program to address $4.8 million shortfall

McAllen ISD benefits staff on the district's budget team presented a plan to move employees onto a single medical plan, raise the individual deductible to $1,250 and pursue several plan-design and vendor strategies — including a mandatory mail-order option for eligible 340B prescriptions — intended to reduce a projected $4.8 million shortfall in the employee health fund.

The proposals are aimed at reducing program costs and shifting some expenses to utilizers. "We think it's relatively low impact with significant, savings in dollars. So it's one that we're recommending," said Mr. Silva, the district's benefits presenter, describing a 340B mail-order option that would initially affect 42 members and 156 prescriptions and could save roughly $250,000 annually.

Why it matters: the district projects roughly $30 million in medical costs next year and an estimated shortfall of about $4.8 million under current plan designs. Staff said a combination of changes — an employer contribution increase, employee premium adjustments, plan consolidation and targeted plan-design changes — could produce about $4.2 million in revenue and savings and move the fund to a projected $1.5 million positive balance if all modeled assumptions hold.

Key proposals and estimated fiscal effects - Consolidate to one plan: Staff recommended moving from three plans to a single basic plan to reduce high loss-ratio exposure in the higher-cost plans. That consolidation is estimated to produce about $3.5 million in savings. Staff said implementation…