County consultant: keep health plan contributions steady; warns drug costs and rebate trade-offs

Brazos County — At a July 15 Brazos County Commissioners Court budget workshop, USI senior consultant Bobby Anderson told the court that Brazos County’s employee health plan is running favorably but faces rising national trends that could increase costs in coming years. Anderson recommended no change to the county contribution for the FY2026 budget and keeping the $75 wellness discount for employees while suggesting a small reduction in employee-paid dental fees.

Anderson said the marketplace shows growing medical and prescription trends, and that Brazos County should not expect to see the full nation‑level increase in the county’s budget: “We’re not expecting a 10% increase to your budget for Brazos County,” he said, noting the county’s current favorable claims experience.

Why it matters: health plan costs and the county contribution are a recurring line item in the budget that affect both operations and employees’ take‑home pay. Rising specialty drug costs and rebate arrangements can shift dollars between vendor fees, manufacturer rebates and stop‑loss reimbursements, creating trade‑offs for plan sponsors.

Most important facts

- Trend drivers: Anderson said medical trend is increasing (he cited roughly 7.5% projecting into the 2026 plan year) and prescription‑drug trend is “growing around 12% a year,” driven in part by specialty medications. - Plan performance: USI reported Brazos County has run under budget in recent periods. Anderson cited a rolling‑12 scenario where the county’s budgeted cost was about $20.9 million and the net cost was about $18.0 million, leaving a reported surplus of roughly $2.87 million in that view. He also summarized that 2024 ended with a multi‑million dollar favorable result and that year‑to‑date 2025 figures through May showed the plan running well (a net cost/loss‑ratio figure of about 95% through May was reported). - Claims and stop‑loss: Anderson…