Van Zandt County commissioners on Friday approved renewing employee health coverage through the Texas Association of Counties Health and Employee Benefit Pool, accepting a 5.7% renewal for the coming year.

County officials and pool representatives said the increase stems from a rise in high-cost medical claims across the pool and changes to prescription benefit networks intended to lower administrative fees.

The pool representative explained the renewal breakdown and local impact, saying, "So $15 a month more per employee, roughly $600 a year more per employee," and that counties in the pool share risk across about 232 member groups. The representative also said the pool identified an increase in cancer claimants and that higher-cost claimants — defined as those with claims of at least $100,000 — are driving much of the trend.

The pool representative said the board assessed Van Zandt County a 5.7% increase but recommended no change to the county's current plan design because the consultant and local HR staff concluded the savings from switching plans would not justify changes to employees' benefits. County staff confirmed the county currently pays about $170,000 per month toward employee coverage for roughly 179 employees.

Pool staff described a prescription-network change taking effect Oct. 1 that will remove certain pharmacies under the CVS umbrella (named during the presentation) from the pool's preferred network; they said the move is expected to reduce administrative costs and that the pool's analysis showed smaller local pharmacies often produced better pricing for the pool. The representative said that single network change is expected to save the pool about $6 million.

Commissioners asked about negotiating medical bills, self-funding options and ongoing contract talks with local hospitals. The pool representative said the pool and Blue Cross Blue Shield negotiators were optimistic about extending a contract with CHRISTUS hospital but that members would continue to have coverage if a temporary out-of-network period occurred; however, out-of-network reimbursement levels would be lower.

The court voted to authorize the county judge to sign all documents necessary to renew the plan through the Texas Association of Counties pool.

The county will absorb the 5.7% increase; pool staff noted that charging employees any portion of the premium would risk the county losing grandfathered plan status under the Affordable Care Act.