Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Employee Benefits topic
No spam. Unsubscribe anytime.
Commissioners approve health-plan design changes; county will absorb most cost increase
Summary
After committee review, the court approved updated plan designs with Blue Cross Blue Shield as the new third-party administrator, modest member cost-sharing changes, and a county contribution increase the court will absorb.
The Nueces County Commissioners Court approved health plan design changes and a transition to Blue Cross Blue Shield as the county’s third-party administrator (TPA) for medical claims, adopting the insurance committee’s recommendation on June 18.
What the court approved: The court accepted the insurance committee’s recommended plan design changes that include a new Blue Essentials HMO (replacing the prior EPO), a Blue PPO option for out-of-area access, a $500 increase in the individual deductible, a shift from 90% to 80% coinsurance, higher out-of-pocket caps, and redesigned flat co-pay amounts to encourage the use of urgent-care centers and primary care.
Pharmacy and urgent care changes: The county will keep the existing pharmacy administrator (ScripCare) for one year while adding updated co-pay tiers: $10 generic, $50 preferred brand, $150 nonpreferred, and $250 specialty. Urgent-care visits will be a flat $100 and emergency-room co-pay was adjusted to encourage appropriate site-of-care choices.
Costs and who pays: The court approved option 2 from the insurance committee that holds the employee share around 13% while the county covers about 87% of total plan costs. The county’s projected net cost increase is modest (county figures discussed in the meeting estimated a roughly 2% increase and roughly $275,000 additional county cost for the upcoming year); commissioners said the county’s large share of premium contribution historically has been a recruiting and retention tool for county staff.
Why it matters: Commissioners discussed the tradeoffs between limiting employee premium increases and keeping the county’s contribution sustainable. The new plan is intended to modernize benefits, reduce long-term claim volatility and steer members to lower-cost settings for nonemergency care.
Next steps: Human Resources and the new TPA will begin member education and plan enrollment materials ahead of the county’s open enrollment, tentatively scheduled for August. Several commissioners also asked staff to factor the county’s high premium contribution into future pay-and-benefit discussions with employees.
Ending: The court approved the insurance committee’s recommendation and directed HR to continue education and enrollment work with Blue Cross Blue Shield and ScripCare for pharmacy continuity for the remainder of the contract year.
