Commissioners approve revised county health plan design, absorb most costs; employees to pay a small share

The Nueces County Commissioner's Court voted unanimously on June 24 to adopt changes to the county's self‑funded health insurance plan to take effect Oct. 1, 2025. The insurance committee recommended plan design adjustments intended to limit county exposure while preserving benefit continuity for employees.

The approved package (referred to as Option 2 in committee work) keeps the county contribution at about 87% of total premium while increasing certain member cost‑sharing elements. Measures approved include a $500 per‑person increase in the plan deductible, a move from 90% to 80% coinsurance for certain services, modest increases to out‑of‑pocket maximums, a $100 flat urgent care co‑pay, and a $350 emergency department facility co‑pay. Pharmacy co‑pays were adjusted to encourage generic use ($10 generic, $50 preferred brand, $150 non‑preferred, $250 specialty co‑pay).

Why this matters: County leaders said rising health costs required changes to preserve the plan’s solvency. Commissioners and staff stressed that the county will continue to pay the bulk of premiums to limit out‑of‑pocket increases for employees and that the adjustments were designed to incentivize appropriate use of urgent care and primary care rather than higher‑cost emergency care.

Implementation and next steps: The county is transitioning medical administration to Blue Cross Blue Shield as the third‑party administrator and will keep the current pharmacy manager for another year. Human Resources will lead employee education and open enrollment in late summer to explain the plan design changes, in‑network provider lists, and urgent care options. The court asked staff to factor these changes into the upcoming budget discussions.