Texas Association of Counties: Wichita County’s employee health plan shows low loss ratio; small rate increase expected

Jonathan Callender, a health-plan consultant with the Texas Association of Counties, told the Wichita County Commissioners Court on May 16 that the county’s group health plan has performed well relative to the association’s pool and that the county should expect a modest renewal increase this year.

Callender said, “You have been below the state average for over a decade with the health and employee benefits pool,” and that while the pool overall is anticipating a 6% increase, Wichita County’s increase “would be less than 2%,” with current projections around 1.7%.

The finding matters because the county pays premiums and manages benefits for hundreds of employees. County leaders asked whether TAC could provide comparative cost data so local providers and county staff could review claims costs and prices. Callender said TAC would assemble anonymized comparisons for the county and noted TAC would respond to any RFP the county issues.

Michelle Gifford, TAC’s wellness consultant, reviewed utilization and cost drivers and urged continued promotion of available programs. “Musculoskeletal conditions were your top cost drivers,” Gifford said, noting a small number of high-cost claimants are driving a large portion of plan spending. She cited plan statistics showing seven claimants with claims over $100,000 and eight additional claimants over $50,000 in the review period.

Gifford summarized plan performance: the county’s 12‑month loss ratio came in at about 85.7%, with a three‑year average near 82%. She also said the county’s employee population is younger than the pool average, which helps the loss ratio, and that county members earned $1,260 in wellness reward dollars last year for employee incentives.

Speakers discussed pharmacy cost pressures, especially for antidiabetic medications and new high‑cost therapies. Gifford said the increase in pharmacy spending is driven largely by drug price, not by a large increase in the number of users, and recommended targeted communications and chronic‑disease management programs such as Teladoc, Omada and Airrosti to reduce avoidable high‑cost care and surgeries.

Callender noted TAC offers multiple plan designs, including HMO, HSA and self‑funded options, and said the association would provide quotes if the county solicits competitive proposals. He reminded the court that renewal timing gives flexibility around an RFP and that TAC will remain available to the county regardless of the procurement outcome.

County staff and commissioners requested the anonymized cost comparisons and confirmed TAC’s willingness to meet with local providers and the county’s wellness staff before the RFP process. No formal procurement decision was made at the meeting.

The presentation closed with staff and TAC agreeing to follow up on data sharing and wellness coordination ahead of the county’s renewal and any RFP.