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McAllen ISD health plan runs a deficit after high-cost claims; trustees discuss benefit changes and pharmacy measures
Summary
District staff outlined a shortfall in the self-funded health plan driven by increased pharmacy costs and a rise in high-cost claimants. Staff outlined cost-containment measures, proposed a January budget amendment and recommended a board workshop on health coverage options.
McAllen ISD administrators told the board Tuesday that the district’s self-funded health plan ran a large deficit in the most recent fiscal year after an uptick in pharmacy spending and additional high-cost claimants.
Deputy Superintendent for Business and Operations Lorena Garcia presented the health-plan update, assisted by consultants Roger Garza and Javier Riviera of Valley Risk Consulting. Garcia said the district had projected a modest ending fund balance but instead closed the year with $68,496 after pharmacy cost increases and multiple high-cost claims that exceeded stop-loss deductibles.
Garcia told trustees the district has an assigned reserve of $2 million that administration moved incrementally to support plan costs and that staff…
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