Southside ISD reviews health benefits options as brokers highlight savings from telemedicine and specialty pharmacy

Southside Independent School District trustees heard back-to-back briefings Oct. 15 on the district’s employee health coverage and options to control rising medical and prescription costs.

Robinson Brokerage presented the district’s current self-funded program and vendors it uses, including Global Rx for specialty drugs and Attentive for telemedicine and mental-health access. Shauna Robinson told trustees Global Rx ships 27 of the district’s most expensive medications directly to employees’ homes at no copay; Robinson said Global Rx can reduce those drug prices by about 40–60 percent compared with Blue Cross Blue Shield and that about 180 employees currently use medications such as Ozempic and Mounjaro. Robinson said the district’s pharmacy spend this year is unusually high and that Global Rx and other vendor changes could reduce drug spend by significant sums — she cited a $300,000 potential saving from a recent formulary mailing and roughly $764,000 potential savings if the district replaces its PBM after a vendor RFP.

Robinson also described Attentive’s telemedicine and behavioral-health services, which she said are available to every district employee and their family members regardless of whether the family is enrolled in the district medical plan. She said telemedicine visits are offered with no copay and that the district sees about 27% utilization of the service. Robinson presented recommendations including pursuing a third‑party administrator (TPA), procuring level‑funded or fully insured options if the district decides not to stay self‑funded, and replacing the Blue Cross Blue Shield stop‑loss arrangement to lower per‑employee costs.

A representative of TRS ActiveCare — Edward Guzman, customer success consultant — gave trustees an overview of TRS ActiveCare and how it compares with Southside’s plans. Guzman said TRS’s primary plan costs about 14% less than comparable plans and that the statewide pool reduces volatility from high‑cost claims because the pool spreads those costs across nearly half a million covered Texans. He explained that Senate Bill 1444 (as described in the presentation) allows employers to reenter TRS ActiveCare early in September 2026 but that a district reentering early would likely face a “risk stabilization fee” ranging from about 10% to 40% above region rates, designed to protect districts that remained in the pool. Guzman listed administrative deadlines — claims-data submission, a board resolution and a notice-of-intent form — that must be received by Dec. 31 for a Sept. 1, 2026 Effective date.

Trustees asked about details such as prescription deductibles, telemedicine coverage under TRS plans, and how reentry fees are calculated. Guzman confirmed TRS primary and primary-plus plans include $0 telemedicine consults under some plan tiers and explained that primary/primary-plus are statewide provider‑network plans (with out-of-state dependent coverage under attestation in some cases) while the TRS HDHP offers nationwide network and out‑of‑network options. Robinson and Guzman both described enrollment, integration with campus clinics, and tradeoffs trustees should consider if they contemplate leaving the district’s current self‑insured arrangement.

No formal decision was made. Trustees were given details of cost comparisons and procedural deadlines for reentry to TRS ActiveCare and requested additional time and materials before any change in plan administration.

Ending: District staff said they will continue vendor negotiations, pursue PBM and stop‑loss RFP options, and report back to trustees with more detailed financial scenarios before any formal change is brought for a vote.