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Commissioners approve 2026 health insurance rates; authorize $100 spousal surcharge for employer-covered spouses

5855797 · September 29, 2025
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Summary

The court approved 2026 employee and retiree health insurance rates and a proposed $100 monthly spousal carve-out surcharge for employees whose spouses have access to employer-sponsored coverage elsewhere.

San Patricio County Commissioners on Sept. 29 approved the county’s health insurance rate schedule for 2026 and authorized a spousal “carve-out” surcharge to apply when an employee’s spouse has employer-sponsored coverage available elsewhere.

Human resources director Norma Jean Rivera presented the proposed rates and explained the county’s employer contribution for 2026. She said the employer share for employee-only coverage rises by about $4 a month; employer contributions for spouse and child coverage increase more substantially. Rivera said the county’s employer portion will increase $163 per month for spouse coverage and $163 per month for child coverage; employer-paid portion for family coverage was listed as $477 per month.

HR and benefits staff said employee contributions will also rise. They reported employee-only premiums will increase about $3 per month; dependent coverage will see larger increases (roughly 30% on dependents). Under the proposal the typical employee premium increases would be about $95 a month for spouse coverage, $68 for child coverage and $112 for family coverage. Retiree employee-only coverage would rise from about $650 to $764 per month in 2026; there are 11 retirees currently on the county plan.

Benefits consultant representatives described a proposed “soft” spousal carve-out: employees whose spouses have access to employer-sponsored health coverage elsewhere would not be excluded from the county plan, but would pay a $100 monthly surcharge if they elect county coverage while the spouse has access to another employer’s plan. Medicare coverage for a spouse was excluded from the carve-out test; the surcharge applies only where a spouse has employer-sponsored coverage availability.

Commissioners approved the overall rate schedule and the spousal surcharge approach. County staff said retirees and outside entities that participate in the county plan will be billed at the adjusted rates effective Jan. 1, 2026, with employee payroll deductions processed in December to cover January premiums.

The court briefly discussed questions about retiree subsidies and how increases affect outside entities that participate in the county plan; no changes to retiree subsidy policy were approved.