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Willis ISD renews Blue Cross plan, plans rate increases and utilization programs to curb rising pharmacy costs
Summary
Board approved renewal with Blue Cross Blue Shield for plan year Sept. 2025–Aug. 2026 with projected funding of $7.3 million and planned design changes including a formulary shift and pharmacy-utilization strategies; Walker & Associates and Blue Cross presented data showing pharmacy inflation as the main cost driver.
The Willis ISD Board of Trustees on July 9 approved renewal of the district’s self‑funded health‑insurance plan with Blue Cross Blue Shield for the plan year beginning Sept. 1, 2025, with the district’s proposed funding levels as part of the approval.
Walker & Associates consultant Noah Baldy and Blue Cross account executive Ray Bailey briefed the board on plan performance and renewal negotiations. Baldy said the district’s projected funding for 2025–26 is $7.3 million with projected claims near $8.0 million, leaving a planned deficit the district intends to address through premium adjustments, utilization management and plan-design strategies.
Pharmacy costs and plan actions: Baldy said pharmacy spending is the largest cost driver; prescription spending rose rapidly in the period reviewed and specialty drugs and GLP medications were significant contributors. To reduce pressure on the plan, Willis ISD and Blue Cross negotiated a higher pharmacy rebate/credit (from about $370,000 to about $650,000), and the renewal includes a move to Blue Cross’s Performance Select formulary (an “OTC‑driven” formulary intended to steer over‑the‑counter type medications away from plan claims) plus specialty‑pharmacy management (Accredo) and enrollment in manufacturer assistance/patient‑support programs.
Results of negotiation and member impact: Baldy said those steps and the increased rebate produced a renewal result “about 2.79% below current” fixed costs compared with the existing plan, noting the district still expects claims variability. He emphasized the plan retains its current network and does not raise deductibles or co‑pays as part of the renewal. Baldy also highlighted Next Level primary‑care and urgent‑care services the district offers to employees; he said Next Level produced an estimated $1.55 million in utilization savings in the reporting period by diverting visits from higher‑cost emergency settings and improving access.
Board action and implementation: The board approved Blue Cross Blue Shield and the monthly funding levels as presented by a 7–0 vote. District staff said they will form fall committees to review long‑term structural options for the insurance fund (including TRS participation or continued self‑funding) and will pursue ongoing utilization and formulary strategies to contain pharmacy costs.
Ending: Trustees approved the Blue Cross renewal and directed staff to continue to explore cost‑control options and report back with committee findings and plan details this fall.
