Alice council approves renewal of employee health plan with Blue Cross Blue Shield

The Alice City Council on Tuesday approved renewing the city's group employee medical plan with Blue Cross Blue Shield and authorized the city manager to negotiate and sign final documents for fiscal 2026.

Consultant Tad Doro of BKCW Insurance presented the renewal and the plan design changes, telling council the vendor negotiations reduced an initial renewal estimate and produced concessions that limited the employer's increase. "Claims are not what we can control," Doro said. "We can control some things through plan design, but many things we can't control and so we try to work on the fixed cost to lower that as much as possible."

Doro described several design features the council approved: a primary-care-first network called Blue Essentials, a $0 telemedicine co-pay delivered through MD Live, a lowered primary-care office co-pay ($10 instead of $40) to steer members to lower-cost care, higher emergency-room co-pays to discourage nonemergency ER use, and a mandatory biosimilar policy to reduce high-cost specialty drug spending. He said the contract negotiation produced a $40,000 billing credit to the city and a reduction in stop-loss increases compared with the original renewal offer.

The consultant told council the base plan will carry "0 cost change for the employee" while the buy-up plan will increase about $22 per paycheck for employee-only coverage. Doro provided more granular figures: on the base plan employee-spouse and employee-children costs rise by a little over $2 per paycheck and employee-plus-family by a little over $5 per paycheck; buy-up plan increases are larger. He also said the consultant was engaged on a tight timeline (award Aug. 19 and intensive work through the following weeks) and proposed a longer renewal planning cadence for 2026'27 to allow more employee education and open-enrollment lead time.

Councilmembers asked for operational details about the telemedicine benefit; Doro said MD Live visits are $0 co-pay, staffed by in-state physicians when members are in Texas, and able to prescribe non-narcotic medications where appropriate. He also offered to return for a deeper workshop on longer-term strategies to manage trend, including wellness incentives, tobacco surcharges, pharmacy-control measures and partnerships with community providers.

A motion to approve the contract renewal, as presented, passed on a voice vote with no recorded opposition. The item authorizes the city manager to execute all necessary documents and sets funding levels and rates for affiliated agencies and elected officials for fiscal 2026.

Doro said he will begin a standard planning timeline next year to produce renewal illustrations in June and finalize choices before budget season."That's the city of Copperas Cove model," he told council when describing longer-term approaches, "they have a 10% trend line over 12 years with us."

The council did not specify any amendments to the plan at the meeting; staff and the city manager were authorized to complete the final contract documents.