Ysleta ISD board awards employee health benefits contract to Aetna ACO

The Ysleta Independent School District Board of Trustees voted April 16, 2025, to award solicitation 225009 (employee health benefits) to Aetna for its accountable care organization (ACO) plan, with pharmacy services via Aetna/CVS, covering medical, pharmacy, COBRA, FSAs/HSAs and stop-loss administration beginning Jan. 1, 2026, through Dec. 31, 2028, with a possible two one‑year extensions contingent on final negotiations and required reviews.

The award matters because the contract covers district-paid insurance and affects hundreds of staff, the district’s health-and-life insurance fund, and the budget decisions the board must make in coming weeks. Staff reported negotiated changes intended to provide greater rate certainty, improved pharmacy pricing and a monthly rebate structure that staff said will help district cash flow.

HUB International benefits consultant Liz Bebo and Superintendent Dr. Dela Torre presented the RFP process, evaluation and recommended award. Bebo said the district used 12 months of claims data through January 2025 and explained core assumptions used in proposals, including a 15% stop‑loss premium increase estimate and an 8.8% trend estimate from 2025 to 2026. She told the board the district received proposals from four providers, conducted evaluation and best-and-final-offer rounds, and recommended Aetna ACO as best value. "On the employee benefits program in and of itself, so access to the pharmacy network, access to medical providers, chronic condition support programs, none of that will will change," Bebo said, describing the recommendation.

Bebo outlined negotiated contract improvements staff said were obtained during the best-and-final process: a five‑year administrative fee guarantee (the original proposal had three years with escalators in years four and five), administrative fee holidays extended into year two and three, conversion of quarterly lump‑sum pharmacy rebates to a per‑employee‑per‑month administrative credit to improve monthly cash flow, improved pharmacy unit pricing and improved rebates, and advancing some pharmacy contract changes to take effect in February rather than Jan. 1 to net an additional $500,000 in savings to the district.

Dr. Dela Torre and staff emphasized that the board was approving the vendor and the administration approach; premium and cost‑sharing decisions were deferred to the budget process. "No. That's entirely up to the board, to decide whether or not any increase to the premium as a result of either inflation or as a result of, services simply being more expensive moving forward," Dr. Dela Torre said, explaining three paths the board could take on any cost increases: a full pass‑through to employees, a shared cost increase, or the employer assuming the full increase (the district practice for about 11 years).

Board members asked whether employees would experience changes to access, copays or plan design if the board approved Aetna. Bebo and Dr. Dela Torre answered that, if the district continues the same carrier/network arrangement, employees’ provider and pharmacy access and plan design would remain the same; changes to employee premiums would be decided later with the budget. Trustee questions and staff answers emphasized that the endorsement tonight was for administration and plan design continuity rather than a final premium decision.

The motion to award YISD Solicitation No. 225009 RFP (employee health benefits components including medical administration, COBRA, FSA/HSA, EAP services, pharmacy benefit manager services and stop‑loss) to Aetna (ACO plan) was moved by Trustee Mike Dwyer and seconded by Trustee Connie Woodruff. The board voted 4‑1 to approve the award. The motion and award were recorded as contingent upon final contract negotiations, in‑house counsel review and submission of the required Form 1295 certificate of interested parties.

Next steps: staff will finalize contract language, complete required administrative reviews and present budget implications to the board during the district’s May budget workshops. Any changes affecting employee premiums or employee cost‑sharing will be decided during the budget adoption process.