Kaufman County hears midyear review of employee health plan; consultants point to musculoskeletal and chronic disease costs

Kaufman County commissioners on April 1 heard a midyear review of the county—s employee health plan from Jonathan Colliner, employee benefits consultant, and Michelle Gifford, wellness consultant, both representing the Texas Association of Counties— Northeast territory.

Colliner summarized plan financials and projections and said the county—s 12-month loss ratio is 94.91%, down from a three-year trend of about 104.7%. "For the last 12 months, Kaufman County has been at 94.91%," Colliner said. He said the pool—s board will meet in early May to set renewal increases; Colliner added that, given the current loss ratio, Kaufman County's renewal should be below the pool—s needed increase but that exact numbers were "not specified" pending the pool decision.

Gifford reviewed clinical and utilization drivers. "Your top driver cost driver is musculoskeletal," she said, noting musculoskeletal (MSK) claims include surgeries and injury-treatment costs. She said circulatory conditions and chronic conditions such as hypertension, coronary artery disease and hyperlipidemia were also top cost drivers. Gifford noted anti-diabetic prescriptions remain the plan—s top pharmacy category.

Consultants and staff highlighted several program details and recommendations: low participation in the county—s MSK vendor Airrosti (13 participants out of roughly 600 subscribers); greater promotion of preventive exams and spouse/dependent engagement; increased use of chronic-disease management programs such as Omada and Teladoc; and continued emphasis on early intervention to avoid high-cost surgeries. Gifford corrected one item in the packet, saying antineoplastic (cancer-treatment) claims totaled $144,000 for the 2024-25 plan year rather than the larger figure listed in the handout.

Colliner and Gifford said participation and engagement metrics have improved year over year and that the county earned $3,621 in Healthy County employee rewards tied to participation. Colliner said the county—s average annual premium increase has been about 5.2% in recent years, and while last year—s county increase was nearer 4%, the pool—s upcoming decision in May will determine actual renewal amounts.

Commissioners and staff discussed communications and outreach to increase employee uptake of available programs; Gifford offered to work with human resources to schedule on-site clinics and repeated communications. No formal action was required on the presentation.

Background: the presentation and supporting data were provided by the Texas Association of Counties program representatives and included year-over-year comparisons of claims, top diagnostic drivers and participation levels in wellness and disease-management programs.