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TAC presents fully insured and self-insured options to Austin County; commissioners schedule employee workshop
Summary
TAC representatives told Austin County commissioners their fully insured pool option could lower the county's projected liability by about 4.3% and offers network stability via Blue Cross Blue Shield; commissioners asked for a workshop and deferred a final decision to the next meeting.
Orlando Espaza, TAC employee-benefits consultant for the East Territory, and Brian Neiser, TAC associate director, told the Austin County Commissioners Court that TAC could offer the county either a fully insured or self-insured plan. TAC's fully insured quote relies on the Blue Cross Blue Shield network and includes a $500 medical deductible and a $2,500 out-of-pocket maximum for employees.
TAC said its analysis of the county's claims and fixed costs placed total projected liability at about $3,600,000 and that the fully insured product would place estimated premiums roughly 4.3% below that liability figure. Orlando Espaza said the fully insured option removes risk from the county by paying a fixed premium and that TAC caps renewals at 9.5% while their five-year renewal average is about 4.7%.
Commissioners raised questions about provider continuity and pharmacy changes. Commissioner 13 asked whether the county would lose access to specialist doctors during a switch; Brian Neiser and TAC staff said Blue Cross Blue Shield has the state's broadest network but acknowledged formularies and pharmacy benefit managers differ. TAC said pharmacy disruption is the most likely negative change and recommended pre-implementation outreach, letters to employees on affected medications, and open-enrollment presentations to ease the transition.
TAC described retiree options: a Medicare supplement ("County Choice Silver") is available for retirees but cannot be used to incentivize active employees to leave the group plan. TAC also offered data-driven midyear reviews and a five-year-looking liability analysis if the court requested a retiree tiered program.
After questions about customer-service hold times and local provider coverage, the court asked TAC to return for a workshop open to county employees and scheduled a meeting during the next court cycle to allow staff and employees to review plan details and drug formularies. No final plan selection or contract award was made during the meeting.
The county will receive TAC's provider directory and formulary materials and TAC offered to run a geo-study or provider disruption report if given claims data. Commissioners stressed the need for transparency to employees and adequate time to review before making any enrollment decision at the next court meeting.
