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McAllen ISD: high‑cost claimants push up health‑plan spending; district exploring containment steps
Summary
Risk management staff told trustees the district's self‑funded health plan saw high‑cost claimants rise from 21 in 2024 to 38 in 2025, increasing plan payouts from about $2.8M to $4.8M; district leaders said they are implementing benefit design changes and will investigate direct contracting and other cost‑containment options.
The McAllen Independent School District’s risk management team told trustees during a budget workshop that a surge in high‑cost claimants has materially increased health‑plan expenditures and prompted benefit‑model changes and new containment strategies.
Deputy Superintendent Lorena Garcia said the district implemented changes earlier this year that moved employees onto a single basic tier and added coinsurance; she said the district has seen a marked increase in high‑cost claimants,…
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