County faces sharp pharmacy‑cost increases; staff proposes limited premium hikes, plan changes

County staff warned commissioners that pharmacy costs are the primary driver of insurance spending growth and that a small number of high‑cost members account for most of the pharmacy spend. "62 percent of our pharmacy spend is about and that is driven by about 23 members of almost 900 total members on our plan," Becky said while laying out benchmarking and projected plan deficits.

Becky presented two premium scenarios: a broad flat increase ($10–$20 per paycheck depending on plan) that would generate roughly $195,000 in premiums, and a tiered option that targets higher increases for PPO and family plans to better match cost drivers (projected additional premium of about $225,000). She said a final recommendation depends on the PBC board’s upcoming vote on plan changes and stressed that staff were not asking for immediate county budget authority until the PBC decision.

Commissioners discussed the timing and the likely impact on employees and asked staff to return after the PBC board’s action with a specific recommendation for the commissioners court to consider as part of the adoption process.