Jonathan Collender, a benefits consultant with the Texas Association of Counties, told the Wichita County Commissioners Court on May 16 that the county's employee health plan has outperformed the TAC pool and is likely to see a small renewal increase.

Collender said the TAC pool's anticipated statewide increase was 6% but that Wichita County should expect far less, with the county's increase set around 1.7% at the time of the review. "I would anticipate an increase this year, but of less than 2%," Collender said.

The presentation contained the key metrics that underlie that estimate. Collender said Wichita County's 12-month loss ratio was about 85.7%, lower than the pool's target range and well under the pool's recent average. He also told the court the county had a relatively small number of very high-cost claimants: "You had 7 over a hundred thousand, and then 8 additional claims over 50,000," figures he described as favorable for a county of Wichita's size.

Michelle Gifford, TAC's wellness consultant, summarized clinical drivers and utilization patterns that are raising costs nationally and locally. Gifford said musculoskeletal conditions (MSK) were the county's top diagnostic cost driver and that anti-diabetic drugs showed a sharp year-over-year pharmacy cost increase. "Musculoskeletal conditions were your top cost drivers," Gifford said, and she added that new and expensive diabetes medications were increasing pharmacy spend even where utilization rose only slightly.

Gifford highlighted the county's preventive-care participation and available benefit programs. She said about half of eligible members used preventive care in the measured period and listed no-cost or low-cost services available through TAC, including Airrosti (musculoskeletal care), Teladoc, Omada and MDLive. She encouraged continued promotion of Airrosti, noting only 10 county employees used that benefit last year but that it can help avoid surgeries.

County officials asked for comparative cost data to respond to local provider claims that Wichita County is not the most expensive place for care. Collender offered to provide anonymized cost comparisons for procedures and venues: "We can get you some data," he said, and added TAC would work on anonymized reports for the county and its providers.

The consultants also reminded the court that the county will receive RFP notices for health benefits and that TAC will remain available to consult regardless of the county's eventual carrier choice. Collender noted that the pool's overall loss ratio for the previous year ran nearer 99% and that some groups in the market are actively issuing RFPs now, advising the county it should receive competitive responses.

No formal action or vote was taken during the presentation. County staff and TAC staff agreed to follow up: TAC to prepare anonymized cost comparisons for local review, and county wellness staff to coordinate with Gifford on promoting covered programs.

Any next steps the commissioners directed were limited to follow-up and information-sharing rather than policy changes or contract awards. TAC representatives said they would be on the county's RFP distribution list and that they could provide quotes if the county decides to pursue self-funded or alternate plan designs.

The court heard the presentation as part of its May 16 agenda and thanked the TAC representatives for the review.