Primary Department: Human Resources and Talent
Primary Department Head/Elected Official: Andrea Coughlin Rowley
Secondary Department: Choose an item.
Secondary Department Head/Elected Official:
Regular or Supplemental RCA: Regular RCA
Type of Request: Discussion Item
Project ID (if applicable): N/A
Vendor/Entity Legal Name (if applicable): N/A
MWBE Contracted Goal (if applicable): N/A
MWBE Current Participation (if applicable):
Justification for 0% MWBE Participation Goal: N/A - Goal not applicable to request
Grant Indirect Costs Rate (if applicable): N/A
Justification for 0% Grant Indirect Costs Rate (if applicable): N/A - Not a grant item
Request Summary (Agenda Caption):
title
Request for discussion and possible action on HRT’s review of the Aetna SilverScript Employer Group Waiver Plan (EGWP), including options to address retiree concerns and align with the Court’s intent to avoid increased costs for retirees.
end
Background and Discussion:
On August 14, 2025, Commissioners Court approved the implementation of the Aetna SilverScript Employer Group Waiver Plan (EGWP) for Medicare-eligible retirees, which was deployed during Open Enrollment and became effective February 1, 2026. This transition moved retirees to a Medicare Part D EGWP structure to achieve cost savings, reduce OPEB liability, and maintain comprehensive prescription drug coverage. HRT continues to evaluate retiree experience and cost impacts and recommends maintaining the EGWP while implementing targeted plan design enhancements and adding retiree advocacy support to address identified concerns.
Expected Impact:
A recommended approach is expected to improve the affordability and predictability of retiree out-of-pocket costs while enhancing member support through dedicated advocacy services. At the same time, the County would continue to realize operational savings and reductions in OPEB liability.
Alternative Options:
HRT evaluated alternative options, including enhanced formulary and plan design modifications, returning to a commercial prescription drug plan, and implementing a Retiree Reimbursement Arrangement (RRA). Returning to a commercial plan would introduce significant financial and operational risks, while an RRA could serve as a supplemental strategy, but presents administrative complexity, variable costs, and is not recommended.
County Strategic Plan Goal: N/A
County Strategic Plan Objective: Choose an item.
Justice/Safety Initiative (Goal 1): Choose an item.
Infrastructure Initiative (Goal 2): Choose an item.
Economy Initiative (Goal 3): Choose an item.
Health Initiative (Goal 4): Choose an item.
Climate/Resilience Initiative (Goal 5): Choose an item.
Housing Initiative (Goal 6): Choose an item.
Additional notes related to the Strategic Plan:
Prior Court Action (if any):
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Date |
Agenda Item # |
Action Taken |
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03/19/26 |
235, 458 |
Direct OMB and HRT to review the Aetna SilverScript EGWP, address retiree concerns, ensure no increased retiree costs, and report back on 05/14/26. |
|
04/16/26 |
321 |
Direct HRT to return with cost/feasibility of returning retirees to the previous Rx plan |
Location:
Address (if applicable):
Precinct(s): Choose an item.
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Fiscal and Personnel Summary |
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Service Name |
Health & Related Benefits |
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Total Existing Budget |
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$ |
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Additional Budget Request (Requires Fiscal Review Request Form) |
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Other |
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$205,000 |
$205,000 |
$1,200,000 |
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$ |
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Total Additional Budget Request |
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$205,000 |
$205,000 |
$1,200,000 |
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Total Funding Sources |
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$205,000 |
$205,000 |
$1,200,000 |
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Grants - Proposed Budget (For Grants Items only) |
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Local Match Source - Existing Budget: Choose an item. |
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Local Match Source - Additional Budget Request: Choose an item. |
$ |
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Grant Funds Applied for/Awarded (Total) |
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Personnel (Fill out section only if requesting new Position Control Numbers (PCN)s) |
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Current Position Count for Service |
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Additional Positions Request |
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Total Personnel |
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County Attorney’s Office Legal Review (for Harris County Code Items only) |
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CAO Reviewer Name and Title |
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CAO Review Completion Date |
Click or tap to enter a date. |
Anticipated Court Date: 5/14/2026
Anticipated Implementation Date (if different from Court date): Click or tap to enter a date.
Emergency/Disaster Recovery Note: Not an emergency, disaster, or ARPA related item
Contact(s) name, title, department: Sarah Acosta, Director, Benefits & Wellness, HRT
Attachments (if applicable): Presentation