Primary Department: Human Resources and Talent
Primary Department Head/Elected Official: Andrea Coughlin Rowley, Chief People Officer
Secondary Department: Management and Budget
Secondary Department Head/Elected Official: Daniel Ramos
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.
Since implementation, Commissioners Court has directed HRT and OMB to review retiree experience under the plan, evaluate potential options to address retiree concerns, and return with recommendations informed by retiree feedback and utilization data. HRT has conducted ongoing analysis of plan performance and retiree impacts and has gathered additional input through retiree engagement efforts, including a retiree town hall, retiree survey, and updated review of utilization and claims experience. HRT will present findings, potential options, and recommendations inclusive of this feedback and analysis.
Expected Impact:
The review provides Commissioners Court with a comprehensive evaluation of retiree experience, financial impacts, operational considerations, and available plan design alternatives. Findings from retiree engagement activities and utilization analysis helped to inform potential future actions designed to improve retiree experience while balancing financial sustainability, operational feasibility, and the County's long-term retiree health strategy.
Alternative Options:
As part of its review, HRT has evaluated a range of potential options, including modifications to the current EGWP plan design and formulary, additional retiree support and advocacy services, supplemental reimbursement approaches, and a return to the commercial prescription plan. Each option was assessed based on retiree impact, cost, operational feasibility, regulatory considerations, and alignment with Commissioners Court direction. The fiscal summary reflects the costs of modifying the plan design, the formulary, and adding retiree advocacy services.
County Strategic Plan Goal: N/A
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Additional notes related to the Strategic Plan:
Prior Court Action (if any):
|
Date |
Agenda Item # |
Action Taken |
|
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 |
|
05/14/26 |
12 |
Direct HRT and OMB to return with updated utilization data and recommendations informed by the preferences of impacted retirees. |
Location:
Address (if applicable): N/A
Precinct(s): Countywide
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Fiscal and Personnel Summary |
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Service Name |
Health & Related Benefits |
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Current Fiscal Year Cost |
Annual Fiscal Cost |
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Labor |
Non-Labor |
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Recurring Expenses |
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Funding Sources |
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Existing Budget |
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$ |
$ |
$ |
$ |
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Choose an item. |
$ |
$ |
$ |
$ |
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$ |
$ |
$ |
$ |
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Total Existing Budget |
$ |
$ |
$ |
$ |
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Additional Budget Request (Requires Fiscal Review Request Form) |
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Other |
$ |
$ |
$ |
$2,600,000 |
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Choose an item. |
$ |
$ |
$ |
$ |
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$ |
$ |
$ |
$ |
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Total Additional Budget Request |
$ |
$ |
$ |
$2,600,000 |
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Total Funding Sources |
$ |
$ |
$ |
$2,600,000 |
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Grants - Proposed Budget (For Grants Items only) |
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Labor |
Non-Labor |
Total |
No. of Grant Years |
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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: 7/9/2026
Anticipated Implementation Date (if different from Court date): 1/1/2027
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): FRRF and Presentation