Board Approves New Employee Health Plan Options for 2027

The Harlingen CISD Board of Trustees approved changes to the district’s employee health plan on September 16. Employees will be able to choose between an HMO (Health Maintenance Organization) and a PPO (Preferred Provider Organization) plan. Coverage begins January 1, 2027.

Key Information

• HMO employee-only premium: $0
• PPO premium: Monthly cost based on coverage level
• MDLIVE: $0 copay under either plan
• Virtual information meetings: September 28-October 2
• Open Enrollment: October 5-November 6
• New coverage begins: January 1, 2027

Compare the Two Plan Options

HMO (Health Maintenance Organization) Plan

• Offers lower monthly rates
• Requires members to select a primary care physician
• May require referrals for specialist care
• Does not provide out-of-network benefits except as allowed by the plan
• Employee-only premium remains at $0

PPO (Preferred Provider Organization) Plan

• Offers greater flexibility in choosing providers
• Allows members to use out-of-network providers
• Generally costs more when care is received outside the network
• Requires a monthly premium based on the employee’s coverage level

What Is Changing?

Health Plan Choices

Employees will be able to choose between an HMO and a PPO plan.

Plan Costs

The employee-only premium for the HMO plan will remain at $0. Employees who select the PPO plan will pay a monthly premium based on their coverage level.

Plan Benefits

Deductibles, copays and out-of-pocket maximums will change. A detailed comparison will be provided before Open Enrollment.

Pharmacy Benefits

Pharmacy copays and the covered drug list will change, which may affect the cost of some medications. The Human Services team will be available to help employees understand these changes.

HMO Requirements

Employees enrolled in the HMO will need to select a primary care physician. Referrals may be required for specialist care, and out-of-network benefits will not be available except as allowed by the plan.

How the Plan Was Developed

District administrators and members of the Employee Benefits Committee met several times to review the plan’s financial condition and consider different benefit structures and costs.

Employee feedback played an important role in developing the final recommendation. Based on that feedback, the district:

• Preserved the PPO as an additional option
• Maintained the $0 employee-only premium for the HMO
• Kept MDLIVE visits available at no cost

The approved changes are intended to help keep the district’s health plan financially sustainable while continuing to provide employees and their families with access to health care coverage.

Supporting Employee and Community Wellness

The health plan changes are one part of the district’s broader commitment to health and wellness through Living Longer by Design.

The district is working to connect current and future initiatives that support students, employees, families and the Harlingen community. This work may include:

• Exploring employee wellness incentives
• Expanding health and wellness opportunities
• Reviewing school nutrition and cafeteria menus
• Strengthening partnerships with community organizations
• Identifying additional ways to encourage healthier lifestyles

Important Dates

What Happens Next?

Before Open Enrollment, employees will receive a detailed comparison of the HMO and PPO plans, including:

• Monthly premium rates
• Deductibles and copays
• Out-of-pocket maximums
• Pharmacy benefit changes
• Provider and referral requirements

Information will be available in English and Spanish.

Employees are encouraged to attend a virtual Health Care Connections meeting, carefully review the plan materials and understand the differences between the HMO and PPO plans before making their 2027 selection.

Stay Informed

This webpage will serve as the central location for information about the 2027 health plans. Employees should return regularly as additional resources, meeting information, plan documents and frequently asked questions are added.

Board Approves New Employee Health Plan Options for 2027

The Harlingen CISD Board of Trustees approved changes to the district’s employee health plan on Sept. 16. Employees will be able to choose between an HMO and a PPO plan. Coverage begins January 1, 2027.

HCISD will continue to pay 100% of the employee-only premium for the HMO plan. Employees who choose the PPO plan will pay a monthly premium based on their coverage level.

MDLIVE will remain available at a $0 copay for employees enrolled in either plan.

Here is a quick look at the two options:

• An HMO health plan offers lower monthly rates, requires members to select a primary care physician and obtain referrals to see specialists, and does not provide out-of-network benefits except as allowed by the plan.
• A PPO health plan offers higher monthly rates and more flexibility in choosing providers. Members may use out-of-network providers, but they will generally pay more when receiving care outside the plan’s network.

What is changing?

• Health plan choices: Employees will have the option to choose an HMO or PPO plan.
• Plan costs: The employee-only premium for the HMO plan will remain at $0. Employees who select the PPO plan will pay a monthly premium based on their coverage level.
• Plan benefits: Deductibles, copays, and out-of-pocket maximums will change.
• Pharmacy: Pharmacy copays and the covered drug list will change, which may affect the cost of some medications. The Human Services team will be available to help employees understand these changes.
• HMO requirements: HMO members will need to select a primary care physician, and referrals may be required for specialist care. The HMO will not provide out-of-network benefits except as allowed by the plan.

District administrators and members of the Employee Benefits Committee met several times to review the plan’s financial condition and consider different benefit structures and costs.

Employee feedback played an important role in developing the final recommendation. Based on that feedback, the district preserved the PPO as an additional option, maintained the $0 employee-only premium for the HMO, and kept MDLIVE visits at no cost.

Board President Eladio Jaimez recognized the care that went into developing the recommendation.

“This decision followed a careful and thoughtful review by our Employee Benefits Committee, district administration, and Finance team,” Jaimez said. “We appreciate the employees who shared their perspectives throughout the process as we worked to develop a plan that supports our staff and remains sustainable for the district.”

The changes are intended to help keep the district’s health plan financially sustainable while continuing to provide employees and their families with access to health care coverage.

The work also represents one part of a broader district focus on health and wellness for students, employees, families, and the Harlingen community.

Superintendent Dr. Veronica Kortan said the district’s work will include a greater focus on creating healthier lifestyles and connecting current and future initiatives through the district’s Living Longer by Design work.

“This is the first step toward a very different way of how we are going to lean into our heart for people,” Dr. Kortan said. “We are on a mission to make sure that, collectively with our community partners inclusive of UTRGV and the Valley Baptist Legacy Foundation, we will do our part in creating healthier lifestyles for our students, our employees and our community.”

As that work continues, the Employee Benefits Committee and district administration will explore additional opportunities to support employee wellness, including possible health-related incentive programs and partnerships with community organizations.

The district is also looking at health and wellness more broadly through Living Longer by Design. The effort is intended to connect work supporting students, families, employees, and the community rather than treating each initiative separately. That work may include examining areas such as school nutrition and cafeteria menus, expanding wellness opportunities, strengthening community partnerships, and identifying additional ways to encourage healthier lifestyles.

Dr. Kortan said these efforts are part of a larger picture and should help employees and families understand how individual initiatives connect to the district’s overall commitment to health and wellness.

She also thanked the Employee Benefits Committee for representing employees and providing feedback throughout the process.

“I want to thank our Benefits Committee,” Dr. Kortan said. “I want to thank our chair, Dr. Muniz, because he’s spent quite a bit of time with us getting ready for today. Tonight, I want to thank our Board for leaning into that, making sure that we’re going to listen to our stakeholders and the voices of our stakeholders, and creating a comprehensive plan that we can propose today and have approved that’s going to meet the needs of our employees and the organization as a whole.”

Before Open Enrollment, employees will receive a detailed comparison of the HMO and PPO plans, including monthly rates and benefit changes. Information will be available in English and Spanish.

The district will also maintain a dedicated employee benefits webpage that will serve as a central location for information about the 2027 plans. Employees are encouraged to return to the webpage regularly as additional details, resources, meeting information, and plan materials are added.

Virtual Health Care Connections meetings will be held through Microsoft Teams from Sept. 28 through Oct. 2. These meetings will explain the changes and give employees an opportunity to ask questions.

Open Enrollment will run from Oct. 5 through Nov. 6. Employees are encouraged to carefully review the information, participate in the virtual meetings as needed, and understand the differences between the HMO and PPO plans before making their 2027 selection.

Additional information about the health plans, Living Longer by Design, employee wellness opportunities, and related district initiatives will be shared as the work continues.

Please note: Harley, our new AI Chat Bot will be happy to answer any questions you may have.

1. What health plan options will be available for 2027?

Employees will be able to choose between an HMO, or Health Maintenance Organization, and a PPO, or Preferred Provider Organization. Coverage under the new plans begins January 1, 2027.

2. Will HCISD still pay 100% of the employee-only premium?

Yes. HCISD will continue to pay 100% of the employee-only premium for the HMO plan. Employees who select the PPO plan will pay a monthly premium based on their coverage level.

3. What is the difference between the HMO and PPO plans?

The HMO generally offers lower monthly costs and requires members to select a primary care physician. Referrals may be required for specialist care, and there are no out-of-network benefits except as allowed by the plan.

The PPO provides more flexibility in choosing providers and allows members to receive care outside the network, although out-of-network care will generally cost more.

4. Will my deductible and copays change?

Yes. Deductibles, copays and out-of-pocket maximums will change for 2027. A detailed comparison of the current plan and the new HMO and PPO options will be available on this webpage before Open Enrollment.

5. How do I know if my doctor is in the HMO or PPO network?

Employees should review the provider network information before selecting a plan. Provider search tools and additional instructions will be available on this webpage to help employees determine whether their current doctors participate in the plan they are considering.  For now, we will provide staff with a short list of in-network providers who accept the HMO plan.  This list may not be all inclusive.  A provider search link will be available before open enrollment.

6. Will I need a referral to see a specialist under the HMO?

HMO members may be required to obtain a referral from their primary care physician before seeing certain specialists. Additional information about the referral process will be provided as plan details are finalized.

7. Will my prescription drug coverage change?

Yes. Pharmacy copays will change; however, some covered medications may change for 2027.  Covered members whose medication may be disrupted will receive a letter from Blue Cross/Prime Therapeutics the week of October 15, 2026.  The drug list is the same coverage for both HMO and PPO plans.  Additional pharmacy resources will be posted on this webpage.

8. Will MDLIVE still be available?

Yes. MDLIVE will continue to be available at a $0 copay for employees and their covered dependents enrolled in either the HMO or PPO plan.

9. When is Open Enrollment?

Open Enrollment will run from October 5 through November 6. Employees are encouraged to review the plan information carefully before making their 2027 selection.

10. Where can I get more information or ask questions?

This webpage will serve as the central source for 2027 employee health plan information. Additional resources and FAQs will be added as information becomes available and employee questions are received. Virtual Health Care Connections meetings will also be held through Microsoft Teams from September 28 through October 2, giving employees an opportunity to learn more and ask questions.  If you have an questions about your personal situation, please contact the Director for Employee Benefits, Rachel Cortez at 956-430-9553 or via email at raquel.cortez@hcisd.org

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Open Enrollment will run from October 5 through November 6. Employees are encouraged to carefully review the information, participate in the virtual meetings as needed, and understand the differences between the HMO and PPO plans before making their 2027 selection.

• Is my doctor in the network?
• Do I understand the difference between the HMO and PPO?
• Am I comfortable selecting a primary care doctor  if I choose the HMO plan?
• Do I understand how referrals work in the HMO plan?
• Do I know what will my monthly premium be?
• What are my deductible, copays and out-of-pocket maximum?

Virtual Health Care Connections meetings will be held through Microsoft Teams from September 28 through October 2. These meetings will explain the changes and give employees an opportunity to ask questions.

Afternoon Sessions
 September 28–October 2
 3:30–4:30 p.m. each day

Lunch Sessions
 September 30 and October 2
 11:30 a.m.–1:00 p.m.

These are general sessions. For specific questions regarding your personal plan contact:

Raquel Cortez
Director of Employee Benefits and Risk Management
raquel.cortez@hcisd.org
956-430-9553

Click here to join the session

Use this provider list  to help determine whether your current doctors, specialists, and other health care providers participate in the 2027 health plan networks.

Employees are encouraged to review this information carefully before making a plan selection during Open Enrollment. Provider participation may vary by plan, so please confirm that your preferred providers are included in the HMO or PPO network you are considering.

Find your Provider