How does Williamson County pay for employee health and injury claims? (DRAFT – not published)

In short

• The county pays employee medical claims itself. An insurer covers only very large claims.¹
• Medical claims were about $24.9 million in fiscal 2025, up about 6% from the year before (our math).¹²
• The county also covers most workers’ injury claims itself.³

Numbers marked “our math” are our estimates, not official figures. The notes show the inputs and the steps.

How it works

• Self-funded health plan. The county pays claims for its full-time workers and their families. “Stop-loss” insurance covers claims above a set amount. An outside company handles the claims.¹
• Workers’ injury claims. The county pays these itself up to a limit for each incident. Insurance pays above $750,000 for law enforcement, jail and EMS workers, and above $500,000 for others. That has applied since Oct. 1, 2024.³ On Sept. 30, 2025, the county owed $1,012,090 on these claims. That counts claims not yet reported. All of it is due within a year.³
• Other risks such as lawsuits, theft and storm damage are covered by a mix of self-insurance and regular insurance.³

What the numbers show

Medical claims	Fiscal 2024	Fiscal 2025
Owed at start of year	$1,211,156	$1,747,125
New claims	$23,468,612	$24,941,657
Paid	$22,932,643	$25,074,222
Owed at end of year	$1,747,125	$1,614,560

Source: the county’s fiscal 2025 annual report, Note 17.¹

• Unpaid injury claims were about $1.0 million on Sept. 30, 2025. That includes an estimate for claims not yet reported.³
• Settlements stayed within insurance. The report says settlements did not exceed coverage in fiscal 2025.³

The other side

• Self-funding means the county carries the cost swings. When injury losses are more than the premiums collected, county funds make up the gap.³
• The county faces a number of lawsuits. Its managers expect no major harm from them, so the report sets nothing aside for losses.⁴
• The report does not show the health plan’s reserves or what employees pay toward it.

Questions to ask

• How much does the county keep in reserve for a high-claims year?
• How does the county set employee premiums compared with its own share?

What we still don’t know

• Claims after Sept. 30, 2025.

Changes to this page

• Nov. 2, 2026: Rewrote the questions to ask so each is open, neutral and addressed to the public body.
• Nov. 2, 2026: Added what the county owed on workers’ injury claims.
• Nov. 2, 2026: New page.

Footnotes

1. Williamson County, Texas, Annual Comprehensive Financial Report for fiscal 2025, Note 17, “Employee Benefits Plan,” p.71: medical benefits “on a self-funded basis”; “Stop-loss coverage is provided by an insurance company and an independent company serves as Claim Administrator”; full-time employees (30+ hours) eligible, with dependent coverage. Claims liabilities 2025 (2024): Oct. 1 $1,747,125 ($1,211,156); incurred $24,941,657 ($23,468,612); payments $(25,074,222) ($(22,932,643)); Sept. 30 $1,614,560 ($1,747,125). ↩ ↩² ↩³ ↩⁴

2. Our math. Change in new medical claims: 24,941,657 ÷ 23,468,612 − 1 = 6.3%. ↩

3. Same report, Note 18, “Risk Management,” p.71: risks managed “through a combination of self-insurance and traditional insurance”; “The amount of settlements has not exceeded insurance coverage”; self-insured for workers’ compensation, insured for losses above $750,000 (Law Enforcement, Corrections, EMS) and $500,000 (others) per occurrence effective Oct. 1, 2024; “When losses exceed premiums, the deficiencies are prorated and supplemented by the various applicable funds”; accrued liability $1,012,090 at Sept. 30, 2025, including incurred but not reported claims; “All claims liabilities are due within one year.” ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

4. Same report, Note 19, “Commitments and Contingencies,” p.72: the county “is the defendant in a number of lawsuits”; management’s opinion is that outcomes “will not have a material adverse effect,” and “no provision for losses has been recorded.” ↩