By Alexandrea Bailey -August 5, 2025
Facing rising costs, Hidalgo County officials are weighing a major change to employee healthcare coverage that could impact thousands of workers.
At a recent special county commission meeting, Frontier Direct Care Executive Vice President of Growth and Government Affairs Joe Wilson presented an analysis of the county’s current plan, as well as what his company has to offer.
While introducing his presentation, Wilson explained to the commissioners a notion he refers to as the “executive lens.”
“And what that means is we look at big dollars and big numbers, but sometimes we forget about people. We forget about the livelihoods of our employees and the challenges they go through to face health care,” said Wilson.
Frontier offers a non-traditional take on insurance that emphasizes direct primary care, aiming to increase preventive care usage and reduce emergency room spending.
CURRENT PLAN
Hidalgo County currently spends $49 million annually on employee health care. They have about 6,000 employees enrolled in their current insurance plan, Aetna.
According to Frontier, with a 15.8% annual rising trend, Hidalgo County’s annual healthcare cost is projected to increase to $75 million in the next five years. By 2029, it is projected to increase beyond $95 million.
Aetna offers two different plans. It’s important to keep in mind that the median income in Hidalgo County is around $52,000.
Under Aetna’s base plan, individual employees don’t have to pay a monthly rate and the county pays $840 monthly. However, for employees with families they want to insure, the employee will pay $594 monthly, but the county’s cost will remain the same.
With in-network providers, individual patients see a $2,000 calendar year deductible, and families see a $4,000 calendar year deductible.
The maximum out-of-pocket costs for individuals and families is $8,000 and $16,000, respectively.
When it comes to doctors office visits, patients have a $30 co-pay with non-specialists, and a $50 co-pay with specialists.
In the buy-up plan, individual employees pay $100 monthly, and the county still pays $840. For families, employees pay $890 monthly, and again, the county’s costs stay the same.
With this plan, regarding in-network providers, individual patients see a $1,000 calendar year deductible, and families see a $2,700 deductible.
The maximum out-of-pocket costs for individuals and families is $7,600 and $15,200, respectively.
When it comes to doctors office visits, patients have a $25 co-pay with non-specialists, and a $40 co-pay with specialists.
FRONTIER’S OFFER
Frontier Direct Care is offering three types of services as an additional option for county employees.
With Frontier Direct Care, members will go to brick-and-mortar locations, which Wilson says serve 80% of lifetime healthcare needs with no out-of-pocket costs.
There are eight clinics in the Rio Grande Valley, including locations in Brownsville, Edinburg, Harlingen, McAllen, Pharr and Weslaco.
Additionally, Frontier Clinics are able to guide patients through specialty care, RX and referral coordination.
According to Andrew Buelo, Frontier vice president of facilities, under the Frontier plan, patients will have unlimited access to a dedicated primary care provider. They can call or text their primary care provider around the clock.
“That’s how we operate because we know that lots of times things that we can take care of for a handful of pennies, cost thousands and thousands of dollars in the emergency room,” said Dr. Pete Lazzopina, Frontier co-founder and chief medical officer.
Frontier says with their plan, there are no wait times, co-pays or deductibles.
Frontier Direct Pay handles 15% of lifetime healthcare needs. It offers concierge navigation and negotiation, direct contracts with specialists and hospitals, and contracted cancer solutions.
Frontier representatives say patients will have no out-of-pocket costs for healthcare services coordinated through Frontier.
Additionally, with Frontier Direct Pay, there is a 50% reduction in specialty spending.
Frontier RX offers 1,000 mail-order maintenance meds and generics. Employees can have a 90-day supply of medication delivered to their door with no extra cost to the county.
Its annual membership fee is $4.2 million for approximately 6,100 members. It would cost $58 per member per month.
In addition, Frontier estimates they can save the county $3.6 million in the first year, and guarantee a first-year savings of at least $1.8 million.
Homework Reading Assignment: Hidalgo County Turns Bronze Into Gold
