Self-Funded Medical Plan
Understanding Your Health Plan
MISD’s health plan is self-funded.
This means medical and pharmacy claims are paid from Midland ISD’s health plan fund—not from Blue Cross Blue Shield of Texas. The fund is supported by District contributions and employee payroll premiums.
How Self-Funding Works
The dollars stay with MISD until care is used
Blue Cross Blue Shield of Texas administers claims and provides access to its provider network, but the money used to pay those claims comes from MISD’s health plan fund.
Money enters the fund
MISD contributes monthly for enrolled employees, and employees contribute through payroll-deducted medical premiums.
BCBSTX administers the plan
BCBSTX processes claims, applies network discounts, and provides plan administration and stop-loss protection.
The fund pays claims
The remaining dollars are used only when employees and covered family members receive medical or pharmacy care.
MISD ContributionsMonthly District funding
Employee PremiumsPayroll deductions
Health Plan FundShared plan dollars
Claims PaidMedical and pharmacy care
Why MISD Uses This Model
Self-funding helps preserve value for employees
MISD reviews fully insured plans, TRS options, HMOs, and other alternatives each year. Self-funding has remained the most cost-effective way to provide broad coverage while keeping more plan dollars available for employee benefits.
When the plan performs well
In a fully insured plan, the insurance carrier generally keeps premiums regardless of how much is paid in claims.
In MISD’s self-funded plan, unused dollars remain in the fund and can help support improved benefits, lower future costs, or greater financial stability.
When claims exceed contributions
- The health plan fund develops a deficit.
- Additional District funding may be required.
- Employee premiums may need to increase.
- Plan design changes may become necessary.
Use Care Wisely
Small choices can make a meaningful difference
Employees cannot prevent every medical need, but informed choices can reduce unnecessary costs for both the employee and the health plan.
Avoid freestanding emergency rooms
Freestanding ERs are out of network and can cost the plan significantly more than an emergency room connected to an in-network hospital.
Choose the right place for care
Use telehealth, the MISD Clinic, primary care, or urgent care when appropriate instead of the emergency room.
Use ZERO Health for scheduled care
Contact ZERO before scheduling eligible imaging, procedures, or surgery. ZERO may locate lower-cost care and may reduce your cost to $0.
Ask about lower-cost prescriptions
Talk with your doctor or pharmacist about generic medications, preferred alternatives, and other lower-cost treatment options.
Stay in network
Confirm that providers, facilities, laboratories, and imaging centers participate in the BCBSTX network before receiving non-emergency care.
Ask questions before care
Understand the service being recommended, compare locations, verify coverage, and ask whether a lower-cost option is available.
Freestanding ER use has a major impact.
MISD employees generated approximately $1.5 million in claims at freestanding emergency rooms during 2025. Even when a facility tells a patient that it will waive the patient’s balance, the MISD health plan may still be charged substantially more.
We are all partners in protecting the MISD health plan.
Using benefits thoughtfully helps preserve coverage, control future premiums, and keep the health plan financially strong for employees and their families.