Faculty and staff at Texas colleges might want to look twice at their benefits statements. A new analysis from Rice University’s Baker Institute says health insurance premiums at the state’s universities are all over the map, with some employees shelling out thousands more each year than colleagues at other campuses for broadly similar coverage. The differences are big enough to hit take-home pay, influence hiring and complicate university budgets.
According to a report by Rice University’s Baker Institute, the total annual cost of individual PPO/POS coverage, combining employer and employee contributions, ranges from $8,095 for plans tied to the Employees Retirement System of Texas to $15,742 at Trinity University for the 2025–26 plan year. In the sample, family-plan totals run from about $23,037 to $48,636. The brief notes that slightly more than half of the plans examined require employees to contribute over $10,000 toward family coverage. The authors also calculated actuarial values, finding that how generous plans are varies from campus to campus.
“The disparities we found across Texas universities are striking, and they matter enormously to university budgets,” Vivian Ho said in a Rice University news release, and Marah Short added that “the PPO/POS plan is popular for personnel as they age and face higher risks of illness.” Rice University's summary of the brief notes that employee shares for single coverage in the sample range from $0 to $3,993 and that actuarial values span 0.815 to 0.88, a gap the researchers estimate translates to roughly $400 in additional expected annual out-of-pocket costs for a typical employee.
Why the gaps?
The brief points to structural forces rather than sloppy HR work. “The authors hypothesize that insurer market share, hospital consolidation and multi‑institution bargaining power are key drivers of variation,” the report states. To make the case, the researchers lean on local concentration measures, noting for example a Herfindahl‑Hirschman Index of about 5,429 for College Station versus roughly 1,704 for Dallas, to illustrate how local hospital market power can push premiums higher or lower.
Centralized plans and bargaining power
Size helps. Large systems often buy coverage at scale. The University of Texas System maintains a uniform group insurance program for its campuses, and many other state universities get coverage through the Employees Retirement System (ERS) of Texas. According to the University of Texas System, its UT Select plan is administered centrally, and University of Houston benefits materials show that ERS plans are commonly used across state institutions. That shared purchasing power helps explain why some system-level options land at the lower end of the premium scale.
What policymakers might do
Policy researchers have long argued that concentrated insurance and hospital markets leave employers with less leverage and consumers with higher prices, a pattern documented in the American Medical Association's recent competition analysis. The AMA has flagged widespread insurer dominance across U.S. markets, and the KFF employer survey notes that plan-design tradeoffs, narrower networks or greater transparency are among the tools employers sometimes use to blunt premium pressure, even though those moves can shift costs onto patients.
For Texas campus employees, the bottom line is blunt. The sticker price for roughly comparable coverage can diverge by thousands of dollars depending on which carrier a university picks, how concentrated the local hospital market is and whether a campus buys in on its own or as part of a bigger system. Expect benefits offices and governing boards to field tougher questions about plan choices when open enrollment rolls around this fall.
