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Mayor's team asks council to approve switch of city medical TPA to Meritaine/Aetna, citing multi‑million dollar savings; unions seek assurances
Summary
Administration presented a late resolution to move the city's medical third‑party administrator from Horizon to Meritaine/Aetna, citing RFP results and projected platform savings; broker and staff said changes preserve "equal‑to‑or‑better" benefits and that delay could forfeit savings and return of a working‑capital balance. Council asked for benefit parity documentation, continuity‑of‑care protections, and union outreach.
The administration brought a time‑sensitive, late agenda item asking the council to accept the results of an RFP and authorize a switch of the city's self‑insured medical TPA services from Horizon Blue Cross to Meritaine/Aetna. Robert Parisi, the city's benefits consultant, said the recommendation followed a competitive RFP and an analysis of utilization and provider network alignment.
Parisi said the city's utilization pattern indicates many members use providers in Aetna's network that are out of network for Horizon; consolidating the network under Meritaine/Aetna would reduce out‑of‑network spend and improve negotiated discounts. He said the city could realize platform savings measured in the tens of millions over a policy year and that delaying implementation could "leave money on the table"; administration representatives estimated that postponing the switch further would cost the city an additional $2.5 million (administration's estimate provided in caucus) in near‑term excess costs related to the difference in platform performance.
The administration emphasized the change would preserve contractual benefit levels. Parisi repeated the standard public‑sector test ("equal to or better than") and described a 12‑month continuity‑of‑care provision that would protect ongoing courses of treatment for members whose providers are not in the new network. Councilmembers asked for the RFP, the benefit comparison tables, and a proposed contract; administration agreed to circulate materials and to meet with union leaders and hold employee town halls. Staff also said approximately $9.9 million in Horizon working capital would be returned to the city on contract closeout, improving short‑term fiscal position.
Several councilmembers asked for more time and union outreach. Administration committed to multiple employee town‑hall sessions and a concierge helpline for employees and to provide detailed written comparisons of benefits and the proposed contract language before the formal council vote.
