Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Employee Health Benefits topic
No spam. Unsubscribe anytime.
Consultants present options to change Metro PPO out-of-pocket maximum and add lower-cost plan
Summary
Deloitte and USI presented three recommendations: remove the PPO out-of-pocket maximum from the Metro code, allow the benefit board flexibility on premium splits (proposed 'at least 75% / no more than 25%' language), and add a lower-cost plan option; the committee asked for more time and requested draft code language and timing scenarios.
Deloitte and USI consultants outlined options to change Metro’s PPO out-of-pocket maximum, revise premium contribution language in the Metro code, and add a lower-cost plan option intended to give employees a meaningful choice. Angela Watts of Deloitte said the three recommendations recap the June 30 session: remove the PPO out-of-pocket maximum from the code; allow the benefit board to study and recommend plan-design changes (deductibles, maximums, copays); and add a lower-cost option to the plan mix.
“Proposed language would say the Metropolitan government shall contribute at least 75% and the employee shall contribute no more than 25%,” Watts said, describing the code-change option that would give the benefit board flexibility to set contribution percentages by plan or tier. Consultants and staff walked the committee through numerical scenarios showing how plan design, employee contribution percentages and utilization interact to determine total plan cost and employee out-of-pocket exposure. One presenter summarized that, when modeled together, certain combinations of design changes and contribution adjustments can be roughly cost neutral to Metro while reducing employee premium shares.
Committee members asked detailed operational and equity questions — for example, whether contribution changes could be applied by income (the consultants said changes would apply by plan or tier, not by an individual’s salary) and how quickly interim recommendations might be effective if council and counsel act. Legal and staff said interim recommendations are possible; implementation timing depends on council action and administrative lead time. The committee asked staff and legal to prepare sample code language and timeline options for the next meeting and to circulate presentation materials in the interim.
The committee did not vote on a policy change at the session. Staff scheduled the next meeting for August 10 at 9 a.m. and said materials and the full recording would be circulated ahead of that date.
