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Study committee delays vote on proposed PPO out-of-pocket cap and lower-cost plan after union requests
Summary
After multiple union speakers urged more time to review scenarios and numbers, the Employee Benefits Study and Formulating Committee voted to defer consideration of proposed changes to the PPO out-of-pocket maximum and related plan-design options to the next meeting to allow consultants to supply additional modeling and for unions to submit written concerns.
The Employee Benefits Study and Formulating Committee, chaired by Margaret Darby, voted Aug. 10 to defer consideration of proposed changes to the PPO out-of-pocket maximum and related plan-design options until the next meeting so consultants can provide fuller cost modeling and unions can submit written questions.
Union leaders and other public commenters asked the committee for more time before any vote. Joel Cottrell, president of the Fraternal Order of Police, said the FOP was still assessing "both the positive and negative impacts of these proposed changes" and requested an extension. Mead Forsyth, a metro worker and vice president of SEIU Local 205, and Tamika White, political director of SEIU Local 205, separately told the committee they wanted more concrete scenarios and numbers so members could understand potential impacts. "We have asked for concrete plans, scenarios, and actual numbers that we can understand what changes will mean for families and employees," White said.
Consultants told the committee the packet added two slides to help visualize four considerations: (1) deleting or modifying the PPO out-of-pocket maximum in Metro code to allow the board to revise plan design; (2) enabling plan-design changes to make coverage more affordable; (3) adding a lower-cost "0.333" plan option; and (4) adjusting the employer/employee premium split (currently ~75/25) so a lower-cost plan would be meaningful. Presenters noted the per-employee figures are shown on slide 7 and said multiplying by about 13,000 employees gives a rough employer-level impact. One consultant summarized the trade-off: a lower monthly premium may mean higher out-of-pocket costs when care is used, but a broad network could be written into an RFP if the board requests it.
During discussion, some committee members said they would not support removing guardrails from the code without recommended "not to exceed" amounts or other guidance the benefit board could use. After discussion a motion to defer the items to the next meeting carried; the committee asked that unions submit written comments to Christina for inclusion in the next public packet and requested that consultants provide modeled scenarios for single, family, and intermediate tiers and clearer employer-cost estimates.
