Benefits Review Committee - Feb. 26, 2026

Agenda

Vendor Topics of Discussion

• Review of the BRC calendar for the 2026 session
• Review renewal process and timeline
• Dependent eligibility verification presentation
• Review of 2025 utilization data

Draft minutes

Clackamas County

Benefits Review Committee
Meeting Summary for February 26, 2026

This document is intended to be a meeting summary.

Attendance and Minutes: 

Voting Members Present: Nancy Bush, Cynthia Kodachi, Phillip Mason-Joyner, Paula McDonald, Ryan Miller, Greta Nickerson, Jon Santana, Ron Wierenga, Nybelle Caruso, Alex Gonzalez, Cynthia Boettcher, Scott Vandecoevering, Gretchen Pacheco, Ezra Flaherty, Bob Skinner, Rachel Forslund

Voting Members Not Present: Fred Yungbluth, Cheryl Bell, Sandra Montoya

Minutes: Toni McGarvey

Facilitator: Cynthia Kodachi

County Update: Review BRC Calendar, Renewal Process/Timelines and Expectations

Presenter: Cynthia Kodachi

• Review rules of quorum per BRC bylaws
  a. majority of all voting members not just those present
• Review of BRC mission statement
• Review of BRC calendar

Renewal Process and Timeline

Presenter:  Cynthia Kodachi

• First 2 meetings (April and May) will be focused on vendor presentations: Providence, Kaiser, VSP and Delta Dental
• July meetings will begin the focus on the renewal cycle for 2027 including plan changes
• 2027 rates will be discussed later in the BRC cycle

Presentation: Dependent Eligibility Audit - Slideshow

Presenter: Cynthia Kodachi

• DEV audit includes all county employees hired before 3/1/2026. Current hires after 3/1/2026 provide necessary supporting documents at time of hire.
• Retirees are not included in the DEV audit.
• BRC members were directed back to Aptia audit information (forthcoming) and communications coming out from HR Benefits for specifics of audit timeline. 
  1. Timeline and nature of coming communications is discussed
  2. Only those active employees with dependents who are enrolled in medical benefits will be included in the audit.
  3. If you do not have dependents enrolled in coverage at the county you are not part of this audit
  4. Process and communications are not focused on punitive actions and are meant to be supportive of employees
  5. Standard recurrence of this audit after completion of current Aptia project is 3-5 years which is standard for industry.
  6. Submission options are vast and include online portal, electronic submission, submission of photo of documentation, and USPS paper copy submission
• Compliance is per industry standard for auditing of dependent enrollments and mitigation of claims being paid for non-qualified applicants (cost savings)
• Employees can submit substantiating documents or not respond and allow dependents to fall off as will happen once final deadline is reached.
• There are many supportive avenues for employees to reach out to Aptia directly for help in obtaining and submitting documents, particularly if required documentation is difficult to obtain for myriad reasons.
• The first communication from Benefits occurs 3/4/2026 via ClackCo Weekly.

Presentation: Mercer Experience Report/Slidshow

Presenter: Keith Storie, Mercer

• Experience report shares data through November 2025 and includes total Medical and Pharmacy experience numbers
• Report shows a two- year “look back”
• December 2025 not included, numbers not yet reported
• In general, experience running over 100% (at 108.7% over budget)
• General state of the medical industry and higher health care costs are being affected by:
  a. Higher across the board provider costs

b. Multiple careworker strikes in 2025

c. Negotiation “standstills”  in Providence provider agreements and contracts

d. Increased business/general economics costs translate into increased rates

e. Mercer uses/adds margins on claims as a mitigation tool

• Generally experience reports show how plans are running, provide review of high claims and show other outside impacts that affect claims. More deep dive discussion on experience reporting will be discussed during vendor visits in April and May.

Open Discussion:  Providence Collective Health and Alternative Care

• Alex reports feedback from staff stating a reduction in available care due to loss of providers as a result of the move to Collective Health. Employees reporting heightened glitches due to incorrect information on benefits, coverage levels and co-pays around processing of alternative care claims
• Keith Storie reports Mercer meeting with Providence representatives and that it is an “all hands on deck” situation as they move toward identifying resolution of multiple issues relating to the Providence transition to being powered by Collective Health
• Keith Storie reports Providence adding more employee to call centers in an effort to reduce hold times and provide better customer service – but much much more to do
• Keith Storie reports that the initial goal with this move was to provide more cost effective services, a m more robust and supportive technological platform and reducing timelines for future implementations – all good intentions
• Clackamas County Benefits continues to triage issues with Providence Collective Health and can escalate items on a case by case basis to support employees in resolution

Items for continued monitoring and discussion:

• Providence self-insured versus fully funded clients impacts
• More regulation at the insurance level to bring all providers into compliance and equalize revenues for those providers who continue to follow the rules and guidelines. This could result in loss of some Providence providers who do not want to comply.
• Exploring more levers (Greta Nickerson) available to the BRC ahead of June rate negotiations – needing more levers to augment reducing costs as premiums rise (deductibles, out-of-pocket, institution of HSA) – need bigger strategies with more impact
• Keith Storie reports that HSA implementation, although it is a “lift” to educate employees, is an option. 65% of employers have instituted an HAS. Requires much more discussion
• Keith Storie reports preventative programs also help: increasing awareness of how to utilize and be good stewards of the plan to reduce costs with such as items as using urgent care instead of ER, using telehealth instead of in-person visits, providing enhanced preventative programs and interface with employees to reduce high claims conditions.

Meeting Adjourned:

• Cynthia Kodachi adjourns the meeting
• Next meeting: April 16th – in person PSB 369 A/B 1:30 pm

Mercer: Presentation - Experience Report for 2024:

Mercer Presenter: Joe Bober

1. Joe provided review of 2024 Experience Report utilization for general county. 
2. Review shows prescriptions to be drivers of high stop loss claims. This brings up a discussion of showing/not showing “claimant type” on claims review. Joe will remove retiree and active indicators on the stop loss claims report and resend to the BRC. 
3. Keith mentions that providers will be available at the April BRC meeting – great time for BRC reps to bring their member concerns and feedback to this meeting (items such as issues with accessing services or making appointments, frustrations with services provided, insight and questions for providers.
4. Greta brings up limits on alternative care and questions whether we will review this again during the current cycle. Keith identifies adding this to our discussion in April with providers.
5. Cally asks about expansion of alternative care as it relates to naturopaths. Keith reminds the group that naturopaths are considered medical doctors in the state of Oregon.
6. Greta asks about Kaiser alternative care access not being robust. Keith answers by stating that Kaiser reimbursement rates for alternative care (such as massage) are very low and therefore create contracting issues with alt care providers.
7. Keith asks the group to keep in mind when looking for providers in the naturopathic space to always make sure that the service they are providing is contracted with the provider. They may be in-network as an alt care provider, but not all their services may be contracted which could result in more out of pocket costs to the subscriber.
8. Remember: Call the insurance provider and ask if the service is covered. Keep notes on the day and time of the call, and name of the representative if you can. This information can help if the service is subsequently denied after being accepted - Mercer can use this information to fight the claim. 

Member Reports: 

1. Cynthia defined the member reports portion of our meetings as a time to bring your members concerns, questions and insight to the BRC. There is time allocate each meeting for these reports.
2. Cynthia also states that the next meeting will be held in person in 369A on March 20th from 1:30 pm – 3:30 pm.
   Meeting Adjourned:

Cynthia Kodachi adjourns the meeting

Next meeting: March 20th, 2025