Benefits Review Committee - July 9, 2026

Agenda

• 1:30 – 1:40 pm
  General Business:
  • Attendance
  • Introductions
  • Minutes from Prior Meetings
• 1:40 – 2:10 pm
  Experience Report
  Presenters:
  Joe Bober, Mercer
• 2:10 – 2:20 pm
  BREAK
• 2:20 – 3:30 pm
  Medical and Pharmacy Provider Update
  Presenters:
  Cynthia Kodachi, Benefits
  Joe Bober, Mercer

Minutes

Attendance and Minutes: 

Voting Members Present: Cheryl Bell, Nancy Bush, Cynthia Kodachi, Phillip Mason-Joyner, Paula McDonald, Sandra Montoya, Greta Nickerson, Jon Santana, Alex Gonzalez, Cynthia Boettcher, Denim Schneider, Nathan Boles, Niki Edge, Brandon Paullin, Bob Skinner, Katie Alexander

Voting Members Not Present: Ryan Miller, Ron Wierenga, Nybelle Caruso, Tina Marie Sears, Ezra Flaherty

Minutes: Toni McGarvey

Facilitator: Cynthia Kodachi

Consultant: Joe Bober, Mercer

Welcome and Attendance and Announcements

Mercer Presentation:  Experience Report through May 2026 – Joe Bober, Mercer

• Experience reporting trending with high utilization, impacting renewal premiums (currently trending around 16% increase); 

• (Cynthia and Joe) Adding a provider such as Omada has an additional cost but over the long term can show return on investment. Takes time to make an impact but low turnover at the county year over year does help.

  (Sandra) Curious of wellness programming could have long term benefits and help support premium cost reduction.

  (Cynthia and Joe) Omada lifestyle coaching was discussed at prior meetings for this reason. With the changes occurring we do not have the capacity to institute another new provider now but it is a goal. Happy = healthy.

  (Alex) Am I correct that admin and manager buy-in will be required for wellness and lifestyle goals to be implemented. Direct managers can be encouraging. And perhaps revisiting the implementation of GLP-1 to help with chronic condition management.

Update: RFP process to find a Provider to take the place of Providence

• RFPs have been issued to MODA, Aetna, Regence and United Healthcare. United Healthcare declined participation;
• Also reviewing/looking at rx/pharmacy partners as part of this process;
• Each RFP participant will be quoting a year’s worth of claims processing, and confirming that claims are being processed as in or out of network;
• Aetna currently coming in with best premium pricing, with MODA and Regence 13% higher;
• Potential provider disruption is of paramount concern and is also being quoted and reviewed;
• Alternative care has not been completely quoted and requires additional clarification;
• Tier 1 (generic), Tier 2 (preferred brand), and Tier 3 (therapeutic equivalent, new formulary) are being reviewed for minimizing disruption between tiers;
• OHSU is out of network for Regence. The county wants OHSU to remain in network;
• Admin fees are still being quoted, and stop loss will also still be required and add additional cost;
• Claims experience is running high and means the BRC will potentially be looking at changes in plan design;
• Claims through May 2026 currently running at 106%;
• Adjustments to out of pocket costs, deductibles, co-pays, etc. may need adjustments to bring cost down

What comes next?

• Timeframe will be extremely tight, requiring plan design decisions by end of August;
• 7/23 Hope to have most all of the vendor answers received and in review;
• Meeting is set for 7/30 and then every Thursday in August for BRC meetings to keep on strict timeline;

• (Greta) If Kaiser renewal comes in higher than 5% then changes to both plans will be required correct?

  (Joe) Yes, that is correct. Initial increase for Kaiser is currently running at 6.85%.

  Greta) BRC members, consider talking to your members now, have conversations to obtain their ideas to help support the process. We know now that costs will change.

  (Sandra) Did the RFP questions include the use of telehealth services?

  (Joe) No information on telehealth right now, but was built in to Providence.

• (Alex) How about GLP-1s?

  (Joe) New vendor will have return on investment data for integrated health features. GLP-1 will increase rates even more.

  (Alex) For now we can make it an engagement and discussion point with our employees.

  (Joe) We can get pricing. Market coverage is changing as new uses are discovered, but it results in 10% to 12% additional cost on top of already high premium.

  (Cynthia B) This remains the #1 question I receive from staff. They would at least like to see the numbers for implementing GLP-1.

• (Greta) When it comes to hard, high premium increases and adjustments need to be made, we have, in the past, split out a sidebar showing member cost share outside of the 95/5 split to show true cost.

  (Joe) This can be handled through plan design, with tiered plans such as Providence PPO and Provide POO. Current increase, however, is BASED UPON EXPERIENCE and is not due to having a new vendor.

  (Alex) This will also be supported when employees see that Kaiser is also experiencing an increase, and has been trending up for a while.

• (Sandra) Can we obtain year over year comparisons of rates showing rate increases, and include the employee versus employer portion?

  (Cynthia) I can produce this.

Adjournment

There being no further business, the meeting was adjourned at 2:36 pm.

Next meeting scheduled for Thursday, July 23rd, 2026.