Benefits Review Committee - July 23, 2026

Agenda

Topics of Discussion    

• Approval of prior meeting minutes
• Renewal Update and Discussion

1:30 – 1:45 pm General Business:

• Attendance
• Introductions
• Minutes from Prior Meetings (Approving 4/16, 5/21, 6/16, 7/9)

1:45 – 2:30 pm Renewal Update and Discussion

Presenters:
Rachel Forslund, Benefits
Joe Bober, Mercer

Discussion: All Members

2:30 – 2:40 pm BREAK

2:40 – 3:30 pm Renewal Update and Discussion

Presenters:
Rachel Forslund, Benefits
Joe Bober, Mercer

Discussion: All Members

Minutes

Meeting Summary for July 23, 2026
Voting Members Present

Cheryl Bell, Nancy Bush, Rachel Forslund, Phillip Mason-Joyner, Sandra Montoya, Greta Nickerson, Jon Santana, Ron Wierenga, Nybelle Caruso, Alex Gonzalez, Cynthia Boettcher, Denim Schneider, Nathan Boles, Niki Edge, Brandon Paullin, Bob Skinner

Voting Members Not Present

Paula McDonald, Ryan Miller, Tina Marie Sears, Ezra Flaherty, Katie Alexander
Minutes: Toni McGarvey

Facilitator: Cynthia Kodachi

Consultant: Joe Bober, Mercer

Mercer Presentation: Medical and Pharmacy RFP

Discussion

Rachel Forslund introduced herself as the County’s new Benefits Manager and informed the committee that she will be serving as the primary County representative for future Benefits Review Committee meetings. 

Joe Bober introduced Morgan Hoffman as a new Mercer consultant who will assist with implementation activities related to the County’s medical and pharmacy transition.

Mr. Bober presented the results of the medical Request for Proposal (RFP), explaining that proposals were received from Aetna, Regence, and Moda. UnitedHealthcare declined to submit a proposal. Mercer evaluated each proposal, with proposals created by reach carrier repricing the County’s 2025 medical claims, and projecting estimated 2027 costs. The analysis compared projected medical claims, administrative fees, implementation costs, variable fees, and provider discounts.

Mercer’s financial analysis found that Aetna’s provider discounts were comparable to those provided by Providence and produced the lowest projected overall cost. Regence and Moda were projected to result in higher medical costs due primarily to lower provider discounts.

Provider network disruption analyses were also reviewed. Aetna demonstrated the lowest projected disruption to providers and facilities. Mercer noted that Regence’s results were impacted by the pending contract negotiations between Regence and OHSU, making future network participation uncertain. Mercer further reported that Aetna agreed to continue covering licensed alternative care providers using an “any willing provider” reimbursement approach, significantly reducing disruption for employees who utilize chiropractic, acupuncture, massage therapy, and other alternative care services.

The committee discussed the methodology used to compare proposals, assumptions used in projecting 2027 costs, opportunities for additional contract negotiations, provider network stability, and continuity of care following Providence’s withdrawal from the commercial insurance market. Mercer clarified that Providence hospitals and physicians remain contracted with multiple commercial carrier networks and will continue to be available regardless of the County’s future carrier selection.

Mr. Bober then presented the pharmacy benefit manager (PBM) analysis. Proposals from Regence, Moda, CVS Caremark, Express Scripts, and OptumRx were evaluated using projected claims costs, manufacturer rebates, administrative fees, and implementation expenses. The analysis showed OptumRx with the lowest projected overall pharmacy cost, while disruption levels varied slightly among the pharmacy benefit providers.

Discussion focused on formulary disruption, pharmacy network access, rural pharmacy availability, potential impacts to members enrolled in coinsurance-based prescription plans, and therapeutic alternatives for medications that may not appear on future formularies. Mercer explained that approximately one percent of covered members would experience formulary changes and that affected members would receive advance communication and assistance identifying clinically appropriate therapeutic alternatives prior to implementation.

Committee Questions

Committee members requested clarification regarding:

• The assumptions used to project medical and pharmacy costs.
• Opportunities to negotiate administrative fees with prospective vendors.
• Alternative care reimbursement under Aetna.
• Pharmacy network availability for rural members.
• Potential member cost differences associated with therapeutic alternatives.
• The process and timeline for selecting both the medical carrier and pharmacy benefit manager.

Rachel Forslund explained that while the Benefits Review Committee may provide recommendations, final vendor selection will be made by County leadership and the Board of County Commissioners.

Next Steps

County staff will present the medical and pharmacy RFP recommendations to County leadership and the Board of County Commissioners during the following week.

Presentation materials reviewed during the meeting will be distributed electronically to committee members.

Mercer will return at the next meeting with updated 2027 renewal projections and plan design modeling, including projected financial impacts associated with deductible changes, copay adjustments, out-of-pocket maximum changes, and optional GLP-1 prescription drug coverage.

Committee members requested additional information describing Aetna’s administration of alternative care claims to assist members in understanding how those services would be managed under a new carrier.

Other Business

Minutes from the Benefits Review Committee meetings occurring on 4/16/26, 5/21/26 and 6/16/26 had been distributed prior for review. Minor edits had been received and completed, and no additional revisions were reported during the meeting.

Motion made by Greta Nickerson to accept and approve minutes from BRC Meetings for April, May and June as written.

Motion was seconded by Alex Gonzalez

Yay/Nay Count: 15 Yes, 1 Abstention, 0 Nay 
Motion passes to accept minutes as written

Adjournment

The meeting concluded following completion of the scheduled agenda at 2:33 pm.