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The City of Portland ordains.

Section 1. The Council finds: 

1. The Bureau of Human Resources is responsible for the administration of employee health and welfare benefit plans.
    
2. The City’s health insurance costs for the Labor Management Benefits Committee (LMBC) are facing a 13.4% increase for fiscal year 2025-2026, which is valued at $15,000,000 more than current fiscal year. The City has budgeted 8% employee health insurance increases for this period.
    

3. As required by the collective bargaining agreements between the City and its unions other than the Portland Police Association representing members at Portland Police Bureau, the Bureau of Human Resources worked with the LMBC starting in June, 2024, to make plan design recommendations for the City’s self-insured and insured plans which bring costs within the target budget rate.

   The LMBC recommends, and the Bureau of Human Resources supports, the following plan design changes which have negligible impact or are already factored into the renewal costs:

   1. Continue five additional EAP visits, totaling thirteen visits per plan year for employees represented by Portland Fire Fighters Association and Portland Police Command Officers Associations, and ten visits per plan year for others covered under LMBC plan.
   2. Remove prior authorization requirement for nutritional therapy under CityCore medical.
   3. Add CirrusMD virtual visits to CityCore medical to expand virtual visit access.
   4. Cover sedation services under Class II benefits for Moda/Delta Dental members who self-identify as having intellectual and/or developmental disabilities.
      
      Additionally, the following plan design changes are recommended to reduce the renewal rate to 10%:
       
   5. Add Garner, a health navigation support program, to the CityCore medical plan which provides a financial incentive to members seeking services from high quality doctors.
   6. Add Hinge Health virtual musculoskeletal therapy coverage to CityCore medical.
   7. Add access to surgery Centers of Excellence (COE) under CityCore medical.
   8. Add Transcarent cancer support services under CityCore medical.
   9. Adjust Kaiser medical plan benefits to add $150 deductible, increase out-of-pocket maximum to $1,000, implement $15/$30/$50 three-tier pharmacy benefit, increase primary care copays to $15, increase specialty care copays to $25, increase urgent care copays to $35, change lab copays to $15 for simple and $75 for complex, add 20% coinsurance after deductible for outpatient surgery, inpatient services, emergency room, and ambulance.
       
4. The Health Fund Budgets for FY 2025-26 and the Payroll Clearing Fund include appropriations valued at 8% as identified above and included in the City Administrator’s recommendation for the FY 2025-26 budget. Funding the gap between the 8% presumed cost and 10% cost will increase the impact to the 2025-26 budget by $2,679,834.

NOW, THEREFORE, the Council directs: 

1. The Council hereby adopts the City Employee Benefits Program for fiscal year 2025-2026 that increases the cost of the plan by 10%, as reflected in attached Exhibit A. 

Section 2. The Council declares that an emergency exists to avoid undue and costly delay in providing benefits to plan participants; therefore, this Ordinance shall be in full force and effect from and after its passage by Council.