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From YouTube: Committee on Ways & Means on February 3, 2020
Description
Docket #0191 - Order accepting the provisions of M.G.L. c.32B ยง19 within the City of Boston.
A
City
councilor
I'm,
the
chair
of
the
Boston
City
Council
Committee
on
ways
and
means
joined
by
councilor,
asabi,
George
and
councillor
Flynn
I
want
to
remind
you
that
this
public
hearing
is
being
recorded
and
broadcast
on
Comcast
8,
our
cnat
to
Verizon
1964
and
streamed
at
Boston
gov
under
City
Council
TV.
If
everyone
could
silence
your
cell
phones
and
other
devices
we'll
take
public
testimony
at
the
end
of
this
hearing,
I
would
appreciate
it
if
you'd
sign
in
and
indicate
if
you'd
like
to
testify
when
folks
are
testifying.
A
A
Accepting
the
provisions
of
M,
G,
L,
C,
32
B,
section
19
within
the
city
of
Boston,
will
be
hearing
from
the
city's
CFO
I'm
a
handy
and
Marie
Noonan,
director
of
Labor
Relations
ELISA
Cadillac,
the
chair
of
the
Public
Employee
Committee
and
Pam
Tauscher,
president
of
the
Boston
municipal
Research.
Bureau
so
without
further
ado,
we'll
start
with
a
presentation
from
the
city's
chief
financial
officer
emma
handy
great.
B
Thank
You
chairwoman:
congratulations
on
your
first
hearing,
looking
forward
to
talking
through
the
details
of
what
we'll
present
today
happy
2020
to
all
the
other
councillors
and
I'm,
looking
forward
to
the
work
that
we
have
ahead
of
us
this
year,
you'll
see
some
very
familiar
budget
slides
as
I
move
through
this
presentation.
Obviously,
healthcare
is
a
big
piece
of
what
we
pay
for
on
the
annual
budget
and
that's
part
of
why
we
come
to
you
today
seeking
this
authorization
chairwoman.
As
you
mentioned,
I'm
joined
by
n
Murray
Noonan
who's,
the
city's
director
of
Labor
Relations.
B
There
are
several
other
members
of
the
city's
bargaining
team
here
with
us
today:
Vivian
Leonard,
Mariana,
Gill,
Jackie,
Wilson
and
Linda
Fraley.
Who,
if
you
ask
me
any
really
hard
questions,
I
will
have
to
call
them
up
and
ask
them.
But,
as
you
mentioned,
I'm
gonna
start
with
a
brief
presentation
to
just
background
on.
Why
we're
here
today,
once
I
move
through
the
presentation?
B
I
will
circle
back
around
to
who
the
PC
is
and
how
we
engage
with
them
and
why
we've
worked
together
to
come
before
you
today
to
seek
the
approval
of
authorization
to
extend
the
authorization
that
allows
us
to
collectively
work
together
on
healthcare
benefits
for
our
city
employees.
So
moving
to
these
slides.
B
So
the
there's
some
important
context
on
sort
of
why
we
are
where
we
are
today
and
why
we
bargain,
with
our
unions,
collectively
about
overall
health
benefits
for
city
employees
in
FY,
o
1
through
FY
11,
our
healthcare
costs
increased
around
an
average
of
9%
a
year.
We
typically
benchmark
cost
like
this
fixed
cost
and
costs
that
are
growing
at
a
fast
rate
against
all
other
costs
and
you'll
notice
in
this
chart
that
those
costs
were
growing
by
about
3%
per
year.
B
B
We
contracted
with
an
actuarial
firm,
which
has
helped
us
over
the
last
several
years
to
improve
our
forecasting,
which
helps
us
to
predict
costs
and,
obviously
to
budget
responsibly
year
over
year
in
FY
12,
we
were
provided
a
new
avenue
for
addressing
healthcare
reform
because
of
municipal
health
care
reform
that
was
passed
at
the
State
House.
The
chapter
xxxii
B
allows
municipalities
several
options
through
which
they
were
able
to
address
rising
healthcare
costs.
B
The
first
sort
of
outside
of
sort
of
how
benefits
were
set
was
that
they
require
mandatory
Medicare
enrollment,
which
offered
huge
savings
to
the
city
over
the
life
of
since
we've
implemented
that
they
also
through
this
legislation,
created
a
defined
process
through
which
cities
and
towns
could
negotiate
with
unions
to
control
healthcare
costs,
and
there
were
really
two
paths
to
doing
that.
Either.
Municipalities
could
design
plans
that
could
equal
savings
up
to
the
the
GIC
designed
plans
or
municipalities
could
choose
to
join
the
GIC
itself.
The
city
chose
the
former
path.
B
So
the
the
agreement
that
spanned
FY
12
through
FY
15
included
some
premium
share
increases,
as
well
as
the
introduction
of
some
co-payments
for
non
Medicare
plans
along
side
of
those
cost
savings
contract
provisions.
We
also
implemented
several
savings
initiatives,
including
moving
from
fully
insured
to
self-insured
for
Harvard
Pilgrim,
which
is
where
most
of
our
members
receive
their
care.
B
You
can
see
from
this
chart
that
that
dramatically
improved
our
experience
primarily
around
the
move
to
mandatory
medicare,
but
also
some
of
the
other
plan.
Design
elements
actually
resulted
in
a
1
percent
average
annual
decrease
of
healthcare
expenditures
over
the
life
of
that
contract,
so
significant
savings,
and
certainly
what
we
were
able
to
capitalize
on
the
opportunity
presented
to
us
from
municipal
healthcare
reform
working
with
the
the
provisions
in
that
contract
from
FY
16
FY
20.
We
were
governed
by
the
second
P
EC
agreement.
B
We
also,
similarly
to
the
first
round
increased
member
premium,
share
and
also
increased
co-pays
so
and
implemented
some
other
changes,
including
further
implementation
of
self
insurance.
For
remaining
plans,
and
on
this
chart
you
can
see
that
from
FY
15
to
FY
18,
we
were
able
to
reduce
those
costs
from
prior
to
municipal
health
care
reform
still
growing
by
about
6%
average
annual
growth.
B
B
This
next
slide
just
shows
that
that
pie
chart
is
not
fixed,
as
those
things
start
to
take
up
more
and
more
space.
They
start
to
squeeze
other
things
out
year
over
year.
In
particular,
our
pension
liability
is
something
that
we
work
very
hard
together
every
year
to
fully
fund
and
I.
Think
there's
a
very
good
story
there
in
terms
of
the
City
of
Boston
being
able
to
keep
pace
with
that
liability
schedule.
However,
it
is
costly
and
does
continue
to
require
additional
investment
every
year.
B
B
We
obviously,
as
I,
mentioned
some
sort
of
good
slides
to
start
the
beginning
of
the
calendar
year
as
we
as
we
think
about
the
fiscal
year.
That's
about
to
be
upon
us.
We,
our
budget,
is
constrained.
We
have
to
have
a
balanced
budget,
the
state
mandates
it
and
in
fact
they
check
it.
Every
December,
when
we
submit
our
tax
rate
to
make
sure
that
our
revenues
are
in
line
with
our
spending.
We
have
relatively
restricted
tech
tax
growth.
B
We
are
restrained
by
proposition
two
and
a
half
in
terms
of
how
much
our
property
taxes
grow
every
year,
and
so
we
don't
have
those
sort
of
windfall
tax
years
like
the
state.
When
income
taxes
come
in
higher
than
expected-
and
we
do
have
these
ever-rising
fixed
costs,
most
notably
something
like
pension
liability,
but
certainly
also
coming
fast,
on
the
heels
of
the
commitments
that
we
have
to
our
pension
schedule.
The
commitments
that
we've
made
to
fund
our
open
liability
as
well.
B
So
all
of
these
things
put
a
pressure
on
what
we
are
able
to
afford
in
the
budget
and
mean
that
we
have
to
take
a
close
look
at
health
care
costs
and
how
we
can
control
those
costs.
As
we
moved
into
this
round
of
negotiation
with
the
PC
before
negotiating
with
the
PC,
we
projected
that
our
health
benefits
cost
would
rise
by
roughly
7%
annual
annually.
B
It's
really
important
that
the
city
received
this
authorization
to
be
able
to
negotiate
these
provisions
with
the
P
EC
and
ultimately
be
able
to
implement
changes
to
the
city's
health
insurance
offerings
so
that
we
can
continue
to
actively
bend
that
cost
curve
without
moving
to
the
GIC,
which
is
sort
of
the
other
option
given
to
us
under
me,
new
school
municipal
healthcare
reform.
There
are
a
bunch
of
other
slides
at
the
back
of
your
presentation
that
I
will
not
spend
a
lot
of
time
on
just
to
say.
B
There
are
a
number
of
terms
that
may
come
up
today
as
we're
talking,
including
premium
share,
which
is
really
just
the
amount
of
your
monthly
premium
that
your
employer
pays
versus
you
as
an
individual
pay,
the
co-payment
and
dibbles,
and
on
the
next
slide,
you'll
see
a
little
visualization
that
helps
sort
of
break
those
out
in
terms
of
how
they
apply
to
each
other.
For
many
many
years
the
city
had
I
mentioned
historically
in
the
last
couple
of
rounds
introduced
co-pays
this
current
negotiation.
B
That
is
before
you
will
include
the
first
introduction
of
a
deductible,
and
so
some
of
these
plan
design
elements
are
newly
introduced
as
part
of
this
negotiation,
but
they're
all
aimed
at
lowering
overall
healthcare
costs
to
the
city
so
that
we
were
able
to
make
those
investments
in
other
city
services.
So
I
will
stop
there
in
this
presentation.
I
just
want
to
quickly
return
to
this
concept
of
the
Public
Employees
Committee
and
mentioned
that
this
is
a
group
that
represents
something
like
40
unions.
B
They
come
together
monthly
with
the
city
of
Boston
staff,
who
oversee
Human,
Resources,
Labor,
Relations
and
health
benefits,
or
we
work
on
all
manner
of
things
together
related
to
health
benefits
for
our
city
employees.
Obviously,
every
few
years
we
also
undertake
you
know
almost
for
the
better
part
of
a
year,
a
negotiation
to
set
these
health
benefits,
and
so
it's
a
it's
been
a
very
positive
relationship
for
the
city
of
Boston.
B
The
authority
granted
under
municipal
healthcare
reform
to
enter
into
this
type
of
relationship
has
worked
very
well
for
us
and
I
think
yielded
now
three
agreements
that
the
city
feels
very
good
about
and
is
very
appreciative
to
our
partners
in
the
union's
for
working
through
that
process
with
us
and
spending
a
great
deal
of
time
getting
to
know
the
details
of
the
health
insurance
that
we
provide
talking
through
options
and
really
trying
to
understand
what's
best
for
both
the
city
and
our
employees.
In
terms
of
the
benefits
that
we
provide.
B
So
with
that
I
will
I
think
stop.
I
just
want
to
think
again.
The
city
team
that
worked
on
this,
as
well
as
all
of
our
PC
members
that
spend
a
great
deal
of
time
together.
Working
on
the
details
of
this
agreement
and
as
I
mentioned
I
think
it's
been
a
very
good
relationship
for
the
city
and
has
yielded
positive
results,
and
it's
something
that
you
know
will
come
we'll
start
to
see
the
results
of,
as
we
would
start
working
on
the
FY
21
budget
together
so
happy
to
take
any
questions
that
you
all.
A
Great
thank
you.
I
was
wondering
if
you
could
just
speak
a
little
bit
to
the
kind
of
chief
changes
in
agreement
for
the
next
five
years.
Five
years
short,
so
you
provided
us
with
a
summary
of
those,
but
if
you
could
just
speak
a
little
bit
to
that.
B
Sure
so,
as
I
mentioned,
the
primary
changes
around
plan
design
are
actually
the
introduction
of
a
new
medical
deductible.
This
will
be
effective
in
year,
two
of
the
agreement,
so
that
begins
in
year,
FY
22
and
it's
$100
for
remember,
$200
for
family
for
the
HMO
plan,
$250
per
member
and
$500
for
family.
In
the
PPO
plan,
we've
also
introduced
either
some
increases
or
new
co-pays
on
on
certain
services.
B
So
a
small
increase
to
the
specialist
visit
new
co-payment
on
outpatient
hospital
surgery
and
advanced
imaging
those
are
capped
at
once
per
year,
so
most
other
places.
The
co-payment
would
hit
every
time
you
that
you
reached
the
service,
but
in
this
case
it
would
we've
maxed
those
one
out
at
once
per
year
and
then
also
some
prescription
co-payments
that
we
did
have
those
co-payments
before,
but
we
increased
sort
of
the
upper
tier
of
those
cheer
drugs.
I
should
also
mention
that
we
did
make
some
adjustments
to
the
premium
member
premium
share.
B
So
for
HMO
it
was
historically
19
and
a
half
percent
for
PPO,
twenty
nine
and
a
half
percent,
and
so
the
Medicare
plans,
twelve
percent.
At
the
end
of
this
agreement,
it
will
be
20%
for
HMO,
sorry,
21
percent,
twenty
one
point:
five
percent
for
HMO
by
year,
three
thirty
one
point:
five
percent
for
PPO
by
year,
three
and
14.5
percent
by
year,
five
for
the
Medicare
plans.
B
The
last
thing
I'll
mention
is
that
the
city
and
the
unions
work
together
to
shift
the
administrative
cost
of
our
flexible
spending
account
onto
the
city
and
away
from
employees.
The
cost
of
that
was
about
four
dollars
a
month,
but
it
was
sort
of
eating
into
the
tax
savings
that
people
can
achieve
by
using
those
plans,
and
the
goal
of
that
is
really
to
incentivize
and
encourage
employees
to
use
those
plans
to
offset
some
of
the
plan.
B
Design
changes
that
I
just
mentioned
so
that,
for
example,
if
an
employee's
for
the
first
time
experiencing
a
hundred
dollar
deductible
that
they
can
actually
set
that
up
through
their
flexible
savings
account
that
that
will
actually
be
deducted
from
their
payroll
over
the
course
of
the
year,
even
if
they
did,
even
if
the
deductible
hits
early
in
the
year
right
away
and
so
they'll
have
that
opportunity
to
really
spread
that
over
their
pay
periods,
rather
than
have
to
absorb
it
at
the
time
that
they
that
they
experience
it.
I
want.
A
To
note
that,
since
the
beginning
of
this
hearing,
we've
been
joined
by
counselor
Mejia
and
counselor
Edwards,
and
also
the
quick
summary
of
the
changes
that
I
referred
to
is
the
second
and
third
page
in
people's
packets,
the
introduction
of
a
deductible.
Can
you
just
speak
to?
Were
we
atypical
and
not
having
that
before
compared
to
other
municipalities
or
the
GIC?
Can
you
just
give
us
some
context
on
that
short.
B
I
would
say
we
were
atypical
I'm,
pulling
up
my
notes
here
on
some
other
other
places,
so
the
GIC
I
believe
and
I
should
say
when
I
talk
about
ours,
we're
talking
prospectively
over
the
next
five
years,
the
numbers
that
ia
will
cite
for
the
GIC
and
others
are
what
we
know
to
be
current
day,
so
it
doesn't
reflect
any
prospective
changes
that
they
make
in
theirs
as
well,
for
their
non
Medicare
plans.
I
believe
the
GIC
is
$500
per
member
and
$1,000
per
family,
as
opposed
to
our
hundred
dollars.
B
Member
$200
of
family
in
our
HMO
plan,
others
in
cities
and
towns
really
depend
some
have
joined
the
GIC.
Some
have
adopted
their
own
generally.
They
are
somewhere
in
between
the
GIC
and
where
the
City
of
Austin
is
today,
but
usually
significantly
higher
than
where
the
City
of
Austin
landed
through
the
course
of
these
negotiations.
B
The
other
thing
I
should
mention
is
that
the
other
thing
that
the
city
the
unions
agreed
to
is
that
we
will
pursue
a
limited
Network
plan
as
part
of
this
next
round
of
benefits,
and
there
will
be
no
deductible
with
that
plan
as
well.
So
it's
another
opportunity
for
our
employees
to
take
advantage
of
that
benefit
and
that
service
and
to
avoid
the
deductible
by
basically
choosing
a
plan
that
has
more
narrow
options
available
to
them,
but
will
protect
them
from
some
of
the
new
plan,
design
elements
that
are
introduced.
A
B
Absolutely
so
the
advantage
for
us
has
really
been
that
we
are
only
paying
for
the
claims
that
are
incurred
for
city
of
Boston
employees.
If
you
are
in
a
regular
insurance
plan.
Your
experience
of
your
members
is
blended
with
the
experience
of
many
other
employers
members,
so
we
really
only
play
pay
for
the
claims
that
are
for
city
of
Boston
employees.
The
benefit
to
that
is
just
that.
It
basically
creates
savings
with
us
without
us
having
to
change
the
services
that
we
provide
to
our
city
city
employees.
B
We've
certainly
experienced
that
savings,
so
I
think
the
hypothesis
proved
out
in
terms
of
what
we
expected.
The
downside
is
that
if
we
were
to
have
some
catastrophic
expensive
members
or
issues
that
we
would
pay
those
costs
100%
and
that
nobody
else
is
providing
any
sort
of
risk
adjustment
for
that.
But
so
far
we
have
been
successful
in
managing
those.
B
The
city
and
the
PTC
together
collectively
manage
a
trust
fund
that
allows
us
to
plan
year
over
year
and
basically,
we
use
any
surplus
or
savings
that
we
achieve
over
year
over
year
and
put
it
back
into
the
trust
fund,
and
it
allows
us
to
plan
for
things
like
that.
So
it's
really
been
a
positive
experience
for
us
and
allowed
us
to
control
costs
and
not
to
pay
basically
risk
associated
with
other
other
employers.
Employees.
A
And
in
terms
of
in
for
this
Agreement
you're
projecting
a
60
million
dollar
sort
of
savings
over
the
life
of
the
agreement
right
and
then
I
know.
For
the
last
five
years
there
was
a
forty
five
million
dollar
projection
in
the
last
agreement.
How
did
how
did
that
measure
out
against
the
actuals
of
what
we
sort
of
saved.
B
Yes,
so
I
think,
though,
obviously
those
numbers
are
always
projections
and
it's
it's
a
little
bit
hard
to
look
back
and
quantify
exactly
sort
of
what
the
estimate
was
and
where
we
landed
on
that,
because
these
estimates
are
really
cost
avoidance.
Estimates
they're
not
sort
of
hard
dollar
savings,
but
they're.
Rather,
we
would
have
spent
in
this
case,
sixty
million
dollars
more
over
the
life
of
the
five-year
contract.
Had
we
not
so,
it
can
be
hard
for
us
to
actually
go
back
and
sort
of
take
and
tie
exactly
how
that
has
been
achieved.
B
I
will
say
that,
in
addition
to
the
plan
design
elements
that
we
cost
as
part
of
the
contract,
we
do.
We
have
worked
with
the
unions
to
include
other
elements
in
our
agreements
that
have
yielded
additional
savings
above
and
beyond
the
estimates
that
we
have
included.
So,
for
example,
in
the
last
round,
we
estimated
about
three
million
dollars
of
moving
sort
of
all
of
the
remaining
plans
after
Harvard
Pilgrim
to
self
insurance.
We
saved
about
a
million
dollars
from
the
PDP
switch
for
medics
and
another.
B
You
know
three
to
four
million
dollars
on
the
Harvard
Pilgrim
PDP
switch,
which
is
a
prescription
drug
switch
so
in
over
overall
we've
saved
I
think
above
and
beyond
what
we
anticipated.
Certainly
I,
think
the
member
experience
with
self-insured
and
achieving
some
of
the
plan.
Design
elements
have
certainly
all
of
those
savings
and.
C
I
think,
as
I
mentioned,
there's
approximately
40
unions,
who
are
represented
there.
Generally
speaking,
I
think
it's
been
a
very
positive
experience.
I
think
the
parties
try
to
ensure
you
know
the
PC
I
think
it
tries
to
make
sure
all
of
its
members
are
well
represented,
that
we
are
taking
keeping
in
mind
even
our
lowest
wage
earners
to
ensure
that
they
can
continue
to
have
health
care
that
they
can
access
and
actually
afford
to
use.
D
Thank
you,
council
block
for
having
and
sharing
this
hearing
into.
The
piano
is
for
for
being
here
for
this
important
discussion.
Health
care
is
not
only
one
of
the
most
important
benefits
that
we
offer
to
our
city
employees.
It
also.
It
is
also
one
of
the
biggest
costs
in
our
budget.
Health
care
for
our
employees
should
be
affordable.
You
know,
offer
good
services
I'm
here
to
learn
more
about
the
details
of
the
agreement
and
want
to
make
sure
that
the
agreement
is
fair
to
the
city
and
especially
to
our
low
wage
city
employees.
D
They
work
so
hard
for
the
residents
of
Boston.
The
rent
is
so
high
in
the
city
and
a
lot
of
city
employees
that
I
talked
to
whether
it's
in
South,
Boston
or
Chinatown
or
Roxbury.
They
love
their
job.
They
work
extremely
hard,
they're,
very
professional,
but
they're,
barely
making
it
in
this
city,
I
just
hope.
We're
not
increasing
prices.
D
Increasing
the
cost
of
healthcare
on
to
our
lowest
wage
workers
is
that
is
that
a
concern
that
you
also
share
that
looking
at
some
of
these
some
of
the
changes
that,
if
their
prices
would
increase,
increase,
we
who
would
who
would
end
up
paying
for
the
the
cost?
Would
it
be
a
lot
of
these
low
low
wage
city
workers
councillor.
B
B
I
mentioned
before
that
prior
agreements
had
focused
savings
heavily
on
premium
share
as
a
means
for
achieving
a
lot
of
savings,
and
basically,
what
that
means
is
that
we
sort
of
lowered
the
amount
of
the
percentage
that
the
City
of
Boston
was
contributing
to
the
monthly
premium
and
increase
the
employee
amount.
We
did
that
also
in
this
round,
but
to
a
more
measured
degree,
and
that
was
really
because
I
think
we
collectively
all
those
around
the
table
were
concerned
about
I'm
sort
of
just
the
outright
premium
split
being
a
place.
B
That
would
have
a
disproportionate
impact
on
our
lowest
earners
and
so
by
doing
things
like
the
deductible
paired
with
the
FSA,
which
would
allow
for
planning
over
multiple
pay
periods,
with
a
relatively
small
annual
cost,
assuming
you're
an
HMO
plan,
but
even
so
in
the
PPO
plan,
comparatively
to
two
other
offerings
across
the
state
that
that
would
allow
for
greater
planning
and
would
have
a
less
direct
impact
on
our
lowest
wage
workers.
So
certainly
something
we
talked
a
great
deal
about
as
part
of
the
negotiations
and
I.
B
D
Workers
and
I,
see
city
workers
that
that
are
working
hard
and
they
provide
a
tremendous
tremendous
services
to
the
city,
but
they'll
be
in
line
waiting
to
buy
accantus
and
the
suit
might
be
a
dollar
nine
or
a
dollar
15,
and
they
have
a
dollar
chew
on
them
and
they
literally
at
times,
can't
buy
a
can
of
soup,
because
they're,
balancing
the
their
healthcare
costs,
they're,
balancing
food,
they're,
balancing
rent,
they're,
balancing
getting
the
kids
to
the
to
the
dentist
or
after-school
programs.
You
know
this
city,
this
is
a
wealthy
city.
D
You
know
it's
a
booming
city.
We
hear
that
almost
every
single
day,
I,
just
don't
want
to
see
increases
in
healthcare
cost
to
people
that
are
barely
surviving
in
this
city.
I
mean
that's
not
what
this
city
is
all
about,
so
that's
that's
where
I'm
coming
from
as
it
relates
to,
as
it
relates
to
this
hearing.
That's
it's
critical
that
when
we
we
do
impact
low-wage
worker,
you
know
what
else
can
we
do
to
help
them?
D
If
you,
if
you're
increasing
the
healthcare
cost,
is
there
something
else
that
could
benefit
them
and
their
families
to
you
know,
burden
that
burden
that
cost
that
they
have
to?
They
have
to
accept
what
their
families
they're
struggling
families,
but
have
we
thought
about
any
other
programs
that
always
to
to
help
them
yeah.
B
D
B
B
So
I
will
say
we
have
obviously
wonderful
EAP
services
here
in
the
city,
both
through
the
city's
HR
department,
but
also
for
police
and
fire,
but
also
you
know,
we
rely
on
our
on
our
health
care
providers
to
do
a
lot
of
that
work
and
connect
us
connect
our
employees
with
the
resources
that
we
need
I.
Think
as
with
you
can
see
more
broadly
in
Boston,
more
broadly
in
Massachusetts
and
even
nationwide.
There
is
an
incredible
demand
for
those
services
and
I
think
it
doesn't
always
hasn't
always
meet
met.
B
The
need
that
we
that
we
have,
and
so
we
continue
to
work
with
our
carriers,
to
make
sure
that
our
members
are
getting
access
in
a
timely
manner
to
mental
health
and
substance
abuse
services.
But
those
are
certainly
covered
as
part
of
our
plans
and
we
expect
our
employees
to
be
able
to
to
access
them.
No.
D
Thank
you.
My
final
comment,
you
know:
I
am
still
very
concerned
about
our
low
wage
workers
paying
more
for
their
their
health
care.
You
know,
I,
don't
know
how
long
they'll
be
able
to
continue
paying
high
cost
for
their
health
care.
At
some
point,
it
has
a
huge
impact
on
their
family.
If
we
thought
about
any
other
ways
to
address
revenue,
so
we
can
offset
increasing
the
health
care
costs
on
the
lowest
the
lowest
wage
city
workers
would,
though,
who
do
an
outstanding
job
for
our
city?
D
B
So
I
think
as
it
pertains
to
the
authorization
that
we're
seeking
today,
really
the
avenue
that
we
looked
at
was
around
limited
networks
in
sort
of
how
do
we
mitigate
the
cost?
In
that
way,
you
know
as
we
struggle
with
every
time
we
have
this
conversation.
Our
options
about
the
revenue
that
we
are
able
to
raise
unilaterally
without
going
to
the
Statehouse
is
relatively
restricted
and
so
I
think.
E
Okay,
thank
you
so
I
just
have,
and
maybe
this
is
not
the
place
for
it.
So
you
could
just
tell
me:
that's
the
second
part
too,
but
I
am
intrigued
and
I
do
actually
before
I
go
there
I'm
just
wondering
what
opportunities
to
follow
up
with
my
counselor
a
friend
over
here
Flynn.
What
opportunities
do
we
have
to
engage
our
local
hospitals
specifically
through
the
pilot
program?
E
Don't
have
access
to
health
insurance
after
they
retired
for
some
reason
or
another.
Maybe
they
don't
their
spouse
has
I,
don't
know
for
some
reason.
There's
an
issue
here
with
women
in
particular,
and
I'm
just
wondering
what,
if
anything,
the
city
is
doing
around
providing
health
insurance
for
folks
who
have
retired
and
I
have
a
specific
concern
about
women
in
particular,
it
was.
It
was
at
a
meeting
that
I
went
to
with
the
BTU
and
Kenzie
you
were
there
right.
E
You
know
what
happened,
but
I
don't
have
my
notes
with
me.
I
would
have
brought
them,
but
it's
specifically
about
women
who
have
retired
from
the
city
of
Boston
and
because
of
the
way
their
pension
is
set
up.
Are
you
are
either
haven't
been
fully
vested?
And/Or,
don't
have
access
to
health
insurance
and
they're
spending,
lots
of
money,
sure
I'm,
not
insurance
I'm,
just
wondering.
If
is
that
something
that
you
you
can
address.
B
B
This
this
agreement
is
responsible
for
the
employee
benefits
for
6
out
16,000
active
union
employees
as
well
as
14,000
retired
members,
and
so
it
certainly
does
cover
a
lot
of
retired
members.
Okay,
to
the
extent
that
they
are
not
covered,
then
obviously,
no
wouldn't
particularly
address
them,
but
I'm
happy
to
follow
up
and
get
some
more
information
from
you
about
what
exactly
the
issue
is
there
and
see
what
we
can
do
for
both
pension
and
other
post-employment
benefits?
A
B
I'm
not
sure
we're
able
to
say
that
today,
I
think,
certainly
the
cost-benefit
in
terms
of
the
plan
design
elements
would
be
there.
Obviously,
to
the
extent
that
we
are
able
to
make
the
premium
less
expensive.
I
think
that's
another
way
to
make
it
more
beneficial,
but
I
think
we
need
to
go
through
the
RFP
process
and
see
what
the
responses
are
and
what
people
offer
to
us
and
also
sort
of
how
it
hangs,
together
with
our
other
plan
offerings
at
the
time.
B
So
I
think
the
goal
is
to
provide
something
here
that
people
see
as
an
opportunity
and
want
to
join.
Obviously
they
are
making
a
trade
off
for
themselves
and
their
families
to
the
extent
that
they
do
join,
because
they
are
somewhat
restricted
in
terms
of
what
providers
they
have
access
to,
and
so
I
think.
The
overall
goal
is
to
make
that
more
affordable
for
employees
so
that
they
want
to
in
terms
of
exactly
what
that
split
looks
like
I
think
we
would
need
to
have
a
little
bit
more
information
before
we
can
say
definitively.
Ok.
A
B
A
B
A
F
Thank
you
for
having
me
my
name
is
Alyssa
cadelec
I
am
the
chair
of
the
P
EC
Committee
for
the
city
of
Boston,
so
I
speak
on
behalf
of
all
the
unions
that
do
sit
at
the
table
to
negotiate
healthcare,
the
city
of
Boston.
So
thank
you
for
holding
the
hearing
today.
Thank
you,
I
also,
first
hearing
and
new
faces,
so
it's
great
to
sort
of
be
here
and
kick
off
this
process
again.
F
You've
heard
already
a
lot
of
the
background
about
the
P
EC
so
and
how
we
got
to
where
we
are
today.
So
I'm
not
gonna,
spend
more
time
on
that.
But
there
are
some
things
that
that
I
would
like
to
highlight.
This
agreement
continues
the
work
that
we
do.
We
did
begin
in
2011
when
we
formed
the
P
EC
and
we
made
we
moved
health
insurance
bargaining
away
from
each
individual
table
and
brought
them
together
that
joining
together
has
made
it
much
more.
It's
made
it
much
easier.
F
It's
become
more
collaborative
between
the
cities
and
the
unions
when
we
are
talking
about
healthcare
and
I.
Think
the
fact
that
we
are
entering
into
our
third
agreement
shows
that
the
progress
that
we
have
made
from
2011
to
today,
and
hopefully
through
2025
our
goal
over
this
time.
The
unions
have
worked
collaboratively
with
Mayor
Walsh
in
the
city
of
Boston,
to
reduce
the
overall
healthcare
costs
and
maintain
quaddle
quality,
affordable
health
care
for
our
members
and
city
of
Boston
employees.
That's
really
important
to
the
Union
side.
F
Is
that
not
only
is
that
it
is
quality
care,
but
that
it
is
affordable
if
we
have,
as
councilor
Flint
mentioned.
If
we
have
our
lowest
paid
members
who
can't
afford
their
health
care,
then
having
access
to
great
care
doesn't
mean
a
difference,
doesn't
doesn't
do
anything
for
them.
So
that
is
something
that
this
agreement
does
continue
to
do.
It
allows
us
to
offer
different
plants,
including
aluminate
Network,
reduce
costs,
deductible
co-pays,
in
a
way
that
does
recognize.
F
These
unions
have
worked
together,
and
that
has
been
a
primary
thing
that
we
have
constantly
put
across
the
table
that,
even
though
we
have
a
range
of
salaries,
the
higher
salaries
and
the
higher
end
and
the
lowest
that
everybody
has
agreed.
That
is,
it
is
our
goal
to
protect
the
lowest
paid
workers
in
the
room.
The
unions
recognize
that
continuing
to
shift
cost
of
premium
share
would
not
be
enough
to
reduce
City
costs.
Overall,
we
were
cognizant
that
increasing
the
amount
away
and
out
of
people's
paychecks
is
not
the
way
to
move
forward.
F
So
with
this
agreement,
we
did
understand
that
implementing
a
low
deductible
and
new
co-pays
with
limited
of
one
time
per
year.
It
really
then
only
affects
those
who
need
it,
which
is
still
in
effect.
It
still
comes
out
of
their
paycheck.
However,
with
shifting
the
admin
fee
from
the
flexible
spending
account
over
to
the
city,
it
allows
people
to
really
pay
attention
and
plan
ahead
and
possibly
put
that
in
without
worrying
about
additional
fees
at
that
cost.
Reaching
a
five-year
agreement
also
allows
our
members
to
plan
ahead.
F
They
know
there
won't
be
any
sudden
increases
or
changes
to
their
health
care
over
the
next
five
years,
so
they
know
what
the
plan
will
be.
They
know
what
their
prescription
drug
costs
will
be.
They
know
what
they
get
when
they
go
to
the
doctor.
If
they
see
a
specialist
or
they
see
their
primary
care,
they
know
what
that
will
be.
F
So
this
also
helps
our
members
understand
that
as
their
paychecks
come
in
as
the
other
things
that
they
need
to
spend
money
on,
they
know
what
the
funds
they
need
to
allocate
in
advance
for
these,
for
these
costs,
work
need
does
need
to
be
done
on
the
rising
cost
of
health
care.
I.
Think
that's
beyond.
Certainly
this
agency
I
think
that
the
federal
level
that's
work
still
needs
to
continue.
F
But
again
the
unions
have
reached
agreement
with
the
city
we
can
enter
into
this
agreement.
We
certainly
hope
that
the
council
will
vote
favorably,
an
authorization
to
move
us
forward.
This
has
been
when
we
as
I
think
you
heard
my
counterparts
before
talk.
We
meet
monthly,
and
so
we
are
able
to
raise
issues
monthly.
We
are
also
a
razor.
A
able
to
raise
health,
insurance
or
health
benefit
things
that
aren't
part
of
this
agreement.
So
if
somebody
comes
with
something
that
has
come
up,
we're
able
to
talk
about
it
at
the
table.
F
The
opioid
epidemic
is
one
area
that
this
committee
has
really
worked.
Collaboratively
on
on
making
sure
that
our
member
and
all
city
employees
have
resources
access
to
resource,
they
continue
to
work
on
that.
So,
while
it
doesn't
form
in
this
agreement
that
you
have
before
you,
it
is
an
area
that
we
do
continue
to
work
on
collaboratively
together.
F
Our
second
live.
Well,
Expo.
We
actually
have
bags
for
all
of
you
that
will
come
up
in
there.
We
also
have
a
reusable
water
bottle.
That
looks
just
like
this.
There
is
a
flyer
in
there
and
the
nice
thing
about
these
bags.
Is
you
see
this
corner
in
the
side?
They
actually
fold
all
up
into
it,
so
you
can
throw
it
in
your
bag.
So
when
you
go
shopping,
especially
now
with
the
plastic
bag
ordinance
here,
you
don't
have
to
worry
about.
F
You
can
always
just
have
one
in
there,
so
we
will
be
handing
these
out.
Our
upcoming
Fair
is
on
Thursday
at
the
Boston
patrolman's
Association
over
in
Dorchester,
so
we
will
have
another
one
in
April
here
at
City,
Hall
and
then
our
third
one.
We
are
actually
hoping
to
do
at
one
of
the
Boston
Public
Library
locations,
and
so
we
are
encouraging.
It
is
open
to
all
city
of
Boston
employees,
and
this
is
our
way
for
to
bring
our
vendors,
our
health
care
carriers
to
come
in
and
do
things
like
biometric
screenings,
gait
analysis.
F
We
have
different
vendors
coming
in
that
are
local,
that
our
city
folks
today
actually
just
went
to
pick
up
snacks
from
one
of
88
acres,
which
is
a
seed,
nut
free
vendor
to
be
able
to
promote
different
things.
So
we
are
working
also
collaboratively
with
our
city
partners
and
our
businesses
and
our
organizations
to
really
work
on
making
our
employees
that
much
healthier.
Thank
you
for
your
time.
If
anybody
has
any
questions
or
clarification
from
what
you
heard
before,
I
am
happy
to
to
take
that.
Thank.
F
From
9:00
to
3:00,
so
it's
9:00
to
3:00.
If
you
do,
we
will
have
vision
2020
on
sight.
So
if
you
want
to
have
your
eyes
check,
there's
a
registration
link
on
the
flyer,
that's
in
your
bags
as
well.
We
do
recommend
pre-registration,
but
that's
the
only
thing,
and
that's
really
so
they
can
check
health
insurance
too,
to
be
able
to
smooth
process,
but
drop
ends
are
welcome
to
go
through
the
whole
thing
and
and
really
experience
what
the
city
does
have
to
offer
for
its
members
and
its
employees
for
health
care.
D
F
In
this
agreement
there
is
no
animal
wear
change
that
is
specific
to
individuals
with
disabilities,
the
healthcare
agreement
or
the
agreements
that
are
covered
with
care
for
specialists
and
the
hospitals,
and
all
of
that,
so
individuals
will
still
have
access
to
all
of
the
current
care
levels
that
they
have.
Obviously,
when
we
put
the
RFP
out,
we
will
certainly
make
sure
that
none
of
that
changes
for
folks
that
do
have
already
existing
conditions.
F
We
do
have
EAP
and
those
are
things,
but
that
would
certainly
be
something
if
there
is
an
area
that
this
group
should
target
that
we
should
go
back
and
talk
about
at
the
table
to
make
sure
that
we're
not
missing
any
groups
we
do
when
we
sit
at
the
table.
We
do
hear
from
our
members
on
issues.
I
need
to
be
raised
so
when
there
are
things
like
that,
we
do
raise
them
collectively
and
work
to
address
those.
F
For
example,
we
this
was
outside
the
agreement,
but
one
of
our
carriers
used
to
limit
the
number
of
physical
therapy
appointments
that
an
individual
could
attend
in
a
year
as
a
result
of
that
being
brought
up,
the
city
was
able
to
go
back
to
the
carriers
and
negotiate
a
change
in
how
that
works.
So
that
is
one
area,
maybe
so
it's
not
in
the
agreement
itself,
but
it
is
part
of
the
fact
that
we
all
collectively
bargained
together.
F
F
You
know:
we've
been
fortunate
in
being
able
to
keep
those
amounts
low
and
with
this
agreement
as
well
by
limiting
to
if
somebody
does
have
to
have
a
go
to
the
hospital,
so
there
will
be
changes
to
our
members
where,
before
when
they
went
to
the
hospital,
they
wouldn't
pay
anything
now
they
will
have
a
fee,
but
we
were
able
to
limit
that
to
once
annually
if
that
does
even
come
up
other
things,
chiropractic
care
sort
of
those
alternative
medicines
are
things
that
people
do
ask
about.
City.
D
D
F
Expect
any
changes
as
a
result
of
this
agreement
I
think
that
when
we
do
issue
the
RFPs
for
the
new
network,
so
the
limited
Network.
You
know
right
now
with
the
carriers
we
have,
we
we
sort
of
have
all
broad
networks
or
a
PPO.
So
when
the
RFP
comes
out
that
may
make
some
changes,
but
the
availability
people
employees
will
still
have
the
ability
to
choose
between
the
carrier's
to
get
the
service
that
they.
D
E
I'm
just
curious:
when
I
fell
down
my
health
insurance
application,
I
was
told
that
I
was
not
gonna,
hit,
dental
or
vision
for
six
months,
I'm
in
and
I,
don't
know
if
you
represent
city
councilors
too,
as
part
of
the
you
I
mean
I'm,
a
city,
employee,
absolutely
I,
don't
know
I'm
a
city,
employee
too,
yes
kind.
You
know
so
I
fall
into
that
I'm
just
curious
as
to
what
happens
within
that
six
month
period
of
time,
and
you
know
what
what
do
you
tell
your
members.
F
It
is
I
have
had
that
conversation
with
my
members
where
folks
have
come
in
and
asked
her
when
we,
when
we
join
the
MPD
fund
and
got
the
dental
and
got
the
vision.
It
is
a
six-month
pay
into
on
behalf
of
the
city
into
that
fund.
More
explanation
about
that
might
come
better
from
my,
but
in
terms
of
talking
to
my
members,
it
is
a
hard
conversation
to
say
to
them.
F
You've
started,
you
know
where
we
don't
pay
into
this,
but
it
in
there,
and
you
have
to
wait
six
months
to
have
access
to
this,
whereas
your
health
benefits
start
immediately
the
following
month
and
this
is
sort
of
outside.
So
this
is
an
area
that
perhaps
the
unions
would
be
interested
in
having
conversations
about.
It
is
not
again
part
of
this
agreement.
It
is
separate,
it
is
also
part
of
collective
bargaining
agreements.
So
a
lot
of
the
other
unions
do
have.
Some
of
the
larger
unions
have
their
own
vision.
F
They
have
their
own
dental
that
they
sponsor.
My
local
is
is
MPE.
We
do
not
offer
something
else
so,
depending
on
what
collective
bargaining
agreement
you're
under
and
what
union
you're
in,
they
may
have
an
opportunity
to
have
access
immediately
or
fairly.
You
know
before
that
six-month
period,
but
if
they
don't
and
they
just
fall
under
what
the
city
has
then
it
then
it
is
a
hard
conversation
to
say
to
your
members
that
they
have
to
wait
a
period
of
time
for
them
to
have
access.
Thank.
E
F
What
I
understand-
and
we
do
actually
have
Betsy
here-
who's
from
the
btu,
so
jump
in
if
this
is
inaccurate
from
what
I
understand
is
that
the
employees
are
not
that
aren't,
they
are
in
fact
eligible
for
health
care,
but
they
pay
at
the
active
rate.
So
we
have
two
rates.
We
have
the
active
employer
rate
and
then
we
have
the
retiree
rates.
The
retiree
rates
are
lower,
the
premium
share
is
lower.
There's
different
things,
cost
analysis
and
plans
that
go
into
that.
F
E
F
A
I'll
just
say
for
for
folks
who
might
be
watching
this
at
home
that
the
PTC
represents
these
40
unions
of
public
employees
and
technically
well,
and
actually
that
is
the
group
that
they
are
bargaining
for.
However,
they
exempt
employees
at
the
city
of
Boston
and
those
of
us
who
are
not
in
a
union,
including
the
city
councilors,
have
customarily
been
extended.
The
same
plan
offerings
as
the
unions,
so
even
though
technically
Alissa
isn't
bargaining
on
our
behalf
effectively.
She
is
and
that
that's
been
kind
of
the
norm
so
far
here
correct.
F
A
F
So
any
RFP
that
goes
out
through
the
P
EC
committee
has
a
subcommittee
made
up
of
P
EC
members
made
up
of
unions
of
the
unions,
elect
individuals
to
sit
on
those
committees
and
work
with.
We
also
have
our
own
consultant,
who
helps
us
with
some
of
that
language
to
make
sure
that
our
members
are
protected,
so
it
is,
it
is
built
in
and
is
the
way
it
has
been
there
is.
There
was
a
discussion
when
we
move
forward
at
the
table
about
making
sure
that
the
P
EC
is
at
the
table.
F
F
Yep,
so
typically,
the
individuals
who
sit
at
the
table
for
the
PC,
representing
the
unions
are
the
leadership,
so
each
union
designates
who,
from
the
Union
side
anyway,
each
union
designates
who
sits
there.
So
we
do
have
a
range
of
both
socio-economic
representation.
Women
that
sit
at
that
table
as
well.
So
there
is,
there
is
some
diversity
there,
at
least
from
from
the
Union
side.
But
again
it
is
up
to
the
individual
Union
to
determine
who
see
who
they
send
to
sit
at
the
table
and.
F
F
E
F
Somebody
at
the
top
level
for
there
so
I,
you
know,
as
I
said:
I
represent
the
library.
That's
usually
comes
to
sit
at
the
table
for
BTU
police,
send
one
or
two
individuals
of
each
of
their,
so
the
superior
officer
send
one
the
patrolmen
send
one
or
two
the
firefighter
send
one
or
two.
So
it's
not
every
every
division
or
every
group.
It's
sort
of
the
large
umbrella
unions
that
sendin
and
the
smaller
there's
a
lot
of
smaller
unions
as
well
that
they
have
the
opportunity
to
send
somebody
from
their
division.
So.
E
F
Depends
which
union
so
if
so
and
they
like
I,
have
custodial
in
my
so
if
they're
SEIU,
then
a
member
from
SEIU,
since
it's
able,
if
it's
Sina
somebody
from
Sina,
sits
at
the
table,
so
every
every
group
is
represented
or
has
an
opportunity
to
be
represented.
But
again
it's
typically
not
it
wouldn't
just
be
someone
a
City,
Hall
person,
or
you
know
someone
at
Franklin
Park
or
something
like
that.
It's
one
one
or
two
individuals
that
represent
that
entire
organizing
Union
group
I
think
yeah.
A
G
Thank
you
for
this
opportunity
to
speak
about
the
new
agreement
for
five
years
for
the
public
employee
committee
and
the
city.
Having
worked
together
to
reach
this
five-year
agreement
and
produce
quite
a
bit
of
stability
for
employees,
as
Alissa
mentioned,
I'm.
Pleased
to
be
here
as
president
of
the
Boston
municipal,
Research,
Bureau
I
am
also
a
city
resident.
G
The
research
bureau
applauds
the
public
employee
committee
and
the
administration
for
moving
to
the
PSC
model
in
2011
and
for
working
together
to
reach
this
five-year
agreement.
The
results
of
this
work
will
allow
the
city
to
continue
to
offer
competitive,
affordable
health
insurance
benefits
to
its
employees
and
retirees.
G
Now
I
had
a
role
with
municipal
health
insurance
in
both
Governor
Patrick
and
governor
Baker's
administrations.
My
work
included
overseeing
cities
and
towns,
health
insurance
negotiations
under
the
municipal
health
insurance
reform
act.
I
believe
this
is
the
third
such
agreement
between
the
public
employee
committee
and
the
city.
G
So
we're
pleased
to
see
that
once
again,
the
public,
employee
committee
and
the
city
have
come
to
some
ago.
She
ations
I
particularly
note
some
of
the
adjustments
made
by
the
city,
such
as
making
the
introduction
of
the
limited
network
plan
a
little
bit
more
palatable
by
not
providing
not
requiring
a
deductible
for
that
plan,
and
also
the
city
shifting
the
administrative
costs
of
flexible
savings
plans
from
the
employees
to
the
city
of
Boston.
G
D
A
C
A
E
D
A
Of
our
unions
on
to
that
state
plan,
which
has
forced
much
more
dramatic
cost
savings
and
therefore
you
know,
shifted
more
cost
burden
on
to
the
employees
and
that
the
agreements
that
have
been
negotiated.
The
prior
two
agreements
on
this
one
and
the
PA
see
sort
of
continued
a
trajectory
of
landing
somewhere
in
the
middle.
G
D
G
D
No
I
understand
I,
probably
should
have
asked
that
at
the
beginning
of
the
of
the
piano
discussion,
but
that's
it
that's.
The
issue.
I
would
like
to
get
a
little
bit
more
clarification
on
before
before
I
vote
on
it.
I
just
want
to
make
sure
that
you
know
our
retirees
who
are
also
really
making
it
in
Boston.
There
aren't
a
fixed
income,
they
might
own
a
million
dollar
home,
but
they're
also
paying
huge
property
taxes
on
it.
D
You
know
a
weak
cutting
a
weak
cutting
health
care
programs
for
our
retirees.
If
we
are
I,
would
really
like
to
know
that
before
before
I
do
vote
on
it,
our
retirees
live
in
our
neighborhoods.
They
still
contribute
to
our
city,
they're
active
they.
They
coach,
Little,
League
or
softball,
and
they're
active
in
our
church,
so
they
really
have
did
it
their
life
to
our
city.
So
I
would
really
like
to
get
some
more
information
on
that
before
before
we
vote.
G
D
A
E
You
Pam
for
your
work,
I'm
learning
I'm
following
Flynn
this
example
here,
Thank
You
Pam,
for
all
your
hard
work
on
this.
Thank
you,
madam
chair
I
am
I'm
gonna,
go
back
to
just
a
little
bit
on
what
councillor
Flynn
is
talking
about.
I
think
I
keep
going
back
to
the
btu,
because
it
was
my
most
recent
meeting
and
there
were
a
lot
of
retirees
there
who
are
juggling
to
make
their
ends
meet,
who
are
having
a
hard
time
paying
their
mortgage
and
keeping
up
with
all
of
these
costs.
E
B
Thanks
counselors
I
just
want
to
preface
this
by
saying:
I
think
it
would
be
helpful
to
we
will
go
back
to
the
BTU
and
make
sure
that
we
understand
the
sort
of
core
issue
to
make
sure
that
we
are
answering
the
question
correctly,
but
we
believe,
based
on
our
side
by
earning
just
a
moment
ago,
that
the
issue
is
really
around
Social
Security
eligibility.
So
before
the
mid-80s,
the
city
was
not
paying
into
Social
Security
for
our
members
and
therefore
they
were
not
eligible,
and
so
it's
really
around
a
federal
program.
B
There's
relatively
limited
flexibility
to
the
city.
On
that
it
sounds
like
we
need
to
get
some
more
information
to
make
sure
that
that's
actually
the
issue,
because
there
are
some
limitations.
Certainly
our
Medicare
population
is
primarily
City
retirees,
but
there
are
some
cases
where
and
maybe
others
because
of
this
particular
issue
around
Social
Security
and
paying
into
Social
Security
close
enough
and
then
I'll
just
add
sorry.
B
Just
councillor
Flynn,
you
asked
about
some
impact
on
retirees
in
this
agreement,
so
the
PC
was
particularly
concerned
about
mitigating
the
impact
to
retirees
as
part
of
this
agreement
and
so
really
tried
to
shield
retirees
from,
in
particular,
the
premium
share,
increases
and
so
you'll
notice
that
the
premium
share
increases
for
retirees
continue
to
be
much
lower.
They
were
lowered,
I
think
around
the
time
of
mandatory
mandatory
Medicare.
They
continue
to
be
much
lower
than
the
general
population.
A
Just
want
to
acknowledge
that
we've
been
joined
by
our
council
president
kim
Janey
and
also
I
just
wanted
to
ask
a
question.
So
my
understanding,
because
I
think
this
is
the
core
question
right.
My
understanding
is
that
the
new
P
EC
agreement
is
around
adjustments
in
cost-sharing
in,
in
terms
of
that
issue,
of
how
the
premium
slits
are
done
and
also,
and
also
the
introduction
of
a
deductible.
But
it
is
not
agreement
by
which
aspects
of
health
service
that
are
available
to
our
members
have
been
negotiated
away
or
changed
substantively.
That's.
A
That
none
of
that
has
changed
the
only
way
in
which
it
might
be
that
someone's
substantive
offerings
would
change.
Is
that
we're
introducing
a
limited
Network
plan
and
if
they
currently
are
on
a
different
plan
and
they
switch
to
the
limited
Network
plan,
then
they
would
be
more
limiting
the
providers
they
could
seek,
but
again
that's
not
about
cutting
off
services
to
them.
That's
my
question
of
choosing
to
operate
in
that
smaller
pool.
Is
that
all
accurate?
B
Yes
and
the
the
authorization
we're
seeking
is
the
continued
authorization
for
us
to
do
this
in
lieu
of
joining
the
GIC
we're.
Obviously,
all
of
these
plan
design
provisions
are
much
more
expensive
and
things
like
deductibles
are.
You
know
five
times
the
amount
that
the
city
and
the
unions
have
agreed
to
as
part
of
these
negotiations
and
I
think
you
know
there's
a
couple
of
options
in
that
realm:
either
we
can
match
their
plan
and
continue
to
provide
our
health
insurance
or
we
can
actually
join
the
GIC
you've.
B
You
know
I've
seen
municipalities
in
recent
years
continue
to
join.
You've
also
seen
some
start
to
drop
out
of
that,
and
so
I
think,
like
I
said
before.
This
has
been
a
very
positive
experience
for
both
sides
of
the
table
and
we
hope
to
continue
the
peace,
the
arrangement
into
the
future,
because
it
allows
us
the
flexibility
to
negotiate
the
plan,
elements
that
we
think
make
the
most
sense
for
city
of
Boston
employees.
D
You,
madam
chair,
and
somebody
my
comment.
The
question
would
be
is:
could
you
envision
a
scenario
where,
for
the
retirees
that
we
would
increase,
even
as
you
mentioned,
slightly
increase
their
cost
and,
at
the
same
time
cut
their
health
care
services?
Even
if
it's
slightly,
what
programs
is
that
a
remote
possibility?
There.
B
Is
no
element
of
this
agreement
that
envisions
cutting
services
to
whether
retirees
or
active
members,
so
we
neither
have
negotiated
to
be
able
to
do
that,
nor
even
discussed
it
as
part
of
this,
and
so
this
was
really
about
those
plan,
design
elements
sort
of
how
much
do
you
pay
when
you
go
to
the
doctor,
how
much
are
you
paying
on
a
monthly
basis
out
of
your
paycheck,
the
the
intent
and
the
agreement
does
not
provide
for
us
to
either
reduce
benefits
in
any
way
to
retirees
or
active
members?
Okay,.
A
E
Please
counselor
braidin
weavin.
You
were
at
the
meeting
with
me
at
the
btu
I,
keep
harping
on
this
just
because
I
need
to
make
sure
that
we
bring
their
voices
into
this
conversation,
and
there
were
some
concerns
about
specifically
some
of
the
women
who
had
already
retired
and
were
having
significant
financial
hardships
and
we're
talking
specifically
around
health
insurance
right
now.
This
hearing,
but
I'm
just
wondering
if
you
could
help
us
all
understand
why
I
keep
bringing
this
up
into
the
space.
C
H
Teachers,
some
of
them
had
like
up
to
40
years
service,
and
one
of
the
concerns
was
that
their
cost
of
living
increase
was
not
matching
the
increased
cost
of
of
just
it
wasn't
meeting
the
increased
cost
of
living.
So
I
see
here
that
you
know
projected
city,
healthcare
costs
will
rise,
the
benefits
costs
will
rise
by
7%
annually.
H
One
of
the
concerns
of
the
retired
retired
teachers
group
was
that
many
of
them,
especially
women,
and
it
wasn't
just
teachers.
It
was
all
municipal
employees
they
they
were
speaking
for
because
many
of
the
other
municipal
employees,
who
formerly
retired,
don't
have
a
union
like
to
be
to
use
organize
with.
So
they
were
concerned
that
many
of
them,
especially
women
and
they
were
adversely
impacted,
were
living
on
very
had
a
very
low
retirement
and
that
they
were
really
struggling.
H
And
so
my
concern
I
echo
consumers
concerns
that
you
know
there
are
a
particular
subset
in
our
municipal
employees
who
are
really
struggling
even
if
they've
served
thirty
five
forty
years
and
they
tend
to
be
in
the
lower
nor
paid
job
groups,
and
they
also,
it
was
adversely
affecting
women
who
had
had
to
take
a
break
in
their
employment
to
raise
children
or
take
care
of
elders.
So
I
comes
from.
He
is
concerns
and
to
bring
the
voices
of
those
particular
people
to
the
table
thinks.
B
Counselor,
so
it
sounds
like
part
of
that
is
she
may
be.
We
will
certainly
follow
up
on
the
particular
issues.
I
see
someone
we
can
ask
about
it
to
make
sure
that
we
get
the
right
information.
Make
sure
that
we're
following
up
on
the,
in
particular
the
health
care
issues.
It
sounds
like
the
other
side
of
the
equation
is
around
the
cost
of
living
increases
afforded
to
retired
city
of
Boston
employees,
which
you're
right
is
a
sort
of
separate
issue.
B
A
Fixed
costs
and
that's
a
process
this
spring
yep.
Are
there
any
further
questions
and,
oh
and
I
just
wanted
to
add
a
clarification
point,
so
the
7%
increase
in
health
care
costs.
That
was
what
they
were
projecting
if
we
didn't
implement
the
PE
C
changes,
so
no,
no,
no,
no
I,
just
I
wanted
to
catch
up
with
reading
the
report
quickly
have
that
on
the
on
the
record
that
were
hoping
through
this
agreement,
my
impression
is
both
sides
to
sort
of
bend
that
cost
curve.
That's
right,
anything
further!
Oh!
B
So
the
co-pays
that
existed
in
the
current
agreement
that
expires
June
30th
of
this
year
included
$20
for
primary
care
and
mental
health
$30
for
specialist
visit
$100
for
ER
and
then
sort
of
a
staggered
tearing
of
prescription
co-pays
below
for
non
Medicare
and
Medicare.
In
the
new
agreement
we
have
not
increased
the
primary
care
and
mental
health
copay
so
that
stands
at
$20.
The
specialist
visit
for
HMO
and
PPO
only
so
not
including
the
limited
network
protecting
the
limited
net
from
this
increase,
we'll
go
from
30
to
35
er
stands
at
100.
B
We
have
introduced
this
concept
of
a
1
per
year,
copay
for
inpatient
hospital,
outpatient
hospital
surgery
and
advanced
imaging
in
the
limited
network.
That
will
be
one
copay
a
year
of
fifty
dollars
and
it
will
be
one
copay
a
year
of
a
hundred
dollars
in
both
the
HMO
and
the
PPO,
and
we
have
increased
the
top
tier
of
the
prescription,
co-pays
the
medium
and
the
top
tier
of
prescription
co-pays.
B
So,
for
example,
we
have
moved
over
the
course
of
the
agreement,
I
believe
from
in
non-medicare
from
25
and
50
in
the
middle
tier
to
30
and
60
and
in
the
upper
tier
from
45
to
55
and
100
235.
So,
depending
on
what
type
of
medication
is
that's
for
non
Medicare,
there's
some
that
changes
as
well
to
the
Medicare
retail
as
well.
B
The
PPO
plan
will
have
a
250
dollar
member
deductible
$500
family
deductible,
those
deductibles
about
one
fifth
of
the
deductible
that
the
GIC
offers
most
other
municipalities
are
somewhere
around
the
range
of
350
for
an
individual
HMO
in
comparison
to
our
100,
so
still,
notably
below
other
municipalities,
in
terms
of
where
they've
negotiated
over
the
course
of
their
agreement,
to
the
extent
that
they
have
not
joined
the
GIC
or
have
reflected
the
GI
C's
changes.
Okay,.
B
And
I
would
just
add
just
to
make
sure
that
the
connection
is
made.
It
wasn't
important
part
of
this
for
us,
because
we
achieved
significant
savings.
By
introducing
that
deductible,
we
were
able
to
not
take
as
many
savings
through
premium
share,
which
is
how
much
of
your
monthly
premium
the
employee
pays
versus
the
city.
B
The
PC
in
the
city
were
very
concerned
that
our
lowest
wage
workers
would
have
a
hard
time
absorbing
bulk
of
the
cost
created
through
premium
share
shift,
because
just
expenses
that
come
out
of
your
paycheck
and
so
by
doing
a
low-cost
deductible
paired
with
some
incentivization
around
the
flexible
spending
accounts
and
a
limited
network
option
where
there
will
be
no
deductible
we're
giving
employees
a
way
to
more
proactively
manage
those
costs
so
that
we
are
addressing
issues
for
a
lower
low
wage
workers.
Good.