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A
A
A
So
everybody
knows
that
act
47
presented
the
city
of
a
lot
of
challenges.
One
of
the
big
challenges
was
how
we
were
going
to
get
to
twenty
percent
mandatory
contribution
from
our
employees.
When
it
comes
to
health
care.
This
year
it's
estimated
will
be
spending
53
million
dollars
just
on
health
care
costs,
53
million
taxpayer
dollars
on
health
care
costs.
But
what
makes
it
a
challenge
is
that
by
next
year,
that
number
is
expected
to
grow
to
64
million
dollars.
Years
ago.
A
Employees
that
have
had
their
salaries
frozen
four
years
won't
be
a
salary
decrease,
but
would
be
able
to
be
afforded
in
the
modest
increase
that
will
be
coming
in
the
future
years.
That
was
part
one
how
to
get
control
of
the
costs
of
a
health
care
system
that
are
continually
increasing,
how
to
make
it
so
that
city
employees
would
be
able
to
afford
it
and
we
can
get
to
that
mandated
goal
of
twenty
percent.
The
second
part
is:
how
do
you
create
a
healthier
workforce,
so
it
wasn't
so
much
just
saving
money.
A
So
all
of
this,
fitting,
together
in
a
comprehensive
package
of
health,
wellness
and
cost
savings,
is
a
new
approach
to
how
the
city
is
not
just
offering
insurance
anymore,
but
actually
offering
a
full
package
to
our
employees
to
make
their
lives
better
and
with
that
like
to
go
through
the
numbers
with
our
budget
director
director
Ashbaugh,
but
also
take
a
look
at
what
that
actually
means
to
city
workers.
Great.
Thank
you.
Mary.
B
Okay
cover
this,
so
a
couple
of
key
themes:
we're
going
to
focus
on
first,
as
the
mayor
said,
we're
going
to
talk
about
what
it
means
to
move
from
fully
insured
self-insured
arrangement.
We
also
want
to
talk
a
little
bit
more.
The
department
personnel
representative
here
about
the
increased
investment
in
our
health
and
wellness
program
and
how
that
will
play
not
only
in
to
employee
health,
but
also
how
healthcare
mitigating
the
cost
increases
of
health
care.
B
Employees,
which
is
important
and
also
finally,
personnel,
will
talk
about,
in
addition
to
expanding
the
health
and
wellness
program,
adding
some
new
leading
practices
such
as
telemedicine
into
our
portfolio
of
programs,
so
that
we
can
increase
employee
access
to
health
care,
which
also
can
has
a
role
in
mitigating
the
increase
of
cost
and
we'll
talk
about
how
that
will
come
into
play.
So
this
slide
here
the
mayor
kind
of
alluded
to
the
key
numbers.
B
When
we
started
our
budget
process,
we
were
faced
with
a
significant
increase,
employee
health
care
costs,
while
most
employers
going
to
kind
of
expect
this
as
part
of
their
financial
planning
process.
One
of
the
challenges
we
saw
was
that
this
projected
cost
increase
were
significantly
over
anything
new.
We
were
projecting
so
one
of
the
things.
Then
we
worked
with
towers
watson,
the
department
of
personnel
to
look
at
some
alternatives
that
we're
going
to
talk
about
right
now,
and
this
also
dis
out
lates
the
numbers
that
the
mayor
provided.
B
Okay,
so
one
of
the
things
that
you
know
we
were
looking
at
is
under
the
Act
47
plan.
We
are
required
to
implement
cost
containment
measures
which
include
increasing
the
employee
contributions
from
fifteen
percent
to
twenty
percent
of
employee
premiums
and,
while
city
mill
city
employees
will
get
a
one
percent
raise
next
year.
We
were
also
looking
at
the
facing
the
fact
that,
with
that
one
percent
raise
confronted
with
the
increased
cost
of
health
care
premiums,
some
employees
maybe
have
an
adverse
financial
impact.
B
B
So,
depending
on,
depending
on
your
plan,
option
and
level
of
coverage,
employees
will
only
increase
their
costs
from
about
43
to
a
maximum
about
four
hundred
and
eighty
five
dollars,
which
you
know
when
you
factor
in
the
other
health
and
wellness
opportunities
that
we're
going
to
talk
about
is
going
to
help
employees
from
a
financial
management
perspective
as
well,
and
it's
important
to
note
that
you
know.
We've
worked
very
diligently
with
the
Department
personnel,
finance
and
towers
watson
to
crunch
the
numbers
and
we're
able
to
review
these
with
a
k---forty
seven.
B
The
recovery
coordinator,
who
approve
the
changes
that
we're
announcing
today,
one
of
the
things
that,
with
every
financial
management
contract
from
a
labor
perspective
in
budget
initiative,
we
need
to
make
sure
that
it's
compliant
with
the
plan
and
with
staging
and
or
phasing
in
the
increased
employee
contributions
over
three
years
will
be
compliant
from
a
plan
perspective.
And
so
we're
happy
to
announce
that
you
know
we're
able
to
do
this
to
help
our
employees
out.
B
C
The
controller
of
the
clicker
they're,
always
in
control
to
click,
aren't
they
anyway,
hi
I'm,
Stephanie,
Hagen
I
am
the
manager,
employee
benefits
for
the
city
of
Pittsburgh
and
the
Department
of
person.
Now
I
just
want
to
tell
you,
you
know,
as
somebody
who's
worked
in
benefits
for
over
30
years.
This
is
the
apex
of
my
career
right
here.
This
is
it.
You
know
to
have
a
fabulous
leader
in
our
mayor
and
a
fabulous
team
in
the
group.
That's
been
working
on
this
for
the
last
year.
Nothing
is
better
than
this.
C
We
have
this
energy
going
in
conjunction
with
our
consultant
Towers
Watson.
That
is
really
going
to
change.
The
way
benefits
are
given
at
the
city
of
Pittsburgh,
so
I'm
really
happy
and
proud
to
talk
about
that
and
I
just
want
to
acknowledge
a
Todd
Siegel,
our
director
and
LaVon
Shannon.
Our
benefit
supervisor
who's.
Very
shy,
and
would
he
speak
today,
but
we'll
get
her
up
here
next
time.
Okay,
what
we've
done
is
expand
our
existing
City
fit
wellness
program
to
include
more
wellness
activities
and
also
give
a
second
round
of
financial
rewards.
C
It's
kind
of
switch
down
there.
You
can't
really
see
it
very
well.
Today
we
have
about
forty
percent
of
our
population
involved
in
our
wellness
program
and
what
we
do
is
we
give
a
financial
reward
of
two
hundred
and
forty
dollars
a
year
or
twenty
dollars
a
month
if,
in
fact,
folks
get
the
bios
screening
and
the
wellness
profile
and
participate
in
that
year
after
year.
Those
two
things
are
the
linchpin
of
the
wellness
program.
C
They
give
people
information
about
where
they
sit
as
healthy
people,
what
they
need
to
do
to
improve
their
health,
some
of
the
things
some
of
the
actions
they
can
take.
So
what
we're
doing
now,
with
the
ex
your
money
that
we
have
available
to
us
through
the
savings
that
we've
rikudou
are
going
to
offer
a
wellness
reward
number
two
we're
going
to
add
additional
activities
that
people
can
perform.
They
can
also
get
in
if
they're,
not
in
okay,
if
you're
already
in,
if
you've
done
the
bios
screen.
C
If
you've
done
the
profile,
we're
right
now,
I'm
going
to
dub
you
a
website
on
this
December
first,
that
shows
all
of
this.
You
can
go
in.
You
can
see
your
profile.
You
can
see
your
bios
screen,
you
can
see
where
you
sit,
you
can
see
where
your
high
risks
are.
You
can
see
where
your
medium
risks
are.
There's
going
to
be
a
list
of
activities
that
you
can
participate
in
a
lot
of
it
has
to
do
with
coaching
a
lot
of
it
has
to
do
with
online
activities.
C
C
If
you
do
those
things
on
it
before
june
thirtieth,
we
have
to
give
people
about
six
months
to
get
involved
in
this,
and
so
we're
going
to
do
that
and
we're
going
to
kind
of
put
the
money
out
at
the
last
minute
there
in
our
last
phase,
beginning
in
August
nineteenth
and
running
through
the
end
of
the
calendar
year.
But
basically,
what
we're
doing
is
we're
going
virtual
on
this
and
the
challenge
there
is
to
help
our
employees
bridge
that
virtual
device
a
lot
of
our
folks.
C
C
We're
going
to
have
wellness
gurus
all
over
the
city,
beginning
January,
one
and
they're
going
to
go
to
every
single
work
site
in
this
town
and
they're,
going
to
talk
to
people
about
this
program,
they're
going
to
get
them
involved,
they're
going
to
help
them
do
what
they
need
to
do.
We're
going
to
show
them
how
to
use
the
internet,
show
them
how
to
use
their
cell
phones
to
do
this.
These
folks
are
going
to
be
registered
dieticians
nutritionists
folks.
That
really
can
help
folks
get
healthy.
So
that's
where
we're
at!
C
On
this
end,
we
also
want
to
talk
about
on
slide
9.
Thank
you,
sir.
Our
strategic
plan
Towers
helped
us
kind
of
get
going
on
it
and
we've
taken
it,
and
you
know
when
we
show
you
this
next
year.
It
might
look
different,
but
right
now,
what
we
have
is
a
five-year
strategy
to
you
know,
implement
our
value,
proposition
and
change
our
culture,
and
how
are
we
going
to
do
that?
C
We're
going
to
continue
to
work
with
the
mayor
and
the
City
team
doing
right
what
we're
doing
now
we're
going
to
continue
to
do
that,
we're
going
to
stick
at
that
we're
going
to
work
for
better
cost
savings.
We
have
tons
of
programs
that
we're
going
to
look
at
implementing
next
year
to
save
even
more
money
in
our
overall
medical
costs,
which
will
be
fabulous.
C
C
That's
what
it's
all
about
we're
going
to
work
next
year
to
put
our
medical
or
EAP,
and
our
wellness
plan
into
one
solid
unit
saves
a
tremendous
amount
of
money,
makes
people
more
engaged
in
what
they
do
if
they
can
go
directly
to
their
EAP
through
the
medical
carrier.
It
saves
us
money.
It
makes
them
more
appreciative
of
the
medical
plan
that
you've
offered
them.
C
So
we're
going
to
work
on
that
we're
going
to
continue
to
expand
City
fit
wellness
like
we
just
talked
about
the
flexible
spending,
account
FSA
pretext,
saving
on
every
penny
that
people
spend
for
any
of
their
healthcare
coverages.
They
have
a
ton
of
that
available
to
them.
Now
we're
going
to
get
more
people
involved
in
that
I'm
going
to
really
leverage
that
plan,
so
people
have
even
more
financial
reward
for
staying
healthy
and
our
voluntary
benefits
we're
going
to
rework
that
entire
program
next
year
and
make
it
more
valuable.
C
We
want
the
whole
thing
to
be
sustainable,
how's
that
going
to
happen
this
year.
We
have
a
special
program
for
the
spouses
of
our
employees
to
come
in
get
the
wellness
screening
take
the
profile.
We
gave
them
a
hundred
dollar
gift
card.
We
want
everybody,
the
entire
family,
to
be
involved
in
our
medical
coverages.
C
C
Go
down
our
chronic
conditions
go
down
our
chronic
conditions
today,
and
this
is
shocking,
but
our
chronic
conditions
today
are
cancer,
must
do
large-scale
little
I
really
have
a
hard
time
saying
that
word
and
behavioral
health
people
are
so
stressed
out.
They
do
not
take
care
of
themselves
physically,
they
do
not
take
care
of
themselves
emotionally
and
spiritually,
and
when
you
put
that
all
together,
they
are
very
non
productive.
C
So
we
want
to
change
all
of
that,
and
you
know
those
are
some
of
the
results
that
we're
looking
for,
because
if
our
people
are
using
the
plan,
we
don't
want
them
to
not
use
the
plan.
We
want
them
to
use
the
medical
coverage,
but
we
want
them
to
use
it
to
get
healthy
so
that
they
don't
become
chronically
ill.
You
know
targeting
our
programs.
C
These
are
some
of
the
things
that
we've
always
had
and
we're
going
to
continue
to
tweak
them
and
roll
out
new
and
things
new
things
to
be
more
relevant,
and
you
know
the
digital
divide.
Again,
we've
got
to
be
mobile.
We
have
a
lot
of
people
who
aren't
savvy
to
that,
but
we've
got
to
help.
Do
that
person
o
is
going
to
help
them
do
that
the
Wellness
gurus
are
going
to
get
them
on
board.
C
You
know
the
telemedicine
we're
going
to
talk
about
in
a
minute,
but
just
a
lot
of
things
that
we're
doing
in
the
technology
world
to
enhance
our
benefit
package,
all
right,
Sam,
one
more
so
we're
going
to
talk
for
a
second
about
telemedicine,
a
lot
of
people
don't
know
what
it
is.
Some
people
do
know
what
it
is.
The
health
plans
are
offering
these
as
our
fabulous
opportunities
for
employees
to
increase
their
access
to
their
doctors.
What
it
does
it's
a
treatment
model
for
minor
illnesses.
C
You
know
the
costs
and
the
colds
the
flu
season
dermatology
and,
from
our
point
of
view,
we
also
are
offering
the
telemedicine
in
regard
to
behavioral
health,
which
is
huge.
You
know
you
can
call
somebody
and
talk
to
them
about.
What's
going
on
with
you
that
is
HUGE.
What
it
does
is.
It
gives
people
another
opportunity
to
use
care
outside
of
the
urgent
centers
in
the
emergency
rooms,
which
are
your
sometimes
are
over
treated.
The
costs
are
higher.
If
it's
something
minor,
you
can
talk
to
your
physician
online
or
you
can
talk
to
another
position.
C
You
can
do
it
telephonically,
you
can
do
it
via
video
I
mean
we
talked
to
our
relatives
in
Florida
on
the
video.
This
is
what
we're
going
to
do
with
our
medical
coverage.
Here
you
know
our
people
work
different
shifts
all
over
town.
It
can't
always
get
to
the
doctor.
You
know
you
get
sick
when
you
do
your
call,
while
gosh
I
can't
get
an
appointment
for
three
days,
that's
not
going
to
work.
This
is
better
and
it's
the
same
cost
to
an
employee
as
if
they
went
to
their
to
their
doc.
C
For
the
municipal
group
we're
talking
about
today,
ten
dollars,
so
you
can
see
where
the
cost
savings
are
as
well,
and
you
know
they
can
prescribe
meds
when
there's
a
diagnosis,
etc,
etc.
But
it
is
just
one
of
the
few
things
that
we
want
to
implement
at
least
this
year
to
help
people
get
and
stay
healthy
to
save
those
medical
dollars.
So
I'll
get
it
back
to
Sam.
Yes,.
B
Sir
Thanks
did
I
just
also
like
to
thank
Towers
Watson.
There
are
health
and
benefits
consultant
they're
here
in
the
room.
So
if
there's
any
questions
for
them,
they've
been
instrumental
in
putting
this
program
together,
doing
all
the
financial
analysis
working
with
us
to
crunch
the
numbers
and
provide
some
perspective,
best
practices
and
also
you
know
some
strategy
around
our
overall
wellness
program.
This
is
important
to
not
only
us
as
an
organization
an
employer
but
to
our
employees
and
I.
B
Think
what's
important
to
note
also,
is
that
as
an
employee,
not
only
we
mitigating
the
cost
of
the
health
care
premium
for
employees,
but
by
participating
in
the
expanded
wellness
program,
you
can
put
almost
five
hundred
dollars
more
in
your
pocket
by
just
you
know
getting
involved
in
this
program,
so
it's
a
win-win
all
around
for
the
city
as
well
as
their
employees.
So
with
that,
we
can
open
up
to
any
questions.
Anybody
house.
B
B
By
moving
to
a
self-insured
arrangement,
the
city
will
cut
out
the
middleman
so
to
say,
and
then
be
paying
the
claims
directly
in
one
of
the
things,
while
this
doesn't
until
a
certain
amount
of
risk.
One
of
the
things
that
we
is
incorporated
in
this
is
what's
called,
stop
loss
coverage
for
high-cost
claims
so
that,
if
you
have
you
know
a
number
of
claims
that
are,
you
know,
million-dollar
claims
somebody
gets
in
a
you
know
serious
accident,
you
or
you
could
be
in
our
transplants.
B
You
could
be
in
the
hospital
for
days
months
weeks
and
you
know
hike
up
a
lot
of
bills,
so
what
the
soft
loss
coverage
does
is
it
ensures
us
in
against
those
high
cost
claims?
We
looked
at
our
actual
experience
in
over
the
last
few
years.
We've
only
had
no
more
than
half
a
dozen
of
what
we
consider
high
cost
claims
may
be
over
to
250
or
300
thousand
dollars.
B
B
B
A
B
They're
just
sure
that
the
city
has
now
hi
mark
and
yes,
it'll-
be
a
dog
recently
procured
by
out.
Not
so
it'll
be
come
out
now
I
believe
so
is
it
yes
and
who
is
the
better
for
the
thomas
both.
C
Are
providing
telemedicine?
Did
you
come
in,
and
the
company
out
edna
how
stella
dog
and
Highmark
had
is
one
specific
for
dinner,
which
I
can't
quote
you
at
the
second
and
they
have
another
one
for
a
general
illnesses,
so
it'll
upon
our
website
on
I
can
get
that
story.
If
you
need
that
you're,
both
both
ensures
will
be
providing
it's
on
us
exactly.
B
Going
to
be
finalizing
that
we're
looking
at
some
updated
data,
probably
around
I,
think
best
practices
or
maybe
250
to
300
thousand
dollars
in
that
range.
But
we're
going
to
be
finalizing
that
in
the
next
few
weeks-
and
it's
I
think
also
important
to
note
that
these
projections
are
already
incorporated
into
the
budget
that
the
mayor
submitted
to
the
ICA.
Several
weeks
ago,
we've
been
working
on
this
for
months.
C
Antonia
has
a
great
program
right
now
that
they
do
it's
a
series
of
activities
that
they
engage
in.
They
incorporate
the
local
health
department,
the
county
government,
lots
of
resources
from
different
areas
around
the
city
of
San
Antonio,
and
we're
going
to
follow
that
model
too,
and
a
lot
of
the
things
that
we're
asking
for
our
carriers
next
year
and
we're
going
to
renew
our
medical
coverages
next
year,
really
going
to
focus
on
social
responsibility.
C
We
realize
that
you
know
those
carriers
provide
us
a
lot
of
free
services
and
they
underwrite
a
lot
of
our
programs,
but
they
also
need
to
be
involved
in
city
fit.
They
need
to
provide
us
with
some
gateway
to
some
activities
that
we
need
to
look
at,
but
we're
probably
going
to
roll
that
out
just
as
soon
as
we
get
to
it,
hopefully
before
the
first
of
the
year.
C
So
you'll
see
that
on
the
mayor's
website
and
I'm
going
to
probably
see
a
lot
of
publicity
around
the
area
and
some
of
the
things
that
will
be
doing.
But
it's
a
lot
of
its
focused
also
on
our
highly
vulnerable
population
senior
citizens.
Folks,
who
are
in
public
assistance,
you
know
one
of
the
things
that
Delta
deniz
going
to
do.
For
us.
There
are
new
medical
dental
carrier,
beginning
January.
One
they've
made
a
commitment
to
work
with
young
people
around
town
who
don't
have
access
to
dental
care.
C
So
that's
going
to
be
part
of
the
one
that
one
of
the
things
that
we're
going
to
be
doing
there.
So
it's
just
a
large
group
of
activities,
parks
and
recs
going
to
participate
in
this
with
us.
The
biking
program
is
a
huge
example
of
that
lots
of
different
things
that
you'll
see,
and
you
know
if
you
want
us
to.
We
can
have
another
news
conference
about
that
when
we're
ready
thanks
and.
B
I
think
that's
a
good
point.
I
mean
part
of
the
big
part
of
what
we're
doing
is
trying
to
integrate
a
lot
of
the
pieces
of
what's
going
on
in
city
government.
So
benefits
is
not
just
a
program
for
personnel
but
as
Stephanie
alluded
to
parks
and
recreation,
Bureau,
neighbor
empowerment.
There
have
been
a
lot
of
different
initiatives
that
you've
been
probably
covered
over
the
last
year.
Grub
up,
you
know,
increase
in
you
know:
children
access
to
health
insurance.
B
Correct
is
it
it's?
Yes,
it
for
there's
different
for
municipal
employees,
it's
15
for
over
thirty
thousand
and
salary,
it's
fifteen
percent,
and
for
under
that
it's
7.5
right
and
then
police
and
fire.
It's
a
fixed
amount
per
collective
bargaining.
I!
Don't
have
this
on
top
my
head,
but
it's
not
it's
a
little
less
than
fifteen
percent.
The.
A
B
B
You
are
we're
going
to
be
talking
to
them.
You
know
Clark
the
bargains
on
going.
We
still
have
some
contracts
that
have
to
negotiate
so
I
I.
Think
it's
a
positive
thing.
I
mean
this
is
one
of
the
challenges
after
sitting
in
the
last
few
rounds
of
negotiations
is
the
number
one
concern
was
the
mitigating
the
cost
of
health
care
when
we
only
have
projected
one
percent
costs
or
raise
next
year.
So
this
is
a
way
to
do
that.
This
is
addressing
you
know.
B
B
B
A
B
B
B
What
I
have
it'll
just
be
a
matter
that
will,
instead
of
paying
premiums
to
insurance
companies,
the
city
will
be
directly
paying
the
claims,
and
so
we
have
a
process
already
worked
out
with
the
department
of
personnel
in
the
controller's
office
to
how
we're
going
to
manage
that,
and
it's
this
again
and
several
years
ago
the
city
was
self-insured.
So
it's
not
something.
That's
completely
new
to
city
government.