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9,5_ PERSfrom page ................... ............................... PERS continues to struggle with the nation- wide health plan cost increases. However, added to this dilemma is a split among the PERS Board as to what to do to ease the cost increases, especially in light of the horrendous state budget deficits. PERS staff has developed conceptual ideas for change, but none of these proposals will have any significant impact on the premium costs for 2004. In addition, representatives of public agencies have expressed to the PERS Board that their actions this year will send a message to its public agencies whether they should stay in the program or leave to form other pools or health plan arrangements. The Board at its January offsite session was told that the demographics of the public agencies are a positive asset to the overall program. If the public agencies left PERS, it would have a negative financial impact upon the rest of the plan, which includes state employees. PERS staff has been directed to seek input form public agencies and agendize those re- sponses for its April 15t Health Benefits Commit- tee meeting. There has been one meeting of public agency representatives where a number of issues were discussed. Public agency perspec- tives include the following: 1. Separate Public Agency Pool (within PEMHCA): this would allow for possible changes in the programs without public agencies being grouped with the State employee /retiree issues that have hindered changes in the past. 2. Alternative Plans: within the self- funded plans, create alternative plan(s) with different deductibles /co -pays. Consider also offering a consumer driven option within the self- funded program. 3. HMO's: If in the near future, the traditional HMO's (exclusive of Kaiser) may no longer func- tion as "managed care" programs. If that occurs, consider eliminating them and then offering an Exclusive Point of Service (EPO) or Point of Service (POS) option under the self- funded program. 4. Consider Regional Rating: This has both positive and negative implications to the program, but it should at least be explored. S. Public Agency Contribution for Retir- ees: Leave this up to the local public agencies to negotiate at the local level, do not create restric- tions or mandates. 6. Treat Public Agencies as Equal Part- ners: Unfortunately, almost everything done in the administration of the program focuses on "State" issues. Public agencies are usually ignored and /or consulted after the fact. 7. Termination Clause: allow public agen- cies 90 days after the Board adopts the premium costs and plan changes for all the plans to file a notice to leave the PEMHCA program. COMMISSION from page 1 a • a • • • • • 0 With the state facing one of its worst fiscal crises ever, following on the heels of the longest budget stalemate (67 days last year), there has been much discussion in Sacramento regarding the budget structure and process. The upcoming commission meeting will provide a forum for commission members to discuss options for structural reform in the budget process. Assembly Members comprising the Commis- sion are: Herb Wesson (Los Angeles) Chair; Dave Cox (Fair Oaks), Vice Chair; Patricia Bates (Laguna Niguel), John Campbell (Irvine), Joseph Canciamilla (Pittsburg), John Dutra (Fremont), Jackie Goldberg (Los Angeles), Bill Maze (Visalia), Jenny Oropeza (Long Beach), Sharon Runner (Antelope Valley), Darrell Steinberg (Sacramento), Tony Strickland (Moorpark), Joe Nation (San Rafael) (Dem. Alternate), Rick Keene (Chico) (Rep. Alternate). The meeting is being held Tuesday, April 8, 3:00 p.m., room 127 in the State Capitol. Visit the League's Official Web Site -- www.cacities.org PRIORITY FOCUS /PAGE 5