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The unanimous vote caps months of review before the city’s plan commission. Many residents had expressed concern the huge campus along Forsyth Boulevard was too much too fast and would clog Clayton’s streets with traffic.

Ultimately, the prospect of a unified plan for high-rise office buildings, a hotel and some residential and retail space on some of the last remaining undeveloped land in Clayton won over city leaders.

“You can’t always decide not to do something because you’re afraid of the future,� said Alderman Ira Berkowitz.

While Tuesday’s vote approved new zoning and the broad outlines of a development plan, each of four individual phases still requires architectural review and approval.

Meanwhile, there was little discussion of the potential public incentives that Centene wants. A state estimate put the total public assistance for the almost $1 billion project at $147 million over 20 years. Centene estimates the total value of incentives at between $88 million and $135 million.

Most of that will come in the form of local property tax abatement over 20 years. The city is still negotiating a development agreement with Centene that would put a value on the local incentives.

While some residents have raised concerns over the possible tax breaks, most of the more than 100 people who showed up at the meeting Tuesday again made clear they thought traffic would hurt quality of life.

Carol Klein wondered what would happen if the government makes substantial changes to its Medicaid program, which Centene specializes in managing for states. She said she doesn’t want to see these huge office towers become “ghost towns.�

“What happens if these government regulations change that their business is built on?� Klein asked the board.

For now, however, Centene is one of the fastest-growing large companies in the region.

“Just this year, we’ve hired over 600 people in the St. Louis region,� Centene executive Cindy Brinkley told the audience at the meeting.

To accommodate its growth, the company initially asked for 6,200 parking spaces. But Clayton’s approval limited the number of parking spots to 5,800 in the parking garages proposed as part of the project. The city’s approval also included the condition that there be retail space at ground level in the structures.

Centene anticipates consolidating 1,000 employees who work elsewhere in the region and adding another 1,000 jobs to its Clayton headquarters. It already employs about 1,000 people at its current Clayton headquarters.

But Centene plans to lease out about half of its new office space to third-party tenants as it has done with its current building. In all, the development could add space for close to 5,000 additional workers by 2020. A final phase with no set timeline could add still more.

�We’re not going to be adding 5,000 jobs in 24 months,� said Bob Clark, CEO of Clayco, which is handling the development for Centene. “There will be time to absorb� the new employees, he said.