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Members report problems after insurer transition; board notes UCHealth agreement and open enrollment dates
Summary
Public commenters raised problems with Blue Shield overseas claims handling after a carrier transition; the board’s executive director reported a July 8 agreement preserving members’ in‑network access to UCHealth and outlined Oct. 1–24 open enrollment dates.
Public commentators and board staff highlighted ongoing member service issues after recent carrier transitions and affirmed steps the health system took to stabilize access to care.
At the meeting an overseas member identified as Donor Coleman said claims dating to June 28, 2023 remain unresolved after the switch from UnitedHealthcare to Blue Shield of California, citing inconsistent claim processing, nonpayment and difficulty contacting agents unfamiliar with overseas coverage. Coleman asked the board to identify a Blue Shield supervisory contact and suggested a dedicated team for overseas claims.
Fred Sanchez of Protect Our Benefits told the board he appreciated the coordinated work that resolved a broader contract dispute and praised the Board of Supervisors and city staff for their intervention. “We can work closer with Blue Shield to help our customers that are still having some difficulties,” he said, while thanking staff for progress on outstanding issues.
In his director’s report, Ray Guillen, executive director of the San Francisco Health Service System, confirmed that Blue Shield and UCHealth reached agreement on July 8, 2025 so HSS members continue to access UCHealth on an in‑network basis. Guillen said staff continue operational work tied to open enrollment, which will run Wednesday, Oct. 1 through Friday, Oct. 24, 2025. He also said the Civil Service Commission approved supplemental off‑site call center services to provide additional support during open enrollment to reduce call wait times.
No formal board action was taken on individual claims during the meeting; public comment was used to request further staff follow‑up and to urge carriers to provide clearer international contact channels.
