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SFHSS approves 2026 health-plan rates, limits GLP‑1 weight-loss coverage to BMI≥40 and adopts SB 729 infertility changes
Summary
The San Francisco Health Service Board unanimously approved 2026 renewals for Health Net Canopy Care, Blue Shield Access Plus and Trio HMOs and the Blue Shield PPO. The board adopted SB 729-required infertility coverage changes and recommended restricting weight-loss GLP‑1 coverage to people with BMI 40 or higher for plan-year 2026.
The San Francisco Health Service Board voted unanimously to approve 2026 renewals for multiple city-sponsored health plans and to adopt plan-design changes tied to state law and emerging drug-policy decisions.
The board approved rate renewals and contribution schedules presented by Aon actuaries and HSS staff for the Health Net Canopy Care non‑Medicare HMO; Blue Shield of California Access Plus and Trio HMOs; and the Blue Shield non‑Medicare self‑funded PPO. Roll-call votes showed Chair Kremen, Supervisor Matt Dorsey, Commissioner Diana Guevara and Commissioner Wilson voting “aye” on each item.
Aon and staff presented plan-level rate actions as follows: Blue Shield Access Plus HMO (recommended total rate increase including stabilization: 8.7 percent), Trio HMO (9.2 percent), Health Net Canopy Care HMO (1.7 percent before stabilization adjustment) and the…
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