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SFHSS board approves $1.32 million stabilization buy‑down for active dental PPO; commissioners and public press Delta Dental network concerns
Summary
The board voted unanimously to apply one-third ($1,320,000) of the active dental PPO stabilization surplus toward 2026 rates, while commissioners and public commenters urged SFHSS to press Delta Dental on provider network losses and reimbursement rates.
The San Francisco Health Service System board on March 13 approved using one-third of the active dental PPO stabilization fund balance — $1,320,000 — to buy down 2026 rates for the self‑funded active dental PPO plan.
Mike Clark, lead actuary at Aon, presented the recommendation and the plan’s year‑end balances. Clark said the stabilization surplus for the active dental PPO was $3,960,000 as of Dec. 31, 2024; under board policy the annual adjustment is amortized over a three‑year rating period, and the policy calls for applying one‑third of the surplus unless the board votes otherwise.
“Per policy, one‑third of that [balance] is 1,320,000, which means 2,640,000 is available for use in rating after 2026,” Clark said. The board voted unanimously to approve the recommended one‑third application.
Several commissioners and public commenters said the board should press Delta Dental to address provider participation and low reimbursement rates, which they said have driven dentists out of the network. Commissioner Sass told the board she had experienced dentists leaving Delta’s network and worried members have fewer in‑network options. “If they are going to generate surpluses like that, then maybe they should be adjusting their rates so that they can keep more dentists in the pool,” Sass said.
Fred Sanchez of Protect Our Benefits echoed the concern, asking the board to request data showing how many dentists have left Delta over recent years and to consider a special session on the network issue.
Clark said SFHSS staff plan to review utilization data by county and to invite Delta Dental representatives to the April meeting to discuss network strategies. He noted the plan’s 2024 claim experience was favorable relative to prior years and national dental trend assumptions; overall dental claims rose roughly 1–2 percent for the active PPO in 2024.
Action taken: The board moved to “approve the use of one‑third of the 12/31/2024 stabilization fund balance in plan year 2026 for the active dental PPO plan” (motion made, seconded; roll‑call vote: President Howe — Aye; Vice President Zavansky — Aye; Commissioner Kremen — Aye; Supervisor Dorsey — Aye; Commissioner Howard — Aye; Commissioner Sass — Aye; Commissioner Wilson — Aye). The vote was unanimous.
Next steps and context: SFHSS staff will present dental plan renewals and network details at future meetings and planned outreach to Delta Dental was described for the April board packet. The stabilization policy applies only to self‑funded and flex‑funded plans; Delta Dental’s HMO options and retiree dental plans are fully insured and are not covered by the same stabilization policy.
