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Health Commission adopts revised minimum standards for city contractor health coverage
Summary
After public comment and work-group negotiation, the commission approved revisions to the Healthcare Accountability Ordinance's minimum standards to expand compliant plan options (including some California Gold/Platinum and certain Silver plans) while keeping protections on coinsurance and essential benefits.
The Health Commission on July 7 voted to adopt revisions to the Healthcare Accountability Ordinance (ACO) minimum standards that govern health coverage for people employed on city contracts.
Patrick Chang of the Office of Policy and Planning presented recommendations developed over a multi-stakeholder work group convened April'June 2020 that included employer, labor, broker and nonprofit representatives. Chang said the ordinance implements Chapter 12.2 of the San Francisco Administrative Code and is oriented to maintain access to comprehensive, affordable care for contract workers.
Key recommended changes approved by the commissioners include:
- Clarifying that California-written Gold and Platinum plans may be deemed compliant for the ordinance's purposes to simplify employer compliance; - Preserving the requirement that employers pay full premiums for qualifying plans (Standard 1); - Increasing the maximum allowable medical deductible to $3,000 to broaden plan options; - Raising the prescription drug deductible cap to $300 (from $200) and allowing modest copayment adjustments while maintaining an approximately 20% coinsurance level for actuarial protection; - Leaving essential health benefits (Standards 8'16) unchanged and monitoring how COVID-related coverage evolves under state and federal rules.
Public commenters representing nonprofit contractors and worker advocates supported the compromise while stressing concerns about higher out-of-pocket costs for employees and nonprofit financial strains. Debbie Lerman (San Francisco Health and Human Service nonprofit contractors) asked staff to provide small-plan inventories over the coming year to verify plan availability for smaller employers.
After discussion and a roll-call vote, commissioners approved the revised standards. The DPH and the Office of Labor Standards Enforcement will continue to monitor plan availability and affordability for small employers and report back as needed. The commission's resolution and vote were recorded on the public record.
