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Board declines staff recommendation to switch retiree Medicare Advantage PPO to Blue Shield
Summary
After a multi-hour presentation and extensive public comment, the Health Service Board voted 4-3 against the staff recommendation to replace UnitedHealthcare with Blue Shield of California as the MAPD PPO carrier effective 01/01/2025; staff'presented projected savings, implementation steps and network/formulary analyses.
The San Francisco Health Service Board on the staff'recommended plan to replace UnitedHealthcare with Blue Shield of California as the Health Service System's Medicare Advantage prescription drug (MAPD) passive PPO carrier.
Staff proposed, effective Jan. 1, 2025, to add Blue Shield of California as the MAPD PPO carrier and to discontinue UnitedHealthcare's MAPD PPO and several UHC non-Medicare plans. Executive Director Abby Yant and procurement manager Michael Visconti described a multi-year evaluation and an RFP process with a six-member evaluation panel and Aon as actuarial advisor. Aon lead actuary Mike Clark presented financial scoring that showed Blue Shield as the top-ranked bidder and projected savings "as much as $67,000,000" over 2025'27 using the quoted rates and not-to-exceed caps.
Staff also summarized nonfinancial scoring: network…
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