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SFHSS reports large shift to eBenefits and new plan onboarding challenges

San Francisco Health Service System Board · December 9, 2021
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Summary

SFHSS staff reported a successful virtual open enrollment: eBenefits submissions rose to nearly 92% adoption, paper applications dropped 34%, and communications and webinars aided uptake. Staff and board discussed member concerns about PPO-to-Blue Shield network changes and behavioral-health access.

SFHSS staff told the board on Dec. 9 that the 2021 open enrollment was largely successful, with a marked shift to electronic self-service and targeted communications to ease onboarding to new plans.

Operations Manager Olga Stavinska Velasquez said the virtual open enrollment (Oct. 1–29) relied on phone and Microsoft Teams consultations instead of face-to-face counseling. Member services maintained office presence three days per week during the campaign and provided walk-through support for eBenefits users.

Ryn Coleridge, enterprise systems and analytics director, reported 10,539 online submissions and a five-year trend toward eBenefits that reached nearly 92% this year. Coleridge also noted a 34% decrease in paper applications and a 25% increase in self-service submissions.

Jessica Hsu, communications director, described a deliberate email cadence, 23 webinars (seven focused on eBenefits), targeted mailings for PPO members affected by Blue Shield Accolade’s role as the new PPO administrator and vendor microsite coordination to help members verify in-network doctors. Hsu said Blue Shield made outbound calls and offered one-on-one office hours to help members check provider network status.

Union and clinician public commenters raised concerns about behavioral-health access under contracted plans; John Veil of the National Union of Healthcare Workers told the board that clinicians report long waits for ongoing treatment and urged SFHSS to demand accurate, auditable access metrics when negotiating contracts. Ms. Alana Marcucci Morris, a therapist and NUHW member, told the board that "Kaiser's appointment system is designed to force the therapist to choose the time that is happening in the system not what is recommended," and urged stronger accountability in contracts.

Flu clinics: Well-being Manager Carrie Beshears reported 23 clinics that delivered 2,123 flu vaccines (57 high-dose) at worksites; Kaiser facilitated medical-record entry for Kaiser members when member numbers were provided; non-Kaiser members were advised to keep an image of the consent to share with their PCP.

Next steps: SFHSS will continue to refine eBenefits support, coordinate with Blue Shield and other plans on network verification, and consider the union-supplied recommendations on data collection and contractual accountability for behavioral-health access.