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Board reviews financials, approves Hartford and VSP renewals and hears communications, benchmarking and Kaiser reports
Summary
San Francisco Health Service System directors presented financials and plan benchmarking; the board approved Hartford life/LTD renewals and VSP vision rates for 2022, heard a new proactive communications plan for members, and reviewed Kaiser and Aon benchmarking data.
The San Francisco Health Service System board received multiple management updates and approved two insurer renewals during the meeting.
CFO Larry Liu reported financial highlights through Feb. 28: the employee benefits trust fund is projected to increase by approximately $18.5 million to a projected ending balance near $135 million, driven largely by self‑insured plans and expected pharmacy rebates (Aon estimated $7.3 million in pharmacy rebates for the year; the trust had received about $4 million year‑to‑date). Liu said general‑fund administrative spending is expected to be roughly neutral, with a small projected surplus of about $143,000.
On action items, Aon actuary Mike Clark recommended the board accept Hartford’s 2022 fully insured life insurance, accidental death & dismemberment and long‑term disability rates. Clark noted 2022 represents the third year of a three‑year rate agreement that began 01/01/2020 and recommended maintaining current 2021 rates for 2022. Commissioner Scott moved to accept the actuarial recommendation; Commissioner Canning seconded and the board approved the recommendation unanimously.
Aon also presented VSP’s fully insured vision renewal recommendation: hold 2022 rates at 2021 levels and accept the vendor’s proposed multi‑year (2022–2026) pattern subject to annual review. Commissioners clarified that the board would still perform its annual rates and benefits review each year even under a five‑year framework. The board approved the 2022 VSP rates and the stated multi‑year pattern unanimously.
Jessica Sheehy (communications director, SFHSS) presented a new proactive 2021 communications plan to increase member engagement and navigation of benefits. The plan uses Salesforce member call data, targeted outreach for groups such as Hetch Hetchy employees and retirees, a phased sfhss.org revamp to improve accessibility (including translations for top languages and a heat‑map tool for user behavior), and Cortico push notifications to reach first responders. Commissioners commended the plan and asked staff to emphasize outreach to older and limited‑tech members.
Aon’s Health Value Initiative benchmarking study (2021) showed SFHSS exceeding comparators on purchasing efficiency (index ~117.7%), a result attributed to high HMO enrollment and plan design. The board also reviewed Kaiser Permanente’s 2020 claims and utilization experience: COVID‑19 suppressed utilization in Q2 2020, telehealth use rose sharply, chronic‑disease control and medication adherence compared favorably to regional benchmarks, and the Kaiser plan’s 2020 loss ratio (paid claims vs. premiums) was about 86% for the non‑Medicare HMO population. Staff said Kaiser underwriting for 2022 will account for Q2 suppression when preparing renewal proposals for board review.
Board members asked staff to return with additional implementation details where appropriate (contract performance metrics for vendors, member satisfaction tracking and the Kaiser underwriting package for 2022).
