San Francisco health board approves new plan lineup, adds Blue Shield PPO with Accolade and Health Net Canopy HMO

The San Francisco Health Service System board voted on Feb. 11 to accept staff recommendations from a competitive procurement that will change several non‑Medicare plan offerings for plan year 2022. The motion, moved by Commissioner Randy Scott and seconded by Commissioner Mary Howe, approved adding Health Net’s Canopy Care HMO on a flex‑funded basis, contracting with Blue Shield of California to administer a self‑funded PPO with Accolade support, continuing Blue Shield Access Plus and Trio HMOs, and discontinuing the UnitedHealthcare PPO.

The recommendation followed a multimonth RFP and a presentation by SFHSS staff and Aon consultants. Mike Clark of Aon summarized the financial case, saying, “we expect 16,000,000 total dollars of projected overall cost savings for the 3 year period that the RFP covered,” and described those savings as largely coming from lower administrative fees and improved prescription‑drug rebate sharing. Staff said the projected savings would distribute roughly $14 million to employer budgets and $2 million to active employees and early retirees under existing contribution formulas.

Board members pressed staff on operational details. Commissioner Claire Zivanski (spelled in the meeting transcript variously) and others asked about potential provider‑network gaps for members in remote service areas such as Hetch Hetchy and Tuolumne counties, and about formulary changes that can affect members who rely on stable medication access. Staff responded that the Health Net Canopy HMO adds access to Zuckerberg San Francisco General and several Bay Area provider groups and pledged targeted outreach and continuity‑of‑care plans to identify and resolve individual disruptions. Staff also said some contractual performance guarantees exist for administrative fees and claim targets, but that the self‑funded plan structure does not include a multi‑year premium cap.

The record shows one formal protest was filed during the procurement process; staff and the city attorney said they had reviewed the complaint and did not find merit but were preparing a formal response. Presenters also described the RFP scoring process, panel interviews and confidentiality measures used to protect the integrity of the evaluations.

Two callers spoke during public comment. Emily Wallace, a union representative for I.S.P.T.E. Local 21, urged the board to prepare contingency plans for Hetch Hetchy members; Fred Sanchez of Protect Our Benefits thanked staff and asked about the likelihood that claim levels could trigger cost increases under the new structure.

The board conducted a roll‑call vote. The secretary announced: Chris Canning — aye; Karen Breslin — no; Mary Howe — yes; Dean Preston — aye; Randy Scott — yes; Claire Zivanski — no. The chair declared the motion carried.

Staff said they will accelerate member communications and targeted outreach as contracts are finalized and will continue reporting publicly to the board on provider‑network issues and implementation work. The board did not vote on specific rate or benefit tables at this meeting; staff said those will return for rates and benefits review under the normal charter process.

The motion on the RFP recommendation was recorded as: moved by Commissioner Randy Scott; seconded by Commissioner Mary Howe; outcome — approved.

The board adjourned after completing the scheduled action items; staff noted remaining agenda items would be carried to a subsequent meeting.