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Health Service System preps open enrollment; Blue Shield Trio rollout, automation and member outreach detailed
Summary
Acting Director Mitchell Griggs and staff outlined preparations for 2018 open enrollment, including new Blue Shield Trio and Vision Premier plans, automated enrollment barcodes, plans to mail packets to about 75,000 people, and targeted outreach for roughly 20,000 auto-enrolled families.
Acting Executive Director Mitchell Griggs told the San Francisco Health Service System Board on Aug. 31 that staff are finalizing preparations for the 2018 open enrollment season, highlighting new plan options, system automation and expanded member outreach.
Griggs said the system will mail open enrollment packets and communications to roughly 75,000 members this year to ensure all active employees and retirees receive timely information about plan changes. He described operational steps taken to manage high call volumes and on-site outreach, including benefit-analyst staffing, vendor weeks, and 26 flu-shot clinics tied to enrollment events.
Marina Coleridge, Enterprise Systems and Analytics Manager, gave a technical overview of the changes required to support new plans and the volume of data involved. She said about 45 programs were impacted by the addition of Trio and Vision Premier, described the complexity of rate-load files (about 44 columns and thousands of rates), and explained the project27s testing and sequential deployment approach. Coleridge said the team is preprinting a DSW identifier on applications and adding a barcode to automate intake and reduce manual document handling while avoiding exposure of protected health information.
Blue Shield of California representative Jeanette Mone said Blue Shield will begin targeted mailings in late September and will place a Shield concierge phone number on Trio materials. She described an outreach plan that includes three phone attempts to reach households being auto-enrolled into Trio and in-person representation at open-enrollment information events in October. Mone said the insurer expects roughly 20,000 families to be identified as auto-enrolled; those households will receive prioritized outreach and opportunities to opt out during the open-enrollment window.
Board members pressed staff and Blue Shield about continuity of care and facility access under Trio. Commissioner Follinsbee and others asked specifically about obstetrical services; Griggs and Mone said patients in mid-pregnancy or undergoing ongoing treatment would be managed through standard transition-of-care procedures so continuity is preserved. Mone added that Brown & Toland referrals previously routed to certain hospitals would, for Trio patients, follow Trio referral patterns and that communications will specify hospitals included and excluded from the Trio network.
Griggs said the plan includes training for benefits staff, a short animated video to explain deadlines and steps, expanded in-person OE sessions (including evening events for members who cannot attend daytime meetings), and Blue Shield staff on-site or available to warm-transfer calls to a concierge team. He emphasized that some transfers between plans will require case review after the October enrollment window, and that exceptions for continuity of care will be handled case-by-case.
The board did not take an enrollment-related vote at the Aug. 31 meeting. The presentation concluded with an invitation for commissioners to attend open-enrollment events and a reminder to members to check materials and deadlines.
