Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Open Enrollment topic
No spam. Unsubscribe anytime.
HSS credits technology, staff for ‘epic’ open-enrollment season; Blue Shield TRIO implementation yielded early savings
Summary
HSS reported record open-enrollment activity in 2017, crediting ECM and PeopleSoft work for efficiency; Blue Shield’s TRIO auto-enrollment moved ~22,000 members with ~14,500 remaining enrolled and estimated $12.6M in 2018 savings based on that enrollment.
Acting Executive Director Mitchell Griggs and member-services staff told the Health Service System Board that open enrollment for the 2018 plan year was unusually active and that recent technology and staffing changes helped the agency manage a higher volume of work.
Siobhan O’Connor, Member Service Manager, presented metrics showing higher service use in 2017: roughly 14% more calls than 2016, 24% more applications processed year-over-year, a one-day longer active enrollment window (21 days), and about 14,000 applications processed. Staff credited an enterprise content management (ECM) system and PeopleSoft configuration for saving hundreds of staff hours and enabling on-spot scanning of member applications.
On plan changes, Blue Shield representative Jeanette Mone briefed the board on TRIO implementation. Blue Shield auto-enrolled roughly 22,000 members into the TRIO product and reported approximately 14,500 remained enrolled after member choices; Blue Shield estimated first-year savings of about $12.6 million based on that remaining enrollment. Mone described provider-network complexities (notably objections from Sutter Foundation-affiliated clinicians) that required removing about 2,800–3,000 members from the planned auto-enrollment pool and said the city attorney’s office helped coordinate communications to reduce confusion. Board members pressed staff on continuity-of-care protections, appeal pathways and the potential workload from member appeals; staff described HSS’s appeal process and continuity-of-care options for members currently in treatment.
Board members and public commenters thanked staff and vendor partners for expanded off-site clinics and flu vaccination outreach. Several commissioners urged clearer member communications and earlier board engagement before future auto-enrollment decisions.
