Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Rate Relativitiy topic
No spam. Unsubscribe anytime.
Board delays vote on equalizing early-retiree premium ratios after heated public outcry
Summary
The Health Services Board paused consideration of a staff proposal to equalize rate relativities for Kaiser and Blue Shield early retirees after detailed actuarial scenarios and extensive public comment; no 2017 rate changes were made and the matter was continued to the call of the chair.
San Francisco — The City and County of San Francisco Health Services Board on a contentious afternoon decided not to adopt changes to early-retiree premium relativities and instead continued the item to the call of the chair, leaving 2017 rates unchanged.
Director Catherine Dodd told the board she had reviewed 15 years of minutes and historical decisions and recommended that HSS consider equalizing the rate relativities for HMO early retirees (Kaiser, Blue Shield) with active-employee relativities over a phased period. Aon Hewitt actuary Anil Coacher presented numeric scenarios showing the dollar and membership impacts of a three-year grade, a full reset and intermediate phase-ins.
The discussion centered on the distributional effect of any change. Dodd said the change was an equity question: "I think for the sake of equity ... implementing equity over time whether it's 3 years or 6 years or 9 years, is the right thing to do." Board members and commenters disputed whether the change would be fair or affordable. Coacher used 2016 rates for the models and showed, for example, that a full reset could raise certain family-tier retiree contributions from about $1,042 to roughly $1,881 per month in the Blue Shield example presented.
Public commenters and unions pressed the board to reject the proposal. Antonio Casillas, a retiree, told the board the change would “have a disparate impact on retirees because of the greater financial constraints that burden retirees due to their being living on a more fixed income.” Several union and retired-employee representatives said the proposal would particularly harm early retirees with dependents and those who took disability retirement.
Board members asked for more data on age and pension levels before taking any action. Commissioners repeatedly requested breakdowns of the 1,857 affected members (as presented by staff, 1,440 R-plus-1 and 417 R-plus-2) and the distribution of disability-based retirements within those cohorts. Commissioner Stasse asked specifically for age bands and pension information to better assess household-level impacts; staff said pension information resides in the retirement system and cannot be supplied without separate processes.
After proposals, a withdrawal of one motion and several procedural votes, the board voted to continue the item to the call of the chair. The actuary stated that "for 2017, there are no changes to the rate relativities," leaving the status quo intact for the upcoming plan year. The board instructed staff to provide further analysis if and when the item is rescheduled.
The continuation preserves current early-retiree rates for now and signals that any future change will require targeted data and additional stakeholder engagement.
