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San Francisco HSS approves preliminary 2016 Blue Shield renewal after ACOs pledge tighter management
Summary
The Health Service System approved a preliminary 11.5% rate increase for the Blue Shield flex‑funded HMO for 2016 after Aon Hewitt recommended an 11.5% adjustment and ACO partners described programs to reduce admissions, emergency visits and specialty drug use.
The Health Service System Board voted to approve a preliminary 2016 renewal for the Blue Shield flex‑funded HMO program after hearing actuarial findings and provider presentations.
Anil Kosher, the Aon Hewitt actuary, told the board the core need was a 9.9% increase over 2015 rates; amortizing a prior excess cost (about $4.4 million under the board—s claim‑stabilization policy) raised the recommended increase to roughly 11.5%. Kosher illustrated the member impact in his packet: an individual medical/Rx premium would rise by about $5.16 monthly, a two‑party premium by about $10.33 and a family premium by about…
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