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Retirees warn of steep Plan 1 rate increases; board to study subsidy options
Summary
Retiree representatives and individual members urged the Health Service Board to address projected large rate increases for Plan 1, citing examples and urging subsidies to keep the city-owned plan viable; board committed to study options and scheduled further consideration in December and in September outreach sessions.
Retirees and active members urged the San Francisco Health Service Board to halt what they described as potentially dramatic increases in Plan 1 premiums, warning that higher costs would drive members out of the city-owned plan.
Claire Zavonski, representing SEIU West Bay retirees and a former board member, told the board she was alarmed at projected rate increases in the Plan 1 memo and recommended the board consider subsidizing Plan 1 "perhaps... at maybe 50%" to stabilize rates and preserve the plan. "I think these rates will absolutely scuttle the plan," Zavonski said, citing examples in the packet that showed sharp increases in later years.
Dennis Krueger, a retired and active firefighter, echoed concerns and raised a legal risk that single employees could claim unequal monetary benefits compared with married employees if subsidies shift benefits across tiers. "As I look at these rates... it's gonna leave the city open for someone to say, I want the same benefit this person with 2 kids is getting," Krueger said.
Acting Director Lisa Gottby acknowledged the issue and said the board will present an "alternative model" intended to save Plan 1. She asked members to attend and provide input at a rates-and-benefits session planned for September and again in December, when the board can give direction ahead of the rates-and-benefits deadline. "So that will be coming forward during the rates and benefits... in December," Gottby said.
Individual retirees described access problems tied to coverage decisions. Gail Bloom, an early retiree in Plan 1, said UnitedHealthcare was paying what she characterized as very low amounts for out-of-network care (example: a $225 provider charge resulted in a $37 payment). She asked the board and staff to investigate. President Breslin directed Mitchell Griggs, manager of member services who was present, to follow up with Bloom.
The board did not adopt a subsidy policy at the meeting; members requested written input from stakeholders and pledged a more proactive outreach process, including invitations to unions and retiree organizations to meet with commissioners. President Breslin also reminded members that the Board of Supervisors had passed a resolution asking Kaiser for more transparency on rate-setting; Gottby said the health service board must follow its charter negotiating authority and will ensure broad member input before final rate decisions.
Next steps: the board said it will place specific outreach and planning items on the September agenda and bring a substantive alternative model for Plan 1 to the December rates-and-benefits calendar for board direction.
