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Budget committee reviews proposed 2010–11 health plan rates, employer contribution
Summary
San Francisco’s Budget & Finance Committee heard Health Service System (HSS) Director present negotiated 2010–11 rates and a recommended employer contribution after actuarial review and insurer negotiations; the board postponed formal action pending packet materials and minor clarifications.
Supervisor John Avalos, chair of the Budget & Finance Committee, opened a hearing on proposed 2010–11 health benefit rates on Feb. 24. Catherine Dodd, recently introduced as director of the Health Service System, told the committee the HSS negotiated with Blue Shield, Kaiser and UnitedHealthcare to limit proposed increases and arrive at a negotiated overall increase of 9.4%.
Dodd said the county used a November–December survey of the 10 largest counties to compute the employer contribution used in charter calculations and reported “the average of the averages” was $472.85 per month — a 5.2% increase over last year. She said Blue Shield initially sought a 16.3% increase (39.8% for retirees) that was negotiated down to 13.5% for active members and 24.5% for retirees, with the retirees’ savings contingent on enrolling in a Medicare Advantage option.
Dodd described plan‑design changes meant to contain costs: a $5 increase to primary‑care copayments (making Kaiser $15 and Blue Shield $20, with preventive services exempted), a $100 emergency‑room copayment (reduced to $50 for Medicare Advantage members), and a freeze on the vision plan. She told supervisors the dental plan — which the city fully subsidizes — rose 13.2% and appears to reflect higher utilization.
Budget analyst Harvey Rose reviewed HSS fiscal effects and the comptroller’s estimate of $323.1 million in total city cost for health and dental premiums in FY 2010–11, including roughly $185.2 million in general‑fund cost. Rose recommended approving the ordinance and accompanying resolution but advised supervisors on the projected costs and how the negotiated changes lowered the initial insurer proposals.
The committee accepted the presentations and asked a set of clarifying questions of staff and the actuary. Supervisors and staff emphasized the difference between contribution levels set by charter calculation and negotiated plan rates covered by memoranda of understanding with unions. The committee did not take a final vote on the HSS items during the hearing and asked staff to provide the printed rate pages that had been sent to the printer.
The committee’s discussion and the analyst’s material will go with the items to the full Board for final consideration.
