Health Service Board: election ordered, minutes and reserve recommendations approved; closed sessions and disclosure withheld

The San Francisco Health Service Board took several formal actions at its first regular meeting of 2025, recording unanimous roll-call votes on administrative, election and financial items.

Key outcomes at a glance

- Election ordered: The board approved a resolution ordering the Health Service Board election for one expiring seat (term expiring May 2025) and authorized staff to initiate and carry out the election process. The motion passed by unanimous roll-call vote.

- Minutes approved: The board approved minutes for the Health Service Board Governance Committee meeting (Dec. 6) and the regular board meeting (Dec. 12) by unanimous roll call.

- Reserves approved: The board approved the actuarial recommendations to set the incurred-but-not-reported (IBNR) reserves and contingency reserves (90.5th percentile confidence level) as of 06/30/2024 for SFHSS self-funded and flex-funded health plans. The motion passed unanimously; contingency reserves will be incorporated into stabilization calculations for plan-year-end reserves.

- Closed-session votes: The board voted unanimously to move into closed session for a member appeal (agenda item 4). After the closed session the board voted (a) not to disclose discussions held in closed session under the San Francisco Administrative Code and Government Code provisions cited on the agenda, and (b) not to report any actions taken in closed session. Both post-closed-session votes were unanimous.

How board members voted

All roll-call votes recorded the same five yes votes: President Howe, Vice President Zavansky, Commissioner Kremen, Commissioner Sass and Commissioner Wilson. No “no,” “abstain” or “recused” votes were recorded on the motions listed in the meeting minutes.

What the motions covered and next steps

- Election resolution (agenda item 13): The resolution set the nomination and voting schedule, clarified candidate eligibility (active and retired employees enrolled in an SFHSS plan, plus qualifying surviving spouses/partners), named the SF Department of Elections as the vote administrator and authorized staff to initiate candidate outreach and publication of election materials. Nomination forms were scheduled to be available once materials were approved.

- IBNR and contingency reserves (agenda item 16): Aon actuaries presented the recommended IBNR for unpaid liabilities through 06/30/2024 and contingency reserves calculated at the 90.5th percentile confidence level for self-funded and flex-funded medical and prescription-drug plans. The board approved those figures and acknowledged that the contingency policy now uses the 90.5th percentile per prior board guidance; the self-funded active employee dental PPO is excluded from contingency reserve requirements.

- Closed session and disclosure votes (agenda items 4, 6, 7): The board followed standard procedure to hear a continued member appeal in closed session, then voted not to disclose the closed-session discussion and not to issue a reportable action for that closed session, consistent with the San Francisco Administrative Code and California Government Code provisions cited on the agenda.

Ending: Records and availability

All formal motions, roll-call tallies and the written election materials for the board seat were placed into the meeting record. The Department of Elections will administer the board-member election per the schedule approved by the board; SFHSS staff was authorized to post public notices, nomination forms and candidate information on the SFHSS website and make hard-copy materials available upon request.