Health Commission approves revised minimum standards to expand compliant silver plans for city contractors
July 19, 2022 | San Francisco City, San Francisco County, California
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The San Francisco Health Commission on July 19 approved a set of revisions to the Health Care Accountability Ordinance minimum standards intended to expand the range of compliant health plans available to employers that contract with the city.
Max Guerra, health program planner in the Department of Public Health’s Office of Policy and Planning, outlined the work group’s consensus recommendations. The package preserves automatic compliance for gold and platinum plans when employers fully cover premiums and deductibles, and it would expand the availability of compliant silver plans by adjusting cost‑sharing rules. The proposal syncs the out‑of‑pocket maximum to California’s patient‑centered limit while requiring employers to cover an initial share (described in the presentation as the first $4,000 toward an $8,000 maximum) via employer reimbursement mechanisms such as HRAs or similar arrangements.
Guerra said the recommended changes would increase the number of available compliant silver plans from 2 to roughly 30 in the local small‑group market, improving options for nonprofit and small‑employer contractors. He noted that 7 of 8 work group members supported the package. “Altogether these recommendations should increase the number of available silver plans from 2 to 30, with 75% of silver plans overall becoming compliant,” Guerra said.
Debbie Lerman of the San Francisco Human Services Network, a work‑group participant, urged the commission to adopt the standards and stressed the need to preserve affordability for nonprofit employers while ensuring quality coverage for workers. Commissioners praised the collaborative process and moved to approve the resolution, which passed on a unanimous roll call vote.
The resolution will be disseminated to city contractors, and DPH together with the Office of Labor Standards and Enforcement (OLSE) plans outreach and education events to explain implementation details to employers and employees.
Max Guerra, health program planner in the Department of Public Health’s Office of Policy and Planning, outlined the work group’s consensus recommendations. The package preserves automatic compliance for gold and platinum plans when employers fully cover premiums and deductibles, and it would expand the availability of compliant silver plans by adjusting cost‑sharing rules. The proposal syncs the out‑of‑pocket maximum to California’s patient‑centered limit while requiring employers to cover an initial share (described in the presentation as the first $4,000 toward an $8,000 maximum) via employer reimbursement mechanisms such as HRAs or similar arrangements.
Guerra said the recommended changes would increase the number of available compliant silver plans from 2 to roughly 30 in the local small‑group market, improving options for nonprofit and small‑employer contractors. He noted that 7 of 8 work group members supported the package. “Altogether these recommendations should increase the number of available silver plans from 2 to 30, with 75% of silver plans overall becoming compliant,” Guerra said.
Debbie Lerman of the San Francisco Human Services Network, a work‑group participant, urged the commission to adopt the standards and stressed the need to preserve affordability for nonprofit employers while ensuring quality coverage for workers. Commissioners praised the collaborative process and moved to approve the resolution, which passed on a unanimous roll call vote.
The resolution will be disseminated to city contractors, and DPH together with the Office of Labor Standards and Enforcement (OLSE) plans outreach and education events to explain implementation details to employers and employees.
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