Health Service Board approves 2024 rate increases for Blue Shield plans and non‑Medicare PPO

President Scott opened the Health Service System Board’s May 2023 meeting by reminding members that pandemic‑era underuse plus a rise in chronic and specialty care had driven a step up in health plan claims and utilization that the board and staff had been analyzing for months. "We are about 50% staffed at this point," Scott said while outlining operational strains that factor into plan negotiations.

Aon actuary Michael (Mike) Clark presented the staff recommendations and rate cards for non‑Medicare plans, saying Blue Shield’s broad Access Plus network required a recommended 14.4% increase for 2024 while the narrower‑network Trio plan warranted about a 2.9% increase; Clark said roughly 4 percentage points of the Kaiser and Blue Shield increases reflected plan experience and the remainder stemmed from expense escalation. He also explained that a one‑time Sutter legal settlement provides a partial buy‑down for some plans.

The board pressed carriers on member experience. Commissioner Breslin described members’ difficulty verifying in‑network specialists and reported a case where a member was on hold with navigation services for an hour. Tiffany Gill, Blue Shield’s account manager, said referrals are typically authorized for an episode and members usually do not need to re‑visit a primary care physician for each specialist visit; she offered to research individual cases and pointed to an SFHSS 'find a doctor' tool.

After discussion, Commissioner Canning moved — and Commissioner Breslin seconded — a three‑part motion to approve the Access Plus and UnitedHealthcare Select EPO renewals (14.4% increase), the Trio and UnitedHealthcare Doctors EPO renewals (2.9% increase) and the resulting 2024 rate cards. The board approved the motion unanimously by roll call.

Clark then presented the non‑Medicare PPO recommendation. He said the non‑Medicare PPO overall rate impact (including stabilization and the Sutter buy‑down) would be about 1.7% for 2024 and described how employer contributions for the highest‑cost plan are tied to the second‑highest cost plan per the City’s MOU. Commissioner Follinsbee moved to approve the PPO rate cards; the motion passed unanimously.

The actions approved at this meeting will be transmitted to the Board of Supervisors as part of the city’s approval timeline for 2024 benefits. Staff and plan administrators said they will follow up on member‑reported network and navigation problems and provide clearer outreach during open enrollment.