Health Service Board approves 2023 retiree health‑plan rates for Kaiser and UnitedHealthcare
June 09, 2022 | San Francisco City, San Francisco County, California
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The San Francisco Health Service Board on June 9 approved a slate of 2023 retiree health‑plan rate cards following presentations by actuaries and carrier representatives.
Aon actuary Mike Clark summarized proposed rate actions for Medicare and retiree plans. Clark said Kaiser’s multi‑region plans (Washington, Northwest and Hawaii) showed “favorable rate actions” and presented a recommendation to approve the fully insured rate cards for early retirees and Medicare retirees. For the Kaiser Permanente Senior Advantage (KPSA) California Medicare plan Clark reported a 1.86% insured premium reduction for the 2023 plan year and described a CMS reconciliation that will be trued up next spring. For UnitedHealthcare’s Medicare Advantage Prescription Drug (MAPD) plan Clark said the recommended insured rate is $447.22 per member per month, reflecting a 4.7% increase for 2023 after earlier stabilization offsets expire.
Board members asked about utilization and whether lower rates reflected lingering pandemic suppression in claims. Clark said the 2023 forecasts assume utilization moving closer to pre‑pandemic levels and that Kaiser’s integrated HMO model tends to produce lower rates than national PPO plans. Commissioners also asked about monitoring for potential service reductions under Medicare Advantage arrangements; director Yant and Clark said staff will continue utilization reviews and member‑service reporting.
Public comment periods drew no callers on the rate items. Each presented rate card was moved, seconded and approved by roll call; the board voted unanimously on the Kaiser multi‑region, KPSA California and UHC MAPD recommendations.
Votes at a glance:
• Kaiser multi‑region retiree HMO rates (Washington/Northwest/Hawaii): approved unanimously.
• Kaiser Permanente Senior Advantage (California) 2023 KPSA Medicare retiree rate card (1.86% insured premium reduction): approved unanimously.
• UnitedHealthcare MAPD 2023 retiree rate card ($447.22 PMPM; 4.7% insured increase): approved unanimously.
What it means: The approved rate cards become the basis for retiree premiums and employer contribution calculations for 2023. Clark and staff said final plan costs will be reconciled with CMS funding next year and that member contributions for many Medicare‑only retirees remain at $0 when total plan rates fall below the 10‑county benchmark used in the charter formula.
The board paused for a 15‑minute recess after the multi‑region action and resumed to complete the remaining retiree rate votes and other agenda items.
Aon actuary Mike Clark summarized proposed rate actions for Medicare and retiree plans. Clark said Kaiser’s multi‑region plans (Washington, Northwest and Hawaii) showed “favorable rate actions” and presented a recommendation to approve the fully insured rate cards for early retirees and Medicare retirees. For the Kaiser Permanente Senior Advantage (KPSA) California Medicare plan Clark reported a 1.86% insured premium reduction for the 2023 plan year and described a CMS reconciliation that will be trued up next spring. For UnitedHealthcare’s Medicare Advantage Prescription Drug (MAPD) plan Clark said the recommended insured rate is $447.22 per member per month, reflecting a 4.7% increase for 2023 after earlier stabilization offsets expire.
Board members asked about utilization and whether lower rates reflected lingering pandemic suppression in claims. Clark said the 2023 forecasts assume utilization moving closer to pre‑pandemic levels and that Kaiser’s integrated HMO model tends to produce lower rates than national PPO plans. Commissioners also asked about monitoring for potential service reductions under Medicare Advantage arrangements; director Yant and Clark said staff will continue utilization reviews and member‑service reporting.
Public comment periods drew no callers on the rate items. Each presented rate card was moved, seconded and approved by roll call; the board voted unanimously on the Kaiser multi‑region, KPSA California and UHC MAPD recommendations.
Votes at a glance:
• Kaiser multi‑region retiree HMO rates (Washington/Northwest/Hawaii): approved unanimously.
• Kaiser Permanente Senior Advantage (California) 2023 KPSA Medicare retiree rate card (1.86% insured premium reduction): approved unanimously.
• UnitedHealthcare MAPD 2023 retiree rate card ($447.22 PMPM; 4.7% insured increase): approved unanimously.
What it means: The approved rate cards become the basis for retiree premiums and employer contribution calculations for 2023. Clark and staff said final plan costs will be reconciled with CMS funding next year and that member contributions for many Medicare‑only retirees remain at $0 when total plan rates fall below the 10‑county benchmark used in the charter formula.
The board paused for a 15‑minute recess after the multi‑region action and resumed to complete the remaining retiree rate votes and other agenda items.
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