Health Service Board approves 2023 plan changes, uses stabilization reserve and renews VSP vision

The San Francisco Health Service Board on April 14 approved a package of rate and design actions for benefit plans covering city employees and retirees.

The board voted to apply one-third of the 12/31/2021 stabilization reserve deficit — $403,000 of a $1,210,000 shortfall — toward rate buy‑ups for the non‑Medicare self‑funded PPO plan in plan year 2023, leaving an $807,000 carryforward. Aon actuaries presented the recommendation and said the adjustment follows the system’s stabilization‑fund policy; the motion passed by roll call vote with no opposing votes.

On vision benefits, Aon and VSP presented a 2023 renewal that includes a new Light Care option (allowing nonprescription blue‑light or sunglasses when no prescription is needed), anti‑glare and UV lens protections, and minor plan design updates to the computer‑vision care benefit. The VSP program’s 2021 loss ratio was reported at 109%, activating a contractual not‑to‑exceed 2% premium provision; Aon recommended applying the allowable premium change mainly to the Premier buy‑up. The board approved the 2023 VSP premium and member‑contribution schedule (Basic +5% to reflect Light Care; Premier up about 8.7% including the enhancement) by unanimous roll call.

For retiree dental, Aon and Delta Dental recommended two design changes for the retiree Delta Dental PPO: lower the premier and non‑contracted dentist deductible to $50 per individual and $100 per family (down from a $75/$150 single/family structure) and raise the plan‑paid coinsurance for premier diagnostic and preventive services to 100% (eliminate the member’s coinsurance for cleanings/exams/x‑rays). Aon estimated the combined change would increase retiree PPO rates about 7.7% but would reduce time‑of‑service out‑of‑pocket costs for members who use premier network dentists. That motion passed with five ayes and one no (Commissioner Breslin), 0 abstentions.

Board procedure and next steps
The board recorded the votes by roll call for each action and opened public comment for each item before voting; staff will incorporate the stabilization reserve adjustment and the approved benefit changes into the 2023 rate‑setting process and communicate plan changes to members through the usual enrollment materials.

Actions recorded
- Stabilization reserve: approved use of $403,000 (one‑third of $1,210,000 deficit) toward 2023 rating; outcome: approved (unanimous).
- VSP 2023 renewal and Light Care/computer vision enhancements: approved (unanimous).
- Retiree Delta Dental PPO design changes (deductible and premier coinsurance): approved (5–1; Commissioner Breslin voted no).

What the board said
Aon presenters repeatedly framed the recommendations as consistent with long‑standing reserve and underwriting policies. In discussion, commissioners asked staff and vendors about provider network accuracy, plan utilization trends and whether benefit enhancements would encourage preventive care use.

The board’s approvals will be reflected in SFHSS rate materials and the 2023 plan offerings for active employees and retirees.