Health Service Board approves 2022 medical and dental rate packages, including new Health Net CanopyCare and Blue Shield PPO Accolade
May 13, 2021 | San Francisco City, San Francisco County, California
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The San Francisco Health Service Board on May 13 approved multiple 2022 rate and contribution changes across medical and dental plans, including the introduction of a Health Net CanopyCare HMO and a Blue Shield PPO administered with Accolade.
Staff from Aon presented the overall rates and rationales before individual vendor presentations. Key approvals included:
- Blue Shield Access Plus and Trio HMO plans (combined staff recommendation: Access Plus ~0.8% increase; Trio ~2.0% increase) were approved by voice vote after a motion and second by commissioners.
- Health Net CanopyCare (new flex-funded HMO) 2022 rate cards were approved; Aon noted there is no rate stabilization balance for a new plan and that the plan 27s projection positions it between existing Blue Shield HMO rates.
- Blue Shield PPO administered with Accolade (self-funded) was approved with an overall rate increase of about 2.7%; staff emphasized Accolade 27s high-touch advocacy model and included integrated services (on-demand behavioral health through Ginger and musculoskeletal support via Hinge Health).
- Kaiser Permanente (fully insured) was approved at a 4.96% premium increase; Kaiser underwriting said the insured rate reflects enterprise costs and pandemic-related expense drivers.
- Dental plans: Delta Dental active-employee PPO recommended rate decreased by 14.4% for 2022 (driven largely by using stabilization balances accumulated during 2020 claim suppression); DeltaCare USA HMO rates were unchanged; UnitedHealthcare dental HMO rates decreased ~10%.
Board members asked vendors about network continuity for members, transition-of-care protections, the length of administrative fee guarantees, and how pandemic-related claim suppression was factored into 2022 projections. Blue Shield and CanopyCare representatives emphasized transition-of-care measures and provider recruitment to minimize disruptions. Delta Dental leadership committed to continued work with SFHSS staff to address billing and network concerns raised by members and commissioners.
Each approval was moved, seconded and carried unanimously on voice vote; staff will proceed with implementation and provide follow-up reporting (including utilization monitoring and measurement plans) as requested by commissioners.
Votes and next steps: staff and vendors will continue month-to-month utilization monitoring and return updates (financial and utilization reports) to the board; several commissioners requested a periodic utilization review to watch for pent-up demand as pandemic-era suppression eases.
Staff from Aon presented the overall rates and rationales before individual vendor presentations. Key approvals included:
- Blue Shield Access Plus and Trio HMO plans (combined staff recommendation: Access Plus ~0.8% increase; Trio ~2.0% increase) were approved by voice vote after a motion and second by commissioners.
- Health Net CanopyCare (new flex-funded HMO) 2022 rate cards were approved; Aon noted there is no rate stabilization balance for a new plan and that the plan 27s projection positions it between existing Blue Shield HMO rates.
- Blue Shield PPO administered with Accolade (self-funded) was approved with an overall rate increase of about 2.7%; staff emphasized Accolade 27s high-touch advocacy model and included integrated services (on-demand behavioral health through Ginger and musculoskeletal support via Hinge Health).
- Kaiser Permanente (fully insured) was approved at a 4.96% premium increase; Kaiser underwriting said the insured rate reflects enterprise costs and pandemic-related expense drivers.
- Dental plans: Delta Dental active-employee PPO recommended rate decreased by 14.4% for 2022 (driven largely by using stabilization balances accumulated during 2020 claim suppression); DeltaCare USA HMO rates were unchanged; UnitedHealthcare dental HMO rates decreased ~10%.
Board members asked vendors about network continuity for members, transition-of-care protections, the length of administrative fee guarantees, and how pandemic-related claim suppression was factored into 2022 projections. Blue Shield and CanopyCare representatives emphasized transition-of-care measures and provider recruitment to minimize disruptions. Delta Dental leadership committed to continued work with SFHSS staff to address billing and network concerns raised by members and commissioners.
Each approval was moved, seconded and carried unanimously on voice vote; staff will proceed with implementation and provide follow-up reporting (including utilization monitoring and measurement plans) as requested by commissioners.
Votes and next steps: staff and vendors will continue month-to-month utilization monitoring and return updates (financial and utilization reports) to the board; several commissioners requested a periodic utilization review to watch for pent-up demand as pandemic-era suppression eases.
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