To: Members of the San Francisco Board of Supervisors 

Date: February 10, 2025 

We are Protect Our Benefits, Inc., representing 19,100 retired San Francisco City and County employees who were impacted by the transition from United Healthcare (UHC) to Blue Shield of California (BSC) and its affiliates that went into effect on Jan. 1, 2025. Despite assurances from the Health Service System and from the Board of Supervisors that our benefits would remain the same, and that only our healthcare card would change, we are hearing about and experiencing first-hand many issues of concern with our fellow retirees. 

Since the actual transition went into effect just over a month ago, we have heard from more than 100 retirees who have either been denied critical treatment or have experienced a dramatic degradation in healthcare services. The complaints range from the very serious, to the very concerning.  

  • The very serious category includes a denial of cancer treatment and several planned surgeries that were denied with no warning. These members had been covered previously for these treatments under UHC. 
  • The very concerning issues include a number of physicians who will not accept BSC; prescriptions denied or cut from a 90-day supply for a $10 co-pay to a 30-day supply for the same $10 copay; and crucial pain management treatments like acupuncture and chiropractic services being denied. 
  • In the less serious, but equally concerning category, some members report their gym memberships are no longer available to seniors in all areas of the country in need of their therapeutic activities.  

While we have reported many of these problems as they arose and then been corrected, the transition has been difficult and concerning for the individual members as well as those of us who monitor the benefits of our fellow retirees. Many hours have been spent on the phone remedying these situations. Remember, our constituents spent their careers serving and defending the residents of San Francisco. Retirees face many healthcare issues, including cancer, heart, respiratory and other issues that need ongoing care and pain management.  Many have chosen to retire in other, less expensive areas outside of California where BSC is not accepted. 

It is not our job to fix these problems, but we have been thrust into the position of attempting to do just that, by advocating strongly that YOU undertake the necessary actions to remedy the problems. We’ve recently discovered that the contract with BSC has not yet been signed.   

We urge you to reconsider signing this contract until the many problems we have encountered have been thoroughly identified and corrected. We ask that we be kept informed of progress, in detail, as the many issues are rectified. 

Furthermore, we urge you to provide us with a list of amendments, IN WRITING, to the current BSC contract and how it differs from the previous UHC contract. We have also become aware of class action litigation filed in reference to AI algorithms being used by BSC to deny healthcare services at an alarming-high rate. As a result of these denials, our members are being forced to go through an extended appeals process. 

Therefore, we insist that a better communication and outreach program with all retirees be established, that a hotline is set up and monitored, and that all problems are documented and  made available to Protect Our Benefits.  

Remember, we are only slightly over a month into 2025, and these many issues have already cropped up. We can assume that this is just the tip of the iceberg – and as our members begin to utilize covered medical care and services in the coming months, many more issues will certainly occur. We demand action now before it is too late. 

In unity, 

 

Fred Sanchez 
President
Protect Our Benefits
925/858-9961 

 

 

Download a copy of this letter here.