to have this come up, you know, it happens to be something that was legally mandated and we've gone through a whole discussion with the health plans and so forth. and now this is brought to our attention after some months and now we're ready to close and getting ready to publish. so, i guess my question is do we have other regulatory issues that these plans need to be or that we need to screen for or the plans need to bring to our attention affirmatively. and if we don't have that kind of on our checklist, i would ask that we get it on there because it may be something of a larger consequence. and i know that your staff can't spend its time screening all of the stuff that comes from the department of managed care, but it seems like we had a hole here to get this done and i'd like to know how we plan to solve it. >> that's a very good question. we did have one of our steps in preparing for the rates and benefits to have our

consultants do a review of any federal or state changes that need to be brought to -- [speaker not understood] on the rates and benefits and this was missed. so, we do have a process for it, we miss it had, and i think it wasn't until kaiser let us know this was occurring, really last week and saying this is now part of the rates benefits that we were alerted to the fact. i think it's fair to say we should also be working as a double-check with our health care benefits to make sure they aren't aware of anything as well. >> thank you. >> when did kaiser and blue shield remove it? >> the kaiser notice was it was removed essentially immediately because it's a legislative mandate. so, it has to be done immediately. >> any other comments? we have a motion. >> i move the adoption of the removal of the cap on transgender benefits. >> second it. >> this is for plan 1.

>> plan 1. >> okay, it's been moved and seconded. any public comment on this item? seeing none, all those in favor. >> aye. >> opposed? it's unanimous. madam secretary, item number 6. >> item 6, discussion item, presentation of blue shield dashboard. president breslin. >> this item is not ready for this month, so, i'm assuming we want it on the september calendar. so, we will continue this matter to our september 12th board meeting. regular board meeting. thank you. any public comment on this item? seeing none, [speaker not understood]. >> membership rules committee, item 7, action item, adopt and make editorial changes to the health service system membership rules and

regulations including, but not limited to, the following. add federal eligibility requirements per patient protection and affordability care act. clarify eligibility requirements for retirees hired after january 10, 2009. clarify eligibility rule for surviving dependents of safety officers killed in the line of duty. allow hss to terminate benefits if member address and contact information are incorrect and hss has been unable to contact member for over one year. clarify medicare enrollment requirements for dependents of active members. clarify cal-cobra eligibility. and list benefit coverage periods for 2014. president breslin. >> i move that we adopt the changes to the health membership services rules and regulations. >> seconded. >> any comments, any board comments?

any public comment? it's been moved and seconded. all those in favor. >> aye. >> all those opposed? it's unanimous. item number 8. >> item 8, action item, approve revised section 125 cafeteria plan for 2014 calendar year, effective january 1, 2014. president breslin. >> i don't know that we approve the changes to section 125 of cafeteria plan. ~ i move that we >> second. >> any discussion? any public comment? all those in favor? >> aye. >> opposed? okay, now we're onto the regular board matters. >> regular board meeting matters, item 9, action item, election of health service board officers (president and vice president) for fiscal year 2013-2014. president breslin.

>> nominations are open for the president and vice president. >> i would like to make a nomination. i'd like to nominate karen breslin as the president and [speaker not understood] as the vice president. >> second. >> all right. any discussion? any public comment on this item? >> the only discussion i have is since we don't have a full quorum today, other commissioners, sometimes they defer, but i don't know the process with this commission. otherwise i move the second if there's no -- >> what do you mean we don't have a quorum? >> we have a quorum. we don't have a full board. sorry. fair enough. >> all right. any public comment on this item? all those in -- all those in favor? >> aye. >> opposed? okay, item number 10. >> item 10, action item, appointment of chair and members of the following committees.

president breslin. >> all right. the rates and benefits committee is a committee of the whole. i'm appointing commissioner scott to be chair of that committee. and the finance and budget committee, i'm appointing supervisor farrell as chair. and commissioner limb and commissioner scott to be on that committee. and for the membership rules, commissioner [speaker not understood] as chair and commissioner breslin as members of the rules committee. and for the governance, commissioner limb as chair and dr. shlain as a member and

commissioner fraser as a member. so, these have to be approved by the board, so, i'll need a motion to approve. >> i'll make a motion to approve that list. in its entirety. >> okay. >> second. >> great. is there any public comment on this item? seeing none, all those in favor? >> aye. >> opposed? unanimous. okay, item number 11. >> item 11, discussion item, report on network and health plan issues, if any. >> anybody have anything to report today on this item? item number 11? seeing none, any public comment? oops, do we have somebody? come forward, please. thank you.

my name is dianne olek and i have a question about something not covered by delta. [speaker not understood]. the academy of sleep dentistry recommends you be seen once a year to make sure the oral appliance isn't moving your jaw or teeth in any way because that can be a side effect of the oral appliance. kaiser will cover you for a three-month follow-up, but after that you're on your own. and i don't understand since the issue is aden tal issue why if i have money left on my delta dental plan why they will not cover that. ~ and i'd like the board to discuss that or find out from delta dental why. >> [speaker not understood]. >> i'm sorry, we'll be happy to look into that. thank you. >> thank you. any other public comment?

no public comment. no other public comment. item number 12. >> item 12, discussion item, opportunity to place items on future agendas. >> we always have a full agenda. commissioner scott. >> madam president, i want to go back and reinforce the opportunity now that i'm serving as chair of this rates and benefits committee. i think that we all went through the heartache of the -- this past spring. and we're on track to do the very same thing if indeed we are not proactive in terms of doing some pre-planning. so, i note the very same groups that had a defined interest and that not only means those who are represented, but also other plan members as well will come forward and share with us very

explicitly, not just in comments, but in writing their views about what they think we should be trying to do from an overall health plan standpoint. we all know that no matter how those things are framed, we can't do everything and i'm not as a new chair going to promise that. but we can indeed engage in a healthy internal discussion. and doing that on the front end can help to shape the outcome. i'm happy to be very persuaded that just as we have start today engage with some of these health plans, not only kaiser, but i think it's true for all of them, that we need to do that on a continuous and sustained basis so that we are neither surprised when they have to make the more formal recommendation about rates, everyone can then get very, very clear about what should have happened, why it didn't happen, and who wasn't there when it happened, and so on and

so on. so, my great hope is we will take the time during this fall. i know we're busy with open enrollment. but during this fall to meet formally, informally, and certainly during the course of these meetings to present the ideas and come to some broad based outcomes that we would like to see. i would welcome that as chair of the rates and benefits committee, but i also think that it has to be a wide partnership to get that done. so, i hope i'm not over committing for the staff or the board, but i hope that we will take that to heart. >> thank you. in september we will have a specific agenda item to address this, which you might have to put some input on as to how you want to do that. that would be great. >> president breslin? i also wanted to add -- i'm sorry, i missed this in the director's report. we have started negotiations with kaiser for 2015.

we started on august 1st, and we just had our second meeting. so, we'll be working, working with you going forward. >> thank you. >> any public comment on this item? dennis [speaker not understood], actively [speaker not understood] retired firefighter. i'd like to congratulate the new elected officers and i look forward to watching the year. and second of all, having sat through over a year of i guess presentations and actually negotiations that originally approved the gender -- my mind went blank there, but for the gender operations and so on. it's good now to see that that is recognized as any other procedure because at the time when they went through all that procedure, they tried to tell everybody that this is just

another medical condition that has to be dealt with. so, it's nice to see even 15, 18 years later from that time this is now recognized for what it really is. so, i applaud the board on that one. >> thank you. claire [speaker not understood], retired seiu. again, i want to congratulate everyone on their positions as officers and also as chairs. and suggest that commissioner scott said a special letter go out to organizations, retiree organizations and the unions, the public employee council and the seiu inviting them to perhaps have a meeting with one or two commissioners so you have a quorum. you know how that goes. but that you're available to meet so that you can have some discussion either with the leadership or with the rank and file to determine what their concerns and issues are and to be able to bring those back

because that's i think the only way we're going to be able to keep this discussion and dialogue going, and to make sure that it's a partnership. put it on them to come forward and have that dialogue. so, again, congratulations and thank you all very much. and i want to second what dennis said about transgender. i went through that battle three times on the board and it's nice to see -- you know, we worked out some centers of excellence and we worked outweighs to keep that benefit affordable. and it's nice to see that it's now being accepted as any other condition. i wish we had made that decision, but if it came from gmhc, i'm happy those guys did it. and i think part of the national health care also eliminates a lot of discrimination. so, we're getting there little by little. but thank you again and congratulations again. >> i just wanted to comment that we have to make sure we contact or include all members, not just unions or retirees, as

i mentioned earlier. and that would mean we would have to send out a letter to every single member in the system, in my opinion, because not everybody is in unions. you can see in the past certain people show up and certain people don't. and, so, not everybody gets represented in a way. that's something i think you have to look at when you're talking about contacting people. any other discussion on this item? all right, item number 13. >> item 13, discussion item, opportunity for the public to comment on any matters within the board's jurisdiction. my name is herbert wiener, i'm a retiree. last month they had a conference on bullying at the work site. it was part of labor fest. and the address concerns

bullying at the work site and the tremendous toll it takes on employees. there were heart attacks. there have been suicides. now, unfortunately, san francisco is not blameless in this. and i would like to see the employee vip program -- vap program, excuse me, you know, work on legislation or rules and regulations regarding bullying at the work site. it really takes a tremendous toll and, you know, [speaker not understood] occur all over the city. bosses harassing workers, peers sometimes harassing workers and this really has to stop because it slows down production. we have a limited work force. we have a heavy work load. and placing employees under stress does not help this at all. so, i would like to see this addressed in the future. thank you. >> thank you.

any other public comment? seeing no public comment, we will -- i'll entertain a motion to adjourn. >> i move adjourn. >> in favor? >> before i second that -- [gavel] >> this meeting is adjourned. thanks. [adjourned]

>> bryant, i want to start off by thanking sf gov tv and media services and every media of the commission and making it available to the public online as well as channel 26 to the public and the audience, please silence all your cell phones and electronic devices. if you are to participate in public comment, please fill out a public comment speaker card, there's some