i'm noticing here you're not recommending the risk sharing option, so do we want to even have more information on that? i don't see why we want it if it's not a good option. >> i think we felt administratively the problems of not having one year settled why we were pricing the next year and rolling it into the following year would be beyond what we would want to take on, the benefit, the benefits versus the work, and tracking all of the finances didn't seem to be advantageous and we would be able to get to a similar savings model with the flex funding arrangement that would allow us to see that and bring the pricing from the last year into the pricing for the next year. >> so are we thinking about taking this on for 2015 or the

following -- or looking forward? >> this is for the 2015 renewal cycle. >> and actually considering going that way for the 2015. okay. commissioner. >> just a comment on what commissioner fraser was saying and i would like -- [inaudible] fully insured, the flex funding. i have some references with the fully insured and might give impression to the members and assuming it comes out and lower everything else and this is what she's saying and short term and give impression to the members why didn't you go with this one, so i have reservations with fully insured but just one question for you when you bring all of the comparisons what data

are you using? 2012 season or how many years of data are you bringing? >> well, as we did with the flex funded work for blue shield we would look at 36 months of data as current as we can get it. >> up to 2013? >> yeah, up to the end of the year. that would be our goal so we basically built the template for this for flex funded and if you go to the website the same analysis and side by sides that we presented before and i understand your opinions and i personally off the [inaudible] and maximize the trust for my client and specific and that's my optic and i understand that and i appreciate it very much what was said and i understand that whole argument. it's absolutely fair to say but i am charged with one role to

maximize assets of the trust and find the money and bring it to your attention. now, fully insured -- you could do that and we could see that or see if there is money to put it in the trust and is this better for kaiser in the long run? i will answer that question. you didn't ask that. kaiser's preference is still fully insured and run their organization that way as one big kaiser family, not we take advantage of this and do that and i want that on public record that is absolutely -- and i can say that without looking to kaiser and that's their prerogative so with that do you want me to look at it or stick with fully insured or this and there isn't a lot of difference

between the two and it's up to you guys to decide what you want to do. >> commissioner scott. >>i would offer a motion that we request that the actuary look at all three models discussed recognizing there might be a slight distinction between self funded and flex but i think at this stage to have an informed discussion to allow us to see all of the aspects and we're not down to decision time that we want to do this, and if we decide at the next meeting -- well, having the other option in the midst of the two we're going to talk about is more confusing to everyone then we can take that step at that time but i would like to start with all of the complete information so we can make an informed choice. >> yes. >> everything but the risk

sharing option. >> i am thinking of dollar signs every time we talk about more actuarial work and we have to think about that to some degree. >> so the motion is -- could you repeat that please. >> the motion is we direct the actuary to do analysis on the options presented today -- >> [inaudible] >> page 12. >> recommendation. >> okay. the fully funded option, the self funded option, and the flex option. >> i second then. >> okay. any other discussion? any public comment on this item?

>> i am richard roth, a retiree. i am glad you're looking at all of the options. and it's important. and also -- maybe this is off topic but i want to talk about kaiser's communications or lack of communications and commissioner fraser i took your advice and found out the drchz of observation and hospitalization but i didn't find out from kaiser and they should tell people. the doctors didn't know what it was and i asked the billing department and everything. last year was challenging for the rothman household and i think kaiser was very insensitive. their billing office said one thing. they mail bills out and say another. we call up and say one thing. they still mail the bills out and the final and send it to the collection agency even though we kept writing back and i think there needs to be more

communications between kaiser hospital and their billing department because i don't think one hand knows what the other hand is doing. >> thank you. come forward please. >> my name is diane erlick and i have a question about the self funded epo and similar to the current plan. does this mean for instance the paperwork for the individuals that have plan one have to do would fall on the individual -- would fall on us at kaiser if you choose that plan? for the people in plan one they have to submit all of the paperwork to medicare and all that stuff. would we then be doing that with kaiser and would the people actives doing the paperwork that they do to submit to the insurance company? >> no. absolutely not. i'm sorry. absolutely not. for

the member it would be invisible. this funding mechanism would be invisible to you so if we didn't tell you wouldn't know we changed the funding. >> okay. just to comment on what richard said about being in the hospital. it's not just kaiser. there has been a lot written about that. i get a lot of these newsletters. it's all hospitals. there's a great deal of confusion about that and none of the big hospital chains have been very honest about that. >> thank you. all right. there is a motion to have our actuaries pursue fully funded, the flex funded and the self funded for more information at the april meeting or may meeting perhaps. all in favor say? >> aye.

>> opposed? no opposed so that is unanimous. thank you. moving on to the next item please. >> membership rules committee, item six action item approval of flexible spending act fsa carry forward option up to $500 for 2014 plan year. president breslin. >> we will take this as a full board item or as a committee of the whole, and i will be chairing this for the moment because commissioner ferrigno is not here. if you look to the first part of that which is page 14 you will see the change to the flex funding and there will be additional item number seven, and it's a flexible spending account. fsa require annual enrollment and don't carry over year to year and effective year

2013 and unused balance up to $500 can be carried forward to the following plan year. the health fsa carry over option up to $500 is independent of the annual fsa election requirement. we discussed this at our last board meeting or maybe the one before and we all agreed -- oh i thought we agreed pretty much it was a good idea for the members so i would entertain a motion to approve this rules change. >> so moved. >> second. >> okay. moved and seconded. any discussion? any public comment? seeing none all in favor say? >> aye. >> all those opposed? no. no one opposing. all right.

thank you very much. on to the next -- back to the regular board matters now which is item seven. >> item seven action item approval of recommended health care sustainability budget plan. lisa ghotbi. >> i'm sorry i should have spoken up a little bit quicker. i think the approval has to be for the rules but separately also for the cafeteria plan, both of the documents are updated and approved. is it possible to take -- under item six it was approval that the fsa language needed to be included and updated in the health services and rules and also in the annual cafeteria plan document so i'm sorry if it was confusing but there are two sets of documents here, the same language however, and so -- >> so maybe we can revisit that item, item number six and if you restate that motion. >> the motion was to approve those documents. >> membership rules and the cafeteria plan. >> correct. >> and i would second that.

>> okay. any public comment? all in favor say? >> aye. >> opposed? all right. thank you. thank you. now we're at item number seven. >> item seven action item approval of recommended health care sustainability budget plan. lisa ghotbi. >> thank you. under tab seven is a presentation to the board as required of the health sustainability budget summary of 2013 expenses and plan for 2014. i'm going to ask the board for a continuance on this really at the last second we recognized an error in the math we're and we would like to continue this until the next meeting and bring it back to you. >> okay. i don't need a motion to continue, do i? do i need a

motion just to continue? okay. the item will be continued unless there is an objection. item eight please. >> item eight action item approval of resolution ordering the 2014 board election for two terms and authorizing the staff to in fact and proceed with the election. lisa ghotbi. >> so before you under tab eight is a resolution ordering the health service board election, setting the dates for the election, offering the health systems to operate the election and proceed and the two elections are president breslin and commissioner fig rigo and will occur on the dates listed and

the individuals will assume on the meeting of may 12. are there any questions on this? or any comments? >> june 12. >> did i say may 12? i'm sorry. june 12. >> any discussion? i need a motion on this item to approve. >> i move that we adopt the resolution as distributed. >> second. >> okay. any public comment on this item? all in favor say? >> aye. >> opposed? okay. it's unanimous. item number nine. >> item nine discussion item presentation of rates and benefits calendar for plan year 2015. lisa ghotbi. >> okay. so it's that time again for rates and benefits cycle. commissioner scott will be leading this year in the cycle and before you is a

calendar of the plan schedule of topics between february and taking -- but taking the final vote in june and to the board of supervisors for the july meeting. it is i think well laid out. it is going to be a busy time but i think we've got a good plan for making sure that we are making -- we're reviewing things every meeting and making decisions so it's not all backing into one meeting. of course at the final meeting we will revisit it and do a final approval. any questions or comments or suggestions for the calendar? >> commissioner scott. >> as always i am going to appeal to everyone that will be involved in this process that you use the time that is provided during each of the

subsequent meetings to bring forth your concerns, your views and your comments so that we do have a robust discussion, and not have to appeal to other forums because we didn't like the outcome. we will try to be as public and transparent about this as we possibly can, but i hope that people will actively engage throughout the process so that when we do come to a final recommendation we all know how we got there and that's an appeal to every one of the members who are covered and supported by these trusts and participate in the plans and if we have to fill the room that's fine. if we have to stay longer that's fine but i do hope that people will come out, share their concerns, as we address these topics. i only appeal that you stay on point, not talk about the end game but the things that we're dealing with at that particular moment if

you can, but i do hope that there is wide and active engagement during the process. thank you. >> and i noticed that the february meeting is when we will discuss the retiree delta dental and that would be the time when you would be -- the last meeting after the prior meeting about other options for retirees. will that be discussed at that meeting? >> correct. at the february meeting. i think at the last meeting the board asked us to look at other options in terms of higher amounts. we will bring those back as well as the board asked us to draft a survey to the retirees to get their understandings and preferences so we will have that for you to review. >> so if the member vs any suggestions. >> >> i welcome them to come up now as far as the retiree dental plan. >> there is one concern i have

about delta dental and that is it came up last meeting about how many times you have your teeth cleaned in general. two times a year was considered optimal. i think four times a year is actually a preventive for root canals and extractions and i think this ought to be reviewed at the next meeting. >> thank you. >> i just wanted to comment they have surveyed some dentists on that and i haven't gotten consensus that four times a year is actually recommended. we're going to be asking the retirees about what they're saying but we're not getting that recommendation. >> come forward please. >> i am diane erlick. at the

last meeting i asked why delta dental didn't cover the follow up care for the checking your mouth and the dental plan for sleep apnea and the representative explained to me that retirees do not have i think he called it tmj coverage and if we have that in our plan it would cover that, the active hadn't, so i request that you maybe get tmj coverage included in our plan so if we have the money left over in the plan something like that would be covered. >> thank you. >> thank you. it's on the list. >> thank you. >> dennis krueger activity and retired firefighters. in my continued saga of the dental coverage one of the questions that come up is "how many would it cost for me to have a plan

like the active employees? how many would it cost for a $2,500 a year plan?" so i am hoping delta which seems to have -- very good monopoly on the dental system and coverage which probably has 25 or 30,000 people from the city could come up with rates for maybe $1,500 plan, a $2,000 plan and equal to the $2,500 plan, and then i would like to have some consideration from delta in our $1,000 plan if you have one root canal or one crown your coverage is gone so you're not able to get the one or two cleanings a year so i think some consideration should be put into the policy that even if you get to a thousand dollars

because of a crown or some kind of procedure you still should be little entitled to get the two cleanings a year because again as everybody seems to know oral health is also contributor of physical health so thank you for those considerations. >> thank you. >> i will just respond and just say those are the concerns that we heard at the last meeting. we are pricing out those titles. we are also pricing out preventive care being excluded from the cap. >> thank you. any other public comment? all right. seeing none item number 10. >> item 10 discussion item report on network and health plan issues if any. >> anybody want to come forward on this item? any comments on this item? any public comment

on this item? seeing none item number 11. >> item 11 discussion item opportunity to place items on future agendas. >> commissioner fraser. >> thank you. i'm not sure when i would like to ask this, but i think it might be useful for the board and for our members to have a presentation that's a little bit more on the public health side but related to the importance of exercise and in particular a comparison of exercise to many medical treatments because there is fairly good evidence that 30 minutes a day is more effective than many of the medical treatments we're paying for and i think getting that information out is useful and i will take the burden on getting a speaker but i hope the board is interested in providing the information to the members. i think it's a great idea. any

other suggestions for future agenda item? seeing none any public comment? item number 12 please. >> item 12 discussion item opportunity for the public to comment on any matters within the board's jurisdiction. >> you can comment on anything in our jurisdiction. >> dennis krueger active and retired firefighters. the other side of the coin i just want to thank the representatives from delta for looking into a particular situation that arose and even during the middle of the holiday i was still getting contacted by him and he resolved all of the questions they had so again i want to thank the representative and i found him exceptional help for me. thank you. >> thank you. all right. any

other public comment? now i can entertain a motion to adjourn. >> i so move. >> second. >> okay. all in favor? >> aye. this meeting is adjourned. [gavel]out.

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thanks for joining us on this beautiful december day to mark this ground breaking of the exciting new edition of the san francisco landscape. my name is mike sanford. i work for the reality corporation. it's my pleasure to be your mc today. on behalf of reality and all of our partners and this development project. welcome. i was talking to my daughter this morning, she's 4 years old and she says to me like most days, "daddy, what are you doing today?" actually i have a very exciting day. we are meeting with people this afternoon and most importantly i get to be part of this ground breaking project and the mayor is going to be here. he runs the city and thinking she would be very impressed with her father. and

she says okay, can i watch my little pony on your ipad. she will be the media worker and i know this will be the cutting edge when she's ready to join the work force. 333 brandon is the lead project development in san francisco. like everything that we are inspired to do in this great city it's a very special project. it's located at the nexus of the industrial city's past and all the future. it creates a unique opportunity for us to explore the character and contemporary spaces and operating systems designed to increase worker productivity. it incorporates many of today's many ideas of sustainable development and operation. as you will hear from our partner david johnson and his firm. it

has our leadership goal to high quality enterprises in san francisco and nurtures a business environment that supports strong economic growth as you will hear from mayor lee. it also established new benchmark for what is possible today for commercial development and you will happy hear from our company leader. john kilroy. i think you will understand that we are a huge believer of san francisco. we have demonstrated that faith in local management, resources and development. it has taken a big teamworking together very closely to bring us to today's ground breaking. that is a lot of people and we are glad to see to many people with us today. it's my pleasure to introduce one of the city's biggest visionaries and supporters. the mayor learned

from the very beginning what a very exciting opportunity this has been and he's supported us every way through this development. i know my daughter will understand 1 day how special it is to have him here. please welcome honorable mayor lee. >> mike, thanks very much. congratulations to you and certainly to john and what a wonderful design concept you have here for sure. i'm really excited to see this go up. first of all, happy holidays! it's always great to be with john kilroy because he's been a great partner in our economic recovery for the city. i can't think of another developer who has been so diverse in its work and the kind of tenants that are coming into his buildings. if you have a chance, like a lot of us walking down from the bart station to the ballpark on second street, you will see what i mean when you see the

vibe -- of that whole corridor and the wonderful projects that it's done. today's site, i have to say to you, i have been to this site before. any other it's a parking lot but it was the firefighter's chili cook off site. on occasions you have some good events here but it represents some of those areas that are under valued and the great companies like this and you look at these historic areas and you think what could we do to bring more value to it and as you see this open floor plan, windows that can operate. the idea that you can have a building that not only matches some