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]

>> the garden contains plants referred to by william

shakespeare's plays and poems. located near the academy of sciences, shakespeare's garden was designed in 1928 by the california spring and wild flower association. here is a truly enchanting and tranquil little garden tucked behind the path of a charming rot iron gate with romantic magic. the overarching cherry trees, the gorgeous big walkway and brick wall, the benches, the rustic sun dial. the pack picnic, lovely bench, enjoy the sunshine and soft breeze and let the >> bonnie banks. bonnie banks. my definition of noise is uncontrolled music.

without format. pretty simple affair. pancakes, and you're -- people get up on sundays around noon, weekends or whatever. should not be too hard to walk into place. have your audio alarm clock go off for two hours waking your up while you are eating breakfast with many interesting visuals once in a while. improvisation. listening or not to the person you're playing up against or people or machines. trying to get as many different people in as possible. different genres, experimental noise, electronics, dissonance some drums.a tiny bit of

ambient -- the first noise pancake shows, 1999, the first waffle noise, 2001. god-waffle noise, noise pancake came out of cubist art, place on mission street, brutallo, where the church -- opened up his house and saturday morning cartoons. a big space. you can have everybody set up and barely move equipment around; small room for an audience to move around, walkover and get pancakes

without getting burned up in the kitchen. there's like people in their hard-core gabber; people into really fast death metal; black metal. people who don't listen to music at all. guy like larnie bock (sounds like) set up huge, motor driven harp. i don't know how to explain it. 40 foot of motors that he had running over strings and wires. and then played each string individually with the mixer. there is a feeling of euphoria

when somebody's really good at what they do. experiencing a buffer, pushing your bowels out your rear. different. a lot of noise. you don't play clubs with a cleaning schedule, a guy coming in the morning emptying the beer bottles. you play the warehouse. if you travel around you will see the exact same kind of weirdos doing their own thing. it is like in the bay area it's even more absurd. there seems to be more people that in a place like new york or tokyo. we did a show in new york, i didn't think that anyone was at hardly, and people come up

and said i saw the show. i wish they had some kind of breakfast noise going on over there. i think a lot of people were being, walking out of the shows. that was incredible. i can't believe it's over already, after two hours. if you are reluctant to enjoy something like this it will probably take a mass of peers to sell you on it. it's fine if you stay away. most of the people that come to the shows are pretty happy to be here. you may not be one of them. which is fine. this is the san

municipal transportation agency and parking authority. please call roll >> brinkman present. heinecke present. director lee. lee present that were director nolan. present director rubke. present. present mr. chairman and directors you have a quorum. thank you. i'm asking you to silence all electronic devises. their prohibited at the meeting any person responsible for that one going off maybe removed if the meeting. they cause microphone interference for the