6,000 retirees that are not engaging in the dental benefit now. >> i was concerned that we might lose members that can't afford an extra $5. plan three was another $70 a year for a single. >> it's a difficult choice because if we lose members, the premium is going up for all of us. >> i think commenting generally on this, we've had a sufficient level of public comment about the fact that i'm paying premiums, and not getting my basic coverage done and my dental issues are larger than that. so, we either are stuck staying with what we've got and continuing to hear that or considering something that is going to have some level of cost

attached to it. there is no free benefit here. i think that to a degree that we need to, i hope the survey will have a cover letter explaining what it is we are doing, why we are asking you to complete the survey, kind of characterizing a little bit of what the options are so people understand what we are doing here. i would strongly support that all retirees in that we are responsible for whether they are participants today or not be given an opportunity to give us in put on this. >> also in the letter to mention the difference between the three categories to make that very clear when they fill this out. >> yes. are there other questions or comments? is there public comment at this time? excuse me, protocol

demands that i should ask for a motion before i ask for public comment. >> that's true. >> please stand there because we'll get to that momentarily. do we have a motion to adopt a recommendation to retirees? >> i move we send the retiree survey. >> there is a motion and second. are there any questions by the board on the motion , if not, we now have public comment. >> thank you. i appreciate the information you gave me at the beginning of this process, warms my heart. i support the survey most assuredly and i'm glad that you are considering

surveying all retirees because i they we might be able to bring people back in the system and that's what we really want to do is enhance that, but i think we do have to define the three categories so people know which categories their dentist is in and what we find among retirees and among actives as well, people don't like changing dentist when they find a good dentist they trust and they hang onto them and dentist are more important than other doctors, sorry doctors in other categories that might have a relationship with their patients. but dentist, very intimate and they may hang onto their patients than physicians. i think we've all agreed that the preventative practices

are most assuredly signature with regard to maintaining physical health and dental oral health. at some point years ago, if you got cleaning for the year, you paid no further cleaning benefit. you just had to meet that cleaning in the first year and all that was covered 100 percent. that was many years ago. it was really wonderful and it had a good impact because everyone who worked for the unified school district made sure they got regular cleanings. it would seem to me that in alternative three that we might consider that same deal with alternative one. i don't understand why if you increase the benefit to $200 you are really not giving them anything. it's the same as no. 1 as alternative one by $1 as alternative one by

discounting the $200. seem to be we should be focused on prevention and keeping those preventative services not at all part of that total premium. we want to encourage our members to get those preventative services, but thank you. >> thank you. >> herbert weiner extractee. last year i had two molars removed. anyway, i have an e-mail from my dentist. i recently had my teeth cleaned and this is her opinion. i got it by e-mail. i hope to submit it to you hard copy. "to whom it may concern. it's important for herbert weiner to have three teeth cleanings a year

due to periodontal problems. herbert had to have three teeth removed and he has general bone loss. if the patient loses anymore teeth, it will affect his health" i'm submitting this into the record for documentation. i don't think i'm an exceptional case. i'm citing my case as an example. also you need to remember if you don't have this done, it may lead to root canal and more extractions. it's cost preventative to have this procedure. thank you.

>> other public comment? >> dennis krueger retired and inactive firefighters. i haven't had a lot of time to study this but i see the plan they are looking gives you your best bang for your buck as far as the value of what you can get out but it still doesn't account for the d and p. i would like to see that maybe factored into that particular plan. going 32 you this, the biggest bang for your buck of course is the $2500 with everything. if i cost it out right, it's paying by -- >> could you cite the reference? >> you are paying $1560 for

two people for $5,000 worth of dental coverage. you are getting the biggest bang for your buck. i know a lot of retirees cannot possibly afford this. what i would like to see is a tiered system where people have a choice of which dental plan they want to choose. i understand as people get in for 1 year and then get what they need done and then they get out. but the premium reflects what benefit they are receiving. if they pay the higher premium for 1 year they get that benefit. they go back down the next year, that's their choice and they get the premium reflecting what they are getting. i don't see it as a complete usage of the system on the users part. both people are receiving a benefit here. if you go back to the beginning where they talk about the usage and realize no

you that only 19 percent of the people are using their thousand dollars, that money is pure profit going back to somebody somewhere along the line or maybe it's used to offset the rest of the plan to other people. i don't profess to know all this. and what they figure. but i'm looking at what this usage is as compared to what people are paying for. so, again i would like to see possibly a tiered system so people have a choice and the three plans that you are looking at, no. 3 is by far the best, but the best bang for your buck is the highest plan. the last question, if you have more than employee plus two, does the rate stay the same or does it continue to go up? >> director? >> employee plus two or more

is actually the definition. we often shorten it to employee plus two. it's two or more. >> thank you. >> are there other public comments? >> good afternoon commissioners, richard rolph man, retirees. i looked at the dental x-ray and teeth cleaning and preventative. at kaiser you get a free exam every year and what if you used your -- you have a crown at the beginning of the year and you go over the thousand dollars and you might want to put it off until next year to get your teeth cleaned and you might have or x-rays and you might have more serious problems. so i think the commission in delta dental should look at the teeth cleaning and x-ray as a

preventative method included in the rate and not raise the rate because they are preventing future cost down the road unless they want to make more money off us going to the dentist more often. i think they are looking at it the wrong-way. i agree we need to survey the ones that are not in the system but maybe ask them a question or two why they are not in, i think i know the answer. but it would be good to know why they are no the in the system. thank you >> director? >> i just wanted to in direct response to the last two comments point to slide 26 of the deck which we reviewed at the last meeting and we can have our actuary o'neal speak to this. you can see the last ratio on this product is 99 percent.99 percent of every dollar is going to care for

people's teeth. there is no profit made. there is $0.01 to at administer the care to preventative care. there is no free lunch here. we can't just cover cleaning. somebody has to pay the dentist to do the cleanings and it has to be embedded in the premium. we have to remember that and we have to remember to keep everybody in, as said best, we need more people in the plan to bring the premium down. it is complicated insurance. i'm hoping we are all grasping that idea to keep everybody in one big pool to keep the cost down and affordable for

everyone. >> any other comments? if not, we'll move to recommendations. i will entertain a motion to that affect. >> we have a motion. >> all in favor say, "aye". >> aye. >> opposed? the ayes have it and we'll move to item 6. i will get the rhythm of this before we move forward. >> item 6, action item, report on receive policy. committee chair scott. >> as we are going forward, just as we went through the policy affirmation on the blackout period the same is here. for those who read the men's of the board, i'm sure the vast number of you do, at the last meeting we instructed

the actuary to go out and prepare certain plan alternatives. i think that we might have implied that we should have been talking about the various, the policy guidance that go into preparing these directives. these option. so that's what we are going to be doing over the next several of these policies is confirming and instructing the actuaries to do certain things. and the amendments that you will see in the documents are having him look at the alternatives that we said we wanted him to look at. if there is no confusion later on that he's done something, if you will that we didn't ask him to do. so this is belts and suspenders type of an approach. all right? >> well said. first we are going to review the ibnr fund status and any changes to the policy. so you have before you the -- >> and would you please

clarify what i b.bnr is >> for any self funded plan which is now why you # your flex funded program with blue shield and city plan, you hold the liability so at the time of terminating the contract, any claims that are paid after the date of termination that happened at the date of termination or earlier you will have on your balance sheet as a liability and you are fully funded without paying any further assessment. any on going -- on the program is required to do this. you do an excellent job. an additional caveat is that this gets approved, i don't set it as your independent actuary. you have an audit june 30th and the auditors also approved these numbers. it's doubly approved. with that, our

first document reviews the amount of the reserves that you presently hold under this particular requirement. they are the city plan medical rx reserve which is primarily for all active participants, all retiree participants and medicare or paid by medicare. that plan and delta dental is $7 million $869. this is an amount approved by your auditors and on the books since 2013. additionally you hold $18 million 371,000 fou blue shield, this also approved by your auditor and what we need to look at today

is that at last year's meetings we updated the policy to be current with the then funding structures that were being taken by the trust who facilitate the coverage of the employee and retiree base. since that time we talked about the potential of kaiser to take risk and we need to update our policy to include all vendors appropriate to consider the policy. we have caveat to cover dental, city plan and funded and now red line and brought to your attention the ibnr policy. i think this is incredibly good to have these policies discussed and approved at the board level. it's very good fiduciary and good responsible work. what we've done is change the date and also under the third bullet point under

the other.bnr policy is flex funding which is hmo and self funding which is the case for kaiser once you take the risk depending on the renewal. we want to do one of the two options that we were considering under kaiser. there are no other changes of this policy at this time and my recommendation is that you approve the changes to the ibnr policy. >> is there a motion? >> i move we update the policies? >> is there a second? >> it's been properly moved and seconded. is there a discussion by the board? any public comment? hearing no public comment, we are now ready to move to a vote. all in favor say, "aye". >> aye. >> all those opposed? the ayes have it. we'll move to item no. 7.

>> city clerk: action item review status for contingency reserves and policy. committee chair scott. >> i will turn this over to our actuary for explanation. >> okay, very good business practice when you are taking risk and you are part of a trust under self funded benefit add m rgs to -- administration for a contingency reserve and you approved it by your prior actuaries for a city plan and delta dental because those are the two funding arrangements that you had at the time that you are exposed. so you had a policy in place, we just rolled that policy forward and after that, the next question was will we take and consider this for blue shield funding,

absolutely. the parts not decapitated, we have a standards review for that and for kaz -- kaiser will you want to take that as well and the answer is absolutely. as the amounts of june 30th, $10 million and blue shield flex funded amount is $13 million $180,000 and these are all in your audit papers and the next thing is what do you do with the policy? we are at the same place where we were with the ibnr because we can roll the program onto the risk taking side, that would be kaiser the end of the cycle if you decide to do that. they -- this is at the door and we

redated it and if you include kaiser, they are covered under policy. there are no other changes to this document around here it was approved last march, and i recommend you, unless you have questions, accept these changes and approve it. >> i just want to remind the actuary that there is another reason to modify the policies accordingly. we could take blue shield self funded. we are paying currently 2 1/2 percent federal taxes on the blue shield because it's still a fully insured flex funded model. we can get rid of millions of dollars if we took self insured too. the policy would cover that as well as any decisions we might make. >> yes. thank you for that clarification. >> i'm ready to entertain a

motion? >> i move we prove the contingency policy update. >> second? >> second. >> any discussions by the board? public comment? hearing none. we are ready to vote. >> all in favor say, "aye". >> aye. >> opposed? the ayes have it. item 8. >> city clerk: action item, review plans stabilization reserve policy. committee chair scott. >> i will have the actuary take the lead in the explanation of this item. >> okay, this is the item we discussed under united health care city plan. so what's happened now is that you have a flex funded or a potential self funded blue shield product or as kaiser product to be offered. at this point,

we, when we initially looked at flex funded last year they said are you going to recommend a stable reserve? i said not until your two other reverse and your continued reserve is fully funded. their ample dollars are for both reserves and they are able to fund a claim stabilization reserve much earlier than i thought you could. so we've had to cl this in the stabilization because it was addressed the city plan which has the $17 million. so what we have done is we've included the flex funded and/or self funded hmo both buckets in this particular document to say going forward instead of saying when we get there

we've gone ahead because it was probably not prudent on my part to waiting a year. so that we've gone ahead and decided to codify anything that could possibly happen. with that said, this document goes through all of the various changes and one of the things that's important to understand is when we calculate this, there is no gain or loss generated by the egg wip. any premium part of this process we changed some of the language in here to clearly outlaw in the fact that they do not create a gain or loss. we had to add additional language in part of this. i this i think this thing is fully updated for all possibility set for claim restabilization and when you are fully funded for your ibnr which is first, contingency

second, you are very responsible and we use the amization and depending on kaiser and we amortize this over the history of the contract. unless there is any questions, i recommend you an approved the changes. >> i have ready to entertain a motion. >> i move we update the stabilization reserve. >> is there a second? >> second. >> are there questions boo i -- by the board? any public comment? no public comment. >> all in favor say, "aye". >> aye. >> opposed? the ayes have it. i believe we are at a moment to rise and support the full board. i would recommend we take at least a 5-minute

recess. with that we will. thank you.