tentative and i have to establish why i'm saying this. it's that no greater than 5 percent for blue shield and hopefully lower. so i'm visiting with the aco's about 14, quite a bit. talk to them about 15, what the metrics have to be to keep that number under 5 percent so we can come back and say we have enough math and enough conviction to say we are going to be 5 percent or less for 2015. that's my tentative general -- renewal for 2015. anything about that one? >> yes, ma'am? >> can you talk to be a little bit about the idnr and contingency reserve. here i just don't remember. are we

fully funded on the idnr and fully funded on the contingency? >> yes. >> congratulations. i was wrong. i voted for it. the question i have is if we have funded the i dnr and contingency reserve because the premiums were higher in the beginning because we had to establish that? >> it's possible. yes. i'm looking at it fwr that perspective. i'm not saying i'm happy with five. you don't need the cash buildup or the balance sheet from the ibnr. it's all paid claims and i have to tweak it and do my stuff and now that we know all this. a lot of what we have to do in 15 is predicated upon experience which we don't

know. why i say all this stuff is that we be the -- bet ahead of the curve with the data i have this pattern. i won't know until this runs until the end of 15 after 3 years of data. i need 36 months of historical data to tell you how the house is operating. any other questions? >> i just wanted to point out the aco's are doing a great job on utilization. but part of the equation in total cost is unit cost and we have as we understand from blue shield some very large organizations that are renewing for 1115. this organization for blue shield is renewing for 15 with new contracts. so it doesn't get credit for all the work he's doing. he's been very

aggressive to work with the partners to ensure the unit cost is also going to be something we can sustain for 2015. it's based on also his work with the associations that we partner with. >> we are still in a two horse race. blue shield and kaiser. any questions? >> any other questions? this is a discussion item. so, thank you very much. any public comment on this item? seeing none. item no. 6. also in item no. 6 there is a substitute, pages on your desk. city clerk: discussion item review active and early retirement claims experience and benefit design and determine preliminary contribution for 2015 plan

year. mr. hewitt. >> this time i got data from kaiser in november. and they sent necessity -- me the premium and claim summaries. kaiser is fully insured and we talked in january about whether or not we wanted to consider taking risk and just what kind of renewal given the ruckus from last year we should anticipate. so this is a twofold presentation. one is, do i want to keep the temperament of possible taking risk and some board members are opposed and others lukewarm and others think it's a nice idea. that being said we are going to review the data briefly and i can give you my actuarial view of the trajectory of the data of what it implies of a fully in insured rate. so just to give

you a sense of what we have. we have a premium built upon experience data, 100 percent experience rated for inpatient claims, outpatient claims and of the rx data is all supposedly specific to kaiser. where they have to have a big access charge which has been a lot of discussion if this meeting and other meetings at the other.cms. that is allocated not a specific basis but over all allocation by book basis. how does kaiser's active experience look? it's at 88 percent is their loss radiation. -- ratio. they have a better contract, they charge less than blue shield. depending on how it comes out, we would hope it would not increase because it was at 20 and went which was a factor

in a premium shared and if we are just as successful from my perspective of getting the 9383 implemented across the board, then we have a percent of premiums. we won't have this aberration that we brought to the board many times about the kaiser pick up and the blue shields family paid $700 and the kaiser family pays $300. here is the data i have. 88 percent loss ratio and if we go to the early retirement claims it's 83. that's very close to blue shield. i don't know why. i have no idea. when i reviewed all this data and took basically same thing but did not want to hold it to any kind of, we own the rate for blue shield. they create a rate that's kaiser and send it to us to review it and we try to negotiate it. hopefully

we'll be able to negotiate it very clearly. when i do bring the renewal, the numbers should be very low given the loss ratios are low versus high. it should be very low. i would anticipate, even with taxes i would anticipate a number less than what we saw last year and maybe half of what we saw last year. that would be my, and i'm not putting that out there as a forwarding kaiser aside to forward the process. that's just said that it's possible to obtain that rate. and finishing up the exercise which i was charged to do from taking the risk perspective. that if we take and create a premium equal to this year's premium, can we post that premium, pay all the fees, pay all the icm and still create

money on the books for the balance sheet on the trust. i will complete that trust and you guys can say yay! or nay. that's my review of the data and my review of what i think it implies. i'm hoping to be able to say that kaiser believes us also and the rates are relatively low and review all of their analytics. this is a preoccurs or to that. any questions? >> sorry i'm asking so many questions. on the kaiser, i note you said loss ratio but it's only through november 2013. typically you look at claims run out at 6 months sometimes to a year. is this include ibnr? >> yes. they are there months lag. when they give me that,

that includes 3 months more. they can't give me data -- it's always 3 months earlier because of that. >> because they are almost exclusively, they are not exclusively paying themselves. they don't have that much out of network. they think they only need a 3-month. you believe 88 percent is fully inclusive? >> yes. >> and it includes profit and all of that? >> yes. absolutely. they have all their money. yeah. that's 12 points of action. that's why, and not that to digress or get off the subject, when we have the main report this is the historical trend for kaiser. the loss ratio is low and when you look at it from an experience from premium perspective, there is cash on the table. the question is do you want me to continue and you said yes. do the math and

show us what this is all about for 2015. >> any questions. >> any public comments? seeing none. we are finished with our benefits and rates, now we are on regular board meeting matters. item no. 7. city clerk: item 7, discussion item, president's report. >> i just want to say thank you again to the staff for all of their work that they have been doing. i know they are involved in moving and i did get a chance to review the wellness center and it's a very nice space. i liked it. the ergonomic chairs that i sat in. i think it's going to be a very successful stop and they are in the process of

moving upstairs. i want to thank our secretary, the board who she's now our full secretary. i do say thank you to the staff a lot, but i don't think i really point out how much laneey does for us. she's the glue that keeps us altogether. thank you. with that, i'm moving to item 8. >> item 8. directors report. lisa guppy. >> yes, we are all moving tomorrow in terms of the office. the center moved on february 28th. so four of our staff members moved downstairs. the fifths being the one we are trying to hire now and the employee assistance program is going to be down in the wellness center. this space the large

and it's empty right now. we've got the chairs and tables in but we still have to get some equipment in and we had bio metric screening this week and it was lovely to have that much space to have people be able to come in and have the biometrics and have the staff to be able to support that kind of event. we are glad to be able to host wellness activities. we are planning a grand opening venturesome event -- event -- some time in may. the office is closing at noon tomorrow. we will be opened at minimal staffing and we'll close and noon and the doors will go down and the stores will close and we'll move everything over the weekend. we have a move committee that has been working very hard and thanks to those folks and the team

that have been leading the move. in terms of positions, we have 6 open positions and making slow but steady progress on the contracts and compliance manager which we reposted at the 1831 position. it says 1832 position and the finance position and the health coordinator. that is continuing and it's a slow steady process. some of these are in civil service positions and we are waiting for the testing in order to hire a benefit analyst. operations was a little bit quite or in february. the analyst were working on all the backlog left over from the year-end of the beginning of the year transition. and you may recall

that we rebuilt the system for mea cafeteria benefit and it went well for open enrollment and everything was working beautifully until we realizing the new hires weren't working right and that's now corrected for everyone. communication's team, has been working hardworking on the wellness plan, the demographics report that you will see today as rosemary is pulling that together and we have a really beautiful new hire video that the idea of having our members be able to watch a video and learn a lot about it, about their benefits is something that i think we have an interest in pursuing. the one we did with open enrollment and rosemary is interested in getting feedback. this is in the website later today and we

were interested in having people look at it and see how they feel in terms of it's ability to convey the benefits selection and choices that people have to make. as you may recall we are doing an rfq, a request for qualifications of a variety of communication activities for getting around e benefits. when we have everybody making their selection for benefits online on the website, there is a lot of communication materials that have to be built to make sure they are making an informed decision. this rfq process will allow us to bring web designers and other folks to use technology and learn how to make those choices and i want to mention the retirement survey. we are timing it so we are fully moved and ready to take those phone calls. it's scheduled to go out at the end of this week or early next week.

finance has been working on making sure the contract is one of the last ones to complete and we are doing the fsa and cobra rfp which is released on monday. that will be three rfp's on monday and the controllers report that will provide some information for the data basis going and we are working on the data for union negotiations. a lot of request on that and there is city's report is being updated and we providing a lot of report and data for that calculation. i think we've talked about the wellness efforts and it's launched. they are doing big conferences down there in the big conference we have and starting to do other trainings and in terms of meetings, we wanted to just highlight that. we are working with the

city's cat program so the catastrophic illness program and long-term disabilities programs are really well integrated and working effective for the members going through that kind of situation and needing both of those benefits to work together. and we've also been continuing to work on kaiser and clinic can engagement and we have one on one meetings with every member of the staff to see how things are going in the department and what we can do as a management team to make sure that we are giving them the support they people and what the management team will be incorporating as a result of that. >> i'm sorry, also included in the packet is a presentation to the civil service commission on the impact of the affordable care act on city employees. with that, is there any questions? >> any questions? any public comment on this item? all

right. discussion item? item no. 9. >> item 9. discussion item on financial reporting as of january 31, 2014. pamela levine. >> pamela levine. there is a change that has occurred between last month and this month for the trust fund. that is we are projecting $2.2 million greater -- one second. let me back up. we started the year with the 77 700-0000

fund balance. we then have reported as we've gone along every month that that has been increasing. now we are projecting a fund balance of 98.3. the difference between that month and this month is that we have increased an increase in admin fees for blue shield and then we offset, we reduced our projection for transfer to ibnr for flask so that change results in $2.2 million change between months. it's very small when you think of the larger amount of money that we are dealing with and we have been just bouncing up and down about 2 million, $3 million over the last couple of months. in terms of the general fund

as the director lisa mentioned, we have a significant number of vacancies over this fiscal year and we are projecting that we are going to end the fiscal year with a balance of $496,000. $645,000 is due to delays in hiring. we have several positions that we are either in kesing or about to interview. hopefully we will be able to hire them in the next month, month 1/2. but we still will need some money at the end of the year. the 250 offset by $150,000 of professional services that we are projecting based on the projections for the move and for the tenant improvement on

the first floor, and the third floor we have not been billed for all of it and we want to make sure we are staying in our budget. as you know as we do a very large construction project there is still a change at the very end. we also have seen a larger number of workers' compensation claims. so, we have had to find some funding for that. so the increase in savings from hiring is offset by an increase in the expenditures. >> i'm ready for any questions if you have any? >> questions? thank you. any public comment? thank you.

item no. 10. city clerk: item 10, discussion item. 2013 open enrollment demographics presentation for 2014. marina coal ridge. >> hhs. we have a presentation online. first i want to recognize rosemary, my colleague here. i just take the data and play with it and she does a nice presentation layer. this is our annual demographics report. it's a great report. i won't go into detail. i will just call out the heights from the report. the structure of the demographics report is such that will look at our of ours. it's the independence and we'll take a break out

perspective from that and draw and look at members and employees and retirees and a couple snapshots by employers. highlights here are the enrollment across our medical plans and increase by 1167 lines of enrollment for the 2014 plan year. for employee lines it's a net increase of 356 and our retiree lives it's 811. our total lives we have are medical is 109, 761. we did see a 1 percent increase for kaiser that year and some slight decreases for blue shield. >> i know the commissioners

are there. for the public. hhs administers dental for the unified school district and the community college district. those are administered separately. looking for those that we administer dental for we had an increase for 1075 lives for those dental plans with 600 being our retirees. some high level notes when we look at all of our lives in 2014. interesting to note the number of lives over 65 years decrease by 1036 individuals which we thought was pretty significant. we can only do a couple things. it looks like sampling of those records and in fact any of those members

deceased and we did have a lot of members that were significantly older. a higher percentage of our members that live in san francisco are without dependents and of course that's consistent with what we see in terms of migration with families in san francisco. next slide. thank you. what we did know about our employees is that 45 percent of them have no dependents and 65 percent that do have dependents 39 percent have a spouse or partner and 27 percent of those have employees e plus two coverage so they are coverage two or more dependents. with regards to our members versus our dependents when we look at those retiree members those are surviving spouse or partner. 55 percent of our

dependents are actually children under 26. >> take ing a look again is the average age by plan. it's a little hard to read. it's kaiser being blue shield. the average rate across all our lives is 46.3. it's higher in blue shield enrollment and higher in the city plan enrollment. i won't speak to the next slide. it does breakout for you our enrollment in each age bin. always one for anybody interested in geography. we have a break out by lives in the county that our members

reside in and a number of those in san francisco. if we are looking at employees 41 percent of our employees in san francisco. we can see the most populus county here as identified in descending order. we have a number of tables in this presentation. i'm not going through all the numbers. if you have any questions about those by all means. you can digest that. it's a lot of information. if you look at the numbers we see a proportion of the retired members shifted by 1 percent with the retirees gaining 1 percent. i know that's consistent from our operations team they processed a lot of retirement applications and a lot moved from the retirement categories and employee and retiree members to 1 percent and blue shield to 38 and

city plan is at 11 percent of that. moving on to the next slide here. again we've got in the top right, the actual numbers. i was just talking about the 5 percent kaiser and 11 percent blue shield. here we are breaking out that proposition of the employee retiree members that make-up those components are. we are also breaking out in the lower right hand corner for you the employees and retiree average rate -- age for each of our plans. average age is 70.3 and blue shield 48.3. average age on retirees 71.3. and kaiser

71.42 and 75. you get a nice picture that breakout the gender with male and female. i will tell you that our employee and retirees it's 43 percent male and 46 females and which one of our groups are trending significant different from that. for the most part our employer groups remain consistent proportionally. here we are going to look at your age bands across your members and our enrollment by county of residence on that next slide.

tables, a bunch of tables. a number of our employees, domestic partners and retirees of domestic partners dipped. that is consistent with the ruling. a lot of the members now convert to spouse as opposed to domestic member category. they are working on the w 2 adjustment. with regard to our employees, the member of employee lives covered now by hhs medical plan by 74. that is an upward trend. we have an increase to 360 employees in that area. and same thing in the employee lives enrolled in kaiser increased. we see this along all of our demographic subsets