plan and reflected in places we have the medicare advantage where they're receiving great supplements in the government but not applying those risks inaccurately and it could be better picture i will accept those rates this year i think our members not a matter of immigration but we no longer have the third option for a hmo but but we should consider a third option in the future for better rates especially for retirees thank you very much. >> other public comment? hearing none we're ready to vote all in favor of the motion to accept the rates as decisions certify by i. you guys have it we'll move to item 4 >> approval of final blue cross

blue shield hmo rates for retirees for the 2015 plan year. >> okay. we're at item 4 you should have before you the packet that outlines the rates for active early retirees for fluctuation you funded under blue cross blue shield has discussed in may 8th it was accepted we could use the law of money that was moved to the clayton stabilization as the subsidy for the difference for 2015 so this clearly outlines in the executive summary you to its fully dloelsz i'm going to move along on the next page page 4 you see four what's going is the

the difference are flat year over year and the early retirees are up 4 percent. this actual rate card was approved in the other meeting so it is one hundred 96, 83 there's a specific labor negotiations we've given you this rate card we've got comparisons and i don't have anything else to share but i recommend you approve those rate cards. >> are there questions do i hear a motion. >> i'll move approval. >> it's been properly moved and seconded that the rate shields be approved my public comments and i'm not the language of the

rate cards should be approved. >> the rates. >> it will be corrected public comment? >> claire are a i have a question in the second-rate cards that's the one hundred and 96, 83 that represents one bargaining unit. it is my understanding when we take would be category such employee only as zero is that carried over into each of of the categories so those employees are paying only for their dependants and not paying for the members if those rates haven't been alternated in some way and i can tell you what we do w in my company that didn't apply >> fit it a hundred percent

coverage the rates only reflect the coverage costs. >> the way it works for the one hundred and 96, 83 you take the illicit premium they get one hundred percent credit that's zero the question is how is the mou language reader for the e plus one it didn't distinguish between the employee only and then the didn't want indemnifies of costs it takes the combined e plus premium and multiples by a certain percent then you pay x x percentage points that's how it is written so the good news is -

>> let me say you've basically rated this with with the mou for the union; right? >> right so the clarification the real good thing all the people employees only pay zero before the 93, 83 they pay in the case of united health care or the cities health care plan 93 percent so those people in the subsequent table those people get full credit for the premium that's a good thing. so it's well negotiated situation so i hope that answers our question and comments? dr. >> i believe the language is in the handout but it actually is employee accomplice one and

dependents who want to enroll sea the city shall contribute 93 percent the total health care insurance provided the city's contributions s are capitalized in the second highest cost plan so i think one of the major changes both for blue cross blue shield the difference and u h c is that the cap on city plan for the employee only is listed by the language it referred to the employee only and the redact is on the table we only paid up to the second hive plan now we're picking up the whole one hundred percent. >> thank you for your clarification. >> is 9010. >> there is no 90. >> no collective bargaining or unions have 9010; is that

correct eric. >> we'll moved off the 9010. >> what was one of our goals. i mean, it wasn't one of our goals but hoped to move to the d hr model to make that happen that's the unions >> okay. other public comment or question? seeing none, we're ready to thoet vote. all in favor of the motion as stated certify by i. opposed? we'll move to item 57 and item 5 action item fraufl of the carvings for the rates and benefits for the 200515 item unit >> item 5 is i turn your altercation to page 2 of the

kaiser rate in the second paragraph you get an early rate with the kaiser they have to wait to get their final reimbursement amounting amount so we set the rate for 2013 or 2014 you needed 32412 having you have a count and apply that to their initial non-final rate you'll go through a reconciliation every year you subtract $22.30 for the medicare rate it's $3.18 that's a good one as you said earlier, sir this is a phenomenal rate i to your attention to page 3 and it outlines the rates and people

are not paying anything for e only these everyone else gets a reduction comparisons on page 4 and as i wanted i'll say that again we'll get a final number and next year there is a credit or debit to this rate based on the credit that was given but those numbers are all going down it's very good and it helps that's a large portion of our retired population to help the liberty that's i think in excess of three to $4 billion and numbers have a tremendous impact of cutting the liability that helps the balance sheet of the city so this is really green good, i recommend you approve it. >> part of the recommendation

or question? >> why is it that kaiser didn't have the final approval from c.m.s. and blue cross blue shield did. >> it's a difference how they do their work but maybe i'll ask kaiser. >> is there a date how did blue cross blue shield. >> are there kaiser representatives here would you, please come forward or blue cross blue shield. >> good afternoon cindy kaiser permanente nooindz on my understanding is call the carriers get the final materials from medicare from roughly the same timeframe we don't set those nailing until their final. i would assume others choose a

other decision so we'll tried to come up with the right rate that's on objective we generally feel much anymore comfortable around the end of june beginning of july it's not final but we've processed more information one of the key components is the risk of the population so a group that has over a certain amount of members their adjusted we don't have this information for our large groups we don't get that until about the second to third week of june and then we have to process it through so around july we get the data that's what flujts the number it's not the final reimbursement rate but what makes it unstable is the risk adjusting piece of

it >> thank you. i want to hear from blue cross blue shield why they know. >> is there a representative from blue cross blue shield. no representative oh, there is a representative from blue cross blue shield would you, please come forward >> good afternoon mime bob. >> just lift it up there you go. >> bob manager for blue cross blue shield. >> all right. >> my understanding is similar we do get guidance as the year going on we have early guidance from c.m.s. from the revenue we don't have a final as opposed to our final but we feel comfortable idea of where our revenue is going to be based on our quality. >> you make a decision earlier. >> correct.

>> and if it comes out different do we get a reimbursement for the next year. >> no. >> thank you. >> the reimbursement didn't come out credible. >> thank you for your clarification. any other questions for the blue cross blue shield representative. all right. and can i ask a question >> can you tell us is the population for kaiser pretty stable in terms of numbers. >> for the retirees. >> yeah. >> actually, it's getting bigger but stable and growing more blue cross blue shield is flan or doctors and kaiser is gotten when i started you tell i it's up to 9 thousand people it's getting bigger and bigger maybe younger people come on into the kaiser pool i don't actually know to be completely

honest but it's fairly big. any other questions >> it seems like we should be checking into the reimbursement for the following years they're not what they've projected them like kaiser. >> their trade if they set a rate we agree to the rate up and down we're not in the position because we didn't necessarily want to have to deal with the reconciliations because it bounces we got a big one next year but what if it didn't continue we don't want to diesel with the reconciliations to be competitive with other offers but we could go that route i think we should bring it up for

a item in 200015. >> i can give you those numbers by blue cross blue shield plan. >> my question is why are redealing with kaiser and blue cross blue shield different their giving us money back but blue cross blue shield didn't do anything. >> we can see if we can negotiate that. >> the thing we realize they pick a rate that's too low they eat the difference. >> i would be pronounced interested to see if they've ever done that but that's okay. >> i was going to say that kaiser let's compare 2012, 2013 and 2014. 2012 kaiser was at the 15000.2.

in 2013 they were 15.3 and 2014 they were 15.8. blue cross blue shield was 10.4 or five in 2012. 10.6 in 2013 and 11 in 2014 so people are restoring everyday but both of them seniors have been growing and blue cross blue shield grew a little bit more >> all right. okay any other discussions you've heard the recommendation i'll ready to entertain a motion. >> i'll move approval. >> second. >> it's been properly moved and seconded the rate be approved as discussed public comment? hearing no public comment we're now ready to vote all in favor, say i. >> i. >> nfls the i's have it item 6.

>> item 67 action item approval of final kaiser for the the difference and that's for the 2015 year. >> item of this was approved initial approval was on. >> april the 10. >> april 10th yes, sir. >> and what you have before you on page three and four is what was brought to your attention the 9383 we have brought for your approval the one hundred 96, 83 nothing has changed since april 10th we cleaned wording and added footnotes and taken all recommended changes to the

rate card commissioner limb or vice president limb pointed out under the 10 county amount please put this for retirees that only so it was clear we took all of those and i think we've gotten everything for the health services board that's a very nice business proposition you guys were happy about the minus 2 for clarification to the not another minus two but a 24 rate by kaiser this is additional information i recommend you approve the rates for both rate cards. >> are there questions? there are no questions. you've heard the recommendation >> move approval. >> second. >> it's been properly moved and

seconded that the rates as describes be approved and accepted is there any public comment. i call again is there any public comment? i call again is there any public comment even a thank you. (laughter) thank you. >> well, if we must i was looking at the fact we've discussed this in april i do want to thank not only the board by the vacancy i didn't see and thank kaiser for keeping rates reasonable for their faith in a our membership but thank you all for your efforts very much. >> all right. thank you. victory has a thousand fathers

and defeat is an orphan >> i actually came in late but i am an early retiree and i want to thank you so much for this my insurance because compared to like every time i go into the market and looking at any work 30eb89 we have really low rates i never realized until i used is i didn't pay that much out of the pocket so i'm under 62 so i'm in the gray area i don't think you'll hear from my group 45 to 62 group sort of in the middle i appreciate it i'm retired from 9-1-1 dispatch i never used the medical before when i start to use it the difference in the prescriptions they're so high now if you have

to pay out-of-pocket i never used a lot of this stuff i'm getting older i'm noticing that's a big thing there's a lot of us in this group and i want to say i really appreciate it and i haven't been that, you know, pro-active about maybe knows trying to do some work with you guys you know what i mean i'm going to be more pro-active it's a saved my backside a lot of times. >> thank you very much for your comments. (laughter). >> all right. any other public comment? hearing none. are you ready for the vote all in favor, say i. opposed? same sign the i's have it we'll

move to item 7 >> item 7 action item approval of final city health plans for the difference and retirees for the 2015 plan year mr. hewett. >> can we go to the item 7. we have approved these in february and we went back and provided a one hundred and 9683 card same as kaiser and we have those rates because of the application of the examines stabilization build up driven by the adaptation of the 2013 egging what we were given a fairly large offset therefore those numbers have gone down

quite a bit hyperglycemia i'm happy for the retirees and the early retirees but under the one hundred 96, 83 what obey the 9393 second rule what does that do to the attraction of those people well, it fact or facts makes it go up quite a bit $400 unless they're getting the sthiend they'll greatest to another plan so the 9683 they'll pay zero in 2015 so with that, being said i recommend you adapt both rates the one hundred 9383 and other >> you've heard the recommendation any questions. >> he move approval the final

rates and benefits for 2013. >> it's been moved and seconded and recommended. is there any public comment. >> again representing retired employees of the city and county of san francisco. you can join us actually, i really want to thank for the plan one rates and bone on behalf of the usual population you've heard me talk about despite the fact they get stipends seeing those rates going down most of the people in the areas have families and those costs create a hardship it's not just the premiums but i'm sure you're aware of the project manager's prrgz they have to pay out with health care and with families having you

have a need for health care a lot of time they have teenagers that are exploring the areas in their areas at the accidents happen. thank you. the aid has made a huge difference but the rates are coming pell i hope we can keep the rates affordable and that's ore on so thank you, again to everyone >> any other. hearing none we're ready to vote favor opposed the i's have it and that will be the order. i'd like to interject something that's been a wonderful year for a health care plan standpoint i

happy to be a firm believer in the writinger. has anyone else else heard of the under writer curve, of course, i have i want our tucky to talk about this curve no mathematics >> the underwriter curve in theory not that i'm a hundred percent believer but it will not stay down but we're in a trough the low end of a 3 year but there are periods of times to create costs those numbers will go in different directions to mitigate the impact of a 3 year

cycle they've put in a second phase a 5 year phase year by year phase of trying to straight line that even when the underwriter curve is down without any of the kinds of programs it will eventually go back up and . >> i think we may be creating undo exception that the size will be better year after year and it's a cautionary note there are internal things called trends it continues to go up. so we need to be conscious of that. okay. we'll move to item number 8. item 8 action item approval of

final dental plan 2015 renumb >> we will have the general plan are you nonetheless you've voted to increase the diagnoseic point it is an increase of approximately 82.9 percent for that category that allows the thousand dollar persistent that's innovate applied so if you utility it $300 it's a very, very good situation. with that, we have all the rates we have the bp o and the delta pear rates there are the pacific union dental hmo there's 6 sets of rates number of those numbers are changing except the one you added in last month. i recommend that you approve the rates

>> you've heard the recommendation are there questions? i'm ready to entertain a motion >> i move to approve the dental plan for 2015. >> it's been properly moved and seconded is there any public comment. >> yes. >> dennis encouraging active and retired firefighters i want to thank you for what started after a vacation of mine my progress into the future i came from the dentist today and he told me that a thousand dollars goes no where in today's dental history and delta they seem to collide so i will be back in the future and taken this project

only is something again dental health oral health is part of our overall physical health and should be tread with a lot more respect and broadening so people who have one crown are not denying any further dental coverage for a year thank you for the tuckries and delta dental i'll be back. >> hearing no public comment we're voting all in favor, say i. opposed? same sign and it's that will be the order. we're now at item number 9. excuse me. item 9 action item approval the vision plan for 2015 plan year mr. hewett >> we're kind of