of a grade we would like them to present to us not just a written response to the staff. >> i agree. >> why they don't offer it, what customer service on earth does not have access to secure messaging? >> and they own a company, optum that does way more than secure messaging, and that i used to advice for, and so, the capabilities are there, just not turned on. >> the call back capability reporting, what exactly is this. >> this is a wish list item, and we would love for the administrators to have it. if a member calls in and the issue is not resolved right then and there is say that it is a claim that needs to be

adjusted and they say that i don't want you telling me that it is adjusted in ten days, but i want you to call me to tell me that it has been adjusted i don't want to assume that it is done, i want that confirmation and they asked for, a commitment from them to give them a call. and being able to track the keeping of the commitment from the member, if you tell them that you will call them on a certain day, did you really do it or not? and most administrators do not have the external reporting capabilities to show if they are keeping the commitment with the member and there is a lot of noise generated by unhappy members that don't get a call back. >> and so we want the reporting to be provided and there is only two that can do it and it is only for the select clients and we want uhc to do it but today they are not able to do provide those to clients.

>> it is complicated for the members who have medicare, and i try to track the bills, and because the time being and you don't know when you hit your $250, and you have it, and just to track that is not simple. and the cross over just disappeared in mine for one reason or another, and i am not saying that this is their fault, and you try to call the medicare and see what, you know, for a member to get it involved in this is really not easy. and they tell you to call uhc and they say that it is medicare's fault and so it is complicated.

any other comments or questions by commissioners? >> you don't need to do the request, you are right next to me. >> yes, i am trying to turn my mic on. >> when do you expect this follow up action plan to be completed? >> if they are working on it, i understand it. and so, is this within, the next month or two? next year? >> we will ask, and the uhc to respond within three weeks, we typically give each administrator three weeks to respond to each error report, because of the of the amount of reporting that they needed to provide, it was unavailable at the time, but we will give them three more weeks. >> if we were to follow the suggestion of the president, and president fray sure, and assume thating we take an action, this afternoon, that we probably will, based on the fact that commissioner shlain is here and we will have our hides if we don't, november

will be the earliest that they can come before the group and present this information,; is that correct?? >> correct. >> okay. >> they will not be ready by september? a month away? >> september? >> i am sorry. september,... >> so we will be ready >> september? >> we will aim for the september. >> okay. >> and did you want to convey that to him? >> president? >> i think that we have done that. >> okay. >> i think that uhc, is yeah, yep. >> you are here. >> okay, thank you. >> and so the public comment, at this point. >> sure. >> with united healthcare and i am not a part of the audit team and we do have a specific audit team that works with aon and bring me in on the findings and so we did all go over the responses and i know that they are working on the reporting and things and i guess that my own thought will be that we have not met with the hsf and we have disagreed and provided them more feedback and we removed one error and so the results that you are seeing

have not been finalized and we do that and we know what the true response is and what does have to be followed up and i don't know if that could be accomplished considering that we are in the middle of august in time for a september board meeting and we could certainly keep in touch and look at those, but to your point, if there is no october meeting it will be move before the final, final will be done and it is just a timing matter. and you know, i can certainly, connect with our audit team and find out. >> that would be good. obviously, they are guide interested. >> absolutely agree. >> agree. >> thank you. >> any other public comment? >> all right, seeing none, this is not an action item and we are not approving at this point. >> why don't we take a i am sorry, under estimated, how long this will take, and i note that we have different times as everyone noticed that? and the problem is that the public can't see that. and so using this one, let us be back at 2:40.

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>> next item please. >> item 7, approval of wellness plan, director dodd. >> the wellness report? >> so you have seen this before. and i know that stephanie worked with president frasier on her concerns on it. and so we want to bring it back to you for final approval and it has been presented in final draft form and the mayor's office and the department heads

but it is not, we will put it out widely once it is finally approved by the health service board, are there any other questions for stephanie? >> i just would like to say thank you very much for incorporating the comments that i suggested and i think that it makes it a stronger document, and it was already a strong document and with that i will move approval. >> second. >> any public comment? >> we will call the question, i am sorry. >> rebecca ryan from the municipal association, and i just want to take a moment to echo my colleague bob, and we are extremely excited about the launch of the wellness program, and we are committed to working towards sustain able funding, and long term metric driven,

analysis, and ultimately our goal, of course, is to link, wellness to healthcare costs. we leave that it is righteous and morally correct to care about people's health and the people that we represent, but we also believe that healthier people, should have an impact on the cost of their healthcare. and so, we see this as completely aligned with the work that we have done and. again to speak on another topic, but a related topic and i too want to express my appreciation for the tremendous effort that it took to insure that the rates were not only were stabilized but actually reduced, and that is unprecedented in my, almost, eight years here and in my over 30 years in work in the labor movement, and the rates, simply do not go down, in my

experience. so i think that people don't understand the incredible accomplishment that represents and i hope that we will continue that work, continue the work on accountability, and transparency, which i also believe is integral to managing healthcare costs and i hope that you will know that the municipal executive association and all of the labor groups in the city are your allies in this regard. and on this initiative. and we stand ready to help in whatever way that we can. >> thank you so much. >> thank you for the comments and recognizing the staff as well and the commissioner who participated in that process. >> now, any other public comment? >> all right, we will call the question. all of those in favor? >> signify by saying aye. >> aye. >> all of those opposed? thank you. >> next item? >> item 8, action item,

approval of the health service system membership rules, updates lisa ghotbi. good afternoon, chief operating officers, we just have a few rule changes proposed for the 2015 plan year, we are anticipating a few others, but those were related to the care act that actually were delayed and so they will be seen by the board next year for 16. and the first one that we will be talking about is regarding the healthcare fsa, care are forward and you may remember in january of this year, we amended the 14 plan year, rules, to incorporate the new provision announced by the irs to allow for the carry forward of up to $500 on the healthcare, and since that time, we have had more clarification on what was allowed in terms of managing that carry forward and so these

changes incorporate, some changes to the 500 and i wanted to just point to page 14 and just kind of review those, and so, what it allows us to do then is to say that carry forward balance of between, of a minimum of $10 and a maximum of $500. and we had carry forward balances of two cents, you know, it costs more to administer monthly than it was benefiting, and so, we would like to put in place a minimum and the carry forward is for one year and so the member has one additional member to use that $500 after which it will be forfeited and we believe that this is the best marriage of the benefits to the member with the administrative issues that this represents. so, if you have any questions

on that? >> you do not say if it is less than $10, because the members will be asking, that i have $9 in there and you are saying, that it is forfeited. >> and so, it is no language in there, that says that... >> and we do have that language, and so what you are saying is that we say after a year it is forfeited but we don't talk about the fact that there is forfeit turf unused funds at the end of the year on fsa and i think that it was about the balance of the rules and not describing the plan design and so we do have that language in the cafeteria document and in the other documents about the fsa benefit, but the rules, language and what we have an appeal, we often refer to the rules, and to administer that and if we need to put that in we can, but usually we take the plan benefit information and

put it in either the cafeteria plan or the other document and so the benefit guide, for example has an extensive amount of information on the part of the fsa benefit. >> so it is really up to the board if you want to add it to the rules we can, but there is that balance, of benefit design, detail in the rules, verses elsewhere. >> so i think that the commissioner lim what you are saying is that someone or a member were to read this, they would wonder what happens to the $10? >> yeah. >> because, i mean, you might put it in some other, i mean communications, but it is back to it and it does not say that. >> on page 15, is that where you are reading? >> yeah. >> so, when it says, for one plan year after which any remaining care of funds will be

forfeited. >> that is after it is carried forward. that is when after one year, and i mean, that it is over for the over funds will be forfeited. but not for the one that is... so... >> not the existing. >> not for the existing one. but... for example, you say for the 2014, i have $9.95 in there. and it is not going to be carried forward. and the members say that okay, could you give it back to me? it does not say that it is forfeited in here. so... >> right, so, we do have a whole section in our cafeteria plan, document which is on, you know, starts on bfour, and the cafeteria plan that talks about the forfeit turf the unused balances and they use it or lose it rule, it depends, and we, you know, we don't have it in the rules, we have not traditionally talked about the forfeit tur in the rules and we

could add that and bring it back to the board if we feel that it needs to be there and when we do the appeals we go to the rules and if we need a further plan, we will often pull the eoc language into the appeal document, or the benefit guide or the other resources that we used to help to explain the benefit to members. >> and may i make a suggestion, and commissioner lim that perhaps, might meet your understandable point. what i believe that i am hearing, is that looking actually cafeteria document that we do have under tab nine. >> okay. >> on page, 4, there is a great deal of detail related to the carry over, perhaps, we could just insert a short line which i am sure that our council will write for us very quickly, maybe. and it just says, that the almost a par ren sis anything

under $4 will be forfeited. >> you can make the motion now. >> i want to be sure that meets your needs s that okay if it is in this other document. >> o. that i think is what we wail plan to do, and let's move it once we can make a quick par ren ses to insert on page, b4 on the cafeteria plan under tab nine. >> yes. so, i am just, i am comfortable making a motion without changing a document that is not before us right now. so i will go ahead and make that motion for the cafeteria plan. >> i want to be sure that for commissioner lim you are okay with that as a strategy. >> fine. >> okay, good. >> any other questions on this first item. we have four more to go. so the second one is described on page, 24, and that is an attempt to clarify the dual

restriction coverage for the medicare advantage and the medicare sponsored plans and so since the product was adopted right hand the uac plan, all of our plans that we offer, for medicare eligible retirees, now, are a medicare sponsored or a medicare mapd project. and so, dual coverage for a member is a problem. and it will result in termination if they join in aoe medicare sponsored plan. it will result in termination of their benefits at hsf and it is very difficult and often takes us a couple of months to sort that out, when it happens. so we wanted to make sure that we are being clear here in the rules and also in the benefit guide where we have added additional rules to this effect. >> any questions on this one? >> great. next one? >> the third change is on page 35, and it is just a couple of words, but it has a big meaning and it has to do with the

timing of premium requirements. premium contributions are due as of plan year 2015, the proposal is by the last day of the effective coverage period. so, we are or we will no longer be requiring payment in advance of the coverage period. any questions? >> any questions? >> no. >> all right. >> okay. >> and the last major change is on page 41. and this is to review our appeals language, and make sure that we are clear about the process for appeals when it comes to the hss determination of the credited service and qualification for the retiree health benefits and subsidy. and so, there is a new process that is put in place, that is clear that obviously you are not going to go through the health plan first and that appeal will come to the health service system and there was,

also, some report helped us with just a clarification on that language and hopefully you will see that in front of you. >> i want to be sure that all commissioners got the updated >> yes. good. >> i want to mention that the updated does not have the back side and so you want to keep your other page. >> good point. >> the other page that is in there that was about to throw. >> yes. >> my afollowgies. >> but this was just a new language on this section. >> so it is there any questions, i think that should work, further process needs to be put in place, we will bring that back to the board, but this we think should be sufficient. >> all right. >> any other questions? for lisk. a or comments? >> no. entertain a motion? >> i move to adopt. >> and okay. >> sleep... >> i move the adoption of item 8 as presented. and discussed. >> so is there a second? >> a second. >> all right. >> any public comment on this

item? >> no? >> my name is diane and i have a question about the dual coverage, i have had double coverage because many years ago when my husband was working there was a possibility that he would transferred out of california and so he put me on his medical plan too and so i have double coverage and i don't want to lose the health services system what do i have to do. >> because we want to protect your privacy that you talk to the staff and we don't want to make you discuss this in front of the public on tv. >> but thank you for raising that question. >> any other public comment? >> all right. >> seeing none, we will call a question, all of those in favor? signify by aye. >> aye. >> any opposition? >> great, thank you very much.

>> next item? >> item 9, action item, approval of section 125 cafeteria plan updates, lisa ghotbi. >> so, the changes for the cafeteria plan document are in some way consistent with the changes to the rules, the first one being on page b4, and discussing the update to the fsa healthcare and the fsa carry forward. and so i think that that one, does go because it has that entire section on the forfeit turf the unused balances and i think that it does cover that issue from the rules, and in more detail, but just wanted to see if there were any questions? >> so i would like to make a motion to amend this to make it clear that the minimum of $10 means anything under $10 is forfeited. and if you happen to have