ready to entertain a motion. >> i move that we do not disclose. >> is there a second? >> second. >> it's moved and seconded that we do not discuss the discussion item. is there any public comment? hearing no public comment all those in favor signify by saying aye. >> aye. >> all those opposed? so ordered. [gavel] we're now ready to move to regular session. i am disturbed they're not moving in here. what is the problem? are they going to march on the house or something? >> [inaudible] >> okay. we will take a brief pause. >> send the police chief out

there. [inaudible] >> we're going to take a brief pause and have the people back. they're normally clawling on each other in here. here we go. (recess).

>> i declare -- [gavel]

i declare the february 12, 2015 meeting of the health systems service board officially open. would you please stand and repeat after me the pledge of allegiance. >> i pledge allegiance to the flag to the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. >> i will ask our secretary to please call the roll. >> president scott. >> present. >> commissioner breslin. >> here. >> supervisor farrell. >> present. >> commissioner ferrigno. >> here. >> commissioner lim. >> present. >> commissioner shlain excused. we have a quorum. >> the printed agenda is

before us, and i know that we're going to be going through the minutes and so forth, but i'm going to reorder a couple of items and i will indicate what they are during my ordered president's report. and so we will go through the minutes first and then i will pick up after that so item 3. >> item 1 -- action item approval with possible mod i wases of the minutes of the meeting below of the regular meeting of january 8, 2015. >> are there any amendments or adjustments or is there a motion? >> i move to approve. >> second. >> it's been properly moved and second that the minutes of the january 8 meeting of the board be approved as distributed want is there any discussion by board members? any public

comment? there is public comment. would you please come to the microphone. please identify who you are. >> my name is is aerial go tey. >> i am sorry. all right thank you. >> and the comment is not just for those in front of me -- hello catherine but those behind me standing behind me and sitting who are part of this process. in october 2009 during the storm like the one that just passed i was walking my horse to the paddic and found it was taken down for repair, and there was thousand lot -- thunder and a lot of noise and i went from a standing

position to being on the ground. i was not certain that what happened. what happened this 1200-pound beast took a step forward and when we heard it and he hoof made contact with my face. he broke the orits to both of my eyes, my nose, my nasal passages, wiped out a third of my pallet and jar. i wear a prosthetic thanks to modern medicine and the before sitting before me now because i tried the best i could -- my husband and i. without a handbook -- there is never one when you have a big accident. something that generally isn't seen in the public sector but instead the prosthetics i wear today inside of my mouth, a lot

of titanium. i set everything off front and i had to explain to them it's internal but there is only one other person in the country that wears this like i do that allows me to speak and supports -- if you put your finger where you're sitting and that bone i don't have and i don't have all of my jar and missing part of the pallet still and i have a jar that is implanted. there were numerous bone graphs and five years of multiple surgeries to get me to a place that i can stand before you and say thank you. i am here to say thank you. thank you jennifer sitting back there and lisa who is no longer here. chad who is jennifer's

predecessor and all of those i can't name because they choose not to be named and obnoxious from my point of view and i know you have to protect yourself there is so much that happened and people with ill intent and i had no idea how to move through this and literally a here of being denied. they said it was cosmetic. forgive me. this comes out. i'm not just this. i am ashamed but i wanted you to see what you allowed to happen with your care and thank you. everything is bone graph and titanium. forgive me once again. this prosthetic is not just a denture. it allows the rest of my bones in my body to know through contact that it's

still viable and being used so that the rest doesn't disintegrate and i know you have a crazy agenda and you're busy and i wanted to let you know if it wasn't for the day i wandered into lisa's office and everyone went by and catherine was there. i didn't know that at the time. she knows the story. i said "i don't know what to do." i was at my whit's end and felt there was no place to go. i didn't know i wanted to live the rest of my unable to swallow or speak or chew or breathe because it also supports the flesh that comes over your naval passages and lisa said to yourself and to those behind and in front of me this needs stewardship. i want to say thank you for that.

thank you for concern enough that qonz i knew how and i didn't but i did everything i knew and going into the offices and who to talk to and if that didn't happen i would have missed out of things because i wouldn't here and my husband's appointment and the relationship i have with my son which was strained at the time. i would have missed out on so many things. i was ready to give up so know those people that come before you are often -- there is no handbooks and the hospitals don't give you a step by step process and then you will do this and this. it has to be figured out so not only thank you but if there is anything i can do. i'm not very

articulate. >> you're doing very well and we thank you for your statement. >> thank you. >> i can be an advocate. if there is someone that needs to be spoken to just to be calmed or someone that you answer to that needs to hear a voice i can be more articulate than today but please use me. >> all right. thank you very much for your statement. >> thank you. >> so on the item is there any other public comment? hearing none we're ready to vote. all in favor signify by saying aye. >> aye. >> all those opposed. [gavel] the ayes have it. next item is -- we're getting ready to according to the agenda move into the rates and benefits discussion and then finance committee matters and then on to

our regular board meeting. i am going to take the prerogative of reordering the item number 12 which is the president's report to this part of the agenda, and also after as we go through the other portions of the agenda item 9 i want to combine with item 11 in our agenda. there will be no special discussion on item 9. it will be combined into item 11 so with the -- and in addition we have item 16 which is designate d as a discussion item. i believe it has to be probably carried over because it is an action item, and item 18 is identified as an

action item and it's actually a discussion item and that too may need to be carried over but we will get to those items or those issues when we get to that portion of the agenda. this is the director's report prior to the rates and benefits committee. we need to be out of this room by 430 this afternoon and that's not a soft time. that's a hard time. there is another city committee that will be meeting in this space. we have an agenda that is extraordinary. we are going to under take the labors of sieve fissous and get through this and the great person, the god condemned to roll a rock up a hill. i happen to be wearing a watch and the face is of this

god and i will turn to my fellow commissioners so they can see it, so it can be done, and my hope is that those will be presenting will be focused in their remarks, crisp in their presentation. that board members -- we all know that we have other commitments. we have another closed session this afternoon. we need a quorum for that, and that public comment i would ask that it be essential and targeted on terms of the topics that may call -- they do all call for public comment, so to the degree that you can help us complete the full agenda today we would be very appreciative, and with that i would like to close my remarks and move to the rates and benefits committee we we're acting as the committee of the

whole. let's begin with the item. >> item 3 action item initiation of black-out period and rfp. >> catherine dodd would you speak to this. >> director dodd. you have the memo in the packet from me. this is pursuant to -- the memo is notification to the health service board that the health rates and benefits in 2016 is issuing rfp for vision services pursuant to the providers selection policy currently in place and the board must be notified of a black-out period when a rfp is released from the on set to conclusion of the plan with a primary provider and communication between board members and providers seeking

contracts with hss solely related to hss contract suggest restricted and communication includes meetings and telephone. >> >> and email and text messages and letters and faxes and any other social media or contact with service providers pertaining to hss except during board or committee meetings. board members that communicate with service providers for reasons not related to hss agree to disclose in writing to the director and the board. >> this is not a new policy and it is my expectation that every board member will follow it, not only in its spirit but to the letter as we proceed in these deliberations so with that it's an action item i would like to know -- >> i just have a comment. i want to say this applies to the

vendor as well as the board members that they're not supposed to initiate any contact either and there is a penalty if you do so. >> all right. >> which is written in our rules. >> okay. all right. with that additional clarification this is an action item. i am ready to entertain a motion that we adopt the black-out period. >> i move that we adopt the black-out period. >> is there a second? >> second. >> any comments or discussion by the board members. any public comment? hearing no public comment we're ready to vote. all in favor signify by saying aye. >> aye. >> all those? it's passed. [gavel] item 5. >> item four action item approve city plans and administrative fees in employer group waiver plan premium for the 2016 plan year. aon hewitt. >> aon hewitt good afternoon. >> good afternoon and you will

be a continuous presence in this process. >> do you want me to stand the whole time? >> no. you don't have to stand there. i thank you for at least clarifying in this action item what egg whip is. >> okay. so before you have the presentation titled city plan administrative fees and group and egwp presentation f we go to page one we basically say since we're self funded under this program, the city plan funded we have fees that we doarkt with the payer which surks nighted health care they're the administrative fees which are disclosed on page two presently for 2015 for o.k.tives it's $13.54 and the numbers there are the. >>

>> same and they're combined rated together. that's the precedent since i got on board and prior to me and have the medicare and integrated with the egwp and the numbers are listed there and the numbers are low are 3% higher and don't have an increase for years and i reviewed the numbers and i believe they're reasonable as presented and i recommend that you approve these numbers so with the next statement we wanted to disclose to you some of the programs that are part of this offering to the city plan member base which is a small amount of early retirees and actives and a large 6700 retirees under the pp o program. there is shared savings and within that is a facility reasonable and customary. what these programs are is uhc goes

out and negotiates this and maintain their fee schedules and all claims payments so there is no way -- they are active in trying to maintain that -- you know, you get the best deal possible and an example would be you go to out of network facility they negotiate it and get it down so they brought it down so there is a savings. okay. they keep 35% of that savings so what we do because this is a pragmatic idea and we accrue it in the ad min fee because we're charged that and the claims invoices and a new program part of the managed care aco, the forward thinking things is that -- let me restate that. they have implemented a value base pricing agenda so they're as current as possible with all opportunities to integrate

positions at hospitals and minimize excessive utilization in hospital facilities and keep doctors on point through the programs they have done implemented to be very strict in how they manage this health care. this is all a benefit to those people that utilize your programs. we made an accrual for that. at the end of the point where you go to some of the physicians and they make savings we pay a portion of the bonus dollars they get for taking these actions. the amount you pay is much less than the savings you will receive. this is the same thing that goes on with blue shield so those are the numbers. with full disclosure we wanted to outline those and what has happened we had these prior numbers in 15 at the bottom of the page. they have gone up. one of the reasons is they come up with a very strong and robust value based pricing. we didn't have

that accrual in the ad min 15 item in the ratings so if there are no questions i tried to outline this and keep timeliness with the presentation and are there any questions because this is basically it? >> are there any questions on the employer plan egwp. >> these are the fees. >> the fees. on this item. >> any questions? >> 14% increase? >> that's my estimate. i put it in there so it's not them wanting it. it's me accruing that in the fee and we're putting in the bucket to pay for the potentiality and when we have invoiced we have the shared savings portion and that's part of it and i want to build that fee into the ad min so we get all of the shared savings after the fact and they save a lot of money and then i divide it by

the membership base so they saved a lot of money on claims. then i divide it by low membership base for certain portions of it so it turned out to be a good estimate and historical data was $2.23 as an accrual so it went up 14% from what i put in there last here. >> catherine dodd. >> director dodd and i asked them do the value pricing three years ago when i look through the notes and that they're implementing it is a sign of the times this. is one of the best practices in the industry in terms of negotiating the best prices and the best quality and i am supportive. >> all right. >> okay. any other questions? >> the recommendation is to accept premiums -- other questions? is there a motion to accept? >> i move to accept.

>> second. it's been properly moved and seconded. any additional questions from the board? any public comment? seeing no public comment we're now ready to vote. all in favor signify by saying aye. >> aye. >> all those opposed? [gavel] it passes. >> now for the last portion of this one item number 4 is the egwp premium. you decided in 2013 to adopt a egwp versus the drug subsidy for the medicare portion of this and egwp is where you act like you have your own plan and all of the benefit from farma and the maximum opportunity to save money. it has saved money and dr. dodd when i came on board and we need a full calendar year. the driver behind that is that i want to egwp. that was very

smart and so far it's been great. they are raising the number. i want to give you a little history. we came in at $142. we stayed at that amount. -- 56-cents and up $156.96 and we were in 142-2013 $142 and we are behind it with united health care and by giving us the low number. that's their decision. i think it's fantastic for the members. they want $171.09 and i see nothing wrong with that number given the marketplace so i want you guys to accept this number. >> you have heard the recommendation. are there questions? is there a motion?

>> motion to accept the recommendations. >> okay. >> that's it. >> that's it. >> yep. all right. madam secretary. >> item 5 discussion item. review ined but not reported ibnr status. >> aon hewitt. what you have before you is full disclosure what you have on your books for the ibnr reserves and for the self funded programs. since you take the risk you need on the balance sheet the liability. what it is if you stop the program at a given time can you pay the claims, the run ought claims that happen before that time and remitd and invoiced and then you would have to pay

after that. that is a financial responsibility of any self funded program and we do these on a physical year basis to correspond with the audit and these were approved by the auditors and we wanted to bring them to the board so the board members would know where these numbers stood, and the most marked changes is that blue shield has gone up $4 million. blue shield's claims payment was exceptional when they first started under the flex arrangement and right now i can't explain why but we had this reviewed and you need to have on your books 22 mindz so that's the end of my statement. >> director dodd. >> i would like it to be clear that the $4 million for blue

shield reflects our payments to the hospitals. it doesn't reflect blue shield increasing their rates. >> no, not at all, not at all. they didn't increase anything. it's just our reserve and the speed we pay the claims. if we turn it off at this point we should hold $22 million which you are doing. this is as of june 30 and right now you have that amount on your balance sheet. that's all of my comments. >> any clarifying questions from members of the board on this item? >> okay. >> madam secretary. >> item 6. discussion item. review of contingency reserve fund status. aon hewitt. >> i am back again and this is something that my prior actuary you had reese evans who was a exceptional actuary was strong

in favor of. he shared with the board where you're self funded and take risk in addition to the required terminal liability have a contingency reserve. we have reviewed this with the board and you reviewed the scpls this is sharing the amounts on the books now so you have a contingency reserve which means do i have a reserve if this thing got out of hand? i am taking risk and i need money on the books just in case expenses got interesting so you have the amount listed for city plan. you have money for delta dental and for the pp o and 14 million plus on your books so a total of 24 million of contingency reserves. i think this is wonderful. i really applaud the board for

letting us review the policy once a year. i am thrilled they're on the balance sheet. before me they were not on the balance sheet. they have consistently have been and kudos to the ceo and director dodd for this and this is great and i wanted to share the amounts and the auditor has already approved this. >> questions. commissioner lim. >> [inaudible] based on the dates or the study? >> the document that we presented and we look at the various enclaves and study on that and keep what we think is the right amount of money at 99% confidence interval so if it exceeded that we wouldn't have ultimate funds but 99% of the statistically modeled% -- the 99% confidence interval this is the amount of money that the program says