year where we also had to implement the federal taxes, so the pe cory fee which is per employee per year, the transitional reassurance year and $63 per employee per year. all of these add up to an incredible amount of money that was pumped into our rates. we were successful in taking the money we applied for through the early retiree insurance program, the 6.92 million and lowering the rates but that certainly didn't off set all of the fee associated with the obamacare. despite all of that. >> >> affordable care act. and the increase when you subtract the taxes was .1 4% in 2014 and for 2015 negative 2.8 percent

so those are significant accomplishments. as was mentioned earlier the board passed and forwarded to the board of supervisors a transparency resolution which included asking that we not -- that we review our contracts so they don't have anti-competitive language in them. we continue to monitor our acos. we increase the finance team in terms of funding. we launched our analytics program and selected an all payer claims data base vendor and as we said earlier the well being program became a reality, and is in of itself one of the jewels in our crown, so with that that concludes my report. the

financial data, audited financial data is in the general report. you've already seen it when you heard the auditor's presentation. thank you. >> are there questions of the director regarding the annual report from members of the board? this is an action item. >> yeah. >> i would love to accept the annual report. >> okay. it's been moved. is there a second? >> second. >> it's been properly moved and second that the annual report for the period be accepted. are there questions from members of the board? any public comment? commendation or otherwise? thank you. all in favor signify by saying aye.

>> aye. >> all those opposed? it passes unanimously and i would add for the record this board's thanks for the hard work of staff and its cooperation of both past and present throughout this 18 month period to bring this level of accomplishment and success to the work of the system. >> item 18 action item. presentation of 2015 demographics. director dodd. >> i'm going to call upon our analytics director who worked with our communication manager who put the demographic report together just to give a couple of brief highlights. >> thank you marina colridge data analytics system. >> hello. how are you?

>> i will raise the microphone. >> that's good. thank you. >> for those tuning in on sfgtv you will find our demographics report on my hss.org. and i am just going to high level walk you through how we compile this report and again my thank you to the communications manager, rosemary. i play with the raw data and numbers and she makes it look good. we start out our demographics report by giving incite to the lives of the scribers and the independents and we then look at the members. >> >> and sub scribers or all of those across our employ ears and then we look at the employee population and page 21 we look at the retiree population and the final pages from 29 onward take a look at the individual

employers so each of the sections tend to repeat in terms of what you see in them with our demographics, and i will say this report is already dated because as we spoke earlier our director that we have implemented some aca guidelines so the city as well as the school district have expanded to benefiting the temporary employees at 20 hours and closer to 112,000 lives as we look at our plan year. mostly significant for us for the first time in five years we see that our blue shield enrollment increased and of course that is been in part of the effort and strategy put forward by the health service system and the board. with regards to most of the other demographics we see here they tend to be consistent

year over year in terms of gender mix, population, age and employers and the dependents and the to the subscribers and with the active populations and others and nothing overly insightful there. we continue to -- yes? >> the overall age of kaiser -- of blue shield being lowered than the overall age of kaiser? >> yeah that is true. i will speak to that and i am glad you reminded me of that piece. when we look at our total lives you will see that the age of blue shield is slightly lower than kaiser and on page five of your demographics report, average age of 44.23 to 44.1. that is true because some of the medicare dependents and disability

dependents that are lower age than when you look at the same group of dependents in the other health plans and it's specifically the dependents of retirees that are driving that number. we like to look at the statistics and study by the gender mix and we have brought to the board some of the risk studies and looking at it by other statistics and previously we reported blue shield had a higher age. that's still true. a lot of the studies we're looking at active population and that is true today and when we look at all of the lives there is the one group with the retiree dependents that is pushing that different yecial. we continue to see 96, 97% of the population whether active or retired are in the eight bay area counties and those in the board room and heard about the

impacts of the market in california and it's substantial because that is where our membership is. in your own time you can look at page six. we added more analysis by age groups and you have seen in the previous year's reports. i have skipped ahead to page 16 where we're now looking at both our employee members and dependents combined. again that blue shield out bound migration has stableidesd and we saw that increase and i think -- just quickly browsing forward over to our retiree members on page 21. just in summary i will say that we did see a significant increase in our enrollment in retiree dental in 2015 over 2014. that increased by 1185 lives which was almost four times as great an enrollment

boost that we have seen previously. doing a deeper dive on that data it looks like 32% of the new live are people that waiveed in the previous year so the supposition is that the change in the mental benefit helped people select the dental coverage where they previously had not and finally some notes by our employers. we certainly for the other three employers and by that i mean the unified school district, the community college district and the court. when you look at the proportion of their active population to the retiree population they have more than 50% of retirees as a proportion to the number in actives whereas and city plan for example we've got roughly 27,000 retirees and 62,000 employees so the proportion is considerably less than 50%.

also for -- i think this is new this year but certainly city college had a decrease in enrollment maybe due to the instability issues going on over there and the unified school district continues to be the second largest employer so high level and those are some of the questions. are there any questions from the demographics report? >> just a point of clarification. i would not characterize the community college district as unstable. i think they're on the public record. the question is the accreditation standing of the college so we have no comment on that other than the impact of what it may have done for health plan participation. >> i stand corrected. thank you. >> just to clarify. thank you. are there questions from the board on the demographic

report? any points of discussion? any public comment on the report? this is the discussion item. >> claire. i want to thank both marina and rosemary for this outstanding report. i think it's very helpful to our various retiree organizations as well to get a better handle on where our members might be as well as where the health service board members are and i think that this is always very helpful and it's beautifully put together and i wanted to thank everyone for their hard work. >> thank you. i think i speak on behalf of the board also there are a couple of documents i think we should be carrying with us as we go through and this is obviously one of them. not only the process of rates and benefits but as a reference pieces, and i would commend that to those that are looking at this presentation to look at this particular item, the

annual report as a way of kind of maintaining point of continuity along with the other more substantive items in the director's report as well. we're ready to proceed to the next item. >> item 19 discussion item report on network and health plan issues if any. >> i would imagine that we will have -- since the director -- are you from blue shield? >> [inaudible] >> all right. thank you. i was going to ask that you come first. we're at the center of the storm here so please identify yourself. >> we will. chris perrareace and adam gunter from blue shield. i want to thank director dodd. she made some really good points about the anthem cyber attack earlier so i apologize if some of the information is redundant but i want to clarify a few points so

anthem blue cross is a separate company from blue shield of california. they are currently conducting an investigation to determine the impact and scope of the incident. anthem has confirmed that blue plan members who access care through blue card may be impacted. we don't have any details about the level of exposure and it's a plan where members can access care outside of california and just a reminder blue shield of california offers a hmo plan to the city and county of san francisco members which means that care outside of the members assigned medical group is generally limited to emergency or urgent care services. and so the final point i want to make is that anthem has committed to

providing detailed information of any blue shield member whose data was impacted by the breech and we will keep the board and also director dodd abreast of the situation, but there is no timeline as when we might get that information. >> thank you for those clarifying comments and for the record director dodd talked about this in the prior events with sutter and so forth on kind of an updated basis so it's been very heartening, the outreach and engagement of you and your team to be as fully disclosive as you are so we're in a position to inform our members and i am sure that won't go unnoticed as we go forward in the partnership. >> thank you. it's also great to work with director dodd's team as well. >> are there questions from

the plan representatives? okay. thank you. are there other plan representatives who wish to come forward? >> hi good afternoon. kate kesler. vice president for strategic accounts for kaiser permanente. a couple of labor updates. last time i visited you we notified you of a strike union. that strike did happen and a seven day strike. it went through that. it's ended. everybody is back to work. no agreement has been reached however and we are working with them and hope to reach an agreement in the future -- >> can you give me clarification. what does it stand for? >> national union of health care workers and represent about 2600 workers in northern california. >> thank you. >> one other update we did reach a three year agreement with the california nurses association and that was

ratified the end of january so just wanted to let you know that has happened and is in place. okay. >> i am glad you're continuing to work in a labor management way at kaiser permanente. thank you. >> thank you. >> are there other plan representatives wishing to be heard at this time? is there public comment on this item? >> i will make it brief. i just want to thank chris and adam and their vice president. they came out to us and spoke to all of our members about the blue shield sutter issue. we had a very full meeting and it was really very, very helpful and i wanted to publicly acknowledge their willingness to do so and they're assistance with all of our members. it was quite gratifying so thank you to all of them. >> thank you. any other

public comment? item -- >> 20. >> 20, yes. >> item 20 discussion item opportunity to place items on future agendas. >> hearing none. next. >> item 21 discussion item. opportunity for the public to comment on any matters within the board's jurisdiction. >> is there any public comment? hearing none we will proceed. >> item 22 action item. vote on whether to hold close session for employee evaluation. president scott. >> i will willing to entertain such a motion or action by this board. >> i move that we go into closed session. >> there is a motion. >> second. >> there's a second that we move into closed session for employee evaluation. is there

any discussion by members of the board? any public comment? we're ready to vote. all in favor signify by saying aye. >> aye. >> all those opposed? we will now go into closed session. [gavel] (closed session).