data and what we would do with the preliminary rate so i have outlined on the next couple of pages what we came up with, and unless there are any questions about that it's out there and in its actuarial glory and we have what i think are reasonable trends. the data is kind of flat and the medicare data -- even though it's 6700 people it looks like they're not going to the doctor that much and used to be the case with early retirees so the trend rates are very nice so with that being said unless there are questions i will just move on. okay. >> question here. >> oh there is a question. yes, sir? >> no, i am just going ahead of you and looking at the 2016 rates. >> these right here. >> yeah. >> okay. you have a question or you want me --

>> just go -- [inaudible] >> go right ahead. >> so i'm at the preliminary rate on page 10. okay. on plan year 2015 we have the rates that are presently part of the rate basis for this year. we did all the math with the numbers we have and the trends that we developed, and overall the rates for 16 -- from 15 which dropped approximately 20% from 14 i am saying they should only go up 4%, three and a half, 4%. now, that's good, real good as an act area and if we have the rates and they need to go up based on this information we over did it but this indicates everything we knew about the program sustained itself and recommended to have a slight increase and as we are teeing up sir so well we might

want to do a rate pass, and then in addition to that as i shared we're still investigating other opportunities for the possibility of changing the funding structure of the retirees, the medicare folks, so if that comes to pass at any time that will change the dynamics of this also. with that being said that's where we are, a mild increase. other questions? >> questions from board members regarding the preliminary rates? >> what do you mean with the funding structure and changing it. >> you're self funded and you have the egwp and the drug piece and medicare pays a lot and you pay the rest and there are programs fully insured developed like sort of medicare advantage pp o and not change the ppo and they're out there and prevalent

in the landscape and they allow people in the programs to really manage the care and they they could possibly put us in a same position or better and have a long trend rate for the people and as i work for catherine and pamela and everybody at hss and it's my responsibility to share these opportunities so they're looking into them, so we're on top of what is available to do the best we can for these people in terms of providing medicare coverage so that's what that means. >> i would just add my desire. >> yes, sir. >> -- as we go through the process and it's true for any other adjustments or changes we're doing programmatically with providers. there is a point in time i think it would be yourself -- i will turn to director dodd and indicate when that is as you're coming out of

preliminary conversations into more substantive conversations about this you make members of the board aware so any of us that want to participate in that meeting to hear what the thinking is going back and forth between providers and some of us will show up unexpectedly maybe but show up when dealing with the providers and plan designs and those issues so if we're going to act like the committee of the whole we have to get beyond today's meeting and get down in the weeds and i did that prior to becoming board president and i anticipate i will do some of that again during this season, so if we're acting as a committee of the whole we have to take on that responsibility when those opportunities present themselves. all right. okay. >> okay. thank you sir for

those comments and very highly respected. lastly just as a matter of closure on these preliminary rates we have provided on page 12 the standard rate card. this is what you see every year. it has our projected rates, our ad min fees that we talked about earlier. we adjusted certain numbers so -- i know we have a lot to do. this $208.09 number right here and stabilization and it's from the number earlier and what does it translate into an adjustment with the rate? so that is everything there. we did two rate cards i believe because we have two contribution formulas. we have the two of them and what are the differences and prop b and

questions from the past and footnoted here. >> i would put this as a reference document as we go through the process. director dodd. >> it doesn't have the county yet for the final recommendation. >> we don't have the final 10 county but i spoke to the existing county and made it 3% bigger as a proxy. >> and how did you approve it and last year plus 3%? >> yes, sir. >> quick question on the preliminary rates for the early retirees. >> yes, sir. >> how does -- the formula works out because as far as their claims -- incurred blames [inaudible] ratio and pretty good in terms of their claims -- in terms of their claims -- >> [inaudible] >> the claims experience. >> we have to blend it with the actives. >> they're part of the

actives. >> yeah. that's our policy and that's why they go up the same amount. >> exactly and looking at -- >> yes and -- >> yeah absolutely well observed and our policy is unless we change it we do that. >> thank you. any other questions from the board on this item? okay. so this is again the beginning of sisphysis' rock and we will come back to it. any public comment? >> good afternoon commissioners. i am claire representing rrccf. my question is as was talked about that early retirees are being combined with the actives to determine rates, but i think there has been discussion about the possibility of having them

somehow banded with the medicare retirees to see if there is some way to give relief on those rates. is it possible as we go through the process that we will see both options so you have an opportunity to see which works out to the advantage of the early retirees? >> i am looking to director dodd but i will ask director dodd. we will take that but if you have an answer that's fine. >> i think what will go into the discussions is what what happened at the last month and the ektsicize tax and whether we're allowed to blend them and that's probably the most significant factor and we don't know that information yet. >> okay. so that would have to do with -- >> rules way beyond us.

>> right at the federal level and this is this continuing story. meetings are a chapter. sometimes we have to remember what went before and what is coming up, so again for those who are in our broader audience we ask you to go back and look at some of the materials on rates and benefits from the last meeting and obtain and review this and as we go forward do likewise. i'm going to claim the privilege of the chair and call for a hygiene break of 10 minutes. 10 minutes we will >> combine nine and 11. >> yes. so if you had indicated we ordered nine to be part of 10 and 11 so madam secretary. >> item 10 discussion item.

hss fiscal year 2015-16 and 2016-17 general fund administrative budget. pamela levin. >> pamela. where is she? director dodd if you would please. >> catherine dodd. this item was presented at committee this morning and represents a base budget leading up to the mayor's requirements and no additions. we pulled out four area we're asking for additional funding for and not anticipated in your packet. it says what they are and we can go through them but i think the finish committee spent enough time and i think you're good. >> mr. chair just open this up to questions and we had a great

deliberation not only with this board but the other board in the future. >> all right. are there questions from the board? >> i will repeat what i said and i would like to see paying for the governance committee and a consultant in the future and we had a lot of work to do this past year and don't want it to slide again for years. that's all i have. >> duly noted. all right. other board comments? this is an action item. >> item 10 is a discussion item. >> discussion item. public comment? hearing no public comment item 11. >> item 11 presentation of fiscal year 2015-16 and 2016-17

health care sustainability fund $2.05 budget. pamela levin. >> our chief financial officer is looking a little puzzled. >> >> i apologize. >> that's all right. we're in regular order and looking at the budget. >> mr. chairman and if i may and ms. levin thank you and may i suggest we open it up to questions and comment focus we have them opposed to a full blown presentation like earlier today. >> all right. any questions or comments from the board? i would note there is an item in this budget that provides for board and executive staff education. it is our intent that once this is reviewed and

discussed by our committee that we will talk about what we will be doing specifically around that issue going forward. we will be conferring with the governance committee to try to detail what might be a board education process or items for consideration, and obviously those will have to go back to be reviewed by our city attorney to be sure that they fit within the guidance of which this budget is created, so we're looking forward to future discussions on that, so with that is there public comment on this item? >> i also wanted to say that dr. dodd mentioned earlier this is the first time we spelled out exactly what these items to be used for so i thought it was great. for 205 we never did this before and anybody that

has the material there is a lot of work by the staff here so thank you. >> and i would add my complements to pam and her team and director dodd in assembling this information in such a clear manner so we can indeed explain where does that $2.05 go? what is it used for? how did we do that? is there any public comment? >> thank you. claire [inaudible] and actually speaking for myself and i want to add my complements to the staff and to pamela levin for putting this together and i am actually quite relieved to hear that there will be now more education and opportunities for the board to go forward. there has been a long, long gap between the old days whether we regularly attended a lot of the seminars that helped keep us actually ahead of the game and we also felt as board members

that many more of the staff should have been able to avail themselves of those educational opportunities and during tough budget years it's been hard to do, but actually the trust fund can in fact sustain those kinds of expenses because they impact the entire system, and they are for the good of the s.s they just don't impact one particular group over another so i am relieved to see this and my complements to all. thank you. >> thank you. so we're now down to item -- the next item. >> regular board meeting items. item 12. we did that already. >> please. >> item 13. election of vice board president, president scott. >> as you know with the

departure of the prior president i was elevated and elected and confirmed by my peers to be the president of the board thus creating a vacancy for the vice presidency of this board. happily commissioner lim has been reelected to this board. as you know we went through a whole process of authorizing an amount that was a handsome sum of nearly $35,000 if we had to conduct an election. he has saved that money and i think we should thank him for that because he was unopposed in his election happily so please join me in congratulating him on his term. >> [applause] his term expires in 2020. it's hard to believe that where will we be? so with that election we

now come to some full strength. we still have a cacan'tacy, a replacement for commissioner fraiser and we hope that the mayor's good offices will work their will soon to complete now so we're now at a time of the election of the vice president of the board and i am more than willing to entertain a nomination. >> i will nominate commissioner lim for vice president. >> is there a second? it's been properly moved and seconded. any discussion or comments from the board? that means everybody but commissioner lim. he can't say anything. any comment at this point? hearing none is there any public comment or any of that at this point? no. so all in favor signify by saying aye. >> aye. >> all those opposed? now, commissioner lim do you care to make any comments as vice president of this board. >> thank you. it's an honor

to serve for the next five years. >> thank you. all right. >> item 14 discussion item director's report. director dodd. >> before you begin director dodd. this particular document is very extensive. okay. very extensive and a lot of detail. a lot of work by the team has gone into it. it covers a great deal of information and we're not going to go through every item in detail today. catherine and i reviewed this and she's going to highlight and make specific references. i think this is a very useful document again to the general public to track the proceedings and where we are and where we're trying to get to and a wide variety of service to the membership that we serve particularly in the areas of wellness and others, so director

dodd. >> thank you president scott. catherine dodd director. first i wanted to highlight in the handouts and in your packet the recent data breech that occurred for anthem blue shield blue cross in country and we expect to hear from them in the reports and as far as we know blue shield of california is separately incorporated company and there was no data cross over unless some was data traveling and have a file in another state but blue shield of california is a separate company and separate from the anthem blue shield. i wanted to start out with that.

i will highlight some of the things and 34 increase in member visits and 22% increase in calls over january so we don't know why that is. we think that both of them were probably related in terms of anecdotally collecting data to the blue shield sutter issue. the advertisements in the newspaper, et cetera. there was a lot of concern from people. the other major thing that operations worked with communications on as well as data analytics on was identifying all of our part time employees, the affordable care act requires that employees working 30 more hours a week be given benefits so our

systems weren't set up to do that. the human resources department decided to a lot benefits to people working 20 or greater hours per week, not 30, because currently that is who is eligible but these are temporary exempt employees that wouldn't have gotten them so there were 700 people identified and mailed information. we still probably have one more mailing to go out so i think the significant thing is we're likely -- a lot of these people already have benefits someplace else and why they work part time. we haven't had a huge influx but it's clear from the ones that have come in that our membership data, which you will see later on in the demographics will easily top 112,000 members for this year rather than just the 111,000 members, so it's adding to our

membership. these were rush mailings that had to go out. everybody worked really well together to get them out. our privacy officer, marina coolridge rolled out a department ride security awareness training called secure the human, and we all be taking those over the course of the year, and urging other departments that deal with phi to do the same. we had an all day kick off for the all claims data base so that is moving along. i want to draw your attention. it's been a year and a month actually since we launched the wellness program so of all the packets that are in here i want you to take note of a couple pages in the wellness packet on page three the most important thing that we have to

highlight is that we created not just a foundation but we created an infrastructure for wellness in less than a year for close to 63000 employees which is unheard of. that's like -- when you think of a large employer is over a thousand people we have done an incredible job and identified 150 wellness champions that are getting information to use in their departments every month. we partnered with kaiser permanente and blue shield of california. kaiser did a lot of on site activities. blue shield as you know did the well being assessment which the data was presented on last month. we also partnered with rec and park and that allowed us to offer wellness classes at city hall and at the wellness city for free which was an interdepartmental effort. we

opened a wellness center and continued the programs and expanding them this next year. we expanded flu shots and we got a 20% response rate on our well being assessment. more and more are moved to doing a well being assessment rather than a risk health assessment and a important distinction to make and the literature is citing that health is by someone's sense of well being versus how much they exercise. it's really about a sense of well being and that drives their ability to eat right and move enough, so stephanie, the wellness manager's annual report is in your packet as the annual report as the aep annual report which are worth being proud of. the

next -- the other activities that i want to highlight is i did meet either by phone or in person with blue shield daily during the blue shield sutter issue. pam and i -- the cfo met with every person and the managers and to put the budget together and it's been thoroughly prepared and we have met several times -- i know you approved the strategic plan but we have met and you have the worksheet in front you that has the timelines and outcomes and we were overwhelm ded by how much we agreed to do and i drafted a letter to the department of managed care regarding the sutter blue shield it's not in here -- >> yes, it is. >> okay, great. >> it's behind the well

wellness -- >> it's at the end of the report. >> it's at the end of the wellness report. >> thank you. one of the issues that came up that our communications manager identified -- rosemary identified is that the information that has to go out by law to all of the hmo members when a contract isn't renewed in a managed care setting meets the litmus test of compliance for legally what needs to be in there but it's very confusing for the actual member so i drafted a letter urging them to make readability one of the issues that the letters have to be understandable just as our health literacy information has to be understandable, so with your approval we will send that out. i think blue shield did their best but they were contained by the law, and i have

in the packet through different pieces of legislation which i actually took to the state legislative committee yesterday. the first is sb -- all by senator hernandez. the first is sb137 and this bill requires that health plans maintain a current directory and it include whether or not practices have openings so that you won't sign up for a health plan and they say "i'm sorry. we're not taking new patients." they need to be updated weekly. i recommended that we take a support if amend position and the amendment would be that we add in urgent care centers. i will be working with supervisor farrell's staff who is on the state legislative committee because there were some other suggested amendments, but this would certainly solve a lot of

our problems in terms making access easier for our members. on the other two bills in the packet sb26 is similar to the leno bill from last year and hailed as accountability and transparency and quality bill. i recommended a watch on it at this time until we have a chance to work with the author and get a sense of exactly what's in it, and again on sb125. it's unclear whether this applies -- this bill changes the open enrollment periods, unclear whether it applies only to covered california or to all employers. it shortens the time -- it lengthens the open enrollment period but shortens the processing time to two weeks in terms of entering all that data and having people eligible january 1 so we will be again clarifying that with the author

and making sure there is adequate time. i am sure other employers will be up in arms as well so i had to present these at the legislative committee because it was prior to this board meeting, and i will continue to attend that meeting and follow the progress of these bills, but i would like your approval of those positions at this point. >> are you finished with your report? >> and that concludes my report. >> all right. are there questions to director dodd on any aspects of her report? >> i had a suggestion about the wellness report in the future when you have something this thick it would be nice to have it in a separate binder or something if possible and it wouldn't have to be in here. it was very difficult to put together. >> okay. >> okay. any other comments

on the director's reports? the director has made a recommendation regarding some legislative -- i'm sorry. >> two recommendations. one for the department of managed care. >> one the department of managerred care letter and the draft is in the materials and secondly regarding bill number 137 -- >> 137 and watch position. >> and watch positions on the other two bills, 26 and 125. >> 125. >> so is there any recommendation or action by the board? she's asked for an endorsement. >> this is not an action item. >> i understand. this is an discussion item. is anyone going to raise an objection if she does these things? i don't hear objections by the board members. is there any public comment? oh there is public