so, really targeting the population that eap has brought in more frequently and not just thought of it as when you're in a crisis anyone a talk one on one that their scope of services is definitely more broad than that. that also can help us keep efficiencies with only a team of three people to serve the entire city. the wellness center is booming. we try to open up the 1 pm timeframe to be open use were people could just commute to the wellness center and we have to offer exercise classes 4/5 days because her swelling at noon to such an extent. both an interest of topics but also just in size. we had our first official cap on a quest worry actually have to turn people away because we can't fit them all in from a safety standpoint. it. it's exciting to see so many people coming any interest in difference types of class. we are not just doing zuma and

yoga and the total body conditioning classes and tai chi and things like that are really growing. on the flipside, were struggling to get people to come to seminars. the other great seminars in every once in a while we have a gym to get 25 people but we can get people to come anytime for group exercise or the other side of the house the educational side, having to get more creative on. we just had a great week were we did combo-, and learn and we were able to get some more interest but we are definitely needed to continue to be creative with how to provide health education. however, we did do a partnership with department of public health on back safety and we had a lot of hss staff trained because we do a lot of listing of open enrollment books and things on those lines so it was a nice opportunity

bring a valuable training to protect the healthy and safety not only all city employees, but really helps a good number of hss please. we continue to support the meetings with health and wellness activities and have opened up both the colorful choices challenge and get fit on route 66 two retirees. the update is not huge but it doesn't hurt us in any way to include them in for those it helps, it helps. we will continue to learn more about what their retirees need as we continue this journey. >> anything else? >> that's it. >> thank you. questions from the board? well i for one have admired your work and persistence and your enthusiasm over these past two years this two-year period of time. it was really kind of the league in fate but you have brought a great--you and your team have brought a great deal of skill

understanding an effort to this and i think the results are beginning to show. so, the fact that you do not have to our reach as much people were seeking you is a testament to that. so, thank you for all you are doing. >> thank you. >> are there any questions from the board? if not standby because of public comment. you may be called back. >> thank you commission. this has been a wonderful program for our members. our members get very excited at each meeting when margaret sullivan is there and the prices are fun. people are happy to talk about their experiences and the changes in their life with regard to the programs that were being offered. so, i see this is very positive for retirees because the worst thing we can do is basically

sit all day in the back room at a meeting and not move a lot. but some of us-i know actually, and one event is that at the retirement board instead of clapping, we did this. we got our exercise as well as let the board note we were happy. i want to thank the wellness staff. they are just really fantastic. a lot of our members like to come down to the classes as well. i think it is really an outstanding program. the one thing i want to add is, yes, it has always been an issue very much an issue for me when i was an active employee and member of this board that eap is woefully understaffed. they do a phenomenal job with just three staff with all the needs in the subject i think we haven't-we have just cracked the surface with the amount of work they could do and for the counseling on a number of issues the other thing that occurs to me because i had a supervisor like this would take the information for this

person's own personal interest, whether it's with regard to what the eap does or any program like this, not sure with employees. i see this as something that they got what they would actually work to make sure that the employees under them did not have these benefits, or, in this case when you're asking for several hours a week to be devoted to this program that some of those supervisors don't really see this as a value and wouldn't grant employees who requested the opportunity to spend the time. i think we have to do a little more education with management with middle management to let them know this is actually a plus and at the other end of the greater production and there will be better morale and that actually will improve the workplace and suppressing those employees is

not really the answer. these are the kinds of programs that make a big difference. i saw you need drivers in my years at uni. i saw people in my the traits that suffer from a lot of physical maladies because they didn't have these opportunities and we need to work harder with those specific employees groups anymore activity sitting here at the desk all day is not. or even driving around in a car for half the day. not good. we need to expand this and thank you so much for having this great program. we all really enjoy it. thank you >> thank you for your comments. any other public comment the one if not, again thank you stephanie to you and your team. we will now pick up with item number-secretary, tommy >> item 9, action item. approval or revisions of health services system membership rules. >> mitchell briggs chief operating officer of health service system. every year health service system has the board to review any membership will changes we have put into our membership and rules for fact that following plan you.

so these are summarized on the first page in your deck. the first change to review is section or hotel, page 21 in the rules themselves. in regards to entitlement to medicare. this reflects operational policy group but equally, for 2017 when we had to medicare advantage plans being offered for medicare enrollees. >> excuse me what do you mean by reflects operation policy? images were already doing it and this is been done to comport with what we are doing? work this is something we intend to do? >> is something we intend to do for 2017. because of the family set up next medicare in romans, one being it could be retired employee. it's not on medicare but has a spouse is already reached medicare age >> i understand the effects

operational policy means i could interpret that to being we are already doing something like this and we are now conforming our policy to do what we are operationally doing. it just my reading. >> right. so, for this particular pool change, i will read what we have changed in section h page 21 would be added section 6. if retired member or dependent becomes entitled to medicare the number of dependent will need to transfer to another planet were to maintain hss coverage of no medicare advantage or medicare prescription drug plan is available in the pre-medicare plan. so again it's about families that have one medicare in romans and another member of the family not medicare. so, in section k, page 24-25 of the rules, it currently read that

medicare advantage and medicare protection program participation is required from medicare eligible retiree numbers independent of enrolled in the plan administered by hss. the previously read in apd plan for student drug plan, for instance, that would have been blue shield, medicare plan that was in the 65, plus medicare advantage that would have been access plus which had the pdp as well as the original self-funded city plan had a medicare sponsored pdp plant. now, we are restating where there's only one offered and that's a medicare advantage work in apd plan, for retirees eligible for medicare. the last change is appendix a which is a change we have to do every year and that is changing all the coverage periods for the plan

year. so, these are the periods based on our seven the premiums by payroll whenever we get that payment this is the coverage or not that's been covered. so, that is all the changes for the 20 1710 year. >> are there questions by members of the board? >> you know i know it's written in the rules retirees who fail to enroll in medicare will be transferred to the city plan 20, is that still there? >> that is still there and thanks for reminder me that's actually page 25. >> okay, thank you get any other questions? if not is there any public comment? i'm ready to entertain a motion that these plan changes be adopted. >> so moved >> moved and seconded. is been properly moved and seconded these plan changes be made as

described in the item. all those in favor say, aye. any public comment on a motion? know. i'm out of order here. all those in favor say, aye >>[chorus of ayes] opposed? it passes unanimously. >>[gavel] >> next item >> item 11, discussion item update on aetna life and disability utilize asian. karen hill. edna. >> thank you so much for your patience. >> no problem. i learned a lot today. so i'm karen hill. on the group insurance account executive with aetna. i met with director dodd and mitchell previously to go over the outcomes of the long-term disability in the life insurance that we manage for ccsf and was invited to come

and go over those results with you. so i'm going to talk about the long-term disability as well as the life insurance. i have a presentation. >> and there it is >> okay. if we could go to slide four, please could. great. who is covered. this just gives an overview of the two different plans for long-term disability in which unions are covered under those specific plans. so, the one plan has a 60% benefit to $5000 monthly and it has 180 day illumination period. the other plan is 66 2/3 benefit of $7500 a month with a 90 day illumination plan. so, key findings. i have a few slides below that will review the outcomes for claimant activity diagnosis and duration them a

day's close claim activity claim distribution by top eight diagnoses and claim resolution. just as a point of understanding, the majority of appeals filed were upheld. one was overturned, and so basically when there is an appeal, not to change somebody's mind about a decision but rather for the claimant to bring additional information so that we have more information to look at that may impact the decision and change is but truly the majority were upheld as denials >> you adjudicate your own claims? views served as the appellant body? >> aetna, does, yes but there's an appeal unit at aetna which is totally separate from the claims in. so, the different folks, different sets of eyes

>> what remedy two people have if they wish to pursue this matter beyond your appeal process? >> after appeal the next option and is only one appeal allowed x option will be litigation >> litigation, okay, thank you. >> just looking at some benchmarking information ccsf had a higher percentage of claims than aetna. group and aetna business. so, the following category had a little bit high. skeletal and group of diagnostics is always the top one with every client i've ever worked with. so you're running a little bit higher than a book of business than the pure industry. neoplasm, injury poisoning, those were the ones running just a little bit higher than the benchmarking that we looked at. however, you had a lower percentage of claims and at the pier and book of business for mental disorder. that would include things like anxiety, depression, those kinds of things. that was a good outcome.

>> does this comport with our pharmacy analysis? i don't think it does. >> the good news is you got lots of folks that have those issues are not moving into long-term disability. >> i see. the drug therapies are working now. >> exactly. >> thanks. all rights. >> the highest percentage of claims was age range of 50-59 and that's kind of where we see that happening industrywide. 62.2% of claims were for females. we could do a claim satisfaction survey and the results show 80% were still under the category of excellent, very good or good. so, we had we actually surveyed 100% of your claimant's midpoint and end point of the claimant and we tried to surveyed 153 individuals. only 45 people responded so that's what you're getting there with respect to the survey. okay.

so, this slide is just giving you a picture of the open-close denied and pending claims. for the period there were 37 open closed and denied impending claims compared to 113 four 2013 and 106 in 2014, but long-term disability data lags, so you're going to see much different outcome when we look at this time period later on this year or at the end of this year because bucks more claims will come into it >> there were 34 claims out of 23,000 people covered? >> that were open during this time period. >> all rights. >> the most common reason for denial is noncompliance, which generally means that they didn't respond to the requested information that we needed in order for us to make a decision. sometimes noncompliance could be somebody has diabetes or anxiety or

depression or that kind of thing and are not taking the medication. we can check this to pharmacy records and those kinds of things. you could actually have your claim denied for not taking your medication. so those are the kinds of things you see with noncompliance. this slide talks about the diagnostic and average duration of days. again, you see must go skeletal disorders at the top of the list. for that disorder, it has the most total days approved it's overlooking out when the claim became effective and what timeframe it was approved through. but, you see under your logic disorders, it has a higher average duration. this next slide kind of highlights the average duration by month by location. these locations on

the right of the slack to margot department of public health, municipal transportation agency, the department of human services, and superior courts. so the average duration months or 2014 was 8.5, compared to 11.8 in 2015. then, the superior court had the longest duration. that was the division or area that had the longest duration. this next slide is just showing the closed claims and the top reasons. so the second-highest closure for) is returned to work which is a good outcome. right. that's what we want we want people to get healthy and back to work and is better for everybody. it's petty for employers and for the claimant. so, that's a really good results. our next slide, this

is a claim distribution this was taken for the entire period of one [inaudible] 2015 and you can see that the top diagnoses are the malignant neoplasms, must go skeletal it just a different way this diagnostic group is defined. i want to just highlight that when i met with director dodd she was curious about the cancer because it's a pretty significant portion of the claims related to cancer. so, she asked me to dig in and see there related to smokers and with respect to the disability, we look at all active claims there's actually none of the claimant's that are doing with cancer due to smoking. the highest percentage are

breast-cancer and then you have prostate and: cancer. that's where they are. they're not due to smoking. the next slide is talked about claim resolution. the good news here it is 63% of the claimant's return to work. again, very very good outcome. the next slide is showing some statistics on our social security disability integration. so, we have an advocacy firm we work with and we look at every claim to see if we can assist with getting them approved for ss the act and so there have attorneys. they do things like help the claimant fell out claim forms, do all of this omissions and communications with ssd i am working at those claims approved. it's at no cost to the claimant. something we do as part of a value added

service. so, you can see out out out of all the claims we manage for all these years, there are eight that are greater into years duration, meaning they had not been approved for ss di yet and it's not in common. sometimes it takes a very long time to get it through and approved. but we continue to manage those and work with the claimant's as well as ss di. the next slide i'm going to be talking out of the life insurance. >> as you go through this, if you could summarize some of the more detailed slides on claims status and so forth? i mean as you go through. don't have to hit every slide. we have the data in front of us >> got it. okay. were almost done with the presentation. that shows you who is covered and what he is benefits are for each category. the next slide is just the key findings. the top causes of death were cancer and heart disease. of the total

claims 25% were for males among 19 for females. so on and silver. if we just take a look at slide 16 >> canasta question >> yes, dr. follansbee >> is at the top causes of cancer were cancer, 50% and that 25% of the claims were males for cancer and 19% were for females with cancer. so when i had those two numbers up that's only 44%. just kind of curious what am i missing? >> white director dodd assets in question were actually looking at all the claims. not just look at that cancer claims. if i'm looking at all the claims for mail males and 5% of the male claims were for cancer. the other 75% for mail claims were different

>> probably would be clearer if you stated that so we can get a sense of the demographics. >> very good. very good call out. i will change that. >> okay. thank you. >> okay >> other questions? >> so this slide gives you a visualization where the slides fall. you can see cancer and heart disease are the top two. not uncommon that's pricey with the majority of my clients. >> we love you that you are value added. thank you. >> think good >> other questions from the board? yes, dr. >> statistics show mortality rates are holding steady at 100%. >>[laughing] >> thank you for that. i agree. very good point >> is there any public comment on this item? seeing none,,

thank you very much. director dodd >> i know you want to slip through the value added but this is a slide we want employees to know about. people don't read their life insurance contracts and their legal services available. it's really valuable service from a life insurance company. >> payroll planning and care at a busy >> yes. i'd like to add i'm working with mitchell and ebs on a communications campaign and we are going to really do all we can to highlight those value added services >> thank you for saving that because were going to these other benefits that were talking about this would be of great educational points. >> yes that will be the carriers for the voluntary life that's going to meet new 1-1-17 so doing lots of the medications around that >> all right. thank you. any public comment?

>> my curiosity has to do with any coordination with retirement system that handles disability benefits and i was looking at the ssi but not everyone who goes out on a disability retirement through the city is on ssi. it seems to me this would be valuable information for carmen as well but i'm just carries out any coordination here. thank you >> thank you for that comments. any other public comment the one if not, we are now ready to move to item number 12 >> 12, action item appointment of health service board committee chairs and members for fiscal year 2016-2017. pres. scott >> there are, under our new i should not say new. it's been were into the second year. the

newly revised terms of governance we have two standing committees at this board. finance and budget. and governance. could you for we have rates and benefits as a separate committee. as i tried to say time and time again, when we deal with the rates and benefits we do so as a committee as a whole. so, after much reflective thought and a great deal of arm twisting, i've come up with the following recommendations for this board's approval. for finance and budget, who has the responsibility for oversight of the financial oversight of our system, including oversight of audits in the budgeting process, requested the following members serve. commissioner sass as chairman, commissioner ferringo as member and commissioner lim as members. for governance,

established to assist in developing and overseeing governance policies and practices of the health services board and its committees, including the board evaluation and the directors evaluation, executive director's evaluation, i asked the following numbers to sir. commissioner breslin as chair. commissioner involves the as number and myself as a member of that committee. i am ready to entertain a motion on this item >> i moved to approve >> moved and seconded. that we establish the committees on finance and budget and their membership as well as governance and its membership. is there any board comment? is there any public comment? seeing none, hearing none,

public comment is closed. all those in favor say, aye opposed? it passes unanimously >>[gavel] >> item 13 discussion item update on the new city plan and kaiser permanente medicare retiree benefits educational session. >> at this point is that are coming, this is where i wish to make my comment. this board undertook to make, take a decision on 21 june two, the board majority, to undertake a new plan. at that time, i said that to the new vendor partner, uh see, we would be having a high degree of accountability and by that i meant that we

would be reporting and discussing this item every board meeting through open in romans and following open enrollment. so, i know the staff over the past month has engage in a great deal of planning and work activity and i want people to be aware of what is going on around the planning and activity of this effort. there is going to be wide ranging series of retiree and other meetings around this topic and i'm encouraging strongly members of this board five, and their schedules to attend one or two of these meetings so we can hear what is going on at a ground level. we are eating going, again, as always, to [inaudible] i may be able to do that trick myself. i'm not sure coming back from a college reunion but i may be able to do that. in any event, my hope is that through all this effort, both communication here during the course of the meetings concerns and issues will surface. we have a very clear commitment from you hc to try to respond to these questions as they come. we can

only note was questions are if people put them forward. but it's equally incumbent upon this board as it has opportunities of the members thereof, we have opportunities to talk to people about this change that we accurately do so. so, that is really my plea and my encouragement as we go through this process. with that, deputy breaks and others >> mitchell griggs. today we have with us from united healthcare shannon hostage account executive of our medicare groups. she is going to give a presentation of the implementation of taking this migration expected migration from the original self-funded city plan coronation of benefit plan and also the members medicare members from blue shield. we have also been

working ever since the decision was made every week the same project manager and team from united healthcare as we did last year bringing the national people ppo with united health to. i think a very strong project management team we have with united healthcare we also brought in kaiser into our meetings with implementation for the educational sessions. with that alternate over to sharon. >> chairman house united healthcare. >> could you pull the microphone down just a bit? there you go >> i have a presentation >> you need to bring it closer to you if you can and talk directly into it. >> okay today i'll be talking about our implementation plan which will focus on retiree communications, educational meetings, as well as how united healthcare plans good so assist hhs responded to retiree

questions. the first slide is the communication overview. i'll start at the top left." across. first, we have the announcement of the plan changes as well as the roman material that with it hhs sent out the retirement benefit guides. that is targeted to be the last week of september. within a few days of that mailing, united healthcare will mail out their 2017 plan guides that will go to all medicare eligible city plans, blue shield members as well as anybody who is turning 65 and aging into medicare in the 2017 plan year. from there, in december following enrollment and after cms approval of the enrollment

retirees can expect to receive their confirmation of enrollment among their id cards as well as a welcome packet from united healthcare. going down to the educational meetings those will begin the last week in september and go through the third week in october. we will be mailing meeting invitations on september 12 which will include all the dates and times for the available meetings. yes? >> dr. dodd >> is commander with united healthcare in kaiser? >> yes to all talk about that on another subject we have more ongoing education so, for now and even after the open enrollment or not will do our reach as needed. currently were teaching in a targeted outreach to those providers we know have not historically accepted the

plan. were doing that proactively. at the meetings, we will have a member provider guide to care flyer. it's a two-sided flyer. one side addresses the retiree on the other side is for the retiree to take to their provider and helps educate them on the plan offering. then, later in the fall, we will send a retiree postcard reminding retirees that they can contact us for help with outreach to their providers to make sure that they'll accept the plan or help them find a provider if they so wish. as of september 6, our call center will be ready to start answering questions on the 2017 plan year. then, as far as the website goes, we are in the process this month to

want some 2017 highlight changes on the website. next slide talks about the educational meeting good we are partnering with kaiser to host 18 in person meetings and five teleconferences to help retirees understand the new plan offering and get any other questions answered. we will have a reservation line that is going to be managed by you hc, so that we can make sure there is enough seating available for those who want to attend and then address any special accommodation needs. while that line is managed by you hc, the messaging on the line is generic or so, that's kaiser members can also call in. then,

we will be tracking the summary of the meetings the attendance and any issues that come up and like you said, report it back to the board. the next slide is a county map of where the meetings will be held. these counties were selected based on the highest retiree populations and then we also added to the budget sheet retirees. the next slide is a calendar of all of the meetings, so this includes the meetings that hhs is also setting up a grade you on an annual base. those meetings are highlighted in blue and all of the non-shaded dates are the ones that we are hosting with kaiser. >> october 10, that is you said san francisco >> correct >> that san francisco

>> south san francisco conference center >> but that's not in san francisco. sma looked at it they might think it's in san francisco. >> you might want to put the word south san francisco >> we will correct that. thank you. then, there are two updates to this calendar since it was published for the board. october 12 the time for the our ecs health care meeting is from 10-12 pm and then hss has added an additional venue on october 19 41 s. van ness health fair from nine-4 pm. the last couple of slides talked about how were going to support hss and also respond to retiree questions. we will create a frequency frequently asked questions document or database so that we can make sure that you hc as

well as ages hss benefits analyst are responding consistently to those retiree questions. we have a uht service account manager we refer to as a sam. they will actually be on-site at hhs the first week in january and if needed longer than that. the sam's are available from 8-5 pacific time monday-friday to answer any escalated questions. >> the same district we e-mail? >> it is e-mail and resource for hss. the retiree can call our customer service line if they don't feel like they got their questions resolved we will contact hss and hss is would refer those calls to us. >> because they're not all e-mail ready? >> no. it's a partnership between ages as of hss and uht. if it's okay >> then, for any questions hhs

as does refer to a sam were committed to respond to those with at least a status and knowledge meant within 24 hours . it's our experience the majority of those issues are resolved within those 24-hour period. again, we will provide reporting to hss twice weekly basis as well as reporting summarize information to the board. as far as retirees, again, retirees should be contacting customer service at first that we do have a dedicated hss san francisco hss phone number for them to call. it's the same phone number that we been utilizing the ppo plan and beginning september 6 they can call in with questions regarding the 2017 plan. they should be able to get most of the questions if not all answered through that long.

again, if there is any need to escalate it or have a deeper high-tech individual service, they can contact each ss and again they would refer those to our sam. new for 27 in, we worked with hss is to implement a standardized template. the benefits analyst will be working with them to implement that process. though complete the form for us which is in your appendix. no e-mail it to the sam's mailbox and go from there. we will also have hard copies available at all of the educational meetings in case retiree does not have time to wait for someone to talk to them one-on-one. we will collect those. we will fill them back at our office and somebody will outreach to that retiree. the lead sam will maintain the log of questions. again, for our reporting purposes. then, we will be

poured back to number and types of questions we are getting to the board. as far as expected questions, it's been our experience that two most common types of questions are, does my provider except the plan and all my prescriptions covered. for the provider questions, we take down the provider information. we compare that against our list of providers who have historically accepted the plan and if they are not on our list will do a knowledge to the provider and educate them on the plan and explain how they can about accessing the plan. once all the research is done we contact the member back and let them know the outcome. >> it's on this point that he was the subject of a meeting between myself and director dodd

and representatives of you hc and brown and tolan and commissioner breslin attending and talking more explicitly about the physicians participating in this plan. it was a commitment made at that meeting that there will be at least monthly, but if it's needed more frequently contact between these two organizations to ensure every brown provider has a clear understanding of what the plan provisions among reimbursements and changes are. so, again, as your reporting back on everything else, we like to hear a report some commentary on how the process is working as well. >> okay. as far as i can thank you. >> thank you >> as far as prescriptions we take up the list of the prescriptions the retiree is taking can we compare that against our formulary list and get them their coverage and

their benefits explain that to impute if there's any need to contact their doctor to get a new prescription we also help with that. then, the last is just again the new template. we are creating. attached again be a one-page template. it split right now between what we consider to be pre-enrollments questions and going four for post in rome and get the top section is just the demographic information of the retiree and again whether the questions provided related or prescription related and going forward, we expect to also have questions concerning claims or authorizations either on the prescription plan or the medical plan. >> all right. thank you for your presentation at either questions from the board? >> i don't know here the one to ask this or not, it came out at one of these meetings that anybody, any doctor that

doesn't take medicare member would not be reimbursed for. that was it was also said that was the same as the present ppo plan present city planned with that is not accurate because presently in the city planned as long as you see a licensed doctor you'll be reimbursed in the medicare level. i talked to eugene about this >> we been extensive research. right now, there are four members who currently seen on medicare providers. were looking at each of those individual cases and determining how best- >> four members >> in the city planted it >> novel city plan. that would be over for medicare, right b1 >> correct but there seen on medicare providers. >> so what is the plan to deal with those. >> were looking at each case individually and working with hss to determine the plan of action for each of those matters. >> because that is what they were promised. going into this that everybody basically it was

if you like your doctor you're still can see him. if that sounds similar to anybody. yes, but that really was not exactly the way it's turning out i don't think. >> right >> let's be accurate. you are following up on it and you have a process and were talking about for instances. correct? >> correct >> one of the underlying themes is that the provider must be must accept medicare >> understand and you're working on it? >> correct >> and you come back and tell us what has resolved or what have you. thank you >> so, if the person has only part b is not outlook >> we do have a part b only. were implementing the second group number if you will go before part of avalon. >> originated city that a and b >> but now we have the two options. if there is city

planned to go into the ppo plan >> if that blue shield to? >> bill going to the ppo or b plan only >> when did this change? >> it's probably been i believe at least a month ago. >> because there's quite a few widows >> i think this point the issue there's a lot of staff work that is going on with the intent of trying to make sure this process and to implement this decision as smoothly as possible. so, as issues arise, i believe the staff is trying to address these things serially. so there might be changes that are happening today, tomorrow and next week and were going to hear about them. again next month. so, i want everybody to be on notice this is when to be a regular part of our process through open enrollment and changes or

new information will arise at each of these meetings. it will be captured fully in the materials that'll be distributed. so nobody will be surprised at the end of the day as to where this came from or what was done. that was our intent from the beginning of the time of making this decision. please, proceed >> any other questions. >> any other questions? >> yes. people not out of the united states they stay on the city plan? >> if they permanently reside outside of the nine states, correct cured they stay on the city plan >> okay. because i told people they have to have their offer and b. that's not right, i guess. okay. then there was some question you said you had a list of 801 providers yet to come along. to fix 800? to fix

it on. that was at the june meeting us about the figure in the minutes to fix that was the target providers. >> how are we doing? >> were doing mailing out regime are doing a phone outreach as well. >> i have something else but is not related to this exactly. to fix if we need to stay on this topic for the moment. >> okay >> i have a question about the item question template on your appendix. that i guess you're the member would fill out if they had a question. >> so, the intent of it is for hss to use it. however, as a special circumstance for the educational meetings we are going to have a hard copy at the meeting. if a retiree can stay together question answered or they don't want to wait to speak to someone they can complete it we will collect those and bring them back to our same to respond back to each

number individual. >> so this is not an ongoing sort of question template. this is people at the time of enrollment stephen >> is ongoing for hss to use so they can refer questions to our sam to do that higher touch service with a member. it is short-term for the educational meetings whether retiring would actually completed >> so hhs hss staff will have eight better bit of instructions about how to fill this out >> correct. reagan about training for them >> you can just list just say brief discovery of december the drug is. with the communication was because a lot of times drugs may be approved for one indication but not for another. all the staff will have the

information is required for this form? >> correct cured today hss us does refer questions to us that it's to create more standardization between the benefits analyst so that we get consistent information coming in. whatever information hss staff they'll put it on the form and usually we take that we research to our ability to a lot of things make in our reach to the member talk to them directly to see the specific concerns are. >> i think that was my concern about the standardization of the information being transferred. there would be less upsetting to the member or enrollee as well as our staff, to know in advance what is going to be required in that box . so that there is not further outreach or questions back to either >> or repetition >> or repetition judge if everyone had the same sort of

destruction this is the minimal amount of data you need in order to cement this form and to make sure the staff has all that cured maybe they do. >> event the question is about coverage or prescription drugs please provide the names of the drugs and the question and the reason they're being prescribed. >> whatever you need in order to make a decision i think, the minimum should be also used the diagnosis and the reason for prescription. one drug for noncovered reason or non-licensed reason and that is your reason for denial than it needs to be stay with the reason really was >> right. we are again doing training with hss that in september so will blow that out a little more sober getting to it >> not to lose sight of the reason. you are trying to get a constant clear stream of information that is somewhat a way you can process it, deal with it and respond to it

>> correct >> that's what were trying to get at here. so, this form after you used it for a while you may decide to come back and modify it, correct? >> correct >> retirees without a and bo how many >> there's about 114 b only people >> without a or b? there are some old-timers still. i don't even know how many are left but there was i guess i would assume stay in the plans? to fix though stay in the current plans. they're not in a medical plan with the blue shield were grandfathered. we call them grandfathered where they would say in the city plan >> you know how many are left? >> it's a very small small number >> would you bring that back so we have that on the record and what your response was if you could let the secretary know. we'll inserted in the minutes in the spot. it's 10, 20 or 30. their plans will not be disturbed. is that what i'm hearing you say? >> that don't have a or b

>> that is correct >> if they don't have a or b. we are on the record date. any other questions from commissioners? >> following commissioner breslin's question would that be communicated also to the members >> butler b only >> without amd is our plan to communicate to those members their coverage will not- >> they still have the option >> right. so, the open in rome at its euros they get applied to plan are eligible for. but we will take an extra step because particularly blue shield extra step and working with them and making sure they understand nothing scorn to change for them >> any other questions? commissioner moon-reynolds >> just a comments. thank you. dr. dodd, thank you for working with high speed about this is the start i think this answers

a lot of questions that were asked during the previous meeting get so, thank you. [inaudible] >> thank you very much. any other questions or comments from commissioners? if you would stand by, there may be public comment that would require your support. is there any public comment? >> thank you commissioners. it has been really wonderful in the interaction that i've had with eu 8c that's in trying to do what we can to our organization to really make this information that distributed to make it work i have a friday deadline for an article with regard to this and i can't remember dodd if you're

writing network i was writing that claimed. >>[laughing] that's what i thought. that's okay. because i written this out so many times >> arms can assign you the electronic version of the flyer. >> yes, thank you >> there is a bit of a shared responsibility >> we are coordinating here, obvious. through news and views are publishing deadline is friday. we are writing up as much as we can. doing two things. one is to put it in our newsletter which will be distributed toward the end of august but i'm also doing an e-mail blast to all of our members so that they get some advanced operation and knowledge because i'm hearing different rumors out there that are people upset as you can imagine. so, either trying to dispel a lot of that and the idea is that members will get an e-mail blast that will tell them what their options are, what they can do and hopefully i will get the customer service

phone number and that sort of thing. really encourage them to go to all the meetings. what we find at a regular meetings for example, are healthier and october many of the members who attend do not have computers or e-mails. they come to our meetings so that our newsletter is really critical. that is how they're getting it's good at about 140 that i personally mailed the newsletter to because they don't have electronic service. so, we are aware of that and working with you 8c with all service, with everyone to make sure that everybody gets as much of the correct information as possible. so i want to thank everybody on all sides for the assistance and also to understand the whatever else we can do to help with this information and will retirees feel comfortable about the information and their options we are here and ready to assist you to, thank you >> thank you for the comment and your offer for supports the work you've done to date. is

there something from kaiser on this point? is there a kaiser represented here? yes? anything you care to offer at this point? on this topic? >> kaiser permanente. i just want to thank hss for allowing us to collaboratively work with united healthcare. it's actually been an enlightening process. it's kind of unique to both vendors on this together but we are coordinating and working so that we can let people know that they do have a choice of kaiser permanente in addition to the blue shield number in addition to that united health to. >> and it's going well? >> so far it's going extremely well, yes. they have been gracious >> thank you. i just want to get that on the record publicly. okay. other public comment

>> i'm sorry for that one could get there are some blue shield people were being referred to specialists that we been told are not accepting not medicare that has some exceptions to that. so i think it's more than just of four people within the city planted think we have to aware of who else might be in blue shield might have special considerations to be addressed and also our big message to all the kaiser people is that nothing changes for them and that kaiser is an option. >> if you have any specifics would you please refer those folks into the staff or follow-up. any other public comment on this item? hearing none, and seeing none, we will move to the next item >> item 14, discussion item report on it work in health plan issues. if any >> commissioner breslin >> i the question for many represented from united healthcare. i talked to jane

perrone the other day about the medicare new plan for pain doctors call the macro and she said she don't say she was going on vacation but i was curiosity is how this going to affect members? was a lot of concern may be a lot of doctors would not take medicare people anymore with this new medicare reimbursement plan. it's complicated. there's a lot of questions and answers. i got 3-4 inquiries >> dr. dodd, can you shed any light on this? >> the macro regulations have not been finalized. i reviewed the comments pacific business group forwarded regarding the regulations. macro is designed to reimburse for quality so that there is a mip fund which is an incentive fund that if you meet certain quality

standard the physicians actually get more money. there have been-i did a literature search after i saw you are e-mail, commissioner breslin, and there've been no articles that have projected that physicians will leave medicare because of macro but it is a new way of financing care that incentivizes quality, not quantity. it probably will likely not be implemented until the middle of next year at the earliest possible and given there were changing presidents, it may not get implemented at all depending on the outcome of the election. this is an initiative that cms has put forward because cms really drives health policy and again, it's about quality. but there's no proje