million and put san francisco in the lead. thank you. >> thank you. next speaker please.

>> next speaker. >> good afternoon. i worked for the city 30 years so i understand the need to be cost effective in everything that we do. since i retired, i've worked in the last four presidential campaigns here in san francisco and on many other campaigns as well. many other current groups that are involved in national politics here in san francisco, i believe this is a very cost effective way for san francisco to proceed insentivizing the state to allocate money. this is a way to get more bang for the buck to go forward in full other funding the system. thank you very much. >> thank you. next speaker, please.

>> i've been to sacramento to talk to the state. it's complex. it will take some time. it's time to start now. thank you for your support. >> thank you. i want to read the final cards that i have in hand and encourage anyone that hasn't spoken to come on -- get in line and we'll bring you up. james, mary ryan, donna, emily levy, pamela smith. jennifer haggy, don curry, david schmidt, ronen k. i can't pronounce the last name. >> good afternoon. my name is catherine baits. i'm a former project manager at a tech company and a resident of

the cast co. ten years ago as an intern, i was tasked with researching improvements we could make to the election system, and in the last ten years, not a lot has changed. this is an incredible opportunity. i really urge you to support fully funding the 40s million to -- $4 million to get this going. >> thank you. come on up. >> thank you. i'm sure you're getting hungry and tired. my name is carly. i'm from the central sunset district, and i'm a volunteer with the california clean money campaign. i think it's a profound and fundamental responsibility of every city, county, state, and our national governmental bodies to make sure that every vote cast is accurately counted. that's at risk because of new technologies, and the response is new technologies. but new means cutting edge means i don't know what's going to happen, all kind of contingency plans. the longer it takes for us to

get started, the longer it will take to secure our electronic system and also the more it's going to cost. looking backward at all the public works projects, we need to do this. we need to do this now. san francisco is uniquely equipped to make this happen. >> great. thank you very much. come on down. >> hi. i'm less other -- lisa hill and i'm a volunteer. i got involved in this because i'm concerned as long as -- along with a lot of my constituents and other friends and just about the corruption of our election system and i am worried a bit about the privacy of corporations coming into count our elections. i love the idea of the open source ballot system and he encourage and hope you'll support the full funding of the program. thank you so much. >> okay. we've got ace washington, chris

hamilton and robert donaldson. i think this is amy -- i can't pronounce the last name. i'm sorry. you're going to have to announce yourself. >> i'm ann harvey. i'm a volunteer with the california clean money campaign and i've been concerned since vote counting was turned over to private for profit corporations with secret systems. i'm really glad you're considering this and please fund it fully. >> thank you. next speaker. >> hi. i'm pamela smith and a voter and mom from san francisco. i support funding for open source for secure and transparent elections. i very much appreciate the work that you all do here. thank you. >> next speaker. >> donna, i'm a former state mediator and we run public sector elections with pen and paper and never had interference

from outside entities. so i urge you to fund this. thank you. >> next speaker. >> hi. i'm david schmidt. i'm a volunteer with the california clean money campaign. i want to say that this is really an urgent matter of ballot security, election security, and national security. so please vote to fully fund the open source paper ballot system. thank you. >> all right. thank you, next speaker. >> don curry. i'm a california clean money volunteer. i'm up here from menlo park. this is just a great idea. go for this. >> all right. thank you. >> next speaker, please. >> hi. i'm emily levy, the director of communications for americans united for democracy, integrity, and transparency in elections. we're a national group doing

work on trying to make elections more transparent, have more integrity and with as much public oversight as pop. i'm heartenedded by the support that i hear from so many people today for open source in san francisco. i'm thrilled of that the city that i grew up in looking at taking the lead on this issue, and i want to support the idea of fully allocating the funds for this project. thank you very much. >> great. thank you. next speaker. >> i'm jennifer haggy, a volunteer with the california clean money campaign. i urge you to support full funding of $4 million for the open source paper ballot voting systems. thanks. >> thank you. next speaker. >> my name is chris hamilton, i'm a volunteer with the california clean money campaign. over here this morning from the are you februarthe -- republic .

>> i'm a member of the open source voting advisory committee to the elections commissions. i urge you to appropriate the $4 million we asked the election commission to ask you for. i think san francisco can be a leader in the nation here and it can succeed where travis county failed by building this project in potions, which is what travis county did not try to do. they abandoned their project because they got rfp submissions for what they tried to commission but not all of them. they threw in the towel. we can build a vote by mail system first. i wanted to mention, as some commenters have mentioned before me, there are already open source election related systems in production in other states, new hampshire has a system called prime three they use.

and colorado had a system built this last year called colorado to outsidity their elections. we already have software for voting for making ballots and we have it for auditing elections. we need the missing middle. that's what i urge san francisco to build. thank you. >> thank you. next speaker. >> hello. my name is mary ryan. i'm a san francisco native and a volunteer with the california clean money campaign. i want to thank you for taking the time this morning to hear about this urgent issue, central to our democracy and he urge you to fully -- i urge you to fully fund an open source paper ballot voting system. thank you. >> thank you. next speaker. >> my name is amy [indiscernible] here from san francisco. i'm here with the california clean money campaign. my heroes. we need for revolutionary san

francisco to take lead to include full funding for open source voting along with paper ballots. open source voting brings the accountable transparency necessary for secure voting system. transparency and secure. our democracy is sacred, and i've seen a lot of reason for concern. we need to protect our democracy. thank you. >> thank you. next speaker. >> ace on the case washington here. i just happened to indirectly fall into city hall and i seen the agenda. i'm here to support open source voting because we -- everybody is getting up here saying this is the city that knows how, a city that's the first and all that. i'm saying this as a parallel. i'm supporting it, but i'm also going to be here at the budget skatole find out if the city knows how, about what a person that looks like me, a black man

in this $10.1 billion budget. you all ask for a little bit. where is it on the budget item anybody that's on the finance committee and that is my primary objective this year is to show a parallel where the city that knows how, but it don't care about people that look like me. you supervisor, although you're the president, i mean, not the president, but you're on that finance committee. my primary objective this year, y'all, is find an item line because may you rest and peace and we've got mark in there. he's smart, but his term is very, very short. i want to know who is in control right here in the city by the bay in san francisco because pretty soon you're going to have to hear what i've got to say was transparency is my objective. when i do my tv shows, it's all about transparency from the room 200 down to the janitor's room here in city hall, y'all, where i call it silly hall.

let this be a message to everybody. ace, i'm going to be there, and i'm supporting this because they need to have transparency on elections. see, i go ba way, way back when they had general elections and the district elections and who else know what they're going to do next. but this is a city that is gone without be being accountable. who is in control of the city that's watching everything? there's nobody. my name is ace, and i -- >> thank you. next speaker, please. >> thank you, my name is roger donaldson i'm here as myself, but i'm also on the san francisco election commission. i think that you've heard a lot of things and i don't want to repeat them, but i want to highlight certain things. one is the slalom report raised

issues and i think that raised the prospect of risk whereas buying this as a proprietary system may reduce the risk, but the risk is to democracy. what we -- so getting the system is something that will improve democracy and the integrity of the election and give us more control and transparency. it's very much worth the investment. furthermore, we heard from the director and that we -- that other such projects have shown -- they're similar projects. furthermore, things like this kind of open source project happened all the time in silicon valley. san francisco is a place this should happen. also, in addition, i want to point out that in 2015, there were rfis put out by the department department of electi. we got many responses from interested vendors. there's a lot of interest behind this, but there needs to be a

commitment to getting it done. there need to be enough of a financial commitment to make sure we maintain momentum. this is fiscally responsible. it is in the long run. this will pay back to san francisco as well as to our democracy. the biggest threat is delay. simply, committing to another $300,000 is a commitment to that delay and that will make this unsuccessful. i would ask you, supervisors, please, what we need is courage and leadership. this is something that may not pay back in the immediate time or in your next election, but it shows your commitment to voting -- >> thank you. next speaker, please. >> hello. i'm a resident of the city, member of clean money campaign as well as invisible sf. i want to call and thank the supervisors for approving in

2014 the $300,000 in supporting the initial study on the open source ballot. this is incredibly important. first meeting i went to, the clean money campaign, they talked about ohio and ohio had debold do the machines. the ceo promised to deliver the 2004 election to the republican party in the state of ohio. there's some rumors that, you know, voters came out of the voting booth voting democrat, and they looked at their battle- ballot and it said republican. they had to go back and change t it's a question of how many voters didn't notice that of. there hasn't been any convictions because the issue is

the system is closed source. so there's nowhere where anybody can check the code. this open source is incredibly important because we can have any programmer check the back code and see that the system is honest, fair, and integral. so, again, i urge the supervisors to approve the $4 million so this is a no-brainer. for $4 million, we're getting $12 million of product. so i would do that any day if somebody came up to me. so i appreciate your time. thank you, supervisors. >> thank you. are there any other members of the public that would like to speak? i'm going to close public comment. all right. public comment is closed. colleagues, i don't know if there's any remarks. supervisor, stefani. >> thank you, chair. i want to thank everyone for coming out today and for their advocacy on this extremely

important issue and for the e-mails i received as well. i agree this is essential to protect our democracy. a learned a great deal from this hearing today and i want to thank you supervisor cohen for shedding light on this issue of how we can make this a reality. i look forward to taking a deeper dive on this and looking how we can partner with our regional -- with counties as well. so i think there's a lot to be learned, a lot more to be learned. it's very complex. so i will be following up with our departments and like i said, this is an extremely important topic, and i do thank everyone for their advocacy on it. it's very necessary. thank you. >> thank you very much. i want to thank everyone that came out to participate in this hearing and thank you for turning out support to the clean money campaign. i think it was very thoughtful and informative. i think this was a good first step for us to continue the momentum and continue to move forward. so with that colleagues, i'm

going to make a motion to file this hearing as heard and as more debate and discussion comes up, we will schedule follow-ups to this particular discussion. all right? thank you very much. is there any other business before this body. >> no further business. >> all right. thank you. okay. don't go too far. i want to gavel down for the next meeting. i would like to call the budget and finance committee, the full committee. if you could exit the chamber quietly, we have more business to take care of. thank you for coming. madam clerk, can you make announcements for this committee meeting? >> please silence cell phones

and electronic devices, completed speaker cards and copies of documents to be included as part of the file submitted to the clerk. thank you. >> thank you very much for powering through. this should be a simple committee meeting. we just have one item. i want to recognize supervisor sheehy has joined us and supervisor yee will you joining us shortly. >> item one, resolution concurring with the controller's certification that services previously approved can be performed a private contractor for a lower cost than similar worked performed by city and county employees. >> excellent. we've got michelle from the controller's office to present to us today. >> good afternoon. i'm from the controller's office. i'm going to speak briefly to

the proposition j before you. they were as stated previously approveapproved and performed by contractors, continued to be more cost effective than at the same services were provided by city workers. in the resolution before you, there are services for contracts related to the san francisco municipal transportation agency, the airport, the port, and the public utilities commission. i'd be happy to answer any questions. >> well, thank you. okay. well, this is a certification that identifies a number of areas where private contractors can do some of our city work for a lower cost than city and county employees. this needless to say is always an ongoing annual controversial issue. this year's prop j certifications include contracts at the airport, at mta, the port, and the puc.

is there anymore detail that you could give us? >> there's no change in the services as approved by this committee in prior years. it's the same on going services and contracts. there are six different kinds of services for the sfmta, four for the airport, two for the port, and one for the puc. >> i'm sorry. just let me interject here. can you talk about the cost savings? >> sure. >> thank you. >> so the analysis shows -- compares the services that are provided through the contract with what it would cost to have similar city staff provide the same service, do the same work. in all of these prop js you'll see there's a certification letter from the controller showing the savings to perform these as contracted services in each of these cases. >> all right. thank you very much. i just want to also -- the record to reflect that we haven't heard from anyone of our

labor partners or labor leaders that would be against or speaking against this certification. so colleagues, i think i just want the record to reflect that. if there are no questions from my colleagues -- thank you very much for your presentation. there's no analyst report on this item. let's go to public comment if there's a member of the public that would like to comment on item 1. seeing none, public comment is closed. supervisor fewer. >> yes. i just have one question. i notice in the report that, in this report here, it says that there is an emergency, i guess, situation justifying purchase of award of a contract. so what constitutes an emergency, we always have a deficit. i just want a brief explanation. >> i can tell you that the language is standard in the resolution. it's been this way for many years. i don't know exactly when it started.

i believe that -- well, i can get you more information if you would like about when that started in this particular language came into being in the resolution. i don't want to speculate about that. >> oh, okay. then next question was, did you ever have a discussion about if we might -- if these departments might look at not contracting this work out, and what it might take for us to actually employ these people into these jobs as the majority of these jobs are entry level positions. >> that, as far as this analysis goes, the controller's office does not look at that. we just compare the contract cost -- what it would cast for the city. the mayor's office might want to speak with that. that's not within the scope of what we provide in our analysis. >> all right. colleagues, seeing that there are no other questions and members on the roster, may i make a recommendation that we approve this with a positive

recommendation? >> madam chair, can we -- excuse me. can we have public comment. >> i did take public comment. >> my apologize. >> i took and there was none. that's why you missed it. i need a second to approve this motion. seconded by supervisor yee. is there any other business before us. >> there's no other business. >> thank you, ladies and gentlemen. we are adjourned. .

>> shop and dine the 49 promotes

loophole businesses and changes residents to do thirds shopping and diane within the 49 square miles of san francisco by supporting local services we help san francisco remain unique and successful where will you shop and dine shop and dine the 49. >> my name is neil the general manager for the book shop here on west portal avenue if san francisco this is a neighborhood bookstore and it is a wonderful neighborhood but it is an interesting community because the residents the neighborhood muni loves the neighborhood it is community and we as a book sincerely we see the same people here the shop all the time and you know to a certain degree this is part of their this is created the neighborhood a place where people come and subcontract it

is in recent years we see a drop off of a lot of bookstores both national chains and neighborhoods by the neighborhood stores where coming you don't want to - one of the great things of san francisco it is neighborhood neighborhood have dentist corrosive are coffeehouses but 2, 3, 4 coffeehouses in month neighborhoods that are on their own- that's this, and you get a

opinion because you can't seem to come to some agreement, and that is certainly i suspect within every health plan's

standards. >> director yant. >> i would just comment that these types of services are relatively new in the marketplace, and there are a number of other programs that are similar to this that are being offered across the country. i learned earlier this week at a workshop that there is some new ways of working with these types of organizations, too. there was a situation with one company who had all of their vendors working together in consultation on particularly challenging cases, and the vendors, the plans themselves worked with the expert opinions where it was deemed appropriate. and so i think that it's kind of an open question now, there's a sensibility among many that there's a place for this type of service. i don't know that any of us have clearly defined how best to utilize it. i share the concern that our members are not knowledgeable and are not accessing it to the

degree that we projected. so i think we could look at this as entering a third year of discovery with this type of vendor service and work with our other plans to see what is appropriate, and how it could work optimally to serve our members. i don't know that we really know yet how this can optimally work. it does seem clear there is a place for it, especially with some of of the more complex diagnosis, people are having high levels of anxiety, perhaps interfering with the recovery or wellness. so, i would recommend we continue to go into it with the eyes wide open and think collectively with others, not just this vendor, but similar services and find out what they have discovered as well. >> president scott: thank you. any other commissioner comments, observations?

is there any -- what is your pleasure? >> make a motion. >> president scott: i'm ready to accept a motion. >> i move that we continue to offer best doctors for plan year 2019 and rate for 2019 plan year. for best doctors. >> president scott: you've heard the motion. a second? properly moved and seconded we accept the recommendation that we continue to offer the best doctors for 2019 plan year for s.f. h.s.s. members, and that we recommend further that that relationship be defined and contracted for 1.15 per member retiree per month for that plan year. is there any further discussion by members of the board? >> i really have a tough time supporting this, but if -- if you do really explore, which i

think we should be doing, why our present vendors, what are they doing for a second opinion, we need to know that. and my, and that's a face-to-face opinion. and dr. follansbee has said before they do. so, why would we need this if they do, and especially if the second opinion is not in that separate group. so, i don't know why we need this, if that's the case. >> president scott: and to add commissioner breslin, i am in absolute concurrence, we were supposed to have done that step before this year, we all know we went through a transition. so, that's what is on the table as far as i'm concerned, that would be a priority that we get a very clear, we all have public presenttations and so forth from the plans around what they do in this area, how they communicated

to the members, is it one of these things that you have to sacrifice your firstborn in order to get the second opinion, or is there more routine process and how does that work, what do we do, so so on and so on. and that's the working mandate if we should endorse it this year. we should not be paying for redundant services, that's why i'm saying if we should discover, all right, here's the range of services that we are getting for the dollar and $0.15, the health plans are providing 80%, it's the other 20% that could be useful and maybe that's the services we contract for, and if best doctors can't provide it, may be provided by another vendor. so, that's the kind of rigor and review that i'm suggesting if we proceed with this in the affirmative. all right. any other comments from the board? >> i think it was foolish to go

ahead and add a million plus to the rates without knowing anything about this sort of thing. >> president scott: i understand. thank you for that comment. all right. any public comments regarding this item? before we take our vote? >> good afternoon, commissioner, retired employees of the city and county. we had several, not very many, members that took advantage of this. in one case, there had been a second or even third opinion within the health plan and the two alternate opinions didn't -- they differed, and the employee, or the member was very confused and not understanding what to do. and when they used the best doctors service, they discovered that there was one more prevailing recommendation with

regard to treatment and some additional tests, and it gave them a great deal of confidence and the outcome was very positive. the other cases involved surgeries and some pretty drastic cancers, and they found that utilizing the best doctor services gave them some additional alternatives which they found again helped them make the kinds of decisions they felt were right for them and so they appreciated it, and i didn't solicit any comments but they came up to me at meetings and said god, i've used this service and what is that doctors thing again, and it was really great, and we are really grateful for it, so please keep it and they were grateful. it's not a lot of members, i understand, but i think what happens is at least in the population that i'm representing, as we get older we have more conditions and we need a little more reassurance, even in using a second opinion. but we are more likely to have

more issues and problems, and i think we also have a number of employees that work in areas where they are more likely exposed to materials that may create some other conditions and i'm going to mention again all of my people who live in an area, certain kinds of materials and conditions they work under that do have the opportunity to bring about very bizarre conditions, i think for a small population they have a remarkable cancer rate and things like that that deserve investigating. this kind of service helps them very much with alternate treatments, or at least to feel the advice they are getting is adequate or is the best that they can get. so, i would strongly support you renew it for another year and i appreciate all the discussion, thank you. >> president scott: thank you. other public comment? yes.

>> my name is diane erlick, and several of our members have also used it and found it useful. i used it last year and i've just opened a new case this year about another condition i was diagnosed with. and i would like to say that both the intake interviews i had last year and the one i just had were far more comprehensive than anyone ever did for me at kaiser, and the closing interview i had the first time i used it, the doctor from the cleaveland clinic, a cardiologist, spent more time with me explaining things than anyone at kaiser ever did, so i would strongly recommend you keep it. and if you do not keep it, if the kaiser members have an opportunity to go at kaiser's expense for a second opinion outside of kaiser, i think it's really important to get another opinion from an insurance company that is not your own, a

dr. representing an insurance company not your own, where they may have a party line. >> president scott: thank you for your comment. any other public comment? hearing and seeing no, we are ready to vote and ask for a roll call vote on this. [roll call vote taken] >> president scott: thank you, the vote is unanimous. with the very clear condition that we conduct the analysis that was described during the course of the discussion. all right. thank you, madam secretary. now at action item four. >> item four, action item, approve delta dental stablization reserve, aon.

>> tom ricks, consultant with aon, and i will keep my remarks brief. don't hesitate to stop me with questions. the first item for the dental program is the stablization review that we do it annually, once we get the claims experience from 2017, per policy. we apply the stablization reserve before moving on to discuss the rating action for 2019. so, this deck is focussed on the stablization reserve for the active dental p.p.o., your only self-funded or flex-funded dental plan. slide two, our recommendation is to apply the stablization policy in this case, would result in $4.2 million amount to be applied to the 2019 rates, to reduce the 2019 budget for the dental program. as all see in a moment, based on the 2017 claims experience,

about $6.3 million of surplus is generated in plan year 2017, to be added to the stablization reserve which helps generate that $4.2 million reserve release plan for 2019. the breakdown of the 2017 year, or the reconciliation is found on the following slide. here when the 2017 rates were set, we were expecting about 4. or $48 million in program costs for the plan, so including administration fees and claims. wa we experienced was $44.9 million, so a surplus. and enrollment increase, resulted in increase in the total contributions collected shown on line four. so, the difference between the increase contributions, as well as the reduction in claims,

resulted in a planned surplus, where we had originally forecasted for the stablization release for plan year 2017, $2.4 million shortfall. we were planning to spend money for the stablization policy, what happened, enrollment went up, claims came down and generated a surplus, so if you compare the real life surplus to the planned stablization reserve release, $5.7 million addition to the balance of stablization reserve. additionally, line six, increase in the contingency reserve, adds to the overall surplus, $6.3 million surplus for plan year 2017 and the active dental p.p.o. on slide four, you'll see the reserve balance. so, the balance as of

december 31, 2016, $9.5 million per policy. one-third of that was allocated to the 2018 plan year rates, $3.1 million. leaving a carry forward balance of $6.4 million. as we discussed 2017 generated surplus, 6,292,000, total stablization of 12,681,000, per stablesation policy, one-third on the 2019 plan year dental rates, or $4.2 million, which will leave $8.4 million to be used in future years per policy. aon's recommendation is that the board applies the $4.2 million to the 2019 rates per policy. >> all right. you've heard the recommendation, are there questions?

>> i guess i have just -- a couple of questions. >> commissioner sass: seems over the years we are increasing the stablization reserve by more than the amount each year we are decreasing using the one-third policy, so the balance keeps growing. in looking at the financial report from pam levin that comes up later, she mentions another $5.4 million increase in the fund balance due to favorable claim experiences, in 2018. so, we are already looking at a larger surplus going into 18 than you are proposing taking out of it. so, if i'm reading this correctly, it sounds as if this stablization reserve will continue to grow year after year by more than we decremented.

and does it make sense -- i know we have departed from the one-third each year with respect to the city plan, but seems like a situation departing from the one-third per year would make more sense than perhaps even for the city plan. so, raise that i want. >> commissioner sass, do you have response to the assertion or assumption that he's making? >> i do. we recognize while we have been planning to spend, overbudget the plan, we have been year after year creating a surplus. we are going to dive more into that, the next deck, the 2019 rating and we have recommendations to both get more aggressive on the budgeting for this plan and effort to reduce this surplus, as well as possible plan enhancements that will benefit members to also spend down the reserves which have grown to be, i think, higher than otherwise we would have. one caution i would say on the

extra spend down in one given year is just to be cognizant of the rebound. so, if you spend a lot of money and you don't have as much the next year, there's going to be a big -- you can cause the rates to fluctuate a lot. so yes, certainly our opinion as well it's spent down to a more reasonable level. >> are there other comments or questions from members of the board? plan enhancements in my experience, also tend to drive up utilization, particularly when they are favorable. so, something to be put in this calculus as well. any other comments from the board? what is your pleasure? ready to entertain a motion. >> i move that 4,227,000, 2017, applied for the delta dental

active employee p.p.o. plan for plan year 2019. >> you have heard the motion. is there a second? >> second. >> president scott: properly moved and seconded we accept the recommendation to approve the rate stablization policy funding of 4.2 million, applied toward a buy-down across all tiers for the next plan year for active employees. any other comments or questions from the board? is there any public comment regarding this item? hearing and seeing no public comment, ready to vote. all those in favor, sig any at this by aye, all those opposed? ayes have it, unanimous. next item, please. >> item five, approve delta dental rates and contributions, aon.

>> hi. tom ricks with aon. >> president scott: tom, give your title. >> assistant vice president and the actuarial team. one of your actuaries for the past several years now. >> president scott: is the title of vice president recent? >> last year. >> president scott: i thought so. congratulation, belatedly. >> thank you. so, this presentation, we are going to walk through all of the dental renewals, not just delta. we will spend a significant amount of time talking about the delta dental active p.p.o., as mentioned in the previous presentation we have several recommendations for plan changes for that plan, and in general, the fully insured plans and retiree plan, fewer items for discussion. if we are going to start on

slide three with the active plan, and as we review the 2017 experience, as we discussed, 2017 generated a significant amount of surplus, added to the prior stablization balance, and before applying any balance to the 2019 rates, stablization had ballooned up to 28% of the 2017 plan costs, fairly large amount of reserve. so, suggesting methodology changes how the rates are set and potential benefit enhancements to benefit the members going into 2019. the next slide has a table of the actual experience for that plan, a lot here, but starting on the left we start with enrollment by month, and what

you are going to see is subscribers and total dependents increasing slightly throughout the year, about 31,000 total employees on this plan, with additional 40,000 members. we then show the rates, the monthly premium budget about $48 million for 2017. and administrative fees, $1.6 million. you paid $43 million in paid claims, which resulted in a 93% paid loss ratio, on an incurred basis, the claims that were incurred and attributed to that plan year, you paid $42.8 million, resulting in 92% loss ratio. so with the stablization balance, we would have planned for a loss ratio in excess of 100%, and what came in was 92,

93. the next slides, slide five, after he shows this is not new to 2017, in fact, 91 to 94% loss ratio for the past several years, and this has generated the stablization reserve. the stablization reserve actually was only established in 2014 for delta dental, so this plan has been generating surplus for quite some time, and the policy put in place to formally amortize that surplus back into the rates. six shows the history of the reserve build-up, so this will show you the starting point of the reserve as of the end of a specific plan year, so in 2013 there was none, the policy did not exist. and then by the end of 2017, the carry forward would be going into the next rating cycle, $8.4 million as we discussed,

and if you look in column d, the last row with the value, what you just approved, $4.2 million to spend in plan year 2019. >> all right. >> i'm going to move on, unless we have questions. but the -- so the surplus is really generated and slide seven by very favorable claims experience. so, over the course of those years, 2013 to 2017, market trend rates are about, between 2.5 and 3.5%. so, much lower than medical, we expect dental to trend closer to normal inflation and you can see on the graph the dark blue line at the top is what was used in forecasting, and the black line below is what you actually saw from an experience perspective per employee per month. so, you can see that you have trended significantly below and even negative trend from 15 to 16, and 16 to 17. so on average cost per member

are going down during those years when we would expect at the very least inflationary. >> president scott: should we construe that people are not using the benefit from this? >> i think we have seen some shift in utilization. i think there's been a lot of efforts to control inflationary price on the dental side. and then we have also seen a population shift, so we have seen between plan 2017 and actual 2017, we saw over 1,000 member increase and that can cause -- >> president scott: are these younger people, older people? >> different utilization patterns. i don't have the exact numbers here for you, but we can bring them back at a future date. we certainly do encourage people to seek appropriate dental care, the message here. >> could i -- yeah, i also am curious about maybe understand this a little better.

certainly one option is that i don't know what share of the dental insurance market delta dental has in the country, but one possibility is that their provider reimbursement is as a control the marketplace and many communities, that they have also maybe are not reimbursing providers at an inflationary, you know, increase or something, and that would show up as well, i would think. if their provider reimbursement has either diminished or not increased. curious to know a little more about why this has happened and how, you know, not because equipment or devices are cheaper in the dental offices, i don't think. fancier x-rays, etc.>> yep. so, we can certainly do more research and bring that back to you. i'm sure there's many factors, but we will seek to isolate them. >> i have a question, too. the employee rate, 64-51, where

did that figure come from. actually, the employee, pays -- >> that's the total budget premium, not what employees are charged in terms of contributions, but the budget rate. so that, is what we set and you approve in these presentations. >> i'm looking at what the book says for 2018, what they were charging. so, total employee and employer rate, 5358, plus $4.62, the employees' share. that would not add up to $64.61. >> focussed on 17, so if you compare the 18 rates, i believe we had reduction. >> this is 2017? >> reviewing the 2017 experience. >> sorry, i didn't hear you say that. >> the rates in the book of biweekly, tom is reviewing monthly rates. >> right, right, i'm reading off monthly rates.

>> have we clarified the question, commissioner breslin? >> i'm sorry, i looked at the wrong year. >> ok, i want to be sure we are on the same page. please proceed. >> so, recognizing that we have a significant stablization balance built and that trends have historically been below ex peck addition, going into 2019, mike and i feel strongly that we should be a bit more aggressive with the budgeting, recognizing if things do rebound, we have the stablization to fall back on. and with that in mind, the annual trend down from 3% to 2%, so we want to recognize lower trends but still expect some reversion to the norm at some point. as well as eliminating pricing margin. so, in the past, some pricing margin has been used to absorb

adverse deviations from plan, what we are seeing is favorable deviation, so the margin compounds the favorable deviation, if you will. so -- >> so that element of risk in th calculation could be backed up, if you had some significant deviation, formally attributed to pricing margin or adverse to the plan, we could take it out of the stablization. >> come out of stablization. but in general, there is a lot less risk on the dental than on the medical, the benefit is capped. >> right. >> wouldn't hit the benefit cap, that's it. those are our recommended changes to the methodology of the budget setting, in order to help spend down the stablization while maintaining a, you know, smooth budget process. >> and you are now on page nine? >> moving to page nine, where we

are going to go through, our recommend -- same active delta p.p.o. in the course of the reviewing, reviewing of the plan as well as the renewal with delta dental, discussions with the staff, we want to recommend several programs. the first of which is called the smile way program. this ahouse members with specific chronic conditions such as diabetes, heart disease, rheumatoid arthritis, stroke, hiv, to receive additional services and so the goal is to make sure the plan is providing adequate oral health for these folks where they condition may require additional services. >> and how would that benefit the access by the member? would it be their doctor recommending to the dentist, is that -- how with it work? >> my understanding