is allowed three minutes to comment unless the board president deems new time limits. concerning the item presented. a caller may ask questio the policy body. the health service board welcomes up to comment for each item. those with accommodation due to disability will the 30 minutes. you can dial in calling 1. press pound. you are prompted to enter the 1145 and pound again. press star 3 to be added to the prompt, you have raised your hand to ask a questionsystem message says your line is unmuted this is yourmuted when your time is expired. for bex click on the raise

hand icon. a raise hand will appear when you are unmuted request to please select unmute to speak. once your welcome caller you can begin speaking. members of the public are encouraged to state their name you may remain anonymous. i will give a audible warning when you have 30 seconds maining. we want to thank sfgovtv and medi with the public. public comment. any comments to future agenda items or general public comment. rnoon commissioners. director yant.tive and retired firefighters and spouses.m here today as a 50 year member of the system and a 35 year commission meet shz. as i look around this room, i only see commissioner zvanski and institutional knowledge of this so, to have watched one of the most respected boards lose all its was a very sad

day for me.see the optuse treatment of the appointed members of this disappointing. when the attendees became emotional because of they were allowed, you called the the history of blue shield is one of bate how is it possible same coverage as united healthcare, but i witell you-- deny treatment, or both. it is history is any indication which we will be back here to ask for adjustments on have done it before, they will do it again.in the city budget before it was even by this board and then to watc the appointed commissioners twist themselves into pretzels to get the mayor wanted, emoval by the mayor of one of the knowledgeable,

and respected commissioners who did this very disinheartening. you toyou do not meet demands of this mayor. board has shown it lf is to be nothing more then a politi the city. rather then the independent commission it was created when blue shield returns here asking for more, i hope you was said today and that the membership thank you. >> any other members can approach as reminder this is general public comment. we have a item specifically for the blue shield plan. >> protect our benefits. i'll just say, ditto to i where don't want to stay up here and just say the feelings are echoed by not only coalition with recc, cara, aldifferent senior advocacy groups, they all feel the same. the disruptions g. a member will call intoday on

he got as of august 15, it no longer be available to him. complement the staff and the chief operating officer. he individual and he didn't have answer for him, but said he would look into it, so the staff istheir jobs and i'm still the staff here. thank you. >> >> i'm not sure in- >> talk the microphone. >> if we are talking about united healthcare and the switch to blue shield. >> this is general public a specific agenda item- >> nu. >> so, the earlier were just- >> the earlier comments had those in them. if you had a blue shield the opportunity is on item 12. be back. thank you. >> hi. because i don't know if i catill

that agenda to speak to the switch. i am surks d teacher and are taught in the district 29 in the hardest schools where you now cant get teachers, and when i retired got united healthcare and the healthcare eligible for improved dramatically and my copays was able to see doctors i wasn't e when i was working and had blue shield and and disappointed and outraged at the pro moving this contract over to blue shield. thank you. >> thank you. no one else approached to the to the remote public comment and the moderator will notify at this time. >> board secretary, we have 9 callers zero callers entered the public comment queue at this time. hearing no further callers, public comment is now closed. >> thank you. agenda item 4, p >> item 4, approval with possible modification of the minutes of this is action item and will be presented by

those minutes include the june 7 meeting, the june regular we have three sets of meetings before us and i welcome any feedback or corrections you may have noted. move approval of the three minutes june 7, june 18 meetings. moved and seconded and we'll take public comment these items. [providing instructions for public comment] no one approached the podium and move and the moderator will notify of callers in the queue is time. >> board secretary, we have 8 callers on the zero callers entered the queue at this time. comment is now closed. >> alright.

vote, please. [roll call] >> i am going to pass since i was not attending but abstain. these minutes are passed. agenda item. >> item 5, election of health service board committees. this is action item and will be hao. >> well, we have come to that time of the year set up new standing committees board, so i would like to nominate thboard for the following committees. for like to nominate vice presidchair of the committee, and she be joined by commissioner wilson me and for the finance budget committee i like to nominate commissioner sass joined by commissioner cremen and howard.motion on the table and

open for discussion. no objections or entertain a second. >> so moved. second. we'll take public comment on [providing instructions for public comment] move to remote public comment and the moderator will notify of callers the queue. >> the phone line, zero callers entered the queue at this time. hearing no caller, public comment is thank you. we'll take roll call vote, please. >> thank you. and thank you for your upcoming committees. we'll take

>> item 6, president's report. and presented by president hao. the new fiscal year and new cycle of our board meet we will soon find thinking about for plan year 2026. we just closed out a where there were some changes to our pl know that has caused some concern, le to work through those with the staff and to alleviate any concerns yoard. but we look forward to and to that will look like in the upcoming year. and happy to take public comment. s [providing instructions for public comment] we'll begin with in person public comment. no one approachedremote public comment and our moderator will notify of any at

this timew>. >> board secretary, we have 9 the phone line, zero callers entered the queue. hearing no callers, public comment is now closed. >> than and agenda item 7, please. >> item 7, directorn item and will be presented by sfhss executive director abby yant. >> thank you. good afternoon commissioners. i just wanted to acknowledge as we all know the and benefits got full approval at the board the second reading, so we are proceedingwith our implementation plan which gets a snapshot on the agenda. note of equity inclusion update luteesha harris provides ting august is transjnder history month. honey mahogany is appointed as the new initiative and welcome her on board to continue the great work that has begun. the la agreement. we did move off the first the wellbeing center, and located eap and wellbeing to

the second floor the 1145 building we occupy and so that's pretty like all good construction projects has a solid 5 to get completed, but we have a great ody is proceeding as the healthcare affordability board and advithe state level continues to grapple with the with on the local basis the cost of ary care subs and behavioral health and work is monumental, so i just would like you to know it will have impact over time with the work we here locally. i do want welcome on board here today-chow who joined the fina >> welcome. >> we continue to enjoy our homan resources department personnel officer and helps us fill really pleased to contin rate low. we have some turn-over. the majority opportunity to promote within the city, stow it is a them and

then it does require a staff. much of the other report, i wto the operations dashboard really--the tool itself really developed s you a good snapshot in of how operations has really their services and continues to do so as r open enrollment that will be quite busy with the plan change retiree medicare product. big part that, so we got method for monitoring and tracking the our call center and we'll talk more about how our coordinates with blue shield call we are actually in a soft launch now the systems. d us with the activities on the month. that has really grown over the i know commissioner howard and i just spoke earlier today about the great mental health services that for the

public safety department is really taken services are available, our members are using them, difficult, but it continues and we get our enjoy the mental health services provided by health plans. i think that's all i the director's report. i can take >> we do have well for us, loud. it is coming through out e public via webex and sfgovtv but i'm guessing the crowd might need us to speak a little closer while the air is on. thank you. >> we can't hear each other. >> okay, yeah. like a efficient ac system so thank you. but, executive director yant, i want mend you and the staff for improvement in i recognize data doesn't always tell the stor the calls and other things and so, but i do want point out that appreciate the improvement and members. >> absolutely. >> any other questions or

comments about t for director yant? >> [indiscernible] >> alright. we'll take public comment. thank you. viding instructions for public we'll begin with in person public comment and no one apremote public comment and our moderator will notify of any e queue at this time. have 8 callers on the phone line, zero public comment queue at this time. >> thank you modera public comment is now closed. >> th next agenda item pleaseism >> 8, sfhss financial report as of may 31, 2024.ion item and presented by iftikhar hussain, sfhss chief

let's make sure your mic >> can you hear me okay? too loud >> alright. the cfo for hss. happy to report the trust month of the year look good. uptake in claims, which seasonal and consistent, but what we saw last year. this month, we added last year's data for comparison and you ar activity was with last years. but what are in a good place. we think about the the year there is drop of $5.3 million, which is built into the rates a $14.9 million stabilization which would have dropped the ba the pharmacy [indiscernible] gone up, 5.2, the highest we had, rates. the sustainability fund net increase because we reimbursed for activi last year, so the reimbursement came in this year and increased. to be ahead of plan and we had er

that we would come in ahead of year, so we will exceed the primary variance remains due to vacancies now filled. and then the au are ongoing. we have mgo looking at e and we are in the year-end close process and they will do and we'll present their results in november at the happy to answer any questions on the financial's. >> thanyour report. i have a quick question. claims are seasonal, is there a particular reason for that or just that is the trend we experienced? >> that is we experienced. i think the claims 45 days-paid 45 days late, so i think this is through. >> okay. thank you for the cl pardon me? >> thank you for the cl >> sure. >> any other questions or comments by board members? alright. thank you for your very thorough report.public comment. [providing instructions for public comment which

the screen] zç we'll person public comment and no one approached the podium. we'land our moderator will notify of any callers in is time. >> board secretary, we have 9 callers ro callers enter the queue at this time. >> thank you moderator.blic comment is now closed. next agenda item, please. 9, dependent eligibili 2024 update. this is a andprinted by olgaation manager with sfhss. >> good afternoon commissioners. ho wonderful. operation health service system. i'm excited to share to results of the 2024 dependent eligibility conducted earlier this year. before we jump into the deto highlight a few of the this year we audited

active employee members with a dependent population of 2127. we had very successful completion rate compliance rate percent, with the financial $417 thousand on a annual basis for terminof ineligible dependents.eligibility verification audit is dependents that are covered for health and dental benefit. it industry standard among health plans in to insure that benefits are only eligible dependents. the re reduce the cost re and insure sustainability in pre board and the coverage of people who are not eligible for health benefits provides a financial risk to administration and a little bit of hithe dependent eligibility audit

conducted by the health audit conducted in 2018 with ll population of the system retirees and active members because of the size of the population the audit was conducted by vendor. there were some ically around consistency of verification documents that could the members in compliance, and so learned from the 2018 audit, when we chose e audit in 2022 be internal audit, we had a lot of research done the standard practices among other entities who deva to evaluate what kind of collect for continued eligibility and that was in the 2 we had population of retirees audited, only spouses and domestic partners were included population so 1 to 1 ratio of members to dependents and we a pretty successful completion rate there as well, 97 percent passed the audit. i believe only 19 ed due to ineligibility

at the time. now, taking again from the previous in-house audit we lessens to the 2024 population with the active employees. however, here we did include so you can see that that and their dependents have increased so we are looking at over 2,000 udited. taking a look at frame in terms of the communications we sent out to our members, we had a pretty robust ng our members on their requirement to comply, and the pathways to comply. with our first to our members, we their dependents were going to be what documentation they can provide to with the audit, and the pathways to be able to do this so a robust communication do members audited throughout the compliance period, which was april 1 30, we also sent additional letters to our first, those who attempted to but

maybe sent an ineligible wrong document. via mail and let them know what is missing to meet compliance.to engage at all by mid-point of the dit we sent a reminder letter rate of compliance for those members. audit after everything was we communicated through disposition were successful or let them know their dependents would have the we wanted to make sure all notice requirements were met.have three groups of that were being informed. the happy pass and let them know ents continue to remain eligible for those who failed to comply for any their dependents, they were notified those dependents would be terminated anthe termination and then the third category where it was ere they complied for some dependents and not others and we those who they

complied for the population of members failed to comply with the verifications for their dependents, we also sent an e-mail communication and that kind of spiked more compliance our membership. and here you'll see, we tried to ssible with this really all our deva communication team to encouragcomply, because making sure they were mply not just because the dependents were eligible, because they are actually comp well was really important to insure we are maintaining eligibility coverage for the dependents who are actually eligible. and the this audit is very much a le divisions of the health service system. the communication team was invopment of the letters, the education materials for our members, the of our website resources that educate them how to comply and the

we included a list of communications along with posting them on our website and providing our members samples of the type of documents s they need to provide in order for them to with the compliance process.also was very much involved in making sure for the disposition we are communications with members were timely. our enterprise and analytic team did a lot of work within our systems we were able to complete the audit out the e-benefit platform for our insuring we were able to keep track our compliant members within the sales force systation between the people soft system and our cument management system where we were able to view the documents provided by our a lot of behind the scenes planning, lot of implementation of system changes, and we did a great job in being able to m what

member services needed in order the support of communications and our enterprise analytical team. to some of the results. as we can see, we audited different populations here, children for children members were provide a birth certificate. for a spouse, provide their federal income tax returns for year specthey were filing taxes or separately dependent on the situation and also the population of registered domestic partners audit and that split population where there were some partners claimed as irs qualified e member was required to provide income ta 23 year indicating the dependentancy. for registered domestic partners who were not claimed ndent, members were provided a list of other documents that d provide as verification that

>> do you also ification of for example, adult children who remain dependents? >> that is adult dependent student were excluded along with unified >> you require documentation >> that is correct and the audit is forthcoming. ciate it. >> of course. and we had a really rate or response rate among our during the early part of the a really good sign we are going to get to the high percent of compliance. as you the data was pulled after the compliance period, dependents were terminated r ineligibility, which is that 5 percent of the population audited. jump to the construct of the way supported or conducted this audit. we dedicated benefit

analysts that the over 1400 documents that weby our members. they were also dedicated to specific deva phone queue we had set up for our members, who were calling support on compliance. we had one dedicated to this project to insure the docu was available, the training were available to insure any escalated issues wo as you see here, a lot of our members lying through the e-benefit portal, 77 percent,b great. we took a lot of time to develop that pathwa it was a resource heavily utilized.y enough, i did a look at our 2022 data, the only 25 percent of in the 20 audit period. we still have a ways to go that full utilization of the portal. one thing i also want to did this parallel approach with inthe children we were auditing were going remain eligible, because most likely

they would be and would be providing would be their birth certificate, the parent relationship wasn't dpoeing to be changing. al among the audited population, we our child dependents. this was a very manual process document retention system and of those all most identified as having complied already, so that allowed us to high number of child with now i'll jump into financial results we see across three in 2018, 2022, and this year in 2024see, the annual savings for ineligible and overall savings for those terminated for ineligibility is quon a before i conclude, i wanted to address a fthe lessens learned and the challenges that we experienced of course, making sure members

are is happening was one of the challenges.t of folks did feel this was with any to be that sense of feeling like they-it being something wrong, which technically this absolutely wato address that by identifying that all of our ing audited and that the consistency in thwas going to be applied to all of secure that trust that no one is sing the other part of it is that, as you can see, the populations audited we in order for us to increase the volume of on a annual basis will require additional strategy whether the audit next internally or with support of external vendors. for lessens learned what we used across and 24 is uments. that really helped out not just the verifications received, but also fwr the members knthose documents

that are going to ce and they knew everyone else was going to be provide those documents as well. and so as far of are still evaluating how we can proceed these audits going forward, the capacity we internally or externally and what that population is going toas a note, the general for those members who terminated and potentially second level apbe coming. the next couple slides e just general in the appendix are much in depth information for you on the the different populations and their compliance within each of d also the type of communications we sent out and the volume of communication we sent out. be happy to questions. >> thank you. thanks for the on. any questions? >> i for the ones-i'm just looking at where you have

people is there any follow-up that is done with phone caor any other efforts to get their attention and get someresponse from them? >> yes, we had a members. for those who had not responded &l of the compliance period, so middle april, we sent them a for those who also failed to respond by the end of e-mail. what we really did with this still--we are doing it as a pilot to see s best, for those members who ended up complying compliance period, even after the termination during period, as long as they complied and insured we continue their is three months of communications, and a opportunity toable to comply. >> okay, that's a lot of work. >> kudos to the staff for following through. >> thank y >> really very tedious and i is now retired, we behalf of my colleagues, i apologize appreciate

the tenacity of the staff and also what it means to our system; what some don't realize is that real dollars, so sometimes it is saved dollars, and need to be spent for dependents who services and somebody drops the ball, so there is a lot of d. thank you very much. >> thank you. i have a couple questions too. how did you select the 985? how many appeals have you received? >> the 985 actuall with a thousand. up reducing due to things like that by the time we sent out the letters. y in january, letters weresent out so there was some discrepancy. the way the membe identified was through identifying all active members and went with the last digit of the and selected a sample of those who met sand mark. and in terms ofi

believe-- >>afternoon commissioners. if a member responded after the deadlines or afte dependents were initially terminated, as to verify the dependents we so no appeals were necessary from that group.believe we received 8 appeals from members that with the audit. a number of those included appeals for spouses that ated because they are not filing taxes as a so, as olga mentioned, and i believe it there er situation where the dependent acceptable documeas olga mentioned, those appe if the member decides to proceed with the second level appeal will be making to this board probably very small number compared to the towas audited. >> i want to commend you and thank you y you have worked with the members they-even

though they were late, that their coverage continued. >> very helpful. >> yes. >> it also means a lot of usphone calls. [laughter brash that is a lot of work. >> alright. any other questions or comments? so, let's go ahead public comment. [providing instructions for comment which is displayed on the screen] >> board secretary, we have 9 callers on the callers entered the queue at this time. >> thank mment is now closed. >> thank yoitem, please. >> item health insurance portability and a training 2024 year.

discussion item and will be presented by rin coleridge, sfhss enterprise system and analytics.get a break do you rin? >> sorry? >> it happens. good afternoon. rin coleridge director of enterprise system and the role of the hippy e doing our annual training today, and today for efit of new commissioners, we are going to revisit high and for our ongoing annual training also do a quicfor 2024. so, let's start by talking about so, it is actually comprised a bunch of different rule jz the key ones are security rule and notification rules. at trying to protect privacy for patients around and around protected health information and we'll pget intodefine that. and there is penalities

the privacy rules gives a array of rights what patients or the individual have control over th it also defines for the rest of us thcan use that information so that it is protected and for us hss, we are allowed phi for treatment, payment and operations. there is also the security rumore if you think on the system it side. it lays out rules to be held accountable physical controls, technical controls. we are making sure we are checking the integrity of the information and information stays confidential. putting guardrails and also allowing it to move. it is trying balance again between protecting information and allowing it forward and just so you know, to our subscriber and members and the their hipaa rights as well and deceased ndents also covered

under hipaa.because someone may not be with us doesn't mean weapply the hipaa guidance for those individuals. it applies to medicaldanter prescription drug, long-term health and flexible spending accounts. see what hipaa is not. is actually never limitation on the individual who is the subject of the informmember wants their own information, they are absolutely allowed to do that. i think what is a important note is that it is ily applicable to em agencies educational institution or law enforcement and so, wlaut le to is something we call, covered a cover entities could be healthcare provider so i think you understand that. it could healthcare clearinghouse so that might be things like a maybe doing repricing or doing billing item in that area is health plans and this is th the health service system falls

undea covered entity. our reve restrictions around sharing phi with the t likewise, i think about experiences in my time work with other departments and we might help with long-term disability claim and i hear people that is under hipaa, we cant give it to you.a couple reasons, one you see hipaa is not in a later bullet point, but insurance doesn't necessarily come under hipaa guidance ing is, the actual that information is a covered entity. not all covered entities. certainly when we public no-brainer, public entity. those are distinctions have to consider, but we are covered entity. >> covered entities can communicate with each other and share the informateaking and if is third party business associate agreements and there are legal framework how we were able to

then >> okay. thank you. >> the other times you can potentiainformation with the third party is if that individu request it. on our website, there are forms 69 atio information shared with this other third party. er? >> that's right. >> it has to be documented. >> absolutely. it is reviewed and we have a flow around that. let's continue to talk about what hipaa sometimes it may not apply to pharmaceutical companies. pharma is not a certainly if they are doing maybe some where it is involving patients and otof the constructs but as a general rule, they not hipaa. it is again this what i really wanted to call out, does not apply disability, worker comp, accident or life insurance. the other becoming prevalent is around wearable health technology. i got things, and people with their phones and their so, maybe in maybe

out. i think it is a education point for members. if the company providing the app or wearable technology is working directly as a business associate for plan, maybe you see this if it is a your provider sent you home with the monitor so you wear that and may be provided by a whole other company, but in that under it. if it's is like, track your sleep or twrack and just a tech company doing that and you are tracking is not necessarily a hipaa thing so that is how certainly, if you take your own data you are tracking and thethe healthcare provider and say hey, look at nowthalities that's with the healthcare back into hipaa land. let's take a look at next slide. >> interesting. >> let's exactly what information is protected. so, this use, phi, protected sometimes people say personal health information. the identifier. this is something that makes le and if you go appendix you see 18

identifiers. data that is phi land. you may dealing with informatiohave a individual identifier, but if there is you can identify who we are talking about, that phi. here is a example, maybe i say mayor has x, the mayor of san francisco has x.think some person jumped into your head now. as you can i never gave names, didn't give al security numbers, i gave no individual identifier but there is a reasonable know how who i'm talking about. when you are dealing think from that perspective as well. you take verifier and with history. again, it is either created or received by a list of things there that i necessarily list, but-and it relates to present or future physical or keep that in mind +?

that's what protective health information is.ing in mind, even though you might see in the list it is create received by and might see life insuring and i had previously said, they were oen not these things slide. because we get back the covered entity.tions that deal with health to the regulations under hipaa and that is d entity piece. let'about you. you and your as commissioners of course might receive and second level appeals and so as part of this process you amount of protected health informati all tend to receive communication from the member outside the appeals process and may contain phi. it is up to the member what they want to do their information. if they want to communicate it to you, by al now that you received it and you are part of the under hipaa requirements how you treat we like to comply with the

cessary requirement. it is a easy mantra to get you out of things you shouldn't, so what that looks like is minimum as necessary. if you dont need it, don't save it if you are trying to resolve some sort odon't need somethe information very restrictive required for the matter at hand for answering the question for whatever the issu that is always a really good guideline for that. with hipaa is you deidentify it.not having it meet that phi definitiy identifiable with the health information, which essentially in the appendix are gon identified so it isn't phi, not individually identifiable. there size of the geographic region like the n only be the first 3 digits. is how aggregate sometime youz have to keep the nrfshz. if we go wrong, there are fines.i won't

read all of these on here.u can see there's a little chart that goes green, which is still penality, doesn't mean good, but the lower penality, versus th higher penality and the variability with how the fines is neglect and timeliness remediating the issue. there are criminal penalities that could also apply and other consequences we have ating hipaa.s, restitution and termination. also, if we ever have a impacts more then 500 individuals within our area we also have to media outlets. i think you have seen some pop up so we doing our best not to be one of also reported to health and human report to california state attorney general office. all sort of ing thes we done want to get there. let's talk this is a integral component of hipaa when we talked about and also when we ful neglect. we should be able to address the things

a lot of actors doing things with phishing e-mail good people hacking into various organizations. we know we shouldn't be sharing pulse words. shouldn't reply to an e-mail that says you right away. in the past we had breaches one of our vendors. we absolutely have. you can see that in the news about the different organizations impacted. heth care which is part of uhc and of all americans. more recent threat act but realized they were out of in the website and that information was shared with third having your trackers is sort of a common tool to help taylor that impacted 13.4 million individuals so happening every day. i don't want to say on like i'm testing fate. let me knock on wood. we have not incurred a breach, we

remain vigilant and you are part that. here is resources for you all. we got annual cybersecurity training and health service board secretary will so there is-teos online to give tips and tricks how you cattle bit more informed about what to do and what not to do, because generally link continues to be us humans. if you are ever in doubt, feel up the phone, privacy officer as a other people. it is always best to ask and complying with minimum necessary a very easy way to limit the information getting out there.usage standards, and the reason we provide you computers is keep us more secure so you don't have information go your personal machines et cetera, et cetera.ly members may be using or leave we also information gets left on network drives.have multi-factor authentication set up and never g-in credentials so easy items.

we put resoon sfhss.org. i got the url in the deck, but you can type in data breach in the search site up for you, but this is to help educate our members about how you ll as a individual, and also helps all of another resource you may able health human service has of stuff on their website related to hipaa. of course our annual hipaa training and using your city e-mail account for any of your here we do as part of th covered entity so again we got the information locked down an security around our government tenant for e-mails so that reason we ask you to use our system and resources. let's finally take a look what is new for 2024. just the one. it was announced in april by said harris administration.n. put

into place to support repr healthcare and so, i won't read all these to you in the interest of time, but again, protect some of those reproductive rights.in the appendix the language of if you have any questions i can take e now. >> thank you. thank our annual refresher, and t to our new commissioners. e to really thank you. this was a lovey and plain spoken presentation, because ung up in technoghtful and really appreciated it. >> thank you very much oner wilson. >> thank you. any other questions? if we have questions we can ll back up. lpth. if not, this item. thank you and thank you again. roviding instructions for public comment which are displayed the screen]

we'll begin with in person public pode im and move to remote public comment and s in the queue at this time. there are 9 callers on the phone line, the queue at this time. >> thank you moderator.callers, public comment is closed. >> thank you.a 10 minute break. we will see you at 2:20. please be diligent and return to be respectful of those who are attending g remotely so they are not lingering and waiting for us.10 inutes. [meeting reconvened]

>> welcome back and thank 10 minute break, being so diligent with we'll take a quick roll call. >> roll call úgwith president hao, present. commissioner cremens, present. supervisor dorsey, present. commissioner sass, here. >> thank you. we will take item 11, please. 11, sfhss annual benefit contracts market evaluation this is discussion andprinted by ger michael visconti. >> welcome. thank you president hao. michaelmanager for the san th service system. today we'll present on the annual bene market evaluation as well as our announcement of are planning for

life and disability. this presentation will be i will begin going through our current plans purview, we approach to assessing the individual plans which ear but a more ernest way this year between annual renewal process and then a recap of the powerful tools with and we use to insure our excellent benefits and are sustainable year over year. after that, we will announce in the fall which is life and disability benefit and transition to my partner mike clarke from aon the history of voluntary life and employer paid basic life sability benefits as well as the y benefits currently available through the partnership.rating actions, go through trends and issue the life and disability rfp later this year.rfp would be for the 2026

plan year as wetened this time of year, conclude them in the in time and in line with the rates and benefits process. so, again, these contracts are under francisco health service system. these are our benefits for dental, of course health benefits for the population and t jz we'll go through each of them as each year we do assess board and whether or not we believe it is brudant etitive bid now each year we present during the rates and benefit a5 rates and the benefits. there are approximately 27 minute plans medical, dental and vision and numerous life and certificates through partnerships primarily with ford and one with manhattan life. through each of

the benefits presented here and walk believe it is prudent to engage year for basic life and insurance and selected rmined that at this time an rmpetitive bid is best assessed for future plan years for the other benefits and we'll walk through each as we go through this. so, i menting that this process is done by the executive hss, our managers, our and actuary as aon through the year and the interim period. we do more targeted markeg this period of time andprint present to the board whether we competitive bid such as rfp like a rfi may be warranted. of co for these benefits we announce that to the coming months we analyze what that scope willthe rfp, narrow the scope down, and ultimatelyprint esent to the board on what the final scope will be in advance of issuing a the

rfp, a black-out period no inappropriate communications during that time have a transparent and above board process for we present the results to this board. as many know you worked in the city the difference between rfp and rfi but it is it as refresher. they are powerful tools. used a rfi is in a lead-up of both competitive the ac again. if any reason let me know and i'll speak up. the last time we in a rfi is was 2021. this ocess and broad forward looking. it is still a formal pro thankfully only takes 2 to 3 months for us. the responses to there is no requirement to subm may be submitted, and again, it can future competitive bid or rfp by helping narrow down the scope or deterout to insure a competitive request

a rfp are narrowly tailored. they take 6 to 9 months. it is at aon and our management executive team.ory that rfp responses this is fees, premiums, any other costs associated underlying benefits. we have a detailed comprehensive with evaluation panel and recommendation to the board. so for those who are not on our board when we last major commercial rfp, the follow slide is summary of process that to any determination to conduct a competitive bid.commercial rfp released in 2020, we began ernest in 2017. there were presentations assessments and private evaluations by us and the team additional plan offerings that may be beneficial to our members.to improve on rebate share percentages. evaluate the fees premium guarantees and reporting for our then current benefits.early

part of 2020, we the self-funded ppo and flex funded hmo plprudent to conduct competitive bid and conducted discuss what we were ideally hoping to gain from and what our research told us would be likely result. the benefit that was, result to us and members. we expanded nefit offerings offering the helt care in 2022. the population doubled all most every partnership with remains strong with health net canopy care hmo team. we achieved a prescription drug rebate share and we 25 percent. we also increased nchmarking across all the plans as we made that a requirement and finally, we had a very successful ve ppo administration at that time to the blue shield team. as we go into shortly, our for our life and long-term disability with end of

december 31, 2025 sue a competitive bid for those benefits plan year. do assess our benefits and i like to go one before transitioning over to mark cle rational for the rfp. we assessed our dental ants. both have either a rate lock or a rate cap for that expires at the end of 26. for that reason, we are going to assess both fits for potential rfp for the 2027 plan year. such an rfp would be disc of the board august next year and rfp those benefits would not be released until months from now. again, we have time the underlying reaswe are considering this assessment at this time.conduct early renewal next year in july and august of 2025, rather then november and december with renewal

request letters. we may issue request for information as we did in 2021us the opportunity to narrow the scope of p's, to determine what are important well as to determine the potential respondents to insure a rocess. care advantage as you are well aware, we just completed process for the 25 plan year. we are going implementation process at blue shield or medicare team g accessment and reporting to the board throughout the process and into next year for the kaiser hmo and senior advantage plans, unique staff model, was mpetitive pricing gained through the expert negotiations of partners at aon made it determine it rfp for the 2026 plan year for kaiser hmo or kaiser senior advantage benefit.the dental benefit, we determined that this very stable and enrollment

of approximately 1900 individuals and e annual renewals as well have made it nop for this population either.is our flexible spending ap count and administration agreement, we had a high degree of market comp titian in the space and considering a rfi in 2025 to determ bid or rfp would be prudent for future plan years. hand this over to my esteemed mike clarke our actuary to discuss intent to issue disability rfp. >> thank you michael. good mike clarke, aon. so, as michael intent to issue life insurance rfp that will take place in this would include but not limited to life and ltb insurance required negotiation mou's for active city county san francisco and superior court employees with coverage beginning 1, 2026.

of note, these not provided through sfhss for the or the city colleges of why it is and court employee also these benefits are offered to only, not retirees. just history on the carriee programs, these actually haven't the last rfp took 12 for effective in the 2013 year when etna was selected to provide th course of the last dozen years, specifically in 2017, hartfo acquired the entire book of business from etna.book of business acquisition in followed were contractual updates, ng over to "hartford paper" for plan year 2020, year agreements including the one in place year today the three commitment

from 2023 to 2025. benefits themselves basic life insurance, we do report the enrolled employee counts when we do so this past february. see those for the basic lifelong term disability insurae employees are in the $50 thousand basic life insurance, but there some and couple other levels up to $150 thousand. insurance, again the level is based on mospecific employee groups. you can see the web links here more information on these covered benefits for employees on death and dismemberment insurance is available to this ccsf and superior court. the supplementalare both employees and dependen the accidental death and protection in case of accidental death or some of dismemberment, vision lo

employees of dependents and disability insurance program for historically, i a good progression overall in the rates for since the start of 2017, there have been three different sets of rate agreement periods. currently the basic life is a bit higher then it was at the but we've been able to negotiate the hartford and long-term disability surance rates for those employee paid cov erages, but we review every year when we do the rate , the experience-what is called los ratio. what the carriers are claims relative to the premiums being paid, and do feel they remain favorable to the insureduce rates not just for the employers employer provider coverages and also for the ntal benefits. just to give a framework of claims are typically submitted a year, typically 20 employee deaths a year and 30 new 5

year histories on each the statistics every year when we do the recent being in february. so, trends themselves, what are we looking for? certainly looking premiums for employers and employees, but i the way the marketplace is thinking about insurance and disability benefits have come a long way.digitalization, the techniques life insurance co in under writer and policy management process they engage customers. for instance, big issue in life insura not named beneficiaries. people may not about beyond the life insurance setting up a will these programs have done a great job of their family members setting protections in case stuff happens, because certainly a death occurs most things are not set up, it is very difficult for families through those processes, so understanding these capabilities from the marketthis rfp. enhanced support

families members and disabled does it look like? there is of competition. always has been and cont we list the prominent organizations and life insurance disability marketplace of this page, and market growth. something we report y year, especially in our rate presentations is of employees purchasing supplemental life. we feel it is low gh this process we can bring more visibility to the supplemental life insurance benefits to the membership see growth in the percentage of eligible employees purchasing supplemental life because to acquire based on the recent rket trends, lot of data provided to the carriers as part pect from a affordable and predictable es for employers and members with minimum three year rate mmitment is customary over the last 9 years. there is 7 million in total spend in the basic ltd

program, 1 million spent by members we expect to see material impact the reduction in the cost. reduction in the premiums goal for the supplemental life and along with just more visibility on ware of the digital tools and other member resources that come with that, michael and i are om the board. >> thank you. thank you i'll start off with my question.even with the rate reductions basically it is ratios remain favorable to insurer. can you flush that out for us? so, every-life insurance is a little morestraight forward, because an event disability has with somebody becomes disabled and have to forecast on the characteristics of the individual disability, what y need to reserve to cover the future cost of those benefits.we look at the actual claim experience, which is every year for

life insurance, just depending on deaths, we have seen over the course of time is higher then the claims being paid out. over the course of the last 9 did see a couple bad years of experience in so there was a period where the harthard had to increase their basic life insurance rate . [indiscernible] i remember stanstay on top that and if the better, we need to consider that in our negotiations with hartfard and we did start to see improvement inable to negotiate for long-term disability, what transpired over time level of disability experience not kept with hartfoer-ford is a great partner to bring leverage. which is very helpful. we still feel the that is keeping up with

the premium and these processes, we will frequently engage in with our clients on rfp for feinsurance and disability. certainly the premiums in line, and agaithe focus and especially supporting families try to bring visibility how people can before those instances may occur. they are low probability instances during active employment but happen to you, the hope is you are protected. any other questions or comments? >> i thank you. you might have mentioned this and if you did i'm sorry if i missed it. what t take advantage of the supplemental? >> i can r supplemental life insurance, ranged 6 to 8 percent. during the time working with know about short-term disability program so not sure selecting that, but somewhere in that 6

to 8 percent raisk. we love to see that get higher. >> great. >> any other questions? alright. well, thank you., next steps with respect to this rfp-- will you be coming back to our board information and timelines, et cetera? board. we do the timeline for the rfp will logically not line up with our other meetings. >> it is gr november or december just to let us timeline you laid out so that we are ress. >> look forward to it president hao. >> just one clarification so everybody is aware, the way this a new organization starting january 1, 2026, currently on disability as of continue to have their claim adjudicated , so that is the way it works. it is based on d insuring organization at that

time. same thing with the death claims.happen december 31, 2025, that is under contract with the hartford. >> thank you for the important distinction. alright. if we dont have other questions blic comment. thank you very much. viding instructions for public comment which are displayed on the screen] we'll begin with no one approached the podium. the moderator will notify of time. >> board secretary, we have 8 callers zero callers entered the queue at this time. >> thank you moderator.ic comment is now closed. thank you. next agenda item, please. 13, blue shield of california medicaprescription drug, mapd ppo transition plan. presented by rey guilf operation officer, olz, operation manager, tiffany gill, blue shield of major account executive and charles lee, the

blue shield of group retiree senior markets. >> great. commissioners. rey guillen, chief for health service system. as joined by some esteemed colleagues the organization olga, the operation manager and from blue shield and together we will walk you joint transition plan for the blue shield medicare advantage organization plan. today i will a short background and outline of are using for our planning. we have assembled to assist transition. then olga along with tiffany and charles from blue w the transition plan details. taking timelight blue shield's tasks and those assigned to the h is ss team. highlight the metric tracks along th path to success and by the conclusion of our to have assured you got this.

we are confident all existing members will be enrolled in the blue come january 1, and 1, there wont be any empedements to the care that members are you are aware june this year, this board ppo plan to replace the healthcare plan effective january 1, 2025. the new blue shield plan match the existing uhc the same access to all the doctors that accept medicare just like our however, we do know that this type ful to our mbers and simply because of the fact that basic healthcare is one of ary basic needs of every individual and so we are going to very sure that we have informedmembers of the information that they need so that they can transfnew plan without any impedement to that care.

on the screen two main objective we set first, we are taking every available step to make this easy transition for our members.every opportunity presented, we are and address any concerns our members may have in order to assure them that they will continue to receive comprehensive and excellent care that they acustom to. to assembled a experienced and and implement this joint transition plan.includes staff from both we have leveraged subject matter s from hss actuary and consultant, aon reviewing all aspects of our plan and communication materials to confirm woe are fo aon will test and assess blue shield claim and operation em to insure they are set up correctly and match the blue shield proposal.

so to iteratkey elements for our joint transition plan ntinuous effort to assure our members through excellentboth from hss and blue shield proactive communication. in addition, we internal and external expertise av and also build upon prast transition experience, including our non-medicare ppo plan transition michael went through th plan year 2022, and the split medicare family transi for plan year 2023. support each individual individual with their own un concerns, but focus on the fact this is same ppo plan design with open access to all medical providers who accept medicare with the same benefit and copayments are enjoyed under the existing uhc plan. fiinsure all our processes and systems are set that our members only experience so, i'll turn it

tiffany gill from blue shield to walk through the specific bl of the transition plan. >> thank you.ld of california. good afternoon.just let know about issioners and wanted to make sure that everyone familiar with blue shield. we are a tax paying healthcare company that headquartered in the bay area, mission is to provide and create a healthcare r family and friends and we believe in operating wi transparency and efficiency and are these to our mission. we also are building a diverse members. we want to make sure that e details and plans that and programs weplace come from a diverse programs and plans and healthcare our members in california and

our mission also i believe aligns very closely ss st specifically where we are affordable and sustainasupporting the primary sure that we have excellent fwr example, we have increased our supporting our physicians with different programs in helping them with achieving their goals with member and patient quality. in doing in place 2022, we were able to a net promoter score for our physicians, which a satisfaction measurement, and increased by 21 points in 2044 net promoter score, which ve seeing as most of the healthcare industry average around 27 points. we definitthe opportunity that you have to medicare eligible retirees, just as we have the active employees, the

members that are under age 65 that as well. i have been around long enough to be able to here and say i'm going to guarantee there isn't going issues or comments that are going to come i can promise is that immediately act on any concerns, any questi issues that arise. i have a full team that be helping me and we assessing and anticipating any questions and needs that come up and terms of commun services types of questions that come through.want to introduce charles lee who is blue shield senior manager of group retiree and he is going to be standing and has already been standing side by me and will be helping anticipate any of your member charles lee, medicare vice, senior manager. we realize oba lot of

questions and concerns from the membership, so we actually set up alreaa blue shield dedicating model, member number is live t now, 800-370-8842. we are already answering and concerns about the upcoming plan. >> my paper says 8852. is it 52 or 42. >> 8852. sorry, i misread that. thank you commissioner so, our member service staff are dedicated to the hssunderstand the needs. they actu few of the board meetings and understand the concerns and so we are ready to answer any and all questions.g with the member service, we also to additional experts and resources, registered nurses, health coaches, pharmacy rkers and dieticians as well. so, we've got a variety of

resources available to on staff on the to address a variety of questions and a variety these folks are available 7 days a the only holidays are thanksgiving and christma in addition to these experts andf sta, wea subset of care navigators. our experience recently, we noticed that getting challenge for folks with the capacity with folks m covid, so we have a specific their role is to help gain to with appoint all these folks to assure you have been hand selected to support hss. to be frank, these are the best best. to insure that communication clear, honest, courageous and we are able to meet the expectations of our members. partnership with hss staff to be able to provide the best care available. and, continuing our

partnership montra, i think olga will continue on with our partnership with hss. >> can we know why we are only 1 p.m.? >> commissioner zvanski, is that for in-person support? >> right, in-person support. >> right now the health service system in-person support is open from for our members for in-person support. due to staffing we experienced last year, we still fully opening the in-pe but we have the timeframes and been twracking the that do utilize the services both to come in full support and for drop in suppornot seen a large increase other then last year. it is based on the needs and our capacity. >> okay. and we are getting complaints or members calling saying, i tried to get access and couldn't, it wasn't

open late enough? they are coming in. we are doing our best to be able to but our call center itself is from 9 to 5 every day, 10 to 5. we are still open and avurce during the hours for calls, correct. you very much. appreciate >> so, operation manager with service system. the operation team working closely with blue shield implementation team to insure a smooth transition for our members handle increased capacity and phone callss that is a result of the transition.background last year at this time, my team member service division 50 percent staffing so to [indiscernible] open enrollment win personal service contract with vsa, a off sito be able to support all our members that are en enrollment time period. this year that high volume of callers, again due open enrollment and of course due to the transition that will be happening

the blue shield ppo plan and very excited to say are fully staffed at member services and ready to be able to members, but we'll continue to engage with vsa center support and to be able to handle any sort calls that may be originating due to thion. and with our partnershi blue shield, we want to make sure that any of the transitioning have that they are seeking and i know executive yant we have been testing the readiness of the service by engaging test how their experience is with calling the call center, this week has been very heavy in myself team members calling those members to engage them and see whether they pate and get the early start gefor them. we had a couple of they had really great fe around the website and

overall their feed customer service level has been quite positive. ioned, we are open for in-person, so call center n't the only way for members to reach out. our the other features we will have in having a blue shield representative in our ng our business hours, so that would allow members more comfortable having the one on to have the we have been working with our vsa partners on staff teams are ready and pport this population. the transitioning population enrollment overall. the major focus of all the training has customer service. the next two slides, you see the set up we developed our goal is to insure our first contact resolution experience.

member services team along with vsa team will continue to support the general open enrollment questions, support that are applicable for open enrollment, but will have the soft hand off approach team to the team s very specific around the an inquiries, especially around naservices and transition of care or support with kinds of questions are asked, we want to make sure smooth to the blue go through the warm trprocess to our counterparts in blue shield, we will continue to inlevel of service that is provided to the first contract resolution. we want to make sure when the member co our team or the blue shield team, they have the answer looking for. we do no situation wheres call-back may be ree, in planning out the support that both teams providing, when members are calling to

insure to continue to be their provider under the blue shield require a call-back for the member, because is some providers may need some educso the blue team-blue shield team is dedicated to outreach to providers going over medicare billing and members to insure they get resolution for their inquiry. additionally the escalationfor our members, because there may be issues sure we have that set up as well. thought through and planned out. teams trained and confident to be able to this transition., between the two slides you can see the escalation and the the blue shield is always that confidence that the member when they get off to have their answer, or know somebody is going calling them back directly with a answer u >> what does warm transfer

mean? >> so, ansfer is generally when a one call to another agent without leaving the member the full situation to the new we give a little bit more of the information to nnecting the member to the blue shield side. >> thank you. rstanding is that we'll have a team of 20 or blue shield staff wimore, 26 more for any overflow calls. as you can of agents that will be avail answered is going to be quite high. transition to blue shield plan highlights. >> thanks olga. charles lee, medicare group retiree. as olga mentioned and to clarify a featso the member doesn't have to call back or make another call. are transferred between a couple teams to be able to assure their questions are answered in a manner and so that they don't have to get back into a queue. we in which we can call through

back channels and get to the head of the qua timely manner. as mentioned, 20 blue shield folks available along with 36 overflow capacity as well. we are going to get this. we got this. i move forward to the blue shield plan--shoot. we this slide is to help e key features of the new plan. as you notivery similar to the current plan and that's by design of course. one key features that we maintained is the network of providers that folks through the blue shield network and medicare participating network. i'll talk about that in . we also have copay and coinsurance with rich formulary n. we also got additional benefits limited

to annual physical health 24/7 along with teledoc. so a vato get the service you need. this plan also offers benefits and beyond medicare, such as routine--hearing exam, we got silver added benefit, we got tran medical facilities and doctor appointments and we also got folks coming home from the hospital forso they dont have to worry what they have to cook and how to of themselves from a meals perspective. as i was talking about other sides, this blue shield medicare ppo continues to give members flexibility and choice.shield plan, of course you got blue te wide network of doctors expansive doctors, but in addition we got

the shield ur members as well. there may be able to take new members, rest assured, continuing members will continue to their care from a in network provider they have today. we maintained consistency with the benefits so no starting 1-1. out of network providers. snetwork providers is very key as well. even though we got california providers, the nation wide network as well. facet of this plan along with the current plan, ability to see any once again, that is any medicare they agree to bill blue shield participating with medicare program, their services offer members will be covered.

in the unlikely situation where maybe provider is not familiar with the of california plan, typically all it takes is for us to them able to explain to them the plan and how would reimbursement the hundred percent schedule without a contract so there is no strings attached e same payment they would receive from original medicare, actually typically all it takes ices, because they want to continue to serve members, to serve their obviously. the next slide we got titled as similar process and methodology for medical specifically on pharmacy transition our team with the hss staff and the current prescription drug vendor, optm and

work together to insure a how we do that is requesting histlevel details that very specific history, open refills, utilization management information, all the data we need to insure that we have got the background, we got the history, and the ability to adjust and put in our to 1-1. once again, these are typke proactive measures we take, work with hss sure we got the r a smooth 1- specifically on the pharmacy side, we pay particular focus for open refill for home delivery and specialty pharmacy. we recognize there is a spfor these pharmaceuticals and therbe any disruption, so we pay particular attention to they got that continuity of care with once again, we got that team supporting those efforts and lastly, we are going about the

transition. meaning, we are not waiting until 1-1 to communicate any changes either form pharmacy or medical, we will reach out to them in december ke sure through member communication if there is pacts to their care. , blue shield also recognizes the medical aspect and is also obviously mental of health, so we recognize that specific need and importan so one of our goals is to make sure that we do noforget behavioral health aspect to tr we want to help educate folks on the various tools shield offers and provides, at the time, recognizing their current care that they are re is stable and continues as >> quick question. so, the mental health benefit? is it contracted through

majellen? >> correct. majellen is our in-state provider and got our bcbsa network of mental we can utilize as a second layer providers assistance and the third is as i was trying to emphasize as much as i could, it doesn't matter if you are on one side of the country versus the they participate in medicare and bill blue maintain that service level. >> so, if anybody is for their mental health be transition there available? obviously if they >> absolutely. >> not using the medicare, but using the united healthcare-- >> as long as they are participating provider, even if we dont have a contract with them, let's say they havewith united, if they are able blue shield, they will be--that visit and be covered. >> but they have to do the billing to >> yes, they have to be willing to bill blue shield, but they one thing we explained our team

will explain is we are not tying them to a contract. we are not trying to for example, 98 percent 102 percent of medicare, we are not going speak, we will pay you exactly as original medicare will pay. it is simple as that, folks understand that and that's without a contract and usually e to see their patients. >> do we have issues using to pay? >> sorry, one more time? >> do we have ld refusing to pay? >> no.have any issues with blue shie this is a ppo network and we recognize the flexibility that this have for folks, opposed hmo plan. that is the key difference. this is plan with the flexibility with that knowledge and network claims as opposed to /anal hmo fee for service model. >> got it. >> are there providers that have dealt with blue shieand had

unpleasant experiences and don't want >> i'm sure there is. to be quite honest.is negative experience, to move forward and what we want do is also have our member-the best of the best gicall and assure them, hey, this is my name, this is myany issues with your claims moving forward, you call us back. we will work through it. to the members, to the providers the hss staff that we will take care any issues. >> that was a issue i heard that people that their doctors do not want to deal with bl of course and that is understandable. you are way out there on the west coast.deal with you? what we would do like we said is them how the plan works, additional information, and we are here to help the member. help the member and that ultimate goal and at least gib us a shot. the medicare intermediary for everyone? it isn't individual blue shield

offices, all bills for medicare go. it is like on of everybody's insurance card with uhc all is number to call all the instructions are on a id cardon will be on id card from blue shield, it gi phone number, the address for billing, and clearly medicare advantage ppo and i would understand, most physicians certainly understand whatit is the medicare program that is of the intermediary and the administrator for the medicare program aspects of this plan if not mistaken is that true? also to mention that, by medicare advantage plans need to cover what medicare offers and we have the option as mentioned to include supplemental such as the transportation, the meawe also have a pers system. it is system, fall monitoring offered to retirees so we go beyond medicare.

comment and a question. i think my cochange people with the slides.appreciate your team at blue shield listened to this period of time. it is very thoughtful comments peoplethink importantly, hearing their concerns is really going derstand what people's concerns are and are putting together or faq, clear between ppo and hmo is a big more we make sense what is managed and ppo healthcar i say as a physician, it is confusing, confusin are able to make clear on that, very very helpful for everybody and reiterating it. you talked about focused on the pharmacy pi concerns and it really is around transition. ard stories and e-mails about people who treatment and worried that will all stop and i think the more we get there and reassure. on a claim standpoint they will see so is getting chemo therapy every 3 weeks and miss a week in there and the more we

can reach out and got this, we really want to make that they understand that and we understandthink really focusing on that-i use term vulnerable. that feels very important. i guess that was my question at >> i just want to also point out and gto details. that's actually that valuable tool for our team to take a look understand the concerns, and to that point, actuall have to give ourselves a pat on the back hss staff. we've developed a mailer that out here shortly addressing bucketing all the these frequently asked questions, and being able to at a initial level answer some of these concerns anpersonal one on situations that is where our best of will bep

available.log every call and if we need to get later on with continuity of care concerns-i listened this week and heard about potentia going to need outside the state where we let them know, hey, as long as medicare and they bill us, we can certaioutreach and insure you got thatyou need available. >> when are you starting the >> sorry? >> when are you starting the outreach anted healthcare people?>> at this point i'll answer th rey guillen chief operating officer for hss, soon. we will go through the communication strategy with you right so, our communication manager jessica she developed a very comprehensive communication plan that is about to be laso, charles mentioned faq document prepared out early next week to our members, that will again, note a lot of our

members both in the public meetings and e-mails ment that is about to drop. we held off a bit in case there we want to make sure to address in is prepared and ready to jessica has ion campaign designed to fully all uhc members about this transition and we are cait a aaa approach. and address. we have listened to and in addition sat down with shield to anticipate membwe want to get ahead we are going to design all communications to insure members provides the same benefits and access to the same providers as uhave now. we are going to address all the and so for the members that call either our customer se shield, again we will address their specthe issues that are brought up, so we will keep will

track them and share between each going to address those concerns in the future communications so much a communication plan that is open going to adjust as we go along.is a multi-channel communication approach. we transition that we can change the way we do things and make them have a communication plan that includes a lot of members don't always envelope, so we'll the mail with message on the front and back and detailed with document in inside. we will send letters because include more information then a postcard. planned. we are going to reach out to the various organizations, such as protect d police association and offer to cohost town halls with of the members. one of the new tools andt not new to everyone, but e-mail. we are going to rely lothen we have in the past, and we also a special website with blue information on it and we can

change it on a dime. if we have any that are arising, we'll make sure we address micro site. matter unless the systems are set much a group each and every division of hss along r external partners are involved in implementing processes that will be required. rest assured, we haven't waited to start this.these changes and system changeago, but they with well under way. again, it is a approach and so, the team is here, visconti from the contract team, his group is already working on finalizing plan documents and verifying all the details are consiand the proposal that blue shield recthe finance folks are setting up the differeg up the systems. rin from our enterprise system

and signing all the data files that will be used to snd our memband from blue shield so the coverage is ready and in placjanuary 1, 2025, and to transition azeezy as possible. uhc plan will automatically be migrated shield plan unless they elect to go to a differ they will not need to fill out enrollment forms, they won't need to system, they are just rolled over directly to the blue shield t going to need to get their medicare card and send that to are just automatically transitioned over. all our oth to make sure we get everything transitioned. we have people soft system, our sales source system, we have a and management system. all those systems need to be ion for the new plan, but all that is well underway. this of our transition timeline our dashboof. all the important tasks with the due dates make sure nothing gets

missed. we have weekly with blue shield. actually several different weekly calls some on the transition plan some on very small system. the transition plan, the joint plan we over 6 times as long as what is presented on meet each and every deadline we have and blue shield is providing to make together we don't drop the ball we agreed to success metric that to indicate how well the transition is proceeding. we will be tra resolution both on our side and insure once a member reaches out they don't have to call multiple times to get the we will track and share the reasons members are calling and address munications. our goal is to educate each impacted member so that they are aware are assured that they are not going to get le. and so, in addition to our communications, we are going to

track participation in webinars and seminars, and in fact for our we are actually developed a qr code we to scan from their phones to let us know they and there will be option to raise their hand in that someone to reach out to me and blue shield number of out-bound calls to members to walk them throdon't have to call and go through the phone system, they say, i want a call back and meone gives them a call back.do still rely a lot on usour fiduciary respcaf tearour system works on u.s. mail and when that we are going to make sure we reach out to the membersif we can get a good address for them and make sure they so we will make work with blue shield to make down each and every member where a is returned.

closing, again, i just want to reiterate, we believe we have we have some quite a bit of experience in we are leveraging the support from partners both bl make sure we follow best practices. working together seemlessly and i thank for that. even within sions operate in silos but abby has working feverishly to break down the silos and each of our used to working together to make sure we looic t we are doing and not the particular task so no balls are dropped as we go through this. we can assure members that they will be transitioned smoothly and when issues do come up and we do are going to address those immediately and use those to make sure that the rest of the transition goes that, any of the presenters are available to answer hit the wall where mamail no longer works, or

phone call or something is being returned, do you have other try to contact those members? >> with every mailing we send out and again,mbers and so with every mailing that is sent out, we to try to track and get a good address for those are hoping that in the past that us to expand the because we know that in today's day and age ny open their mail box as we need to leverage mail to make sure we meet our duties to insure receipt, but in addition, like i agreed to work with us. we will the responsibility to reach out by phone for any piece of mail, so we do-this isn't something we have done in the are efforting to do on a go-forward >> are you contemplating using we have retiree organizations and ac can you utilize those to help sfwh e conclusion of

this meeting is on the reach out to those retireagain, to cohost seminars and webinar, in-person town halls, ready to go on the road so, to whateverthat those organizations request, we wid able to provide that support. is helpful. thank you. >> can i ask estion relate today that? there will be people where we cant find them and doing a nice travel in a foreign country and if i understand, the transition will happen and they come back from travels and say i have a blue shield card because they don't need to >> yes. existing uhc member is automatically going to be blue shield plan. they don't need to have break in cov erage and automatically transitioned over. that is agreement blue shield made with us and the way we falls through the cracks. >> perfect. thank you. , i appreciate the presentation and all the work everybody on this.

a period of first third of my career i was consultant and did competitive bids and sometimes sometimes when i win a bid, i got the was a competitive process and there will be a this is less about message to hss as it to blue shield.we heard loud and clear is that some real deficiencies with california, and as i said privately and will say it publicly, there was a lot of this that caused a lotpeople to really consider spending the over a period of three years because problems that our member employees and are some had with blue shield of california. day, i supported the my confidence in blue shield. it was because of my my confidence in aon.

i should have confidence in you in blue shield.individually, but i appreciate that you are saying right things about to member satisfaction, but you know from the members we serve, they are not seeing a commitment to satisfaction. hundred percent the problem that played out this board, but at the board of supemayor's office and i want you to the good news is, you got it. the ba be a lot of sympathy if my invitation to you and i think i speakon the board of supervisors and probably here, i am going to ask members who reached out who were opposing this to stay in touch with us to meelected official and member of this board.n't going well, but the onus is really prove your critics wrong or you will have a i just hope that comes through

loud and clear and there may be the best of the best, but maybe you need to send ople who are not the best and part of yourreputational things spilling over. at the end ofi supported thisjority did, but i just want to make blue shield is getting the message that it was health service and confidence in aon that won by vote and got blue don't regret it. >> thank you. say yes, absolutely. now it is our trust of the members. we returned the trust of hss with our partners, with our past on the active side. we earned now it is time for us to and win over the folks and earn that rward. >> you need to reearn, because there werlot of us, we took the other way out.e retiree group said no, we are not so you need to work hard to regain the

trust of our y. >> i can't emphasize that enough. >> absolutely. you. very serious issue. want to extend open invitation for you. shield for tiffany and we are not quite ready for public comment yet. you know.each month update us, perhaps we will have standing item onto do so, because we do want to supported the move to blue shield, but it is very si dorsey has described as well.say that your earlier hesitation answering the quknow you do not have a crystal because by using the covered, that had somewhat chilling effect on everybody. ve to apologize, just letting you know that language, so hopefully your should turns into a will we just want to be very candidate with you. want to invest in your success and also demonstrate your partnership and commitment thank you. >> i will share we are planning to be

at next month's d meeting as well and so we ongoing communications updates to share and to be able to identify and pivot to adjust the s any concerns prior to 1-1. >> we will from members, but we also ask our staff. we dont want problems we want their work to go as smoothly. they should not be taking extra time with this, they of their course as should your pethe way around, and i hate to put it this way, we've dumped you before, we can [laughter] and you can quote me on that, because i will work for it if you dont come board a long time and committed to the members. first and foremost and they must we contract with you for nd and best healthcare they can get and that so, we are very serious as sit here. bear that in mind. we have access to offices down the hall. some worked here before we know we

know the back doors. so we can get need to, but this is very very serious anthe city, they work for the people who live a lot of us are born and raised here but we are strongly committed to san francisco, to our city and get the best we can get for our health benefits and that we bargained for and we work for then the best we can get from everybody. we give our best. so, we look forward to ng relationships, and support from you. >> while you heard very strong comments from this board, we do also tell you now that we are partners we are in it to work with you. we do want this effort successful, so please hear our words correctly, that chosen you, but now we from you. thank you. any other alright. let's open up for public comment. >> sorry. >> i just want to acknowledge partnership, we have approached

this exactly that way, it partnership. regular executive meets wiregular implementation meetings. we have assurances e shield organization this is a priority for them and they'll t. we will hold them accountable for that but i want you to relationship is in , it is and we-our team has risen to ng )thank you for the comment, but it we are doing and i hold my accountable for making sure i know where they are care of everything. i use the rocket ship analogy that i rocket ship blowing up because somebody didn't want to telusing the wrong glue. that is how we full commitment of everybody on the team and it is this trai moving really fast, and but everybody partnership with blue shield continues to be i cant speak to historical problems of 10, 20years ago. i can speak with acive employees it works very well, and so we on that

relationship and not that was taken care of by none of the people ini just want to make that very clear from a positive place where members are holding us that is great. we already got members helping e to do that, and we will be a update. >> thank you now we are ready for public comment. [laughter] [providing instructions for ment which is displayed on we'll begin with comment. >> thank you. my name is alyssa matrass, good i appreciate the remarks that supervisor dorsey made. those are some i am a retired teacher of 50 yearunified school district.

i retired and i think had been through this going to say this is not my first with healthcare transitions. three years ago i transitioned from blue shunited healthcare. i'm very happy with united he what wasn't working, speaking as a member and it is to the members that will be serving--it was anything but smooth. teachers retire we had to keep blue shield until june was nothing coming as of july sabled and just had neuro surgery., i kept find out what kind of documentation he could his neuro surgeon and resolved, so he had to go to his appointment so of his neuro surgeon at sf and they cannot

serve he has no card. that was a transition that consairj was available for. finally they called me because nobody could talk to my husband or i my husband because of hipaa. me to discuss that .ered it doesn't work. you have to really know that the devil is in the details. there is part this meeting where i thought i was back at-trying to decide if i should go warranty where they bring you in the office and you don't know what els. >> 30 seconds. i just feel that you need rd a lot of comments that . you can promise the world, but it actually serves the members, you e not accomplished anything, you saved money, but you put thank you for listening and are thank you for very few people in this

building you so much. >> thank you for your comments. thank you. ello. i am dr. toby a retired physician employed by the talk about the process by came to the decision to switch healthcare to blue shield.dr. steven follasbee, who was time commission member was the ze on the commission after hearing and reading all material provided voted no. at that meeting, he voted no for the switch, was clear that no one could explain how blue shieldsave the city million a year without our members.

a week lafollasbee was removed from a new physician was placed on she was sworn in in the morning afternoon she voted yes.board decision. i think it needs to be record that this was an way for the commission to make a change such an important process as wh retiree members have preir healthcare. $22 million in saving i am still unclear that blue will provide "the same servicthe same the city $22 million. this makes no fiscal sense. it makes no sense to me. i for many years, i worked for the someone will lose and it will ere will be providers se

to see our members because blue shield will underpay them. >> please be very clear evaluate their performance. thank you. >> thank you . anyone else is welcome to approach the podium. >> hello commissioners. my name and i'm a retired city gardto echo the previous speaker on that happen about the change. i came to the seem s like it was okay for then i got an e-mail saying it wasn't and come down this meeting, so quite concerned. thank you for your time. thank you for your comments. approach the podium. >> fred sanchez fromprotect our benefits. what i hear uraging. i am only half crazy, not totally crazy.

yes, like somebody in oregon said that the pandemic the reason their shield is because their capitation rates so they said, hey, they just got rid the past. hopefully we'll inform you even now where we are finding difficult so you say you'll work with people, educate that hospital in oregon and say how things will that is encouraging. but, i'm curious, this contract and i heard different was $67 million savings and meeting said $43 million savings, so which one is i'm not sure which one it is. but, it is three year contract.lly this doesn't happen, but if after a year are not happening, can we get out of the in that contract language that iis as if not meet -the cost things, different copays, whatever things there are, you but is there a contract that

allows ment to be terminated after a year if there thank you. >> no one approached the podium. we'll move to our moderator who will let us know if there are remote public comment at this time. >> board secretary there are 9 callers queue at this time. >> thank you moderator. hearing nonow closed. >> thank you. do we have final from our board? no.tiffany and charles. we are generall bunch, but we are also very serious about making sure the concerns are addressed and so, welcome and we really do look forward working from you. we look forward hearing from you next month. and so, please call the next >> item 13, reports and updates from contracted representatives. this is a discussion and any health reps can approach

>> good afternoon. deniskaiser permanente and coming up to let you all been your senior executive account manager for has made some personal choices and one is to to southern california, so she is mome position working on county of la, so he has a counties i think. so, laura zamen is her replacement and will be new i will hand it off to debbie. she wants to say a fewand do a quick introduction of herself and i time here.thank you very much. i jus permanente. i want to say thank you so much for allowing me it has been a honor and privilege and just well and continue doing the great work that are doing, thank you. i will hand it over to laura. >> thank you debbie, >> thank you >> hi, good afternoon. i won't keep you too long be th kaiser.

>> can you speak into the mic. >>debbie and worked together at united go. look forward work wg you all.surance for over 20 years and the public happy to answer any questions, but look forward working with you all. welcome laura.updates. we'll take public comment. viding instructions for public comment which is displaying we'll begin with in pe no one approached to the comment and the moderator will notify of callers >> board secretary, there are 7 callers on the phone line, the public comment queue at this time. >> thank you hearing no further callers, public comment is closed. >> thank you. we actually can go until 4:get out we

don't intrude on the next commission.being mindful of time. with all this health service board meeting to adjournment. thank you. 4 p.m. >> (music). >> hi, i'm owner of

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g, you will hear a chime indicating your time is almost up. when your allotached, i will announce that your time is up and take the next person queu and slowly and if you care to state your