culturally fabric that makes san francisco neighborhoods so unique. >> the idea is take what i think is [indiscernible] about immigration, about belonging, about some of the amazing history of the city. [indiscernible] >> good afternoon everybody. i like to call to order the health service board meeting of december 12, 2024. if you would all please rise and say

the pledge of allegiance. >> i pledge allegiance to the flag of the united states of america, and to the republic, for which it stands, one nation, under god, indivisible, with liberty and justice for all. >> thank you. alright. agenda item 2, please. >> item 2, roll call. starting with president hao. >> present. vice president zvanski, present. commissioner cremen, present. supervisor dorsey, present. commissioner howard, present. commissioner sass, present. commissioner wilson, present. >> with that, we have quorum. >> great. agenda item 3. >> item 3 is general public comment. this is opportunity for members to comment on any matter within the jurisdiction not on the agenda including requesting the board place a

matter on a future agenda. i'll read the public comment instructions allowed. remote viewing is available on sfgovtv and webex. the health service board welcomes public participation. there is opportunity for public comment at beginning of the meeting as well as a opportunity to comment on each item on the agenda. in person comment will be first and remote public comment. for anyone waitic in person you are welcome to approach the podium now. each speaker is allowed three minutes to comment unless deems new public comment time limits. all comments are made concerning the item presented. health service board will hear up to 30 minutes of remote public comment for each item. remote comments from those who received accommodation will not count towards the 30 minute limit. members attending via phone can

call dialing 415-655-0001 and enter access code 26617749489 pound and pound again. press star 3 to be added to the queue and you will hear the prompt, you raised your hand to ask a question. please wait to speak until the host calls on you. when the system says your line is unmuted, this is your time to speak. you will be muted when your time is expired. waching on webex, click raise hand icon. a raise hand will appear next to your name. when you are unmuted a request to unmute will appear on the screen. select unmute to speak. once you hear welcome caller you begin speaker. when your time is expired identify you will be unmuted. members are encouraged to state name clearly, you may remain anonymous. i will give a warning with 30 seconds remaining. when your 3 minutes ended i thank you for your call and place on mute.

we want to thank sfgovtv and media service. we'll begin with in person public comment and no one approached the podium and move to remote public comment. we have two callers on the phone line. one caller raised their hand. there may be a brief pause as i transition and unmute the caller. welcome caller. >> good afternoon commissioners. this is richard rothman, retired worker and calling about two items i talked about before. one is the vsp vision care and kaiser don't talk to each other. i had to take a test twice and wait a hour in kaiser. if they dont want us to be in

kaiser then you need to find a way to have vsp and kaiser talk to each other so my opthu [indiscernible] bleez do that. the other is about kaiser transportation. i had a call on friday to-i consider it urgent, important to go on tuesday and when i called up they said it isn't within the three days. if you read the evidence of coverage, it says, three days or if you have a urgent appointment they can do it. i had to wait a hour on the phone and then call member services and they took care of it. kaiser needs to explain to the members that if you have a urgent medical appointment you can make an

appointment instead of just telling the department or employees no, you can't-or the members, no because you are not in the three days. please ask kaiser to read their evidence of coverage and enforce their rules and that you can make an appointment to see the doctor to have transportation within three days. this is a great service. also there should be a way without calling up to find how many rides you had in a calendar year. i guess the only way i can find out is if i call up. thank you for consideration of these issues. bye. >> thank you caller. we have two callers on the phone line. we have one caller on the phone line. i will give 5 second pause for the caller to see if they want to enter public comment at this time.

no callers raised their hand. with that, public comment is now closed. >> great. thank you. item 4 please. >> item 4, vote on whether to hold close session for member appeal. this is action item and presented by president hao. >> colleagues, we have a member appeal we need to hear at today's meetic, so i like a motion to recess into closed session. >> madam chair, i will make the motion to go into closed session to hear the appeal. >> second. >> great. been moved and seconded. we'll take public comment. >> public comment is now open. for those dialing in, call 415-655-0001 and enter access code fallowed by pound and pound again and press star 3 to raise your hand. click on the raise hand icon to speak. we'll begin with in person public comments. no one approached the podium. we'll move to remote public comment and i'll see if there is anyone in

our public comment queue at this time. we have one caller on the phone line. no callers raised their hand at this time. i'll give a 5 second pause for anybody considering entering public comment at this time. no callers raised their hand at this time. witht that, public comment is closed. >> thank you. roll call. >> president hao, aye. vice president zvanski, aye. commissioner cremen, aye. commissioner howard, aye. commissioner sass, aye. commissioner wilson, aye. >> great. thank you. holly, please go ahead and secure the room and our tech for closed session. thank you. >> thank you. at this time, we ask all public participants to exit the room and i'll close out the room.

>> we are reconvening in open session. i got one of these, i mine as well use it. and now i guess we go to number 6. >> thank you. i want to note for the record we are returning at 251 p.m. and our president hao needed to be excused from the meeting. vice president zvanski will be chairing the rest of the meeting and i'll pull up our next item. vote whether to disclose closed session. this is san francisco code 67.12a. it is an action item and presented by vice president zvanski. >> okay.

is there-the motion then that is before us is to vote whether to disclose any or all discussion held in closed session. the motion i would make as chair is to not disclose. is there any discussion on the motion? >> i second the motion. >> thank you. any further discussion? seeing none, okay. all those in favor of item 6 to not disclose discussion held in closed session say aye. do we need to take a roll call? >> we need to move to public comment. >> oh, okay. open for public comment. >> pub lic comment is open. call using 415-655-0001. enter access code fallowed by pound and pound again.

star 3 to raise your hachbltd for those on webex, click raise hand icon to be placed in the queue. in person public comment will be first and now one approached the podium, so we'll move to our remote public comment. i'll check to see if there are callers in the queue at this time. >> thank you. >> there sh is one caller in the queue, no callers raised their hand. i'll give a 5 second pause for any changes in the public comment queue. no one raised their hand in the queue. with that, public comment is now closed. >> great. thank you. not that-i keep forgetting. sorry. i apologize. not that i don't want public comment. just seems it is easier to keep going through. okay. so, we have no public comment and the vote before us is determination before us is whether or not to

disclose discussion held in closed session and the recommendation is to not disclose. is there any discussion on this item? thank you board members. we have not heard discussion from the public with regard to the motion either. last chance. going once, gone. thank you. and so now it is on us to all those in favor of supporting the motion not disclose any or all discussion held in closed session signify saying aye. >> aye. >> any opposed? we can move forward. it unanimous to go forward to item 7. >> item 7, possible report on action taken in closed session. this is government code section 54957.1. administrative code 6712b.

this is action item and will be presented by vice president zvanski. >> okay. we just got through the issue of whether or not to disclose discussion, and now it is a matter of whether or not we wish to disclose action taken in the closed session. i would recommend that the report is to not report on any action taken in closed session. is there further discussion? >> i second the motion. >> it is seconded as well. any further discussion? last chance. seeing none, any public comment? >> i'll open up for public comment. call 415-655-0001 enter access code fallowed by pound and pound again. star 3 to raise your hand. those on webex click the raise hand

icon. in person is first fallowed by remote public comment. anyone may approach the podium now. no one approached the podium and move to remote public comment and i'll see if there are callers in the queue at this time. >> thank you. >> there is one caller in the queue, no one raised their hand. i'll wait 5 seconds for changes in the queue. no one raised their hand in the remote public comment queue. public comment is closed. >> great. thank you. now we closed public comment. now we can take our vote on whether or not to report on any action taken in closed session. the recommendation was no. any further discussion? seeing none, all in favor say aye. no. excuse me. good. any opposition to say yes?

thank you. got it straight. okay. moving forward. we got number 7 out of the way. okay. now if i'm right and no other action we are going to item 8. >> item 8 is approval with possible modification of the minutes of the meeting set forth below. this is action item. and november 14, 2024 special regular board meeting draft chblt . >> so, it would be-we have october 21 minutes and september 12 minutes? >> i believe that is error on the agenda. >> it should be november what? >> november 14, 2024. >> 14th okay.

>> those minutes were distributed in to material. >> i vote to approve both minutes. >> second. >> okay. it has been moved and seconded to approve. any further discussion? public comment is now open. >> for those calling in dial 415-655-0001 enter access code fallowed by pound and pound again. star 3 to raise your hand. those watching on webex click raise hand icon to be placed in the queue to speak. we'll begin with in person public comment and anyone can approach the podium now and fallowed by remote public comment. no one approached the podium. we'll move to remote public comment and i will see if there are any callers in the queue. we have one attendedee calling in but no one raised their hand. i'll give a 5 second pause for changes in the queue.

no one raised their hand. seeing no callers, public comment is closed. >> good. thank you. okay. the motion on the floor to approve the minutes of october 21 and november 14. am i correct in that? okay. any further comments from anyone on the board? no. thank you. and probably thank you-my guess is the caller is richard but i may be wrong. thank you all. the motion is to approve those draft minutes. all in favor say aye. >> aye. >> any opposition? seeing none, we got that taken care of. number 8. those minutes are approved.

i think we are done with item number 8. we are going to item 9. >> item 9, president's report. this is discussion item and is presented-will be presented by vice president zvanski if you have notes from president hao. >> i don't have any notes from president hao. is there any issues to be brought forward? seeing none i think we can move ahead with that. >> open public comment? >> yes. >> call 415-655-0001 enter access code fallowed by pound and pound again, star 3 to raise your hand. for those watching on webex click raise hand icon to be placed in the queue to speak. any people in the room you can approach the podium. we'll hear from in person public comment first fallowed by remote public comment. no one approached the podium.

we'll move to remote public comment and i'll notify any callers in the queue at this time. there is one caller on the phone line. no callers raised their hand at this time. i'll give a 5 second pause for any change in the queue. no callers raised their hand. therefore public comment is closed. >> okay. very good. and there is nothing to be reported so we can move on to item 10. >> item 10, director's report. this is discussion item and will be presented by abby yabt. yant. >> good afternoon commissioners. >> good afternoon. >> i will be brief because we had a long day already. i just wanted to note my plans for my retirement is on track. i got 91 days.

>> who is counting? >> so, a lot of work to be done in the 90 days. i did want to call out that we will be having an announcement official announcement of the health service board 2025 election for one of our member seats and that will kick off january 9 and that is claire zvanski positions now and the term will be-it is 5 year term from june 2024 through may of 2030. hard to imagine that far out. thank you. yeah. june 2025. the other thing i wanted to just highlight will be hearing more about in the months to come, but we are going to be challenged by the mayor budget instructions.

iftikhar's team are putting together recommendations internally we will be grappling with over the next weeks but that will be a challenge for us and city departments so i wanted to call those things out and if there any questions i'm happy to entertain them. >> what is the percentage they are asking for a cut? is it a flat percentage? hi, iftikhar. >> that is correct. >> yeah, thank you. >> that's going to be a challenge, isn't it? because we run pretty close to the--okay. i think the city needs to take a look sometimes. not all departments can function in the same way.

especially those that deal with employee benefits and actions that are already on bare bones. okay. does that conclude your report? >> yes. >> thank you very much. is there any comment from the public? seeing none. okay. >> we can conclude in person public comment because no one approached the podium. i'll open for remote public comment which anyone dialing in can call 415-655-0001 and enter access code with pound and pound again. press star 3 to raise your hand and for those watching on webex you can raise hand icon and wait to be called and no one approaching the podium and i'll check to see if there are callers in

the queue. we have one caller on the line, no callers raised their hand. i'll give a 5 second pause for anyone wanting to change to public comment queue. no callers raised their hand cht public comment is closed. >> great. thank you very much. with public comment closed, we are now on to item 11. >> item 11, sfhss financial report as of october 31, 2024. this item will be presented by iftikhar hussain, chief financial officer joining remotely. >> i'm looking around, going where is he. okay. >> sorry. big voice in the ceiling.

good afternoon. you have the [indiscernible] trust balance due to high claim activity and it is not clear whether it is just the normal fluctuation in the month of september and october. we have very high claim activity so we are projecting a decline in fund balance. it is not quite alarming yet. last year we had a large stabilization [indiscernible] but the fund balance ended up increasing by $5 million at the end, so we'll watch these trends and see if it smooths out. the early indications in november indicate the trend is [indiscernible] for pharmacy rebates, estimating $16 million. actual numbers will probably be higher, but we are going by what we

received the first quarter. we typically receive [indiscernible] [difficulty hearing speaker] because we moved [indiscernible] in the budget, it has a decrease, but we have sufficient funds for the next year or so and as part of the budget, we will be looking at the health service trust, whether or not [indiscernible] also looking at the assessment rate. the general fund, we are ahead of budget and it is because of vacancies. [indiscernible] we are developing a to be presented to you in the january board meeting and it will cover the results of the past audits and what we

plan to do for 2025. with that, that is my report and happy to answer any questions. >> any questions? >> yes, i have one question. the $2 million with the healthcare sustainability fund projected, last time you mentioned the reason it is a decrease is because the wellbey moved over to healthcare, is that correct after discussion with the mayor? >> yes, so the general fund budget [indiscernible] we decided to move into the trust. >> okay, so the mayor office making a decision that they won't pay it anymore and we have to pay it? >> yeah, and hopefully this [indiscernible] we'll bring it up again as part of this year's budget.

>> okay. thank you. >> okay. thank you. any other questions? making myself a little note about that. and we hope it is just a one year. okay. fine. is there any public comment? seeing none- >> i can open up for public comment. for those dialing in, call 415-655-0001 enter access code fallowed by pound and pound again and press star 3 to raise your hand. for those on webex, click raise hand icon to be placed in the queue. in person will be first fallowed by remote public comment and no one approached the podium and move to remote public comment.

there is one caller on the phone line, no one raised their hand at this point. i'll pause for changes in the queue. no callers raised their hand. public comment is now closed. >> thank you very much. okay. last chance if anybody wants to come forward? seeing none, moving right along to item 12. >> item 12, blew shield of california medicare advantage precription drug ma pd ppo transition plan update. this is presented by olga stavinskaya-velasquez operation manager and charles lee with blue shield of california senior manager group retiree. >> great. welcome. >> good afternoon commissioners. olga stavinskaya-velasquez operation manager health service system. for this report out we will review the hss implementation dashboard.

success metrix and call metrix fallowed by the blue shield ma pd dashboard, [indiscernible] member engagement and take a look ahead as we enter the new plan year january 1. wree are excited to inform the board we have completed all of our major milestones in the implementation of the blue shield ppo plan as reported last month. our two outstanding items continue to be on track with deadlines to january and december of 2025. through the continuous close relationship between hss and the blue shield implementation team, we stand ready for january 1. as we move into january 1, we will continue to work together with the blue shield team focusing on sufficiency, proactive communication, and quick issue resolution as with the emphasis

maintaining outstanding member experience and resolving issues in a timely effective manner. i like to address the next slide is a little different if you look at your printed packet. there were a few updates required. to illustrate our continued support of members, i like to point out that we continue to have a 90 percent first contact resolution on the topic for members calling on the topic of the plan transition. we do see a overall decrease in the calls we are receiving, we were able to support 137 members over the phone with the hss call center and 11 members in person. also through our programming we have been able to connect 168 members to the blue shield call center directly. as we proceed to january, we continue to put forth the same

dedication and effort to insure our members experience limited to no interruption in their health journey and for those who do need support, we continue to work closely with blue shield to insure the members issues are addressed timely and fully. i will pass the presentation over to charles lee from blue shield. >> >> hello commissioners. charles lee, blue shield group retiree senior manager. similar to the hss slide on the dashboard and transition, we are showing on track for everything. the one item we are listing at risk is because last week we received the enrollment file from hss and so we-happy to report this week we continued to process

successfully and so that can actually change at the updated as being green. once again, we received and processed the entire enrollment file. >> wow, okay. >> also similar to hss call metrix, you see here that we've received 900 calls in the month of november, post open enrollment. those 900 calls are broken down by the various support calls drivers here. as you notice it is provide a network plan benefits and plan enrollment and with other items as well. during open pon this in more enrollment, we supported 66 individuals retirees in person during open enrollment. we also had 184 folks that we were able

to assist initially and also transition them to hss for additional help and questions. you'll see here the average speed time to answer is 35 seconds. a little more then--still way below the typical 180 seconds, so it is still a good metric there. and the average handle time is still above 10 minutes at 13 minutes, which means we are still taking our time with retiree questions and helping them reassure them on the transition. and we got hundred percent first contact resolution, which means they dont have to call back multiple times and we are able to address their concerns or they can call back any time should they have questions. >> this is pretty good for start out. >> yes. >> very good. >> you'll see similar metrics on the micro side for the month of november. folks were most interested in

finding a doctor with their providers . form yulary. on line we got the ability to take a look at member materials so they downloaded evidence of coverage and summary of benefits to look into detail and research plan benefits and have their questions-should they have questions they can call into get those questions answered. >> when we say 8 for telephone number we are looking at the system? >> eight meaning there is a section they can click on for the telephone number, so if they [indiscernible] they click on it and there you go. >> okay. >> we wanted to start here on the next slide for member experience. this is a sample of id card members should expect. we received the file on december 4 and

we are processing it as we speak, so our expectation is that during the week of 12-16, so next week, the bulk of the members will receive their id cards. as a matter of fact, we dpot a small batch of folks we processed this week, so some folks may report having received cards over the weekend as well. that is all good news. along with the id card, there is separate mailing for a welcome kit and through that kit it gives plan information and additional details about the plan and in there as well will be additional data or information on amazon pharmacy, which is the home delivery service for the prescription so they will get more information there. welcome kit and id card separate mailings, just to be clear. and worst case scenario,b if a member does not receive their card by 1-1, they can call blue shield

concierge and we can walk them through their member portal and get them registered and so they can directly see their id card that should available in the portal, or two, we can offer to download their pdf of their id card and e-mail them directly to them as well. >> so, are we assuming that members are going to say on the first or second or third of the month, i didn't get my 2025 card, i will call or are we sending out anything that says to them, by the way, if you didn't get your card, give us a call? >> the expectation is that members will receive all their id cards next week. they don't center have to use this as a backup option. >> should we expect to see a card that

indicates it is medicare advantage plan? >> it doesn't specifically say medicare advantage, but at the same time, there is additional information there for contract. it is in small print, you can't see it there. there is additional ppo type language there as well. the id card there is a suit case there that indicates the plan type as well. >> we are supposed to know what the suitcase means? >> the suitcase-good point. the suitcase is the flexibility to use the ppo card throughout the u.s. >> the initials on that say ma? >> yes. sorry. >> that is medicare advantage ppo.

[indiscernible] without confirming first. >> thank you. >> thank you commissioner. my copy is small. >> i was looking at that too, going, ma. alright. good. okay. i guess we wait and find out. and not everybody figures it outright away anyway. >> that is what we are here for. >> right. we only figure it out when we try to make that appointment or go to the appointment and hit the wall. thank you for still being there and helping members. >> of course. so, we want-the next slide we wanted to share the member experience on some of the support we provided in person. for example, the on-site support during open enrollment, those 66 members that during open enrollment came to the office, we were able to directly assist. we wanted to share some high level things here. the first bullet talks about a

specific retiree with numerous prescription inquiries. we were able to reassure them their medications were covered and retiree was appreciative of the direct attention and thoroughness. i will skip the second bullet and go to bullet number 3. we also educated a retiree on materials. as i mentioned earlier, on micro site that is available to folks so they are able to self-help and download the materials and take a look at the specific details at their leasure. we also pointed out specific parts of the micro site from benefits, providers and pharmacy coverage. the retiree was happy we showed them the online resources and as well though, we also connected with member services and were able to directly mail the materials as well. that obviously is a option when folks call in, they can either

download and print, or they can call us and request a hard copy as well. >> that is very good to know. that is good to offer, because not everybody can download. >> exactly. and so going back to the second bullet here, we had a specific retiree that hatheir provider doctor unfortunately not be part of our network, but what we did is did additional leg work and confirmed they are medicare eligible and were willing to bill blue shield so they were able to continue seeing the provider under the out of network benefit or flexibility of the plan. so, i wanted to pause there for a second because we understand that lately, i think we had some questions about a particular provider, john muir and so we wanted to address that. john muir, the good news is john muir

is contracted on commercial active site, however the medicare advantage site they are not directly contracted with us. that happens infrequently, but when it happen thrz is no impact to member accessibility. matter of fact, folks with commercial there with us, not medicare, because the provider typically values that relationship, we have never had any issue with access for our medicare advantage members. they know how to bill us. it is an educational item which we reach out to the provider and educate them that even without a contract, we will reimburse 100 percent fee for service schedule without a contract, so it would be the same as original medicare and they can continue to see their members. this is a case where it is not only critical we educate members, but also providers as well.

so they understand they got retirees have this out of network feature and benefit and that they will be reimbursed hundred percent fee for service. >> i imagine because if the provider doesn't know, it isn't going to happen. >> right. sometimes you run into a situation where you have the dichotomy between the [indiscernible] and that is where we need to reach out to folks and let them know, you know how to bill us, but at the same time, without a contract it is hundred percent fee for service. you are made whole as you see the member through original medicare, continue to see your members. >> great. that is really good to know. >> there is no balance billing to the member? >> no. correct. that is a regulation for this.

there is no surprising or got ya. >> thank you. >> the balance billing issue has come up a few times here and there. >> correct. >> i said to members, there is no balance billing. >> correct. >> if they are seeing a provider and you basically they are going to blue shield, if the provider pushes back, they should just saying it is medicare, you are supposed to take medicare and medicare will cover it and blue shield will pay hundred percent. i have been seeing on the internet some people complaining about their provider isn't taking blue shield, but we have to reinforce the message, as long as they take medicare it shouldn't matter? >> we then educate them so the provider can understand this is a plan and product that pays just as medicare would be, not 98 percent, 96 or 102 percent, it pays as original

medicare would and in that instance most providers would want to continue seeing their patients with that education. >> could the provider say they dont want to deal with blue shield? >> this is their right, yes. this is their right as well not being contracted. it is their right to refuse services since they are not contracted, but like i said before, especially with the existing members, typically providers want to continue that relationship. it is a little more challenging frankly as a new member if you are going to see a doctor as a new member, that could be more challenging, but for existing providers and existing relationships that typically isn't a issue. >> some of the feedback is that what i was hearing is that people are complaining their doctors don't want to deal with blue shield. if they don't want to deal with blue shield, they have that right. >> absolutely. >> you can't force them. >> absolutely.

that is where our member services--we are wanting members to share with us those particular providers and with we want to outreach to them and talk to them and help them understand the plan more and ask them to give us a shot and if they have any--we would leave them additional information for contacts so if they have claims issues or prior authorization issues they have a point of contact to reach out to us should they have ongoing issue and usually that is all it takes for members to continue to receive care. >> if a member were to have a doctor say i don't want to deal with blue shield, the member contact blue shield or hss to say can you reach out and educate this doctor? >> the most efficient way is probably to contact blue shield and give us the name of the providers and what we would do is the outreach and education. >> are you hearing this from

our members? >> just some an icdotal stuff i have seen on the internet and facebook pages for members across the country-the transition hasn't occurred yet, it is saying their providers dont take blue shield. >> it isn't our health service members? >> no, they are our health service members? >> they are our health service members? >> may not be retirees. we have quite a few [indiscernible] checks and balances with pre auth and denial. i encourage you to contact us. very different plan design with a ppo. >> glad to hear they are willing to educate the providers and hopefully they--so we can tell them call blue shield, have them talk to the doctor and- >> once they see the card, the new card, it will make a difference because they are used to your old card

as a active employee perhaps. how you were in the system. if it is on the internet, who knows. >> okay. thank you. >> and then we also wanted to share lastly, we held various in person town halls with retiree groups and one particular at the uesf retiree meeting we were able to assist with 8 plus providers in the san francisco area and we were able to validate all them are in the network and this particular retiree is very happy and she told us she had 10 other friends-- >> great. >> that utilize the same providers so they would be very happy with the experience helping her and share the good news basically. >> okay. you are not anticipating 10 more phone calls? >> no.

we are anticipating 10 plus happy phone calls. >> okay. >> looking ahead, we transitioned in total 19.100 members enrolled in a uhc plan to blue shield. we will continue to support those members and work with a ahn to develop a score card to benchmark progress to insure that we provide the best services and expectations or meet expectations of members moving forward. we are very excited if you can't tell about the opportunity to meet and exceed those expectations when we get to 1-1-25. >> great. >> any additional questions? >> any questions? not seeing any. looks like we are ■going ahead

pretty good. okay. >> are thank you. >> back with you. good, thank you. >> we'll take public comment now. >> public comment is open. for those dialing in dial 415-655-0001, enter ax ses code and pound and pound again and star 3 to raise your hand. in person public comment will be first fallowed by remote. we'll begin with in person public comment. no one approached the podium. move to remote public comment. we have two callers on the phone line. both callers raised their hand. there is a brief pause as i transition unmute callers. welcome caller. >> good afternoon commissioners. my name is christopher, i have

questions about the blue shield plan. what is the plan on handling grievance or appeals related to the transition and how can members navigate this process? >> caller, you can proceed with all questions and the board can choose to respond or not. >> how does the blue shield plan address gaps in coverage for medicare beneficiaries? and are there any additional resources available for members to better understand the new plan? i know the presentation did say there were town halls and the call center, but are there anymore resources they can access? that's it. thank you. >> thank you caller. don't forget there is always the help

line. >> we have two callers on the phone line. there is a brief pause as i transition to the next caller. welcome caller. >> [indiscernible] additional resources available for members to better understand the new plan. i know a presentation did say-- >> i unmuted the second caller. if the caller is listening, there might be a slight delay and we could hear that delay online. we'll give a few seconds and unmute the second caller. welcome caller. >> yeah. this is herbert winer and i just have [indiscernible]

[difficulty hearing speaker] blue shield can contact the provider. >> caller, i'm unsure if you finished your comments. i believe there may be some sound in the background with a delay. it can help to mute your computer. i can unmute you and you can finish your time at about 2 minutes. you are unmuted.

>> can you hear nee? me? >> yes, we can hear you we heard your comment. is there anything you would like to add? >> that is fine. >> thank you caller. i'll put you back on mute. and we have two callers on the phone line. no callers have raised their hand . public comment is closed. >> thank you. next item, please. >> i want to note for the record, our president hao returned at 321 p.m. and chairing the meeting. we'll move to our next agenda item. which is report on open enrollment activity for plan year 2025. this is discussion item and will be presented by sfhss staff who will announce themselves individually. >> good afternoon commissioners.

olga stavinskaya-velasquez, operation manager, health service system. open enrollment presentation i along with colleagues [indiscernible] will review the activity and result of the open enrollment for plan year 2025. we will begin with a brief review of the purpose ofopenen rollment including who we serve. what it takes behind the scenes to run successful open enrollment from finance, contract project management and system and wrap up with member facing activities including communication, member enrollment support and flu clinics. we have also put together a preview oof the early open enrollment in the appendix for your review. open enrollment allows members to make chaichcks to health benefits for the next plan year. the changes are for the duration of the plan year and can only be

changed if they are qualifying life events. section 125 of the internal revenue code sets requirements regarding irvocable of plan election during the plan year and governs the health service system ability to allow members to pay for their healthcare premiums on a pre-tax basis. the health service system provides benefits to active employees of the city and county of scoom distri college of san francisco and retiree population both medicare and non medicare retirees. the overall population grew by 1 thousand members from our last year report out. before we jump to the contribution s of each health division, i like to go over highlights from the pastopen enrollment. this year our largest undertaking during open enrollment was transition of 19.100 lives from the united

healthcare medicare advantage ppo plan to the blue shield ppo plan. with anticipated increase in call volume, we have the support of the health service system member service team along with the blue shield call center and our call center partner, vsa. the call centers handled all most 10 thousand calls with limited system issues. another consideration this year emerjed from partnership and support of the unified school district and request for system and rate updates to support pay frequency change requested by the district. after the approval by the board, our finance division calculates and approve rates for member communication and system updates. they also validate the rates for communication to use in member communications, a process established to insure accuracy. the upcoming plan year 2025,

the contract team in partnership with our benefit partners reviewed modified and accepted over 100 pieces of member collateral, including critical necessary plan document like evidence of coverage, certificate of insurance and summaries of benefits and coverage. through this process insurance compliance with oved benefits and individual plan renewal and uphold the department high standard of clear and easy to understand description of member benefits. at this time, i like to turn over the presentation to [indiscernible] our enterprise system analytic director. >> good afternoon commissioners. director enterprise system here to provide the it component of the presentation. we like to say open enrollment as a full year, so coming into january we'll

be wrapping up activities for 2025 plan year. 2026 kicked off rates and benefits of which you participate in that. my team provides dedicated project management for that, so we can insure all the intricacy which involve hundreds and hundreds of tasks. are completed and on time. in addition to that, we do have annual configuration actirfbties of the benefit administration system and some years we find net new work to do. this year of course we have the heavy lift with the blue shield medicare plan and implementing that as well as decommissioning the various labors of the united helt care plans we have and then olga alluded we did modify deduction schedules for all the unified school district employees to help in preparation for new pay roll system scheduled it go live for them july 1.

historically we have come to the board with updates about the issues with unified school district due to their systems, so we are still working through issues. we still do not have a working interface file. we do anticipate testing another file in the next coming couple weeks. finally, we like to talk about the work and effort that goes into supporting the precision communication that have that targeted messages. we have to do data mining to get there and here is examples of targeted messaging, to get to all the different lists and hand that over so our communication team for all the great work that they do with that. turning it over. >> thank you. good afternoon commissioners. jessica, communication director for the health service system.

each year my team has the honor of providing more then 80 thousand members with their custom open enrollment letters. this year that involved creating 89 different custom templates with hard coated [indiscernible] we could not do this without the support of [indiscernible] who provides with all the data that is ren's team and of course with finance who helps us calculate the rates and approve all the rates. we thank them tremendously for their support. i want to take the time to call out jay [indiscernible] and ryan who worked really hard to create and develop all the 4 benefit guides that hopefully you have all seen and all the letters, collateral materials including our website. >> quite impressive. >> thank you. and of course every year we work really hard to reach all our members and that includes reaching them through every channel we have available. in addition to the letters we

have 4 weekly e-mails which i hope everyone received and our benefit fairs. we hosted 6 of them. flu clinics and webinars. we also ask all the health plan vendors to provide office hours for members to get one on one plan consultations. this year we did something new, because we did get feedback from members that said they didn't know when open enrollment ended last year, so this year we provided 2 thousand posters and 2 thousand table tents distributed to 103 different city departments with the help of our wellbeing champion so it was clear the open enrollment resources and the dates. we didn't want anyone to miss critical deadlines. finally, for our webinars and benefits fair this year we did something different. we changed our strategy.e past vendor hosted webinars.

we noticed participation was a little low so we changed it to sfhss hosted webinars and invited multiple members to present and increased attendance by 300 percent on average and attendance ranged from 19 to 164 attendedees for each webinar. and we also hosted six benefit fairs four of which exceeded attendance goals. we have more detailed results available in the apenedx and thank you. >> that was very prudent and very insightful. thank the staff. thank everybody. >> thank you commissioner. >> now i hand it off to colleague. >> dpood afternoon commissioners. carrie. well being manager hss. couple highlights for flu this year is we typically take 10 months of planning and implementation and execution, so not quite as long as oe, but all most most of the year.

additionally, we did execute on 20 flu clinics this year and as jessica alluded, we had a champion training and we had about 74 champions in attendance and they do a huge part helping spread the message. additionally, team created 21 clinics around flu specifically. this year we partnered with two health plans to execute on the clinics so it is new. we always stuck with one, so been great to know we have other options where we need it. we ended up having 19 locations. we do typically do 2 clinics at dem to make sure we accommodate the population in the jobs they have because they are 24/7. we executed a total of 1700 vaccines this year and we had 2 new clinic locations, so one was at department of homelessness and housing and the second was combined location between police and mta at the forensic

buildings. that concludes flu. i'll turn it over to member services. >> thank you carrie. i like to take a moment to express gratitude ■tto member service staff for their outstanding efforts during this year open enrollment. not only did they handle the increase in call volume and enrollment process but continued to manage the day to day responsibilities with great efficiency. we normally report to the board our direct member interactions through support of members. here i like to highlight some of the other work streams member services staff are responsible for and continue to manage during and after open enrollment. over 1 thousand paper applications and 1500 supporting documents were processed on time to insure accurate

conformation statements. as part of the open enrollment data clean up member service supervisor and staff processed 25 queries weekly and 17 additional queries with hundreds of member records that required review and update to insure accurate data is passed or transmitted to our plan. we also incorporated 2 efficiency initiative to support member using benefit for enrollment. members who added dependents through e benefit but did not subschmidt supporting document were scent twoe e-mail reminders to insure the requires documented were submitted timely and dependents added timely. second, members who initiated the enrollment process through e benefits but did not submit election were also sent multiple e-mail reminders to insure their elections were properly submitted. this initiative resulted in 162

members not having their election submitted. compared to 400 last year. over 400 last year actually. >> that is a huge difference. >> that is what we wanted to make sure we were able to communicate and it is a generic e-mail sent out. no phi data on there. to those members to basically engage them all over again to go into the system and make those elections confirmed. >> good thinking. >> as we wrap up the presentation, i like to emphasize the complexity of administrating open enrollment for a organization as large as the city and county of san francisco, including unified school district and city college of san francisco, including our two retiree populations. this presentation is only a snippet of the required work load. the knowledge and education of staff along with collaborative mind fp frame

we provide quality benefits to the next plan year. i invite the board to review the appendix at the end of the presentation and happy to answer any questions. >> the number 16.940 members who changed plan include the uhc blue shield changes, or that does not include them? >> turn to ren. thank you. >> it was included? >> yeah. >> okay. >> quick question. i received a phone call for a member recently and now i understand why. it was about the phone call with the health service and had to wait a very long time and after 20minutes they were disconnected. 10 phone calls you are receiving. everybody is not

getting-received quickly or immediately i should say. have you found out is there a problem or any issues that you heard from our members that they are not getting timely manner the phone calls answered >> prior to end of open ment we had voice mail turned on at 20 minutes. the work load associated with the cleanup of all the files we have to get through, we were not able to handle the additional work load after open enrollment so that is turned off. we do have support of the call center vsa. all most every queue we have for general information and even specific information for members enrollment currently and for future enrollment for plan year 2025 goes to that call center. the only queues that are dedicated to my staff right now are for our delinquency appeals queue. if a member self-chose a queue

that went directly to my staff, because we have to reduce the number of individuals able to handle the phone in order to take care of the workload, they would have that experience. however, through the end of the month we do have the support of the vsa off site call center and i believe their call data as meeting with them wednesday, they did not have high call wait times and are fully staffed to be able to support those members. >> okay. it hasn't been a issue you have been hearing from other members? >> if the member is choosing a queue that happens-it isn't a large issue. >> understand. thank you. also thank you for all the hard work and your staff do. >> thank you, i'll pass on the message. >> i want to echo that. i think every year you give us a report how open enrollment went and every year you and ren and jessica and

carrie don't cease to impress us so thank you. thank you for the hard work you do on behalf of the members. >> thank you. tell the rest of the staff as well. we appreciate it very very much. >> absolutely. they will hear it from you. we have video playing in the lobby. [laughter] >> good job everybody! >> thank you commissioners. >> thank you. >> any other questions or comments for the group of presenters? if not we'll go to public comment. >> public comment is open. for those dialing in call 415-655-00001 and enter access code and pound and pound again and star 3 to raise your hand. for those online, click raise hand icon to speak. in person public comment is first fallowed by remote. we'll begin with in person public comment. no one approached the podium and move to remote public comment.

i'll check the remote public comment queue. we have one caller on the phone line. i'll pause as the caller may enter the public comment queue at this time by pressing star 3 to raise your hand or press raise hand icon. one caller raised their hand. caller, i'll unmute. welcome caller. i will give a slight pause. the person may be listening and having the background. >> okay, this is herbert winer, and [indiscernible] trying to change my address was

that i went through [indiscernible] clicking on and off and i wasn't able to get the direct phone number and then when i got the direct phone number, then they directed me to all these other procedures and it was very difficult to make a connection. i wish it could be simplified. >> thank you caller. we have one caller on the phone line who has spoken on public comment. with that, public comment is closed. >> thank you. we'll take the next item please. >> item 14, review and approve the health service board contingency reserve policy 210 revisions. this is action item and

presented by committee chair zvanski. >> who is asleep at the switch? okay. for item 14. you all have--okay. i welcome comments from colleagues. >> sure, dr. wilson and i can jump in, because we are fellow members of the governance committee and chair zvanski. i think we heard from mike clark at aon, a recommendation to delete the contingency reserve for the active dental ppo plan, because such a

reserve is not necessary. we had done it already in march. we suspended it for 2024, right? >> yeah. >> and so, this recommendation, which the governance committee approved would be for the board to agree to delete that provision from our governance. and mike, please feel free to fill in any gaps that we failed to flesh out. >> this is going forward. >> yeah. >> good afternoon commissioners. mike clark, aon. this is a recommendation to permanently remove the active employee dental ppo plan and it is only the active

employee plan among the dental plans because it is the only self-funded dental plan. all other plans including retiree plans are self-funded. i know there was a question posed during the governance committee about it the timing, the intent after the meeting is get through the rates and benefit cycle and upon the first meeting of the governance committee in the fall take this for action and the timing is important because next month i'll stand before you all proposing both the [indiscernible] contingency reserves as of the most recently completed fiscal year june 30, 2024, so that is the importance of having this on today's agenda and last week's governance committee agenda for approval today. happy to address any other questions any commissioner may have. >> do we have questions for

mike? no. >> i think we got it. >> if not, we'll entertain a motion to approve the recommendation to remove the active dental ppo plan from the health service board contingency reserve policy 210. >> we are-that is the motion and i'll second that. >> chair zvanski, i can open up for public comment. >> yes, please do. >> public comment is open. for those dialing in call 415-655-0001 access code fallowed by pound and pound again, star 3 to raise your hand. for those on webex click raise hand icon to be placed in the queue to speak. in person public comment will be first fallowed by remote. we'll begin with in person

public comment and no one approached the podium and move to remote public comment. we have one caller on the phone line. one caller raised their hand. there is a brief pause as i unmute the first caller. welcome caller. welcome caller. we are hearing some reverberation, the caller may be listening online and hearing the delay. i'll give 5 more seconds in case the caller is trying to raise their hand, as their hand is raised.

welcome caller. welcome caller. doesn't seem to be ind caishz the caller is trying to-click on the raise hand icon after public comment is received. with that, public comment is now closed. >> that was odd. >> great. thank you. we will take a roll call vote, please. >> roll call vote starting with president hao, aye. vice president zvanski, aye. commissioner cremens, aye. supervisor dorsey, aye. commissioner howard, aye. commissioner sass, aye. commissioner wilson, aye. >> great. thank you. >> item 14, review and approve the rules section 125 caf tearier plan for 2025 revision.

this is action item and summaries can be given by chair zvanski. >> okay. and i just-where did i just have it and just lost it? go right ahead. that works for me. >> so, olga, i might need your help because you can flush out the details. this another item before the governance committee last week and once a year we do have to make updates to our section 125 plan documents and some of them are just based on the changes of years and any plan descriptions. some also provide further clarification. if you want to provide additional summary or additional flushing out please do. thank you. >> the san francisco health service rules have been updated to include and you center the summary of all the inclusions if there are questions on

that it is a request to approve these items annually as they take effect as of january 1 so we request that they are approved today and happy to answer questions on each individual update item and for the section 125 cafeteria plan, we have a three different updates there. we have alliance with-excuse me, alignment with the fsa,ire rs standards along with the mou flexibility credit standard and clean up of available plan. >> it is mostly dates updated, right? >> in which document? >> for these documents, it is mostly dates that get moved forward to the upcoming year? >> there are date updates, but there are substantive updates in the health service rules and in terms of

alignment with irs regulations for fsa accounts, mou alignment for flexible credit and plan changes. >> they are very well documented in this presentation, thank you. >> thank you. >> very well done. >> the substantive chaichcks to the rules help clarify definitions and categories of eligible participants? >> that is correct. >> right. yeah. >> do we have any questions from the board about this document? seeing none. we'll take public comment. >> hopefully we made it more user frndly. >> that is the intent. >> thank you. >> public comment is open. call 415-655-0001 enter access code, pound and pound, star 3 to raise your hand. for those own webex, press

raise hand to speak. in person is first fallowed by remote. we'll begin with in person public comment and no one approached the podium and move to remote public comment. we have one caller on the line. i'll pause 5 seconds for any changes in the public comment queue. no callers raised their hand. public comment is now closed. >> great. let's take a roll call, please. >> roll call-did we take a motion? >> didn't we take a motion? >> sorry, my apology. i wanted to make sure. roll call vote starting with president hao, aye. vice president zvanski, aye. commissioner cremens, aye. supervisor dorsey, aye. commissioner howard, aye. commissioner sass, aye.

commissioner wilson, aye. >> thank you. final item governance committee. final two items. >> item 15, initiate public employee evaluation of sfhss executive director for 2024. this is action item. >> i'm happy to do a quick recap. our current lead is despite the fact [indiscernible] required to undergo evaluation, so there a formal process that begins once we take action starting in january just to go over briefly the categories we will be evaluating executive director. leadership and vision, resource management and governance, management of people, collaboration and communication and client service focus. there is a formal process that we will begin once we approve this process.

any questions? >> i can see abby is looking forward to it. >> we need a motion. >> i make the motion we launch the evaluation of the executive director. >> second. >> for 2024. >> correct. >> public comment. >> public comment is open. for those dialing in call 415-655-0001, access code and pound and pound and star tee to raise your hand cht those watching on webex click raise hand to be placed in the queue. in person public comment will be first fallowed by remote public comment. we'll begin with in person public comment and no one approached to the podium and move to remote public comment.

we have one caller on the line. no one raised their hand. i'll give 5 second pause for any changes in the queue. no callers raised their hand. public comment is now closed. >> great. >> alright. now we are on the final item of the governance committee. >> 17, right? >> uh-huh. >> we have to vote. that's right. always forget to vote. we'll take a roll call vote. >> roll call vote starting with president hao, aye. vice president zvanski, aye. commissioner cremen, aye. supervisor dorsey, aye. commissioner howard, aye. commissioner sass, aye. commissioner wilson, aye. >> thank you. unanimous. now we can move to item 17.

>> item 96ate annual health service board self-evaluation for plan year 2025. this is action item and summary given by the committee. >> happy to take that one too. this is more self-reflective the board doing self-evaluation and it has 8 main categories with 42 questions, so commissioners get ready to do some serious self-evaluation and with us we i like to entertain any questions on this and entertain a motion. you can't wait to do it, i can tell. >> yep are. >> i move we initiate the annual health service board self-evaluation process. >> second. >> moved and seconded and we'll take public comment. >> public comment is open.

call 415-655-0001, access code fallowed by pound and pound again. star 3 to raise your hand. those on webex click raise hand icon to be placed in the queue to speak. in person public comment will be first fallowed by remote public comment. we'll begin with in person public comment and no one approached the podium and move to remote public comment. there is one caller on the phone line, no one raised their hand at this point. i'll give a 5 second pause for changes in the queue. no callers raised their hand at this time. public comment is now closed. >> thank you. now we can do roll call vote, please. >> roll call vote, president hao, aye. vice president zvanski, aye. commissioner cremen, aye. supervisor dorsey, aye. commissioner howard,i rar. commissioner sass, aye. commissioner wilson, aye. >> thank you. that concludes our items on the

governance committee matters and turn to item 18. >> item for reports and updates from contracted health plan representatives. this is discussion item and presented by president hao. >> are there any members of our health plans who like to make any announcements? no? alright. then i suppose we can adjourn and i do want to wish everybody a very happy holiday season and we will be back at this in january in 2025. meeting adjourned. >> adjournment at 411 p.m. [meeting adjourned]

[pledge of allegiance] >> fire commission regular meeting december 11, 2024. 9 a.m. to 12 p.m. this meeting will be in person at city hall room 416. members attends nothing personville an opportunity to provide public comment members

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