discussion item and presented by iftikhar hussain chief financial officer and mike clarke with aon. >> good afternoon commissioners. mike clarke with aonalong with chief financial officer hussain will present the board education topic. this is timely given we are about to enter rate and benefit season for the health plans so we want to take a few minutes today to talk about healthcare trend influencers what we see in the market place. so, start with historical view comparing sfhss and compareters, i will talk about drivers of cost and expectations influencing medical trends and mitigation strategies. we'll both talk about the importance of wellbeing primarily prevention early intervention and advance primary care initiatives and cfo hussain will close to talk through trend mitigation and potential strategies at sfhss. >> i'll show some trend data here and the three lines you see on the slide, the purple line is san francisco bay area cpi. that is all goods and services not just medical services. you can see the purple line dropping but in 2020 with the pandemic more so then the medica