August 24, 2017. Is there any discussion of the item by members of the board . Hearing none, im ready to entertain a motion. Moved approval second. Moving approval for both sets of minutes. Weve done properly second. At the regular Meeting Minutes of weve done properly second. At the regular Meeting Minutes of august 10, 2017 special close session of august 24, 2017 the approved. Is there any discussion . Any Public Comment . Seeing none, we are now ready to vote. All those in favor say, aye. [chorus of ayes. ] opposed, nay. It carries unanimously [gavel] we are now ready to go to discussion item 2. Thank you. Item 2 discussion item, general Public Comment on matters within the boards jurisdiction not appearing on todays agenda. Is there any Public Comment on any item on matters within the boards jurisdiction not on todays agenda . We have some Public Comments. My name is Diane Ehrlich and the reason im here i use the benefit the best doctors and an excellent expense. The problem came with that coordination with kaiser. Kaiser refused to give best doctors the fax number to fax the reports. I got a message when i came home one day about that. They were just fedex a me the report to give to my doctors. I would request that kaiser be asked to cooperate with a Second Opinion benefit we have. All right. Thank you for the Public Comment and a last director griggs to make note of that. We will see if we can follow up to get a corrective action. Discussion item 3. Item three discussion item, president s report get president scott. Thank you. I have my report in part on my iphone. So this is going to be a very interesting activity. The item i want to cover is the status of the executive directors search, which has been going on and what our next steps will be. The application process continues in full swing. I do want to stress that we will remain open for qualified applications right up until the time that we start down the list of final [inaudible] with candidates. Theres always passive candidates in a search like this and the search firm has done an excellent job of following up on leads and having discussions with prospects. We welcome, as we said in several other times during the course of this process, if someone has a name of qualifications of someone you think would meet the qualifications published and posted on the website we welcome the opportunity to screen those candidates. As a reminder, everyone can provide additionalremember the Health Service service system, will provide some input to the kind of capabilities and expectations that we might have for an executive director of the system. The survey that is on on you can participate in. I believe theres paper Copies Available as well. Those who might be in the room. We are looking forward to receiving that input during the course of this process. As of yesterday we had 49 applicants for the position. As you heard, as we open the meeting we are close session on the 24th as you heard, as we open the meeting we are close session on 24 august at which time the board did some initial screening of candidates and we expect we will start the first of our screening interviews nextlater this month on the 22nd. The search for consultant is working with some candidates to see if they might be available for interviews on that date. The board has been solicited to determine if they have the time on their calendars and everyone thus far, has indicated they do. So, as we have gone forward to try to get more direct feedback , we have had meetings with various groups and most recently working with a past board member diligently we were able to pull together a meeting of seven retiree associations across the city and county of San Francisco and the bay area, west bay, east bay, i should say as well. It was a very productive meeting for the portion that i attended. I excused myself so they might talk freely to the consultant and the feedback that i got is that it was very beneficial meeting and from the standpoint of her providing perspectives the retirees are in a very unique position to provide to consultant as we begin taking a further look at these candidates. So publicly i want to thank [inaudible] for helping me get this organized. I know that she went off a little bit at the end of the last meeting and ive gone back with my [inaudible] to try to get a corrected and i think were on the right path here. So, again, its critically important that people step forward and share your views. We are soliciting those who use from active as well as retired members in the system and as we get further into the process we think that will bear fruit as we find the appropriate person to provide executive leadership for the system. The other item that i want to highlight and i communicated to the board is that we have had a recent change in our senior actuarial assignment. From aon hewitt. I knew [inaudible] will be leaving aon hewitt. We were told so, today i would like to some of the representatives from aon hewitt planning to speak to advise me the account executive is here, and can walk us through some of the steps of the transition. As they come, this is not an agenda item as my counsel has advised me good so we wont be resenting a lot of details about the change today. That will be taken up at a later meeting. But i did one for the general public and those present to be aware of the change and what we are planning to do going for. So, please. Thank you president scott. Im very pleased you are . Sorry. Im pleased to introduce you to make clerk today was standing her to my left and i will let him speak a little bit about his background and discuss with you. All right. Good afternoon one other thing i would encourage you today, you have to look like you are eating the microphone. You are particularly tall persons you may have to bend forward a little bit to be heard. I am mike clark with aon hewitt. Ive coached well by and get thank you for the comments or. President scott and the board of commissioners, again my name is mike clark. Im a 29 year veteran of aon hewitt ive been a Health Actuary the entire time. Im a fellow of the society of actuaries. A member of the American Academy of actuaries and a fellow of the conference of consulting actuaries. As you indicated mr. Coach are is leaving the aon hewitt organization. Im assuming his responsibilities as a lead actuary on our work with the Health Services system. I very much look forward to working with all of you, including on behalf of your of your members as i Carry Forward in replacement of mr. Coach are on the actuarial responsibilities. Backed by my team, is not changing but i will be your new lead actuary. All right. And you have members your team here so would you take the time to introduce them . As the case may be. Would you like them to come up . I like them for at least two stands of they can be recognized okay. So tom ricks, who is in actuary as well who supported mr. Coach are in the past and will continue to support mike. Toddwho is our west region Practice Leader for health and benefits is here today as well. Rocky my tory, who will actually be presenting in a little bit about on the timeline as well. Then, scott is here as well in attendance why think many of you are familiar with. Yes. A former board member. Yes. Former board member. It reminds me. [laughing]. Well, thank you very much for this brief introduction today. As i said will have a more substantive conversation about the transition plan, your plans for support going forward. And, Something Else . Also i just want to mention Loni Anderson is not in attendance today due to personal reasons and i know she wishes she could be here to see all of you but i do not want her to go without mention all right. Thank you very much for that. Neil is out of town speaking at a prior conference engagement and ive asked we reach out to him to have him come back for public recognition by this board for his service to us for the past number of years. So, we will arrange for that to happen at a subsequent board meeting. Are there any questions or comments from the board regarding the change . I just want to say that [inaudible] the fiduciaryi mean the actuary to remind ar a fiduciary to the members of the trust and that means work solely for the benefit of the members, and also we need transparency to the board which you know, we should note. Thank you. Thank you. Any other board comment . Questions . Is there any Public Comment on my reports . Good afternoon Board Members. Claires on ski. Ccsf. I just want to come forward and publicly thank you. Commissioner scott, for your assistance for that meeting. I thought it went very well and thought it was most productive and i think the Retiree Organization felt very good about being able to come forward and have that specific meeting. It is really great to see former commissioners scott who still a commissioner in other commissionyes, civil service, right . But its always good to see commissionerhere and to welcome the new team. I was just wondering also about page . Is she still part of the team yes. So we just welcome them but i had to publicly thank you after i went off several times at prior meetings if i dont come forward and rectify that and its not good. So, thank you again. Thank you very much. Any other Public Comment . Hearing and see none will now move on to discussion item number four. Item for discussion item, directors report. Acting executive director griggs. Good afternoon president scott and Board Members did i want to do directors report today in remembering this is the end of our rates and benefits cycle. Were going to end open enrollment at the next board meeting, or the next directors report will be strategizing about future plans for hss. I just want to recognize that and the amount of work thats put in to this process and again thanking the board for the vote of faith and having the act as executive director which appointed me in march. Its been a great experience during this rates and benefits in the cycle. Theres other been some sidebars as well. Yes. [laughing]. The directors for today will be kind of brief because as youll see in your copies we are all about open enrollment right now and each one of our divisions is highlighted that that is what we are working on but i want to talk a little bit about the open positions and we are filling some of those position we were 1209, one pcs Permanent Civil Service position that we are opening and underway with recruitment. For open enrollment because we are expecting a busy open enrollment we decided to hire two temporary, 1209 benefit technicians to help us out with the technical work. We stole a lot of manual enrollment data entry type of processes review auditing aromas before we send them over to the health plans so we will have two temporary 1209s to help us without. All of our other permanent staff will be more available to help members facetoface or on the phone or offsite this year which were doing plenty of those. We also have a 5320 which is an illustrator and art design or graphic designer, if you will. Deposition has been open for a little bit. Weve done some interviewing. Were just about ready to make a candidate selection preparing an offer for that position. We also now that ive got the 5320 interviews done and work on the 1802, which is a Research Assistant which was very helpful. Assessing the director prepare these reports especially in a legislative and federal regulation updates and stuff like that. So we are really looking for to fill in opposition and right now im looking on the job ad for that position. We are also cannabis 1694, we are going to select an intern from the citywide accounting Intern Program to help us work in a position thats technically not fillable at the time because of a leave of absence on opposition board hoping to select an intern to help out on the accounting and finance area. For operations, again were gearing up for october which is very busy in the area and part of the preparation, there is just a lot of training. Especially since we are introducing a new health plan thats blue shield trio. The question we are going to get, we build our questions that are frequently asked questions type of scripts and stuff for the benefits analyst to answer these questions. And to train them in all the aspects as well as, we are enrolling of the sp implement in the bsp premier plan, which is on top of the basic plan. So we are doing a lot of training, as well as conjoin our training with our Employee Assistance program and recalled making it work it today we had our last one before open enrollment, which is managing ourselves and we are doing this type of making it work at work just to help people with workloads and the stress of doing Something Like large open enrollments we seem to be doing these days. To move onto the enterprise system, and analytics, and again a reminder a lot of this is about open enrollment as you know were doing a sub Service Pilot so there putting that altogether, developing a, working with our Comptrollers Office and the people in pay. People that do the programming and office configuration. Which is a whole lot of work. On top of that, as we prepare for the mailings and as we prepare for datafiles we sent out for enrollment theres a lot of test cases we have to do. We just dont program this entry these mailings and send them out. We do a lot of different scenarios and we look at them by hand going through and making sure theyre accurate and correct before we send them out. Again, all the open enrollments, lot of bandwidth and time is modifying our website which has becoming more and more important. People are looking to the web to get information. They want electronic, easy access, searchable, quick things so theres anothera lot of work especially happening right now as were getting to post these things. Finance and accounting, as you can see some of the comments here that pamela our cfo has put in hip get the ssp project, which came live july 1, it is working. Occasionally we have some something we have to work through and get help on either through hr or the Comptrollers Office to correct, but as shes duly noted vendors are properly paid. So our bills are being paid. Which is good. We are continuing efforts in calculating the medical and dental rates. Again this is bear head load for the open enrollment is calculating all those different rates based on the mo you, based on the different plans the coverage levels etc. Its a lot of work. Also, our audit right now is on schedule. Ahead of schedule. Everything is going well with that with rk pgm audit. With contracting and vendor management were working really hard and contracting with the consultants that we use. For open enrollment. Were also just completed an agreement with Lab Communications group, which we are a Citizen Group to provide additional booklets. This is a strategy that i worked on stephanie fisher, our wellbeing manager, to do some type of communication we can havegiven new hires for new retirees, so they can see that the wellbeing benefit we provide has dimension to it. When you have your medical plan your dental plan, but you have these benefits wrapped up in what were calling wellbeing. To communicate that and make sure people are aware of it and utilize it. Its very important so we have been working on this booklet to provide new hires and new retirees so they can go through these things and just like that can are benefic guides and see comparisons and types of benefits we provide. So were looking forward to when that is complete. In communications, again, very heavy with open enrollment could our new coming occasions venture started three having four days before lastminute show shes been here a little over four weeks now. Has worked out very well. She hit the ground running and been actually helpful especially tying up the ends of getting our benefit guides and open enrollment materials to the printer and to the mail house. Shes very energetic. Everyone enjoyed working with her issue here today . Well, she asked if she could stay at work because running out of time. For open enrollment some deadlines were trying to meet her name is . Her name is carol carini. I announced it last week that she had been hired but i will bring the rupp in november perhaps we can meet her in person. As fellows the wellbeing is concerned again some of the work we do and produce out there during open enrollment as many flu shot clinics. Part of what they do in september is work with the champions and training them on these clinics, or how to access information to help us communicate that they are out there. We want as many people to as possible to access those flu shots. Again, some of our own wellbeing activities that were doing in august. We do special been at the Wellness Center at the Catherine DouglasWellness Center which we call [inaudible] and everyone brings their favorite sets of recipes of salsa . About 56 participants. Thats way more we had last year though so that was a successful campaign. Some of the fewer of the meetings thatas acting director that i participated in and one of the meetings this past month was with brown and toland kumar are aco advisory meeting which brown and tolan is very important to us for 2018 particularly, with a blue shield trio implementation and getting there willingness to work with us on that. Were very engaged. It was very collaborative meeting and went very well. They are project managers on it just like we do for implementation and we had a very good discussion about communications. Communications that should come from us, come from them and blue shield so it was one of the better meetings weve had with aco. The last thing which is not included in the directors report, which we just found out yesterday is that sb17 which is the pharmacy transparency bill passed the state legislative has passed it. That is a bill that the Health Service for supported back in march this year. Asking the mayor to support it as well. This particular bill ask drug companiesthey would have to alert Health Insurers at least 60 days before they plan to increase the price of a drug if increases at least 16 over a twoyear period. So its a notification about increases. They also is a requirement they have to say, why they are increasing it. Again, this is about transparency and so one of our strategies going into 20182019 is looking is what we can do about extremely escalating pharmacy costs and this is good timing to start that. We talked lots and a lot of the meetings i go to. Everyone talks about and try to expand the different types of pharmaceutical drugs, why theyre so expensive. I was asked, okay, what do we do now and part of that is legislation. So were on the start without in california, certainly leading in that area. Thats very good news. So the next step is the governor signature . The next up is the governor signature, correct. So were doing a presentation updating an open enrollment so i kept it short. Because really thats a lot what we have to talk about so that is my directors report for this month any questions of the board of the executive director . Just thank you again for your work. We know you are doing two jobs and doing a great job. Your Customer Service skills are excellent. So i thank you very much but i know its not easy. Thank you commissioner and present i appreciate it. I call every once in a while to make sure he showing up for work. [laughing]. Any other comments from the board . Yes. I would second our thanks for all the hard work and the clarity of this report. The question i have and maybe will be addressed later on the trio conversion, since you mentioned brown and tolan and the aco, a lot of members will call for an urgent advisor if youre told to go to the emergency room or urgent care. So are the brown toland staff as far as we can tell from the collaborative efforts, been educate about how to advise trio membersif they are trail and advised him where to go . Because the instruction will be different right. So part of this meeting with Advisor Group meeting we have which is semi annual. We had a quarterly aco meeting believe a semi annual with the leaders of the medical groups. And the acos. So they were there at this particular meeting and i feel very assured they are being trained and talking to their staff about how to answer those questions and to know for this group where to send patients and later on in this meeting were also going to have an update on the trio implementation and jeanetteare blue shield executive account manager if you have anything further to comment on that you can do that at that time. I just have one more question. When we did the big transition to the Medicare Advantage healthcare had staff at hss to help out on the phones. Maybe, is that possible for blue shield could also go do that . Have one of their staff dedicated to the line to help our members. Were going to get a lot of calls right. We will reschedule that and put that into implementations they will be there he was one of the staff will be [inaudible] i think, too, perhaps. I think of her 23. Two. They are physically going to be there and have phone lines and voicemail and we do warm transfer calls older or assistance for her own benefit analyst. Any other questions . Commissioners . Is there any Public Comment on the directors report . Hearing and see none were ready to move to the next discussion im item five discussion item, open enrollment update acting executive director griggs. As hes approaching the podium i want to communicate some of the hhs staff might be looking where hearing these proceedings, your work during in preparation during this time is not gone unnoticed by me and im sure other members of the board as we prepare for this season of open enrollment. I want to thank each and everyone of you for what you have done today and what i absolutely know you be doing on behalf of the members as we enter this new season oh open enrollment. So, thank you again on behalf of the board. Acting director griggs. Mitchell griggs thank you pres. Scott for that introduction and because thats exactly what i want to make sure that is understood of the amount of work everyone has done this year, and people have really rolled up their sleeves and their staffing changes weve had a couple surprises this year. It haswe have got this work done. So we are very very happy. We dont often get an opportunity to come up here and describe open enrollment to you before it happens. Typically in novemberdecember we do an overview and give you my of applications we have entered, or, how many flu shots we did but we dont really talk about what goes into the work. So thats what were trying to do here. I want to preface, too, by saying this presentation is not this a very visual presentation. Theres a lot of pictures that just show you the size of the data, or can i show you the piece of work is not necessarily meant to be read. Thats why it is small. A lot of these things were being drafted when we created this presentation so we did i want to put it out there until its really final. So it is just visual. Sfgov tv, thank you. So on the first slide, i want to talk about our theme. We did a lot of work this year and thinking about what type of theme we want to put out there. Early last year we worked with a consultant and are rebranding. To give us an idea for open enrollment of having a circle of pictures but we often use pictures on our benefit guides and showing the diversity of the retirees, the diversity of active employees. So, we took that and i talked to the staff this year and i said that looks really good. People can see that circle and that o and i means open enrollment and they see that packet in the mail this year and in futures. Hopefully they can see that means open enrollment but in addition to the pictures of our fellow coworkers, fellow retirees, want to make sure you can look at it and also see it San Francisco. I think its very important these days to realize how good it is to be in San Francisco and the workforce is driving to keep the advances we made moving forward. We want to make sure people knew we were talking open enrollment in San Francisco. So these particularthis theme as you will see, the circle, like a large circle will be our larger envelopes. The of twosided envelopes something were to use the half circle for the smaller size envelopes. These envelopes contain the initial open enrollment letter from our booklet expanding all the changes in enrollment applications. For retirees is also can have a flu shot education flyer. On the next page, again, believe me its a lot of work when we sit here decide if its just three pictures, or five pictures, and how its going to look and how the colors are going to balance. These are benefit guides for 20 teen. These are the covers. A lot of discussion and work between the employers, city college, unified School District, and the city itself and what do they want these to look at and what color is best fitting. So the blue is active guide for 2018. Community college, city college of San Francisco is ingrained. Unified School District is blue and the retirees is ggray. Wears the superior court . The superior court we include in the city and county of San Francisco. Sometimes we do their own smaller type of guide thats only electronic we dont usually print those all right. Thank you. So in a again this is just a visual to show you. This is just the front side of these applications. Every year we have to create these enrollment applications. Go through every word for compliance issues, some language the plans require for us to be on their for signature, and again we work with each individual employer especially School District and ccd for specifics they need because they have some very interesting complicated mo mou. So its can its a lot of work. This year, which will get into a little bit later you will see theres a barcode in the upper righthand corner, a square barcode. We will get more into that but its very exciting. Are planning on what were doing as far as automating, bringing these forms into our office. A lot of planning goes into the events we do this year. 2021 events were doing as open enrollment and those events and plus, or more will be 26 flu shot clinics this year. Last year, we did about 4500 flu shots. We are expecting even more this year. Again, we have our one week there and in october could if youre just looking at the visual counteri know you cant read it i willbecause weve had changes since we put the present it presentation to get we have a tickler vendor work were everyone is coming in at hss Catherine DoddWellness Center and people can talk to the plans. They can talk to the benefits analyst and the benefits analyst are down there to talk with people all month long. This year, we are adding two new informational sessions. We did this last year. Offsite session specifically for a group of people last year. Last year was the medicare people when we moved people into United HealthcareMedicare Advantage kaiser. So we went on to do plans. So i think we did about 18 sessions. We decided to do to this year for active in early retirees plans to have kaiser United Healthcare and blue shield here. To walk people through the blue shield trio. Change if needed and that the plan there to describe their plans. Each plan will have about 10 minutes for presentation and then we will have 1050 minute answer question answer after that and then of course we will be there for a little while for them to ask questions face to face. This will be from 5 30 pm7 30 pm. So its out of typical business hours. Our other offsites we do during the month are usually within business hours. So we want to offer something people cant make it to where the sites during work hours. Again, the other visual here with the circle, we are showing how we use the theme in the advertisement for offsite. On the left is typical open enrollment with flu shot clinic and to the right there, would be just open enrollment or healthcare offsite. So the project plan. Last year we implement a process of having brian rodrigo our it administrators also provide project manager. To manage the project for us. We needed someonei need someone to come in and nagged me they need this for me. Going through the particular plan and looking at the timeline because theres lots of moving parts and its difficult for any individual to do that. Its nice to have a project manager. That was pretty successful last year and so we did it again this year and its been extremely successful. Brian has done a superior job. Is this brian . Brian rodriguez, our it administrator. Especially, considering for a why we do not have a communications manager. That position was unfilled until like i said earlier until 1 august. So its been extremely helpful. I want to just to show you here that this is our project plan. This is the gantt chart. Gantt charts show a typically a timeline as well as dependencies from other one test to the other. To the right, is just an overall and of colorcoded i think my colors were grey and red this year. So you can see the things i had to be responsible for. Brian does a great job getting all this together keeping the timelines together and then reminding us. So thats just one page on the right here. Theres 10 pages with a total 450 separate tasks. Something personally ive been excited about this year is doing for the first time we will do a video about open enrollment. A very high level quick reminders visual things just to show people with a need to do. Will this be embedded on the website . Available on the website . Yes. I was hoping to have some of it today but it is still kind of a very rough draft situation so i gave a couple of those storyboards. Ive learned we have the storyboards with pictures and words the voiceover is going to search it on the righthand side you can see theres going to be a voiceover its going to calendar and the voiceover will say what day it is today. So this is very much the look of the video. Its more of an animated type of video. So, pictures will fade in and fade out and there is a handlooks like a hand drawing. Here you see an arrow thats point to the calendar for you to make sure your pain attention to the calendar and watching out for october 31 because thats the last day. It will be abouti think its just under three minutes. It is short. It doesnt go into a lot of detail but what its doing is reminding you what you can do when you need to do it, and to go look at your open enrollment materials online, or, in the materials that we mail. Im going as marina to come up here and really go into some of the details of the system modifications. What it takes for us to prepare systems to prepare these benefits from year to year. Good afternoon. Maria coleridge enterprise systems and analytics manager. Thank you very much to director griggs allow me to speak for a couple minutes because when youre in the technical space youre supposed to make things be understandable with just means we say things like, were configuring the system. It sounds like good, we are done. But actually, this is a menace my work that goes into that. So if you will just put up with me for a couple mattel tried to go into a little bit more of a deep dive about what we do. Mitchell has already mentioned, we have got the new treo plan coming before us and 2018. We have the vision from your plan. We also have the kaiser multiregion andso these are some of the big items on our radar. All of those have significant system impacts. This slide here is just showing early on we took a look at what some of the system modifications would be in this is really just from a programming perspective. So there was Something Like 45 programs impacted, and when we had to do the split carrier that we delivered for the current plan year wasnt until april of this era reportedly finish the programming for the. Some of these programs have thousands upon thousands of lines of code in them and they have downstream impacts, if there something wrong with them and messes up with one of our programs. The process [inaudible] we have to go through and do our specifications and our development request. So we write it up so its very specific. Then, he goes for Program Development which is either some of the people on the pay side of the house, but we also have a programmer on our own team thats doing a tremendous amount of this work. That can be [inaudible] a lot of programs. The same small group of people are testing to make sure all that coding change did what it was supposed to do and did not do anything else that wasnt supposed to do. Some of these have to be done sequentially because one impacts other programs. We have to make sure it is right first, and we only have really, a team of three that sort of work in the space. When doing programming, one that does a lot of the functional configurations, and writing specifications, and then a couple of them that work in testing. So, we have to fit that all in as you know, on a compressed timeline so we try to look at what we absolutely need to have done by the time october 1 comes and what we need done by the time the first interface files are going out for the year, which happens to start as early as november and what we need by the time we had our first deductions of the new plan year. So we try to triage things accordingly to make sure we fit it all in. So, this is just a big highlevel look at some the programs that are impacted. Something, for example, like vision premier plan has new deduction goes because that this is an employee paid benefit and so its not just our own systems. We publish deduction files with various pension systems. We do it with the unified School District and the committee college district. As with a workout and work with those groups and alert them we now have new codes and new changes that are showing up on those. So theres downstream implications whether organizations as well. Thats just programming. Then, theres configuration. Without looks like is, for example, adding treo. So options available in the system. A lot of bloggers [inaudible] senior principal analyst that works on this and this year she said for configuration time has doubled with the vision and turning that configuration on for every single benefit program and we have about 50 benefit programs. Likewise, for the trio, and medical is not just one option turn on or off,. Theres actually a lot of subset options related to medical. Again, for all 50 of those benefit programs that we have. So, its a very timely timeconsuming activity to do that. There is also options for deleting this year its a long swing that as we go to the next slide. This is a look at some of the detailed rate calculations. So you see rates. We put them in our guys and we put there what we call, simple rates such as coverage codes for [inaudible] e 1, or e 2 or family. But in the system we actually have [inaudible off mic]. In the system it is more than just those simple rates. What you are looking at here again not to necessarily enter read to stop it it just giving you an idea what load files look like. There is actually something to the magnitude of 45 some fields that are in these tables. 44. 44 columns in the stables. Last year we had over 5000 rates. Again thats the various benefit programs. Weve a lot of coverage codes because you know, you have domestic partners theres implications in terms of pretax or posttax applications different mou and with those contribution rules are. All the allocations say what am i supposed to play [inaudible] what parts cultivation with part where does it go to dental. And then of course, we start with those rate sheets that get presented to you by our actuaries and that is again, very simple version of that. Then we get an import file from aon hewitt to start that out but that input file again, is just a very vanilla three coverage levels, no things happen with tax or nothing with the other unity at wheaton to bring here just the main contribution models of the winter 96 were [inaudible] but we have a number of other contributions with the School Districts and unified School Districts committee college plus our retirees. So its over 5000 race but its a lot of work. We also then converted to biweekly because thats how weekly peoples deductions have been a lot of times but things dont abide out prohibited theres rounding things, and so things might be off by a penny and in that people soft load for you if one record doesnt tire perfectly that were this amount should add up to this over here its going to fail the hall. Just to say this is a tremendous amount of work to get to these detailed rates, and so knowing that we had treo meant we were essentially doubling all the blue shield rates and i was can choose another couple thousand rates, and so if you months ago when we had a sense of what is coming did a whole rate analysis to say, are there ways to simplify this burden, and we took them up with a 21 page document with 10 recommendations toi guess in a nutshell the biggest change is that normally we created every type of possible combinations that could ever happen and weve decided the work to support that is just too great and we are better off now to really analyze where are 90 of our population today and we get all of those rates be counted actually, what do and if or when a percent of our population today but we have Different Levels [inaudible]. Everything else that we just used to great a value for just in case nobody walks and someday and has that, we are not doing that anymore. Thats usually a day turnaround time between finance and my team to get that rate calculated in the system. To spend all the countless hours calculating all those have time just was not some feasible anymore in terms of the behemoth it takes to maintain. So that isthats what weve done. Even this workbook here we have has 50 different tabs in it. Some of those [inaudible] some of the cell form as if you were just to copy copy and paste into excel format would be more than two pages long. Thats how nested and extensive these forms are with what 30. That just highlevel. Then when we get this, again i team is working closely with a finance team because we share whose calculating what they were looking towhere are the errors and its a lot of looking through these files for anything that went wrong anything that was a missed on that. So moving forward were trying to have that done by the end of the week well see if we get there. On the next slide, this is also with the piece looks like around our notification letters. You all get those nice letters in the mail but we need data to support that. So the picture is sort of on the left and behind his with the data files look like for this. Of course, [inaudible] has been completely removed from the screen. [inaudible]. Every year we end up having to change the program to generates this file because weve got new things coming in and we want to make sure its reflective of picking up all those new benefits so we can really customize a lot of that were within [inaudible] then, we have a lot of manual work to do because we like to put in for some members, especially cff court, in their letters is if you make no enrollment changes this is what you are pain next year. It is a nice service that we do that but those rates are not yet in our system. As i said, we still may be trying to get by the end of this week but i think well probably slip to early next week. So we do that all outside databases we say okay heres the rates recalibrated lets merge them to the individual, nothing went wrong. Its the right union. The right benefit program so we can tell you what your rates are going to be. We go through and this is an example of some test cases which mitchell mentioned earlier. We have all these scenarios. We look for individuals that meet these scenarios so we can check in the source files and then also with what our print house we just turned over all the data source how files to them last night and first thing this morning. Then, will pull back the subset of records and look at all those individual letters , which i think is maybe upwards of 80 letters that we will be pulling across a lot of different scenarios and a lot of different groups, to say, is this information going on out letter correct . Thats the work we are headlong into today. That is also quite extensive. Next slide, though, something we are trying to deliver. Also, is some additional automation. We have Something Like more than 7000 enrollment applications that we are turned in last year and as you know, we have digitized all our member records and we went and implement an enterprise contact Management System to help streamline workflows. We had just come up with the ecm right before [inaudible] last year. It was so new to our team but it was going to be more confusing than less and also it takes some manual intervention for individuals to scan in those files and link them so they can say, this open enrollment obligation goes to this member could we recognize its timeconsuming so were trying to make up this year. The barcode that mitchell showed you earlier on the top right of all of our enrollment applications and you see more of is human here, is trying to first off tell us what type of application [inaudible] because for the Operational Team there able to assign workflows based on which group were trying to take care of and sometimes based on deadline files or changes to take care of retiree applications first, or other groups, or knowing how many are in their, it helps our minister better assign resources to workflows. Then, the other thing were trying to do is you will see on this particular printout esw 123456, its just not assigned to anybody were preventing these forms [inaudible] we are actually preprinting peoples information on enrollment form. Not all your information because you only go down [inaudible] to any kind of Identity Theft but were [inaudible] so when you fax that in or it comes into other channels we can we got into the system we already know, that is a usb application for this particular person. Because we get lots of calls all through the month. Did you get my application . Its very timeconsuming to do that. Not only does it help streamline our workforce because we already have everything identified to an individual but also helps if while were doing our Member Services is getting calls from individuals to up their application they will already be able to put up your how will you address the issue, ive lost my open enrollment form it had my personal code and information on it . Thats what we have in preprinted any other information in that psw is not tied to anything thats out there and any other way. Other than what we have done to minimize from our perspective, because if you lose your form, i dont mean to sound rude, but that is on you. Yes. How do i go about getting a new form . Yes. For that if you just worried about new forms youll be able to download those from our website and handwrite it and will take care of the recognition on his writing is a great. Thats why were preprinting. For us, to your point, to make sure people are not getting the wrong forms were doing Something Else weve never done before, which is actually have your letter and your form together. Thats have a perforated seal perforate your form out there. We make sure that way people are getting the right information we dont have wrong forms going to the wrong people. So a lots been gone into that. Im still hopeful [inaudible off mic] if i could ask a question, i like the presentation of on automation as well. So when an application is received does that go intocan member access that on his or her own chart to see the application was received and been coded . [inaudible] phone call no. Not at this time. Over the next couple years we got other things coming so that might help address that people to start using the website and their own yes. Yes we really do hope to deliver this. Im very optimistic it is still taking a lot of work and same resources that doing all that other stuff but i am feeling good today we will make it happen. If you asked that same question last week, i would be like him i dont know. Thats a good segway commissioner follansbee because in addition to Everything Else lets also try to get that selfService Pilot going and thats a whole other environment that needs configuration. We are going with been a lot outofthebox because we do not have time to do a lot of customization work and we reckon us we want take the information from this pilot to then influence all the customization will do next year when we go more big bang with this. It is a whole youll see are these are just 26 test cases we had. We had to configure again [inaudible] had to configure this whole environment. Were working with people in pay team around preparing welcome videos and instruction videos and faqs and all of our Outreach Communications and documentation were setting up training environment. Were setting up environments. Will be open labs or people having questions about how to do it will come in. Working again with siobhan and Member Services team around training on this environment and how that will workflows and assistance for the open enrollment environments. It is one more environment that needs to configuration and testing with that ill turn it back over to thank you very much. So just quickly wrapping up, when we talk about developing our mailings and arc medications, that is going to 75,000 people this year. So we are sending full enrollment package and can medications to even people of waived coverage in the past. Typically we just sent him a letter saying its open enrollment and go online and look at your benefits thats available for you to change. This year, we thought with a newa lot of the changes were doing with the vision with the blue shield trio and with the kaiser multiregion for early retirees in terms of medicare thats important to everyone who gets of that information, so we are being a bit more cautious this year. Beck includes our presentation on open enrollment and if you have questions ill certainly entertain those. Questions from the Commission Regarding the open enrollment process were anything theyve described . Commissioner breslin last year there was an issue. A lot of actives were not sent open enrollment package intention because they wanted them to do it on the internet. So even last year everyone got a package. [inaudible] there were complaints about it i think what the issue was last year, two years ago, this will be the third yeartwo years ago we started not signing the full benefit guide, the 44 page booklet with a colorful things. What we did for active employees and early retirees is send a summary of the open enrollment changes and the smaller booklet size. But we have always sent an open enrollment letter in that booklet or guide so if they did not receive it, im trying to recall if there was a mailing issue with a male house last year i think the whole email issue went back and forth. Right. I thing i know which one youre talking about. Yes, it was about not getting the full benefit guide. So okay. In our open enrollment letters in our announcements, when people call people can request one if they just get the booklet but they want that full 44 page guide they can just go online and request or call our office and we will mail one to them. Were are saving some trees. Yes. It is. All right. Any other questions . Just one comments. I just want to complement director griggs and marina and all the stuff and pamela for all your hard work during this open enrollment and thank you. Thank you very much commissioner. All right. Any Public Comment on this discussion item . Clairere csf. Im wondering is there any ability to process any of this completely online . Some of our retirees have asked that but we also have a number of retirees who still dont have computers and, so, i heard director griggs indicate you could get a replacement open enrollment form if you lose it by downloading it, but we do have members dont have that capability. So i am hoping that if they call the office to be able to get hard copies be sent to them. Weve a number of retirees who are going to be coming to the october 11 event for retirees and early retirees at the scottish rite, and i hope there will be some representatives from Health Service there because a lot of them are going to bring the packets and they will want to process their open enrollment onsite. So, we would appreciate it if that would be available. Also, we like to acknowledge the hard work that goes into this. Marinas description was a little bit overwhelming, and i think none of us really appreciate the extent to which the finance group and arenas group, and all the staff really get involved when it comes to open enrollment , and this is just the preparation phase. We understand the processing at the other and is also quite overwhelming. So, they just need to know that retirees are extremely grateful for the services. We do have a lot of elderlythere was when i got an email. Hes 80 and his wife is 90 and theyre coming in from sonoma and they want to be able to process their open enrollment on october 11. Thats more typical some of the members that will be coming to this event and we appreciate all the assistance and support we get. Thank you. Thank you. Director griggs, youve heard the request and i think that was available last year if im not mistaken. Yes. At our ccs the event will have [inaudible] i will be there. All right. I will encourage members of the board, if you have the opportunity and your schedule permits you see the calendar, maybe a more confirmed calendar distributed that you take the opportunity to actually go to some of these meetings and actually meet the members and hear their concerns and their issues. So i thought it would be very beneficial last year as i did wonder to myself. Are there any other Public Comment . Hearing and see none, would like to thank you and the team for what youve done today. We will move on to our next discussion item. Item six, action item, approval of revisions to Health Service system membership rolls. Acting director griggs. Mitchell griggs acting director of Health Service system. Every year we bring to you are member roles we have revised. Those roles are usually good for the plan year. Now are looking at rolls for 2018. We have to Public Notice this because it is a change to membership rules and the members have to be aware. Then we presented in a public forum so they can hear those changes as well is give you an opportunity to approve those changes. This year, for our member rules, we are looking at going through