I dont know how long the waiting list is. And you know, there are other things. Try calling durable equipment sometime and waiting on the phone for 45 minutes or a half hour. The other thing, my doctor ive seen for 30 years is cutting back. And the only reason i knew, because i was in to see him, but when you go online to make an appointment, you dont get him, you get apparently hes training the new doctor why doesnt kaiser send out an email saying he is retiring and you can see this other doctor, instead of looking online. If i went online, would have started calling up and saying why cant i see my doctor ive seen for 30 years . You know, kaiser needs to get down in the weeds and fix some of the issues before they start spending money on the warriors and the sharks. Thank you. President breslin thank you. Any other Public Comment . Seeing none. Now well go back to number 8. Back to the regular scheduled agenda. Item is the finance reporting as of june 30, 2019, and as of september 30, 2019. This is presented by pamela levin, the chief financial officer. Pamela levin, chief financial officer. Im going over the report for fy201819. The report in front of you i know is dense and long. This typically would be given at the same time as the audit results. Those are still delayed we think, as i understood from yesterday, that i thought they were going to be out in the middle of december, or next week, and i think theyre still going to be delayed. But all the data that im presenting is exactly the data that will come out in the financial report. They just havent finished all the work. So the trust ended fy1819 with balance of 91. 2 million, this is increase of 4. 7 million from the 17. 74 balance as of june 30, 2018. Ill discuss the increases against this 92. 1 million fund balance. The 4. 7 million increases because of 3. 6 million decrease in the trust fund associated with United Health care ppo plan, resulting from subsidizing the 1819 the 2018 and the 2019 rates from the stabilization reserve. And unfavorable claims experience. Particlely upsets partially upsets. Unfavorable claims experience is offset by the pharmacy rebates and the 3. 6 million decrease in the trust fund. For blue shield access plus, there is a 7. 1 million increase. This is several different factors are contributing to this. The first one is that we had a buyup in the rates to cover the 2016 and 2017 deficits that blue shield had. There are pharmacy rebates and favorable claim experiences. These are offset, these positive balances are offset by incent to payment to brown and toland for the 2018 year, plan year performance. For blue shield trio, there is a 5. 5 million increase in the trust fund balance. Its resulting from the buyup in the rates to cover 2016 and 2017 deficits. There is also pharmacy rebates and favorable claims experience. For delta dental selffunded plan, there is a 1. 2 million increase in the trust fund balance. Resulting from favorable claims experience. Which is offset by the use of the stabilization reserve to subsidize the 2018 and 2019 rates. We have a 800,000 increase in the trust fund associated with kaiser due to three factors. The first is the impact of the pay calendars through the School District and college district. When you have fiscal year ending and there is still a contribution coming from the entities. And thats the its just a timing factor. There is contractual provision governing the timing of the Premium Payments and also members are moving from active to retiree and from nonmedicare to medicare status. There is 100,000 decrease in the trust fund balance associated with claims payments for flexible spending accounts exceeding the payroll deductions as a result of the timing and the reductions. Its the same sort of thing. When the fiscal year ends, there is it doesnt necessarily mean that that all the payroll deductions are actually done. There is some timing issues. Weve always had that. There is 400,000 increase in the trust fund balance due to forfeitures for flexible spending accounts. As we discussed before, the irs allows forfeitures to be used to fund the administration of the flex spending accounts. The forfeitures reside in the trust fund and the expenses for the administration reside in the general fund. So a transfer is required at the end of the fiscal year. So on the chart that you have, at the beginning of the report, youll see a forfeiture is up 400,000 and then negative transfer for forfeiture, fsa administration. I want to note that we keep this transfer to the minimum required to fulfill our obligations in terms of our budget. And we dont transfer any more than what is actually brought in from the forfeitures. There is 500,000 increase in the trust fund associated with the Health Care Sustainability fund. The table that is in there shows budget versus actual, but at the end we have increase of 500,000. There is a 2. 9 million increase in the trust fund associated with investment earnings. This is considerably better than what we had several years ago. I think we can all remember those years. And there is 400,000 increase in the trust fund balance for performance guarantees which is net of the 100,000 dollars paid in 1819 under the adoption and surrogacy plan. There was 8. 1 million in pharmacy rebates received in fy1819. The end of the year, 92. 1 and for the fund balance, but there are obligations and reserves against that. So im going to go through those. There is 44. 7 million in future obligations against the 92. 1 million. Trust fund balance, they consist of 23. 5 million in contingency reserves, 16. 1 million in stabilization reserves. 3. 9 million for the Health Care Sustainability fund. 1. 2 million in performance guarantees for the adoption surrogacy benefit. And after that, the total is 44. 7 million in future obligations. Once that is netted out of the 92. 1, the fund balance is 47. 4. I provided a chart to look at where we are in terms of, you know, the fund balance and then the future obligations. And over the last five years and youll be able to see that the value of the future obligations and reserves has remained relatively stable since 201617. Turing now to the general Fund Administrative budget. There was a balance of 698,000 at the end of the fiscal year due to delays in hiring. After we carried forward 195,000 into this year, a balance of 504,000 remained. We went to the Controllers Office and Mayors Office and requested manual carry forwards. These are up to the discretion of the it requires approval by the Controllers Office and the Mayors Office. They have to be justified and we had 130,000 carried over into 1920 for professional services, materials, and supplies and work orders. You cant carry over surpluses or balances in salaries and fringes. So is there any questions on this report . Id like to take that before i go onto the next. The report for this fiscal year. Okay. All right. I turn to this fiscal year. So were giving a report that summarizes through september 30, 2019, and then a projection for the year end being june 30, 2020. In terms of the trust fund, as i just reported, were starting with a balance of 92. 1 million based on the activities through september. The fund balance is projected to be 89. 1 million, which is a decrease of 3 million. Were projecting no change in the fund balance for the ppo plan. For access plus, the fund balance is projected to increase 11. 2 million primarily due to pharmacy rebates and favorable claims experience. And i just like to put a caveat on all of this, this is only three months, july, august and september. So you know, the crystal ball is not fully developed until about may when we can tell you what well end up in june. For the trio plan, were projecting 8. 9 million decrease in the fund balance primarily due to large claims incurred in july, august and september. We have were working with aon and blue shield to dig deeper into this the large claims. Were projecting 3. 4 million decrease in the fund balance fort delta dental selffunded plan. And that is a result of subsidizing the rates and and when you look at this, its greater than the favorable claims experience. For the Health Care Sustainability fund, were projecting a yearend balance of 1. 8 million. This when you look at the projection in the chart, that is provided in here, budget versus actual, and the projection, were projecting 14. 5 14,000 left at the end of the year when you just look at the annual expenses and the annual revenues. Which obviously indicates that the expenditures, annual expenditures, ongoing expenditures are cripesing at fast increasing at faster rates than the revenues and well have to do something about that. In terms of investment earnings, were projecting 1 million. There are no performance guarantee payments received as of september 30. We paid out a total of 45,000 under the adoption surrogacy assistant plan through september. And we are projecting that we will use 200,000 for reimbursements this fiscal year based on Prior Experience in what were seeing right now. Just to right size this, when you went to approve the servicing adoption plan, we set aside a maximum of 300,000 would be distributed in a year. So were still staying well below, as far as im concerned, well below 300,000. The ammana forfeitures or unused spending account balances, which i described coming to the trust, that wont be known until july 2020 after the runout. And as previously described in terms of use of the forfeitures for the administration of the flexible spending accounts, currently there is a budget of 600,000, but as i mentioned before, well only transfer forfeitures up to the amount that the forfeitures come in and no more. So at the maximum, it would be 600,000, but as you can see from this year, it was 400,000. And in prior years we havent transferred anything at all. I have tried very hard to be fiscally responsible for the forfeitur forfeitures. No pharmacy rebates have been received this fiscal year, but we are projecting an 8 million balance based on prior years experience. The plan showing the expenses compared to the budget of premiums. The cumulative expenses are tracking higher than revenues for the uhc ma ppo plan and the expenses are tracking lower for access plus and delta dental. Again, three months into the fiscal year, well continue to work on that and see how that flows out and continue to monitor it. And then in terms of the general fund right now, were projecting that well end the year on budget. Is there any questions . Commissioner follansbee can you go back to page 4, the blue shield trio flex funded. You said there was during this period, 12 million decrease in fund balance due to unfavorable claim experience, what kind of claims are those, do you have any idea . So in trio, let me make sure i have the right report. Were talking about through september . Yes. Yes. So in the last three months, weve seen a peak in high cost claims. Those are claims over a Million Dollars. What happens with trio is that the correct me if im wrong, mike but in trio, the risk on the claims is born by blue shield. So while this is alarming, there it still doesnt present a really super i believe that at the end of the year, this will wash out. But we are we have a meeting with blue shield tomorrow. Were planning to ask questions. Were seeing their utilization where mike has been in contact along with me with aon. With the account Management Team for blue shield. And were really monitoring this carefully. All right. Mike clark, aon. When we started to see the uptick in the claim experience overall for the trio plan, july, august, september, we did reach out to blue shield, because my inclination is always to focus on large claims first. There is a reason why claims may be spiking one month to the next. But also we put a general ask, what are you soo eking in the data what are you seeing in the data . Theyre saying its isolated. Were seeing one high cost Chronic Kidney Disease claim that just rolled onto medicare, because thats one of the qualifying events, but it takes 29 months for that to happen. Highly unusual cerebral vascular events. But when we look at it over the course of the year, and look at where the claims have come in on trio, its really unusual to see the spike for july, august, september, that we frankly hadnt seen earlier in the year. Pamela commented on the favorability of trio through june 30 where we didnt see spiked large claim experience, but we did see it for july, august, september. Weve had ongoing conversations, just in general discussions around large Case Management with blue shield and how the partners are working with patients who are incurring large claims, so those discussions continue from a Care Management for those patients standpoint. But ill also say that sometimes you just see peaks and valleys and incidents of large claims. We have gotten Early Advance preview of, okay, what portrayed for october and november as well. Obviously not verified yet, but very early reporting, where we did continue to see a little bit of large claim activity in october. And to pamelas point, too, anything over a million does roll into blue shield responsibility because there is Million Dollars per individual for a calendar year on large claim in both the trio and the access plus plans. So part of what also happens, is when a claimant goes over a million, it will still play into the data that pamela has through a given period. And it may take a month or two then for the stop loss reimbursement, to vend that out in the experience. I think thats also happened when you look at data through september, versus some of the early information weve now seen through november. Thank you. Were on it. Any other questions . Thank you. President breslin any Public Comment on this item . Seeing none. Would anybody be interested in a break . Well be on a president breslin in session. Madame secretary, item number 10. Item 10, open enrollment report. Summary of the open enrollment Key Statistics and the member plan migration. This is presented by mitchell griggs. Mitchell, you survived. We did. Mitchell griggs, its that time of year again where were coming to report out about october. As i like to call it, our really big show. It takes a lot of work. Up to it and during that 30 days 31 days, whatever its going to be of open enrollment, and then after, its a lot of work, too. I always get fussed at by the Members Services staff when i say open enrollment is over october 31, because as you see it continues to go throughout the year. This is my 8th open enrollment and i do consider this one as one of the most successful and well get into why i feel that way. Just as a reminder, back in september i mentioned the size of open enrollment. We mailed out 76,000 packets this year. We brought in the county and Court Commissioners into selfservice this year. So that was a total of 36,000 people. We did do a pilot for selfservice for the School District which i believe was about 337 people. And we added more retirees for a total of about 6,000 there. 7,000. So last year we only had 8,000 actives and 4800 retirees. All in all, we had 42,000 people in selfservice. So we were anxious and excited to see how the adherence was. Im going to talk about that, but putting off, because im going to talk about that later. And talk a little more about member assistance. This year, the phone calls, we received 11,000 calls. Thats down 8. 5 . Last year, it was 12,000. We met all the Custom Service metrics. That was good, people waited average of 8 seconds for analyst to answer the phone. And inperson assistance, this is when people come in during the month of october, and the number there says 2158. That is last years number. It didnt get updated. It was 2900 this year. That was increase of 26 . Thats what we want. We want to be able to provide this assistance to people facetoface when they come in. We also go offsite. This year, we got 1800 members we spoke to. We have a lot of people who ask a quick question, grab a benefits guide. We dont necessarily count them, but i went to several of them and is looked like attendance had decreased a bit. This is not necessarily a bad thing. In the years where we dont have huge plan changes, some of that will decrease like the phone calls. But all in all, you know, its good to have that many offsite events. I did notice in looking at all the statistics, it was the lowest call volume in three years. Three years ago we implemented trio, which caused a lot of calls. And then in the last year, were still trying to figure out why we got so many calls. Its the way the planets were aligned. I think there was still after effect of trio. But this year, pretty steady. On slide 3, still about member assistance, we had upgraded and improved our website this year, earlier this year, i believe it was march. So for open enrollment, we looked through october and we had 27,000 individual users go in and check it out. As typical, though i wanted to look at this, everyone looks at it on october 1 and then everyone looks october 30 and 31st. There are few things in between. Some peaks in between that corresponds with our emails, our mass emails we send out to people. And some of them are actually, after the offsite events, people must go home and look at things. On the slide 4, speaking about our website, it appears that 25 , a quarter of the people actually access it through their smart phone, mobile phone. Which is good news for us, because we know there are employees out there who dont necessarily sit at a desk, not at a computer all day at work, but we do believe that most of them have a smart phone. So were glad that people are looking at it through their mobile device. And on the righthand side of this particular page, this is the top 10 pages that were accessed. We had 16 116,000 sessions. So if i were to go to the website three separate times day, thats three different sessions. Thats a lot of people accessing the website. And 40,000 of the top 10 pages were accessed and youll see number 2, the second highest, of course, the home page is always going to be the highest. Thats the first page everyone goes to, but the most visited outside the home pages were pages for ebenefits. Again, thats what we wanted. We wanted people to learn and use ebenefits. On page 5, ho