We are on the verge of this. I have been woring closely with our council to try to be clear about what the role of the executive director and the hss staff is in this process as well as what our responsibilities are as a board as we go forward. So i thought with the guidance of council, after going through other it its other things i thought we wanted to do. To provide opportunity for the board if there are any concerns or articulated issues that we feel we would like to at least be sure that the staff at the beginning of the process and i dont see the board getting diagnosis muddling around in interviews and that sort of things but at the beginning of this process, before the recommendation is brought back, if there are issues and concerned that we wish to at least vocalize and be sure they are made note of as the staff undertakes it work, this would be time to put that on the table. So floor is open for commissioners comments around this particular topic. Are there any . Commissioner brezland . I would like to propose we change the government rules so the board appoints the actual weaactuary instead of the director. It would make it appropriate they report to us in our response to us. Tourial i hear the action. Thats a starting point but i hear you going further. Are there any other comments by commissioners on this topic . The only comment i would make is that the processing to hire the director was very constrained and that we could not have any discussions on you know as a group expect in board meetings we have to be very careful about the brown act and other thing. We find ourselves it is difficult for us to work as a committee or a subcommittee to evaluate our recommendations to the rest and i guess i would prefer we not get overly involved in Management Issues myself. Number one, i dont think we are structured to be able to do that effectively. But maybe more importantly, i think to the extent that we are able to receive presentations on the rfp process and as long as we can rely on the city processes to review and interview and approve a contract. Im very comfortable with that myself. I would like to see howitt done at the retirement board. Im sure they may hire somebody. But i think its important we cant hear you guys. I think its important considering what happened. Some thing that happened last year. Is it didnt seem to be clear that the tou actuarial didnt seem to be clear. I hope we are searching for respond environments to the rfp and one of them is that the actuarial is a key resource for that to happen. We do not have the brain power, the expertise, the level of underring of the requirements that actuarial insights and professional services provide. So we rely very heavily on the guidance that is provided by the du actuary. That they have an accountability to the board as well as to the staff of the hss system. And i realize that that accountability may manifest itself in different ways in different times but there is an accountability to both unities. I also want to be very, very clear that there need to be by whoever the responsents are to this, confidence and expertise and its not to be, in my view, some sort of ad hoc capability that they can go out and get. But rather they have the experience and the resources, the staff, the reach, if you will, to engage in broad matters that would help to shape the strategy for hss as we are going to be facing undoubtedly in the coming years additional issues that we cant even imagine in the health care market. So theres got for a core confidency for Strategic Support and trying to figure out what is next. Not what happened but what is next and what we august to be thinking about as a board kind of on a longerterm horizon. So that requires research. That requires relationships. That requires an expertise of not only the california market but the National Health care market and the issues that attend to. That both in washington as well as in provider communities as well as with the Insurance Industry and so forth. So that as we are dealing with Health Care Policies and understandings for our members programmaticcally we have the confidence that this respondent would bring. I also feel that the tou actuaries relationship with this board is not just a compliance function, a cracking function with helping us to get to a better understanding of our claims and experience with providers but also trying to gain an understanding of the best practices as a relates to the accountabilities that this board has. So that too, it should be a core confidence in terms of the actuary they have some awareness and knowledge of what other large, private and public employers are doing, that we would gain a benefit from. And in some ways this system has been a an innovator and we think we need to maintain that type of role going forward. I think this board relies on our board council, currently eric, he does an outstanding job in providing legal guidance and assurance to our acts as we execute our role as a if h feduciary and then the requirements of what we need to do as being responsible for this trust. But also the actuary in the same component in my mind provides us with program assurance. And that means that we will wind up having quality affordable benefits for our members. So those are levels of expertise that are not possessed by this board but we rely on others to provide. And the actuary, if you will, or that group is providing a real strong key component for us to be able to meet our if h feduciary responsibilities. So the strong contracting manager michael and others get involved in this process, i hope that they will take those matters into account as we go through this rfp, and when we get to the end of the process that these factors will have been taken into account, and they will present us with their best guidance for the recommendation we will be considering. So i shot my mouth off about that. And thats where i would like to stop. So is there any action that we need to take other than the discussion that we had . I dont think so. I have one comment. The actuary is a feduciary who has a duty to the members first and for most. I just want to make sure that is clear. President scott and we are here acting on behalf of the members, so the actuary has a connection to us. A very closeknit circle. Is there a Public Comment . Den nit krueger, active retired firefighters and spouses. Part of this is an outside person myself trying to investigate inside the Insurance Industry. Very baffling. Second of all, experience. What i would like to ask this board to do is try and get a level one level for cataract surgery. Having just gone through it, ive had a number of things told to me. One Insurance Company tells me we only pay for surgery with a knife. Another Insurance Company tells me you have a choice of later surgery or a surgeon with a knife. Third Insurance Company, all they do as i believe ive been told, is laser surgery. So we have three of our providers with three different types of surgery. What i would like to see is the bottom line be laser surgery for everybody. If you want to choose a surgeon with a knife, go ahead. But when you read the data and you look at everything, the precision of laser surgery is a benefit to all members. One of our providers, thats all they give. Another one, ive been told, no. We will give you a surgeon with a knife. I would like to see the bottom floor be everybody has a choice of laser surgery. And then if you want to choose a surgeon with a knife you can. On top of that, they offer you an array of enhancements above basic cataract surgery. You have your eyes cut open. You are laying on a table and they could fix your eyes. So you never have to wear glasses again. But it cost you extra money. If you haves astigmatism we can fix that but it will cost you extra money. Or if you want 20 20, it will cost you money. What i would like to ask if any of these members choose to do enhancements thats a cost sharing measure is in our benefits that the Insurance Company offset some of these costs. They can range as much as 2,500 an eye. I think our members are entitled to the best that we can provide them. And when one of our providers is giving lasik surgery and another one of our providers say you get a surgeon with a knife. Theres a huge discrepancy that i would like this board to take into consideration to stabilize that, if they could. Thank you. President scott thank you. The topic is the rfp for actual actuarial services. Getting back to the topic at hand, i happen to notice that. I have two comments, one, in the past, commissioner, you have commented on the actuary and i was surprised you didnt bring it up under the rps an independent actuary thats what im talking about a feduciary to our members. I would then expand on that, that you really look at that beyond just the feduciary measure, that is true but that you commit to the members for the other departments, especially working for other departments that serve management. And the last thing is at the retirement board, the last couple of meetings the City Attorney that sits as eric does here, has been doing a feduciary program. He had a number of exhibits and was reviewing feduciary responsibility with that board. I think its worth get ahold of that. I dont know that we need that City Attorney to come in and do the preparation i think that eric is capable of doing it. But its already written up but it may be something you can have. And what it does, it not only remind all of you of feduciary responsibilities but it helps education everyone here as to what that means and the extent of how that impacts all the decisions that you all make and all the considerations we have regard to your feduciary responsibility. President scott thank you for those comments and i think i can remind everyone that this board did go through precisely that presentation in a november forum about two years ago and we may rich to have a refresher so thank you for your comment. Are there any other comments on this topic . Wye just like to say as to the members suggestion about laser, maybe that could be brought at the end here as far as adding it to the next agenda. President scott thank you for that suggestion. We will proceed accordingly. Are there any other Public Comments on this topic, item 4, the actuarial rfp . Hearing and seeing none we will move on. Turm 11. Directors report. Executive director griggs. President scott by my likes, director griggs, this is you are i dont final acting executor directioner report. Is that correct . I believe that is correct it. President scott i would like to take the opportunity again to commend you on your leadership and work on behalf of the system during this transition. So thank you. Thank you. Appreciate that. So on this directors report i wanted to focus on a few thing we started talking about on the budget and other issues we are starting for 2018 but just to start with our personnel. We currently have a 1209 position and three 1210 positions that we are looking at or starting reviews and these are benefits analyst so these work on the Member Services. The 5320. We let the Communications Department stay in the Department Today instead of coming to the meeting because theyve been work really hard on the next item which is the annual report and the demographics report but abbey, the new director had an opportunity to meet the new staff at the february 1st all staff meeting. And our 1823 which is Senior Analyst position. The position was posted and closed with 67 appear cants and they are currently being reviewed for minimum qualifications and the assistant Health Education which is a project laced position has been filled. Briefly in operation we are seeing our Service Levels being excellent at this time of year, which is big to say as open rollment was and i think that has a lot to do whereabouts and conner concurs this has a lot to do with the communications and the processing of the applications that were accurate and correct so that always is decrease in calls and therefore we are able to keep the Service Levels in check. Pamela, the cfo mentioned talk that we are expanding the Services Lobby area. That is specifically for self service. So we can put kiosk in there. People who typically dont work on computers and may not have computers at home can come into our office and access their benefits online. And administer their benefits online. When we get that going. We are take advantage of the fact that our paper file room which held about 100,000 files. Which is about 2 million pieces of paper. Now that we scanned all of that and put it into our Management System we have a little additional real estate. So we will expand that area and have a, laker area for members to interaction either face to face or electronically in our self service. So that in the report it says midmarch. We have changed that since i wrote this report and moved it up to february 26th so construction will begin in the lobby on february 26th so for the 6 to 8 weeks it will take to complete that construct our Member Services face to face interaction will be on the first floor. And the wellness conference room. This is exactly the protocol we take for open rollment when we have 5,000 and 6,000 people come into our office. So we will set up open rollment and of course people come in and sign in at the security desk and they will direction them to there instead of up to the third floor. So that will be for about 6 to 6 8 weeks. Independent systems and analytics area. We continue to make modifications on the 2018 plan year. It does take a long time to configure people and test and get it going. Theres lots of little programs and reports that provide us with all kind of wonderful information but when we make one change we have to modify each one of those. So it does take a long time. This is tax season. Getting ready for tax season. We have produced cs. This is the third year. Which is the employer requirement under the Affordable Care act. Once we get through our Customer Service calls, because people do call. I do need my t95 or want a copy. We are going to put together some spends and how much it cost us operationally to produce these and we have done this pretty much every year since the first year we implemented it. And of course Enterprise Service an lit i objects was very involved in producing the demographics report for this month which was also a big task. Finance and accounting youve heard lately what they have been up to during the budget talk and they are also continuing fsp conversion and data cleanup. That can be the way it is when you are dealing with peoplesoft and as far as communications is concerned, we of course spent time on boarding a new graphic designer. We have to do that. In communications and do a lot of training. How people are our membership need to read and be able to understand our benefits and of course extremely Diverse Membership it is with active employees and retirees and many different types of jobs and living in many different areas of the city. We are also already beginning to prepare for open rollment in 2018. We are taking up we are meeting and taking a lot of suggestions and thing that. Had in 2017 and we will perfect a few processes and communications for open rollment in october 2018. There are a couple thing i want to mention that i will ask stephanie fish to give us a very brief overview of her annual report which will work with my annual report which is the next agenda item but one thing i do want to mention that i was able to attend the 2017 wellbeing work award yesterday d that was yesterday. And it was a very great event where many, many departments who participate were able to receive certain award for their participation. And the reason i wanted to mention it, its one of the few times i had the opportunity to go to one of our wellbeing events. So im one of those that will start crossing over to the other side and be very supportive of wellbeing. I saw the engainment of the departments and the other departments and it was very inspirational. With that being said i would like stephanie to give us a very short overview of her annual report which is included in the management report if you are looking at your ipad, its page 180. If you are looking at a hard copy its page 20 once you get into the wellbeing second. The first page looks like our team and theres a great picture of the wellbeing team on that slide. There is. Stanley fisher being manager. Im actually taller than somebody. I guess to raise the mic. That doesnt happen often. Im going to ask you to head to slide 4. So our slide are numbered a little bit different. At the top. What is it . You will be fine, i promise. Its slide 181 if that helps you. Go right ahead, please. So to piggyback on what mitchell was saying about yesterdays eachs we launched a new framework last year to help departments. So theres 60 departments in the city. They all have different need. They all have different assets. They all have ditch size populations, different leadership structure. So we wanted to create a framework that allowed them all to work on wellbeing for their employees but to do it in their own way so that it would be appropriate for their locations. So we created this framework. Some of the features we asked for a department lead for wellbeing so in addition to the champions having a leadership level person to work with, we received 23 department lead which was fantastic. We also instituted award. We wanted to recognize departments for taking on this extra challenge of focusing on employee wellbeing. Obviously city departments do a lot. So asking them to do something along these lines, although very important and beneficial to them, it is an extra ask, so we created an awards structure which is what the ceremony yesterday was for and we were able to distribute 19 award to 19 different departments. In addition to that we asked them for their stories and this was the part of yesterday that iing for to see coming. I should have seen coming but it was neat to see everybody share their story and the that is what got everybody else excited. They were like, i want to do that. And i want to do that. It was very, very inspirational. So there were 86 ditc 86 different stories that were spotlighted. We did all 6 of them for 35 different departments so a lot of engagement across the city. We also instituted the grant this year which was an opportunity for departments to request funding for usually terms and environmental changeses that support wellbeing. We were able to support ongoing programs in the past but never able to give them environmental changes if we needed it. So 49 different grants were awarded over two grants this year to 16 different departments. Skipping ahead, there is a lot in this report. Iie lead to the onsite activities so this gives us an opportunity to talk about our partners we partner a lot with the rec and parks and we were able to deliver 285 onsite activities either through our eap services, through the hss wellbeing team or through kaiser. In addition to that we had ten Healthy Weight Program cohorts this year which is a 13week program to help people focus on healthy weight. And we extendedded our Group Exercise classes so we have always offered them at city hall. And then the wellness centre. We have been adding departments over time and this year we were able to offer d we funded over 1,000 classes across the city which doesnt include the wellness centre. That is in other places. So that was really exciting as well. This is the year we finally got a tag line. We got something to bring all of our programsing to because we do so much. We have this wellbeing at work framework. We have onsite activities and campaigns and targeted programs. And communications in general. And they all look a little bit different and they are all talking about something different. So we needed something to unify all of that. So in 2017 we launched the better every day tag line, look and feel. It has its own color palate and all of that. And it really has helped tie together everything so people are starting to see that the physical Activity Program is attached to this Healthy Weight Program. Its attached to grant program. It all goes tolling and is one comprehensive initiative to work on employee wellbeing. We have always offered campaigns. This year we about five of them. The campaigns offer education in general. There are often opportunity for people to register to either receive targeted emails or to track their behavior. We had over 5,000 almost 5,000 register strands this year for the five campaigns. But dont think that they are lymphed to those people because the materials from those campaigns are seen by a lot of people. Those are the people who took some extra steps to tell us something about themselves. The eap, in 2015, we had a career councillor retire and hired two new councillors ring. So he with went from 1 to 1 councillors in late 2015. In 16 we spent a lot of time developing a new Training Program and in 17, they in the past, they had touched about 1,000 people a year per councillor. And in 2017 it was over 1500 different employee contact. So they took a year to regroup. And get their programs and it worked. They did more trainings this year than ever which allows a very small team to impact a very, very large group. The other reason for the increase in eap services is not so positive. We had a lot of Critical Incidents this year and disruptive events and its hard to know if there are actually more disruptive events or if the eap is just better known for being able to help with them. Its hard to track that. But we had over nine times as many disruptive eachs responses. And sorry. Four times the eachs and we served over nine times the amount of people. So take that for what you will. The other things eap did this year was create a campaign to let people know about all of its services and that its not just about sitting in a Counseling Office with a counselor. They do a lot of that and we saw that in 1300 per counselor opposed to 1,000. So thats a somewhat brief summary of the report in front of you. President scott and the Diabetes PreventionResearch Study is one area of continued interest also. You can just give of a brief comment about that. Yes, so the slide you have in front of you is just a summary of what i presented l. A. Month but the researchers wrappedde wrapped up. We are meeting later this month to look at the data a few different ways and we are working with caser to be able to develop that onsite program. We are hoping we be will table to continue that for our members starting this summer. President scott thats what i wanted to hear. Thank you. Are there questions for the board . Stephanie, regarding the Wellness Program . Thank you very much, stephanie. You and your team for everything that are you doing on behalf of us. Thank you very much. Thank you, stephanie. So just to go over a couple of the meetings on the directors meetings and that happened over january, as pamela mentioned also in the budget discussion, is that the citywide voice over protocol, the voip system that the city is moving forward with this. Is our telephone system. These are our Members Services and phone lines and the capabilities that they can do as well as our own phones on the desk but the city is moving to finally updated technology and we are considered in critical need for it. So we are. Anding to get our new phone system hopefully by the end of the calendar year in 2018 or at least some progress. This is going to give us much more Customer Service. Ease. We would be able to record phone calls for equal control. Which is very important. And we will also be able to use certain technologies. For instance, when a phone call we can pick up a caller id or someone can put an employee id and all the record come up in front of us so a lot less prepettive motions for Member Services and we can get the call started and answered more quickly. Again, you know, it was the end of the calendar year and we always interaction with other departments including our payroll department. So we met with them this year, as usual to go over yearend work flow procedures because every year that is very important. Getting out the w2s. Make sure they are very accurate because a lot of things we do in our processes is reflected on the w2. I also met with on deputy of Human Resources the Employee Relations director as well as the mayors. Health policy advisor for the purpose of letting them know about thing we are thinking about currently for 2018 to go into 2019. Like self Service Benefits and how we can message that through the city. And feedback. I also wanted to give the opportunity to work with them directly on our dependent eligibility audfiction audit. This is an audit that the director mentioned a little bit over a year ago and i did a little late last year. Just the message and helping them communicate that because it is something new that the membership will be experiencing. And then when that happens other area, even the Mayors Office can hear about certain thing. So we often hear about them on a regular basis to talk about the thing we are doing. And then on the topic of the dependent eligiblibility process we are in the implementation part of this audit. If you recall, this is something we discussed and presented in september of 2017. We are in the implementation mode. So we are looking the timeline i have provided here which is more or less the timeline we are going with. So starting in april is when members will get the first notice that we would like for them to verify. Or coverage for a dependent that they no longer meet the beginnings under the member of service rules. So this year we are yo we are we are yowe auditing i think about 22,000 legal spouses. All of them will not be audited. Newer members who are recently married or recently out of their dependents house. We verified them at that point or domestic partners. A majority of that population but not every single one. And as you can see the mailing will start on november 2nd and an email and we will start warning them about a final notice if they have not responded to the audit. And then we are looking at probably the end of july when we are done with the audit process. Currently we are in drafts the communications for this audit. I wanted to list the applicable rules for this audit. Which is what we will include. And the language and the communications specifically what is the beginning of a legal spouse. And that legal spouse, when do they no longer become eligible and those are cases of legal separation, divorce, even though. Also for domestic partners we will be defining what member rules say is an eligible doug domestic partner as well as when a domestic partner no longer becomes eligible. And we will also include our membership rules which tellless them that we often do from time to time audit the eligibility of dependents and also we will be letting them know which is part of our rules, which we added about 2 or 3 years ago. There are fines we could apply to members if they keep their ineligible i believe dependents on for a period of time. Typically with this process we are looking at a 6 or 7 rate of finding 6 or 7 of those 23,000 could be inn h he ineligible i believe. Its a savings of 2 or 3 million in the first year. So again its going to be a process that we are contracting them out. So collection of the certifications and the Customer Service and questions will be the third price so its not going to be on the benefit analysis so we will support the members if they have an appeal process which happens at the end of july. One other update, there were some questions last year feels like last year, last month, about the blue shield presentation when we were when they were taking members independents and bringing them together and doing an average age. So theres an explanation on why we do. That its because we pay claims on all of those individuals. So if you are looking at trend or if you are looking at costs are you combining the members and the dependents together to get average age. So that is explained there in other updates. That concludes the report. So i am here for any questions if there are any. President scott are there any questions by the commissioners regarding the directors report . Just one question, have the confirmation of employee and Retiree Benefits been mailed to all members at this point . Or is that another process . So that went out december 4th i believe is when they were mailed. Do you do your taxes . I did not. I just wanted to say thank you. These are very thorough reports. But i think there should be some way to condense this kind of a report, and with a new director here, i think that would be possible. Not only is it very time consuming for you, the director and but the staff in typing all of this up. Every month. I think all of these details will be documented somewhere if somebody need to know them but i think we dont really need all this much in this report. And i know that this was what was done prior to you and stuff. But im hoping in the future we could cut down on this, unless somebody else would like to see all of this every month. President scott there may be different ways to get the same information, i would agree with you. If we could lighten the road, printing and all the rest of it. It is staff time and staff work. So its a question of how much detail do we need . And maybe thats a consulting point that the new incoming executive director and i can have a conversation about. Point well taken. Any other comments on the directors report . Hearing the loss of a quorum, i am going to ask that we move the action item for the annual report up ahead of the financial report. So if we could take up action item 13. Clerk item 13 acting executive director. Mitchell griggs of the chief operates Health Service system. Today we are presenting the annual report for 2017. We have gone over so many of these things over the past couple of months and particularly today since we did have our budget presentation, so i can be brief on this. But just to highlight starting on page 2, typically we have a message of the director and as we have mentioned there were 2017 not only was a pussy year fo busy year for work. Not one of my favorite years as far as a lot of things that happened outside of work and whats happened in the world and country, et cetera. But one thing i did want to demonstrate are the thing that good happened in 2017 and hopefully we can carry a lot of these things into 2018 with us. The first point that i would like to make is in 2017 we began work on blue shield trio. And even though that was a effective in 2018, the hardcore work was in 2017 so thats why its in the annual report. But just to mention a few things, you know that we did with it, it was a change in the market. Its a change in the outlook of health care in the bay area. And as all the thing we have talked about during our implementation presentations over the months that it was successful. It was hugely successful. So in 2018 we will be carrying that work in and working with blue shield as far as communications and we are viewing their marking items to make sure that we promote and keep that enrollment strong and people moving into it. We have gotten a lot of very positive feedback about it. And even those individual that were confused or werent sure, didnt read my open rollment panel, we have been,ing would closely with blue shield, specifically shavona in operations to clarify and we have about a good 60, 10 success rate in getting people to understand and be okay with the fact that they are currently in trio. President scott could you speak up just a bit. Sorry. And also just as reminder in 2017, we may not remember these things but we improved our disphoria benefits. I believe its watt march meeting we asked all of our plans to align the benefits specifically using blue shield as a model, and then the board adopted a policy on looking at medical necessity for benefits for gender disforium and we continued our work with best doctors of 2017 and we are hoping to do the same for 2018. And we are hoping to do the same for 2019. And new technologies for Member Services. As we mentioned before, we got rid of 100,000 paper files. One other important aspect of that functionality, and that technology we brought in, is open rollment was the first time the staff was able to take all the open rollment applications and process them in an electronic way versus flipping through paper. So we received 14,000 applications. Thats a first as well that i know of in my history with hss but on top of that it was done through an electronic workthree process. And even workflow process and each the staff were happy to pull up the work whether they have them on the phone or trying to research an issue. Not to mention someone didnt have to go manle mann wally file the 14,000 pieces of paper and in 2017 we did a pilot onion line benefits. Self Service Benefits as we mentioned we are going into 2018 hopefully in expanding that to the majority of this city. Not only with open part but some of the changes were difficult to support. There was a learning curve that everyone had to go through as well as being trained and being able to speak to the membership. Let us go ahead and skip over to the overview on page 4. Just so you realize we have about 3,000 additional lives this year. So our membership has gone up about 3,00 3,000 lives. And it was about 16,000 a little less than 16,000 last year. Now we are up to about 18,000. One thing we kind of had a debate here is should we be discussing too, members who are waved because we do actually waved meaning they have not elected to enroll in coverage. These are specifically enrolled in medical and dental or just dental or just medical. We dont necessarily count the waved numbers. But if we were to we still mail to them and still have to ena calls to them during open rollment. It would be 125 or 126,000. So you can see over here the top, on the yearoveryear, and the chart here, that we have howitt increased and then the administrative budget. Last year 11. 1 million and now 11. 4 million. That is of course increases in Salary Benefits of course. We do a lot of with the small staff and i think this particular meeting and included in this annual report you are able to see with about 50 employees we do quite a bit of work. Theres always room for improvement and im hoping with the onboard of the new director we can go through some potential new thing that we can look into as far as helping the staff or improving the staff. As we go down to the next section on the overview, when we talk about the Overall TrustFund Contributions in our overall payout we are looking at 147 million. This was a fiscal year number. So this is the end of 2017 fiscal year. And last year it was about 800 million. If we go to the right, in the other section, the next section to it, you will see that some thing that ive spoken about before, operations we did over 14,000 manual transactions and we helped about 77,000 members either on the phone or face to face. A few other things to mention president scott excuse me, director, in that particular area, there are a number of icons with numbers in them. Im interpreting those numbers as being the number of hss staff in each of those areas. That is correct. President scott thank you. Hi to ask the same question this year. So these bizarre icons we used in the past. And i had to recall. So this is typically the number of employees we have. In those particular areas. Again if we go down to the next section which is called health plans we look at medical plan enrollment. There is nothing real shocking here. With the exception of the fact that 2017 was the first year that we had the two Medicare Advantage plans so there was a slight shift in blue shield since they are only doing active and early retirees and a little bit of increase with United Healthcare because they have a larger medicare plan at the moment and that carries through to the right when you look at Health Premium caused by vendor. When you get to blue shield its 314 million for that fiscal year. Last year it was 331. So there was a decrease because we moved the Medicare Advantage plan out of blue shield. And then of course with the United Health care last year it was 54 million. And this year 75 million. Because we have the Medicare Advantage plan. And below nonmedicare spent by category. This is almost eye dent call to last year, so we are, log at the same percentages in the area of costs. And since we have already gone through so much of our accomplishments over the year, the only thing i really wanted to do was look at the overview. So if you have any questions i can certainly take them at this time. President scott are there any questions by the commissioners regarding the annual report and the scope of work that is describes . Commissioner lin . No questions from me but i want to commend you for your work the work you did for 2017. With marina and stephanie pamela. Our cfo. Thank you for the job well done. Thank you, commissioner lin. I appreciate that. Especially you are taking over as executive director. And all the work that you have done. Thank you. Thank you. President scott any other comments, or questions from the commissioners regarding the pan wall report . Is there any Public Comment regarding the annual report . Hearing and seeing no Public Comment im ready to entertain a motion regarding the annual report. The hss annual report. President scott is there a second . Second. President scott approved and seconded that we move the annual report to the hss staff and its we thank the hss staff for its leadership in the 2017 18 year. Are there any questions and comments from members of the board . If not, any Public Comment. Hearing and seeing none. We are ready to vote saying aye. [roll call] its unanimous. So order erred. We no are no longer at risk for any action items remaining but the importance of the discussion items is still with us. So please. Clerk item 1. Discuss item hss Financial Reporting as of november 0th, 2017. Panel 11. Panel 11 chief Financial Officer deputy director. This will be a very quick analysis of this report. The report today summarizes the actual revenues and expenses of the Employee Benefit trust fund and the general fund to november 2017 as well as the projection through june 30th. In terms of the trust, we will go back and look at what the trust fund balance was on june 30th, 2017, in that 72. 5 million. Based on the activity through november 2017, we are projecting the fun and the year at 72 million. This is a change of less than 1 . We continue to see unfavorable claims experienced through the medical plans and favorable claims for the dental plans. We received 1. 1 million in pharmacy rebates from blue shield ask we are projecting a savings in the 3 budget. No performance guarantees have been received this fiscal year. We have two additional reimbursements associate associated with adoption and Service Assistants plans but the payments have not yet occurredde, and the amount will not be known until june. In terms of the general sum budget based on the Financial Results through november 2017 we are projecting save and salaries. President scott are there questions regarding this mondays report as of november 30th . Is there any Public Comment on this item . Hearing and seeing none we would like to thank you again, chief Financial Officer for your continued diligence and hard work on this report and many other things that you do. We are now at item 14. Clerk item 14rb 14rbgs discussion 14, discussion item demographics report. Marina. Good afternoon. Marina, manager and systems and analytics and we will have a presentation. Clerk thank you. President scott theres a presentation, i believe . Yes, there is. Beautiful. This is the presentation of the annual demographic report. And its quite dense. So im only going to make some high level comments with you here today, and you can consume it all on your own time at your leisure. And for those of you that are not here in the room who want to look at the report later in your own time you can find it on sfhss. Org under the board materials or under the finance reports archived and i would first like to acknowledge the work effort that went into the report. You see it annually, but as we outlined in the directors report we have to generate 26 separate raw data files. We import all of that into a database and we have to execute 0 queries to make it look meaningful and we export that into where we built 31 visualizations and also 31 excel tables and yearoveryear. And we also write the narrative and im using that word we quite literally because the heavy lifting was done by my team member, shelly so i would like to commend her efforts. Thats a lot of pulling this data together into something that makes sense to us. And also on the Communications Team and i heard mitchell introduce our new graphics design erieian and of course carroll our Communications Manager to then take all of these tables and demographics we give them and they lay them out into the finished product. It seems like it would be easier than it is but as we know nothing is ever as simple as it should be. So my high level comments are really that we have remarkable consistency yearoveryear, so even you know when we say population growth, those growth rates tend to be the same yearoveryear. So thats really the theme. The report follows the same layout we have used previously where first we will take a look at all of the lives within the hss groups. And we will take a look at our members comparing our retirees versus our employers, and just to be clear on our lexicon for us and hss member or member of the hss system is akin to describers to our health plan. So when we are talking members its really just a subscriber. When we are talking lives we are talking about the member and their dependents, and we take a look and breakdown further. So we start looking at the same data splices, whether its agree graphic, whether its age. What is your coverage, tiers, all of that sort of things but then we do it then by looking at just the retiree population and we look at by just our employer groupings and of course we do administer benefits for the four employers. So those are your comments there. I assure the board you are well aware that you approved a few thing this past year, including the alternative hmo and blue shield. So our trio hmo and also the voluntary enhanced vision plan through vsp. So those were the biggest changes and those are thing we modified in our report to reflect. So we will see some changes so we can call out. So those things this year. And the big news is our number of total lives that we currently are covering is 120,383, and this report is as of january 1st so as you know we will continue to hire people throughout the year. So we will continue to see that number increase. And mitchell mentioned before that we also have our wave population that we continue to have to support in a variety of ways. So on page 3 we have its not on page 3. But anyway you know from page 5. We have actually a total of 5,899 waved members at this point. And split on that is theres about 31, 20s that are active employees who have waved and 2779 out of our retiree population. So if you take all of thatting to we have 126,382 lives we are supporting with our services [ please stand by ]