If not please. Shavon oconner will go over our Customer Service metrics for open enrollment. How are you . Im very good, thank you. How are you . Just fine. Health Services System and we have slides. I cant see them but i wrote a script. First i want to say im honored to be in Service Employees and retirees in the city of county of San Francisco. Its a privilege to ensure they have benefits, this Service Orientation is the north star by which Member Services does everything. To that point, open enrollment 2017 for a plan year 2018 was exceptional in every regard. Most notably as you can see we took 14 more calls, and then in 2016, we provided 13 more third floor inperson consultations and 22 more off site consultations and mostly at the largest benefit fares you will see in a later slide. We provided 19. 5 more first floor inperson consultations and we received and processed 24 more applications than last year which was the largest year in the history of h. S. S. We did 24 more this year. We also had roughly 10 fewer staff hours and this year instead of having 20 days of active open enrollment we had 21 days which is part of the underlying foundation for the bigger numbers. So 2017 Member Services benefited from the longer open enrollment in october so we had 5 fewer calls and because we process open enrollment in the beginning of november we allocated the staff almost exclusively to processing with a few people answering phones and it worked out really well and we processed in a timely fashion and we were only officer vis level by one second which i consider i pulled together a slide that shows you plan year 2015 over 2016 over 2017 so if you take the long view from 2015 to 2017 call volume is up by 32 inperson consultation is up by 54 and applications received is up 35 so the demand is rising at Health Service system. You can see the increased call volume hit the Service Level and speed of answer was over a minute which is not the best and its an expected impact with this kind of call volume. The next slide. Slide 6. I also did a day by day comparison of 2016 over 2017 we took 1400 more calls in 2017 than we did in 2016 part of it was due to the extra day of open enrollment in 2017 we took 962 calls. Also, there was a higher call generated by the new plans and answering those calls took a little bit longer because we wanted to make sure that people understood what the v. S. P. Premiere was and what trio was. The next slide. To me the real gamechangeer this year was technology and enabled for open enrollment and the the past few years the staff ing is flat but this year the Member Services team was really apt and fluent in the electric content Management System deployed at Health Service last year and instead of handleing application on paper by hand we scanned them all in to the e. C. M. And process them out of the e. C. M. And counted them and it allowed us it probably saved us at least 333 hours and thats a conservative estimate its probably more like 400 to 500 hours which helped us close the delta between the staff hours we had last year and what we had this year and still gave us a little bit more. Next slide. Our inperson contacts have increased and our inperson contracts have been on the first flor because Brian Rodriguez who mitchell mentioned earlier came up with a idea of having these little mini scanners at each station so instead of xeroxing applications and gives them back to members for the records we scan the application in on the spot and it linked in to the system and we gave the original back to the members so it was not only efficient it was green because we probably on the first floor alone scanned five or six thousand applications and thats five or six thousand pieces of paper we didnt have to replication replicate. The largest off site fairs were busyer. City hall was dish sent three Staff Members to the city hall off site benefits fair and they didnt get a break they were talking all daylong and people had tons of questions and it was similar and some of the fairs were flat and one of the p. U. C. Fairs but the bigger fairs we had that are more around the civic center are much bigger this year and Unified School District had a benefits at john owe owe owe we didnt get an accurate count because it was so many people that just like helped them as fast as can you. The next slide. The impact of o. E. , the demand of o. E. Impacted the abandonment rate and when the abandonment rate goes up because people dont want to wait anymore the call volume goes up because theyre going to have to call back and they have questions that need answers so for we were stretched thin because we were out across the city and our calls lasted a little bit longer delinquency and termination volume for october and november had what i consider to be year over year the normal fluctuation its higher this year but i wont go through the slides unless you request. We have the material in front of us. Thank you. I feel open enrollment is like christmas to me and its my favorite time of year. Its also a very challenging time of year and this year was more so and it takes h. S. S. Village to pull this off it takes everybody on our team to finance teresas team, marinas team to pull it will off and Member Services is more front and center and i consider everybody at h. S. S. To be a hero when were doing a really good job, no one knows were there when someone needs us we step forward to help out and it took many hours of evenings and start as every year during open enrollment to process 14,000 applications and so i want to recognize out of the hero some particular people who were there literally every night until 7 00 every saturday veterans day and they are florence lamb, yak chow , marine chan, ruby diaz and jesse. Our newest member. Each one of these people every hour of open enrollment whether on straight time or overtime so thank you to them but i wanted to list every person on the members Services Team and that was edited so thank you Member Services team i much appreciate it and i also really want to thank anthony who is blazing fast at work and he has a very complicated demanding job and already, he processed over a thousand open enrollment applications to help support the members Services Team and i want to acknowledge our noble leader who is the calm force in the storm and its very helpful to have someone just kind of say, slow your roll, focus on forward and keep going so thank you. All said this years open enrollment was epic and spectacular and i appreciate the opportunity for getting this experience. More importantly i really appreciate the team that i get to work with. Thank you. Thank you, are there questions from members of the board . I just have one question, you point out it was a wonderful report and i think also want to add congratulations to the team for all the work and it was spectacular and as you alluded to, call abandonment escalates particularly members anxiety, anger, hostility, and so do you have some idea about how long a member was on the phone before they were abandoned. Interview i think the average time before people abandon was about 65 seconds, i can look that up and provide it to the board. It looks to me like if i were called i would go back to the slide and maybe you had an average answering time and i think it was it was 73 seconds which is a minute and 13 seconds. Abandonment time is 65 is actually longer than the answer ing time i mean, again if there are ways where they look forward. I can look it up. Just look forward to how you can message when the calls come in and are there better times to call . Not better days. Avoid monday and friday but better times to call so members who are thinking about abandon ing their call because they just cant wait might have it would be left with a message how to maybe not be so angry and call at a better time . We did message that call volume was increased and it would we expected a longer hold time and i dont think that we put up messaging if you call first thing in the morning or between 4 00 and 5 00 and you have a better chance of getting through right away and one of the things about i. V. R. S and theyre frustrating as well and so when people finally get through pushing the buttons and listening to the message theyre already like grrr so i think everybody on the team knows that during open enrollment people are going to be frustrated and you just kind of have this practical mentality of like bring this person down and let them know theres no problem that we cant fix and that is the truth theres hardly any problems that we cant solve one way or the other. They may take time but part of this thing is delivering that message because if someone escalated but they know fundamentally well get them where they need to be and they calm down pretty fast. There are a few people that dont and thats just their nature so as Customer Service professionals and benefits professionals we have to deal with that. The comments were addressed to maybe not be fixed at the moment and fixed for future and look at some of these metrics and thank you for the wonderful report. You are welcome. Are there questions or comments . Commission commission lin. Thank you to all the staff that helped during open enrollment and for your leadership during this hard times when we didnt have our director so thank you for all your hard work. Thank you so much we appreciate it. Any other comments from the board . Well, on behalf of those who are silent and those who have spoken i want to say thank you directly and to the individual members of all the teams that you cited that what you have done here particularly this year with the new tools and new complexity that we the board and our decisionmaking delivered to you and you executed on it very well and an outstanding manner and were profoundly in your debt and so are the members of the system so thank you. Thank you so much. Are there any click Public Comments . Good afternoon, claire, i just wanted to add that retirees were grateful for mitchell and the team that came out and we were also very greatful to the kaiser nurses who put up with a lot of chaos, we had people who received shots and they werent prepared and we werent prepared for the response we got and it increased a lot of these off site visits are very, very important and theyre important for retirees because its one of the few places where we gather as a group and i also spoke to some potential Fire Department retiree and i also speak to all the potential Police Department retirees and we talked to them about the fact that we do these clinics and that theres more special attention given to them during open enrollment and we cant thank the staff enough and we cant thank the leadership enough for all of what gets done for us during open enrollment and yes, it was that piece of paper thank you supervisor, i was about to say that, so just a big thank you and we hope that there will be were waiting for electronic complete electronic open enrollment everybody has been calling for that since before i retired but one of these days well get there. The scanning idea was brilliant, it saved a lot of trees and we want to reiterate that we as retirees are extremely grateful for the service we get, especially during open enrollment. Thank you, any other Public Comment . We thank you the plans for being present as well. Thank you. Director griggs. Im also just wanting to mention and i was going to do this at the beginning but, this was a particular tough week for h. S. S. With the passing of mayor lee and a lot of us worked closely with him and his office so it impacted our office and our staff as well and i want i wanted to thank the Employee Assistance program, we were training messaging 5 30 that morning and her team had already prepared a communication to give to all the city on the employees and those department thats were more directly impacted like the Mayors OfficeController Office and memorial and i was able to deliver that to our Emergency Department head meeting that morning and i delivered that message to the director of the d. H. R. And the Mayors Office directly. Thank you. Do we provide e. A. P. To the retirees and the message is this is available to them because the woman that trained me had been a city manager for a while and our department and she was quite upset. She knew mayor lee quite well and believed value over the decades. Unfortunately we did not provide it as a retiree . Id also have you take note of several articles that are contained in the directors report both for your education and he had theyre not pinpoint ing any particular provider or Health System but they are of interest of our working relationships with some of these entities so i would call that to your attention and also i believe buried in the report maybe its coming up in the finance report and ill be corrected by you is a highlight were working on r. F. P. S . Working for something in particular . Yes. Well it was not in my report. Its not in your report, it must be elsewhere. So with that are there any other questions . Any Public Comments on the directors report if not well move onto the next item. Update on blue shield trio h. M. O. Implication, janette moan blue shield of california. Welcome. Thank you. Now that we have crossed the bridge together [laughter] we are now entering New Territory and we expect to see you here frequently in the next month or two. I really appreciate you, i think weve crossed a bridge. Ok. Um im janette and im with blue shield of california thank you for having me and i wanted to do a recap and some Lessons Learned from our open enrollment. We have a presentation that was submitted in advance and i want to let you know some of us here at our level, its not public, but all of the screens are flickering now up here so well be an uninformed group for a while. There is goes. Now it stopped now that i said something about it. Now its going again and dont worry as long as its clear on the screen well proceed. So please. Thank you. We have a presentation. Thank you. Thank you. I want to let you know in advance of going through this presentation that the numbers here were losely based on ex pecked enrollment based on employee who enrolled so some of the numbers are soft and we indicated with special equal signs that they are i just wanted to review the objective of trio in the first place and number one, was to make an affordable highquality health plan available to the h. S. S. Members. The current access plus h. M. O. Is very well run and it has a cost trajectory that could be perceived as non sustainable as a non kaiser alternative so the intent is to provide something to our members that is sustainably for our future. In addition to that the trio product leverages all the good work that h. S. S. And blue shield have done with our deep partnerships bringing that to the next level. We want to create more competition in the work in the Healthcare Delivery system which will also lead to more affordable prices and also higher clinical outcomes for our patients. We intend to transform Healthcare Delivery and of course the bottom line is ensure highquality care for everyone. Part of the plan was to do a threeyear rate guarantee for starters, trio is 10 lower than the access plus pricing and that trickles down to the members theres a trio 2019 rate cap of 5. 9 and a 2020 rate cap of 8. 5 the provider partners including dignity, ucff, are making investments in the product and Financial Investments as well as operational investments. And in addition to that theyre also investing in Clinical Innovations that are providing higher levels of care and hospice in patient counseling, et cetera. Blue shield is invest north this trio offering as a broader bay area strategy to ensure highquality Cost Effective healthcare plans in the bay area long run. And this pi chart i want to re illustrate of the 38,000 blue shield h. S. S. Members, 62 were already using the trio product and when i say the product i mean the network, the same providers in the end we got 40 of those 62 to remain enrolled which actually would be great to be 62 but we learned a lot along the way there are provider nuances and its a great start. We wereen rolling auto members in to trio for january 1st and that again was based on their providers their primary care physicians being in the trio network as well. We had to reduce that number for auto enrollment by 3,000 members and those 3,000 members were because within brown and toll around who generously stepped up and creed to create a custom trio network just for s. S. F. It was discovered later that sutter objected to some of their primary care physicians being included in trio and those were the Sutter Foundation primary care physicians, if you think about it, Healthcare Delivery is a business and sutter is not part of trio so our foundation p. C. P. S should not be part of trio either so we removed 2800 to 3,000 members who were originally thought to have been on the docket for auto enrollment and we took them off. Because we did not want any disruptions to primary care physician relationships. In the end we auto enrolled 22,000 of which 14,500 remains. Trio enrollment savings for 2018 alone is not 15 million its actually 12. 6 million based on 14,500 membersen rolling and my numbers are slightly different because again i updated it. Since we found out the actual enrollment. Is everyone following so far . And so its 12