ALASKA COMPREHENSIVE HEALTH INSURANCE ASSOCIATION ANNUAL MEETING OF THE BOARD OF DIRECTORS

Transcription

1 ALASKA COMPREHENSIVE HEALTH INSURANCE ASSOCIATION ANNUAL MEETING OF THE BOARD OF DIRECTORS Alyeska Resort, Room Columbia A Girdwood, Alaska Thursday, June 26, :30 a.m. Alaska Time Meeting Call to Order The annual meeting of the Alaska Comprehensive Health Insurance Association was reconvened by Jeff Davis, Chair, at 8:49 a.m. Alaska time on Thursday, June 26, Roll was called and a quorum was established. Board Members Present: Jeff Davis, Chair Brian Angel, Vice Chair Shawn Pollock, Secretary/Treasurer David Hill Marilyn Kasmar Chet Lozowski Mona McAleese (Telephonic) (On line at 10:34 a.m.) Katie Campbell (Ex-Officio) Premera Blue Cross & Blue Shield of Alaska AFLAC Mutual of Omaha Insurance Company Assurant Health Public Advocate Continental General Insurance Company Public Advocate Alaska Division of Insurance Board Members Absent: None Others Present: Marty Hester, Deputy Director Shauna Nickel Cecil Bykerk, Executive Director Debbie McCormick Janet Oates Peggy Onstott (Telephonic) (Off line at 10:34 a.m.) Alan Kellogg Richard & Cindy Carl Alaska Division of Insurance Alaska Division of Insurance C.D. Bykerk Consulting, LLC BMI Administrator Media Relations M.R. Onstott Consulting, Inc. HealthLinX Recorders The Board took up Agenda Item No. 23 first out of order. See after Agenda Item No Review agenda. 2. Review and approve minutes (5/5) [Tab 4]. 3. (9:00 am June 25) Presentation of the 2013 audit reports and discussion of audit process and any necessary changes plus notation of the 990. Discussion led by John Leemhuis with objective of approving the 2013 audit reports and considering any necessary changes [Tab 5]. 4. Operations Report presentation and discussion of any changes/additions needed [Tab 6]. Review the operation and status of the ASSOCIATION. Report from BMI followed by discussion of the Board focused on any needed or desired changes or additions to the reporting package.

2 Alaska Comprehensive Health Insurance Association Page 2 of Review the operation and status of ACHIA-FED [Tab 7 plus D, E, F and G]. Discussion led by Cecil Bykerk et al, with an objective to make any necessary decisions. 6. Review and discuss current TAA federal legislation. Consider Premium Relief Program funded by the TAA bonus grant [Tab 8]. Cecil will review the federal legislation and status of our funding. Cecil will lead a discussion concerning a proposal to extend the premium relief for another year. 7. Discuss Board composition [See Annual Member Meeting Agenda and Tab 9]. Cecil will review the composition and what the Nominations Committee will be proposing at the Member meeting later today. 8. Review status of Reinsurance Program for children under 19. Consider evolution of program to reinsurance in the regular marketplace [Tab 10]. Discussion to be led by Jeff Davis. 9. (10:30 June 25) Presentation regarding possible use of ACHIA as a reinsurance mechanism for the Alaska marketplace [Tab 11]. Discussion introduced by Jeff Davis with presenter Jim Grazko by telephone assisted by Hiu-Wan Ko and Sheela Tallman from PREMERA. 10. Report from Alan Kellogg regarding his role with respect to PBM oversight [Tab 12]. Discussion led by Alan Kellogg. 11. (2:00 pm June 25) Amy Dailey along with others on the telephone will present for Express Scripts. Review of specialty drugs with particular note and discussion of Hemophilia services. [Tab 13 plus H]. Discussion led by Amy Dailey. Agenda Item Nos. 1 through 11 were considered at the previous day's meeting on June 25, (8:30 am June 26) Review/discuss public comment. Debbie briefed the Board on her assistance to and interaction with Mr. Doody to resolve his complaint after the Public Comment portion of the meeting yesterday afternoon. Debbie responded to questions and discussion was heard. MOTION: by Chet to approve payment of Mrs. Doody's prescription drug claims. SECOND: by Shawn PASSED UNANIMOUSLY Jeff asked Debbie if she had any thoughts as to Mr. Doody's claim that their calls weren't returned, and no one would follow up with them. Debbie said that upon her return to Kansas, she would be able to put the Doodys' phone number into BMI's system and retrieve the chronology of calls so that she could listen to them and determine what had happened. She said that Chet had brought up the possibility that the Doodys had called the ACHIA-FED number and mistakenly believed they were calling ACHIA. She said that was a possibility because that number was on the ACHIA website and ACHIA correspondence. David added that they may even have called Express Scripts and thought they were calling ACHIA. David said if that's what happened, he could understand Mr. Doody's frustration. Debbie agreed and said that the reason she wanted to check into this was because the scenario that Mr. Doody described was not the BMI customer service model, and that's what led her to believe he may have mistakenly called ACHIA-FED or Express Scripts and thought he was calling ACHIA. David commended both Debbie and Jeff on the professional and courteous way with which they handled the situation. He commended Debbie on her providing immediate assistance and her ability to get Mr. Doody focused on resolving his complaint.

3 Alaska Comprehensive Health Insurance Association Page 3 of Strategic Planning discussion Consider current state of federal healthcare reform, development of health exchanges as well as other elements that may impact ACHIA. Future role of plan including any additional changes necessary or possible as a result of new Federal legislation. Consider further transition to Health Exchange environment. Consider the anticipated wind down of ACHIA. Also consider need for any further legislation [Tab J]. Discuss and resolve the need for any necessary changes. Determine direction relative to the development of 2015 premium rate schedule and plan changes. Formal approval of 2015 rates will be done in the Fall. All. Jeff said it was very helpful for the Director to give the Board her views on the direction ACHIA may take. He said that they were currently in status quo mode, and it was the Board's responsibility to continue to make decisions to ensure the viable operation of the pool. Jeff said that Cecil had reported on issues that NASCHIP was focusing on the previous day, including (1) whether or not their current coverage meets the mandate, and (2) if it doesn't meet the mandate, it would be necessary for ACHIA to move to compliant plans. He said that Cecil was engaged in that and would continue reporting to Board, but those might be the next two sentinel events that may cause them to have to change course as a Board. Discussion was heard. Cecil said he would reach out to his contacts at CCIIO to find out what ACHIA would have to do to submit an application for exception from the requirement to provide ACA-compliant plans. He said they were required by law to continue to offer the coverage, and they had no way of changing that before the end of the year. He clarified that it wasn't the pool that was out of compliance by having non-compliant plans, it was the insureds. Debbie suggested that the Board send a communication to the policyholders advising them that their ACHIA policies may be non-compliant and they could incur penalties. Cecil agreed and said that the Marketing Committee could draft that communication to the policyholders. Jeff reiterated that they would stay the course, work with CCIIO and CMS and wait and watch to determine what the next step would be, and it may be that such a communication would need to be sent to the policyholders at some point. Jeff called a break at 9:22 a.m., and the meeting was reconvened at 9:39 a.m. Jeff recapped the discussion thus far under Agenda Item No. 24. He said that there was a consensus to stay the course, continue business as usual, and consider and take action on issues as they arise. Discussion was heard in response to Chet's questions regarding eligibility of illegal aliens. Cecil reminded the Board that the eligibility requirement for all applicants was the same as for the Permanent Fund Dividend. Chet said that the Board would need to address the gap in coverage with respect to Medicare. Cecil said the NASCHIP group had spent a lot of time pointing out the gap in coverage and trying to work with CCIIO and CMS. He said they know it, and they're somewhere between recognizing it and acknowledging that there was a gap in coverage. He said that several states were in distress because the ACA did not address Medicare-eligible people. Cecil agreed that it would be a topic for the Board to address down the road. Chet asked if the HIPAA eligibility laws need to be repealed in Alaska, and discussion was heard. Cecil and Debbie agreed that the Marketing Committee should meet in late August to draft a communication to be mailed to the policyholders to apprise them of the status of the insurance market, including a timetable for exchange enrollment and open enrollment outside of the exchange, advising them of their current status, and letting them know their options for coverage. David said that in reality, a series of letters to keep policyholders updated as to changes in the market and their

4 Alaska Comprehensive Health Insurance Association Page 4 of 11 coverage status was necessary in order to make sure they were getting the message across. Debbie said they had mailed a series of three letters to policyholders last year advising them of what was happening in the market, how it affected them, and letting them know what their options were. Jeff said the Marketing Committee had its charge, and it could provide its report and recommendations as to policyholder communications to the Board at a future meeting. The Board returned to Agenda Item No Preliminary discussion of rates for coverage issued by the ASSOCIATION including discussion of the process used to establish rates and consideration of rate increase action for 2015 assuming waiver of ACA compliance [Tab 14 and Tab 15]. Discussion will be led by Peggy Onstott with objective of getting issues on the table for the strategic planning discussion to follow later in the meeting. Peggy gave the Board a high-level overview of rate related issues and the products and benefit structure of ACHIA. She said on the benefit side, last year they had set rates using AMR based on the non-exchange plans that were being offered at the time. On the rate side, they had used the same rating parameters that they had used for a number of years and did not make any change in the rating structure to be compliant with the rating rules for the new plans. She discussed how the rating structure would change this year to have a flatter slope than they had previously had, and she discussed rating variables. Peggy said that one of the reasons they did not include the new metallic plans in the rates for 2014 last year was because there was no credibility in the new small plans and they didn't have any data upon which to base their rate decisions. She said they now had some experience they could use, and it would be reviewed for reasonableness given what they'd done in the past. Jeff thanked Peggy and said she'd laid out several things the Board was going to struggle with. He said she had reiterated what the Premera people had discussed during their presentation the previous day, namely that there were still a lot of things shaking out in the market. He summarized Peggy's comments, stating that Peggy would begin her analysis of the rates and would report to the Board her findings at a future meeting. Cecil said he would work with Peggy to prepare the data for presentation to the Board. Katie asked if Peggy was looking at the grandfathered and non-grandfathered business or ACAcompliant plans to base the ACHIA rates on. Peggy said that industry did the best they could with the twists and turns in the market due to Obamacare and the very messy roll-out last year, but that whole area was a mess because of the convoluted market last year. Discussion was heard. Cecil asked Debbie if she could provide a breakdown by percentage of the different cells of plans that were pre- and post-march 23, Discussion was heard regarding whether or not this applied to high-risk pools. Peggy said that if they lined up the metallic plans with ACHIA's plans, the maximum deductible/out of pocket for the metallic plans was somewhere in the neighborhood of $6,300 and most of ACHIA's business was in the $5,000 and $10,000 to $15,000 plans. She said with some revision, the $5,000 plan cwould be workable, but the $10,000 and $15,000 plans were automatically non-compliant. The Board considered Agenda Item No. 26 next out of order.

5 Alaska Comprehensive Health Insurance Association Page 5 of Review policy forms and possible revisions to the Traditional and PPO major medical [Tab K and Tab L]. This discussion will include the possible impact of the Federal mandated benefits and rules relative to lifetime and other internal limits. Cecil & Debbie to lead review and present recommendations. Cecil said that this agenda item was considered during discussions of other agenda items earlier in the meeting. Shawn said that if Katie found out that state law did not carve out a mandated benefit for the metallic plans, the Board might want to direct the Policy Committee to create a plan yet this year. Cecil said that was a possibility if it could be done. Brian added that it would be an advantage if the statutory issue could be worked out to where the policyholders could keep their same networks and doctors. The Board considered Agenda Item No. 31 next out of order. 13. Review in detail the performance of the ADMINISTRATOR for 2013 and first five months of 2014 [Tab 16]. Board discussion about the contract beyond June 30, Discuss pharmacy expert services provided by Alan Kellogg and consider any necessary changes to the scope of his duties. [Tab 17]. Consider any further adjustment to his contract for Discuss actuarial services provided by Peggy Onstott and consider any necessary changes to the scope of her duties. [Tab 18]. Consider with an objective of adopting 2015 proposal from Peggy. 16. Discuss Executive Director services provided by Cecil Bykerk and consider any necessary changes to the scope of his duties. Review his performance [Tab 19]. Consider Cecil s performance and his compensation for the next year. Agenda Item Nos. 13 through 16 were considered later in the meeting. See after Agenda Item No Review of First Choice and its PPO discounts. Discuss steerage into PPO plans and/or higher deductibles [Tab I]. Discussion led by BMI. Agenda Item No. 17 was considered later in the meeting. See after Agenda Item No Review the banking arrangements including the line of credit and letter of credit [Tab 20]. Discussion led by Chad Somers. Agenda Item No. 18 was considered at the previous day's meeting on June 25, Review status of current assessment. Consider timing and amount of next assessment [Tab 21]. Report from BMI with estimation of next assessment timing. Adopt motion regarding next assessment if timing is appropriate. Agenda Item No. 19 was considered later in the meeting. See after Agenda Item No Discussion and action regarding committees [Tab 22]. Cecil will review the composition of the committees and recommend any changes. 21. Report on NASCHIP activity. Cecil to report. 22. Review HIPAA privacy requirements and their impact as well as BMI s handling of privacy and any update [Tab 23]. Discussion led by BMI with any recommendations for change. Agenda Item Nos. 20 through 22 were considered at the previous day's meeting on June 25, 2014.

6 Alaska Comprehensive Health Insurance Association Page 6 of (8:30 am June 26) Review/discuss public comment. 24. Strategic Planning discussion Consider current state of federal healthcare reform, development of health exchanges as well as other elements that may impact ACHIA. Future role of plan including any additional changes necessary or possible as a result of new Federal legislation. Consider further transition to Health Exchange environment. Consider the anticipated wind down of ACHIA. Also consider need for any further legislation [Tab J]. Discuss and resolve the need for any necessary changes. Determine direction relative to the development of 2015premium rate schedule and plan changes. Formal approval of 2015 rates will be done in the Fall. All. Agenda Item Nos. 23 and 24 were considered as the first and second items of today's meeting. 25. Review underwriting policies and practices including HIPAA and TAA eligibles as applied by BMI [Tab 24] including eligibility review process for traditional uninsurable individuals. Presentation by BMI including any recommended changes. Agenda Item No. 25 was considered at the previous day's meeting on June 25, Review policy forms and possible revisions to the Traditional and PPO major medical [Tab K and Tab L]. This discussion will include the possible impact of the Federal mandated benefits and rules relative to lifetime and other internal limits. Cecil & Debbie to lead review and present recommendations. Agenda Item No. 26 was considered earlier in the meeting. See after Agenda Item No Review policy forms and possible revisions to the Medicare Supplement and Medicare Carveout. Note change to law relative to Medicare Supplement [Tab M, Tab N, Tab O and Tab P]. Shawn Pollock to lead review and present any recommendations. 28. Review of the $3,000,000 lifetime maximum including status of current policyholders and consider when and if we need to change again [Tab 25]. Cecil and BMI to lead review and present any recommendations. 29. Review grievance process including PBM type grievances and take action regarding any current grievances. Discuss any recent grievance cases. [Tab 26]. Presentation by Cecil including any recommended changes. 30. Application Review current application for possible changes [Tab Q]. BMI will present the current applications including suggestions for necessary changes. Agenda Item Nos. 27 through 30 were considered at the previous day's meeting on June 25, Review the Plan of Operation and consider other necessary changes. [Tab 27]. Cecil will lead discussion of the current Plan of Operation with emphasis on any further changes that might be necessary particularly with respect to ACHIA-FED s termination. Cecil said that he had looked at the Plan of Operation. He said it was last revised when the Board had accepted responsibility for managing ACHIA-FED. Until the time when there were no longer any policyholders in the ACHIA-FED pool and it was in runout mode, he said there was nothing that needed to be done to the Plan of Operation this year. 32. Review D&O coverage recently placed and any changes contemplated as a result of federal reform [Tab 28]. Cecil will discuss the coverage.

7 Alaska Comprehensive Health Insurance Association Page 7 of 11 Cecil said that D&O coverage was getting more difficult to get. He said that after a couple of months of checking on the status of their renewal, he had finally received an from their broker on Monday of this week indicating that their policy would be renewed with the same coverage and a premium increase from $11,025 to 11,576. He recommended Board approval, and discussion was heard. MOTION: by David to approve payment of the D&O insurance premium for another SECOND: by Shawn year. PASSED UNANIMOUSLY 33. Review of 2013 Annual Report draft [Tab R and Tab 29]. Cecil will make a high level presentation with an emphasis on changes and will request suggestions for further changes. Referring to Tabs R and 29, Cecil reviewed with the Board the 2013 Annual Report. He said he didn't have some of the final numbers when he was compiling it for the Board meeting, and they were working on an issue where one of the charts didn't print out right, but aside from those changes he would make after the meeting, the report was in final format and ready for production. Debbie added that she had noticed a discrepancy in the fonts on page 2 that Cecil would need to correct also. Cecil encouraged everyone to read through the annual report on their trip home and provide him feedback if they found any corrections or changes that needed to be made. 34. Consider possible role for Marketing Committee in communication plan to the current enrollees. David, Mona and Marilyn will lead the discussion along with Janet Oates. Jeff said this was an action item for Marketing Committee, and they were given their charge during the Board's strategic planning discussion under Agenda Item No. 24 earlier in the meeting. 35. Review and discuss possible further changes and uses for the website. All. Jeff said that the website was part of the Marketing Committee's tasks. David added that communications and making sure the members understand the issues were all internal tasks at this point. He said the Marketing Committee would work with BMI to ensure that goal was met. Cecil said that any references to ACHIA-FED could be removed from the website. Debbie reminded the Board that there were still people who checked their claims status through the portal. She said they could remove references to ACHIA-FED but not the insureds ability to access the portal to check their ACHIA-FED accounts. In response to David, Debbie said the runout was three years; however, BMI was going to send a communication to the providers letting them know that, as required by the federal government, they had one year to submit claims before they were foreclosed of the ability to do so. She said that if claims were submitted after the one-year period, it would be necessary for the Board to consider on a case-by-case basis how those claims would be handled. Discussion was heard. Cecil noted that the annual reports had inadvertently been deleted from the website and they were subsequently reposted, so those were once again available on the website. He expressed appreciation to Jim Grazko for letting him know they were missing from the website. In response to Marilyn, Jeff and Cecil said the Board materials were available on the Board portion of the website. Debbie said she would send the whole board a refresher on how to get onto the secure site after Jim Grazko came aboard.

8 Alaska Comprehensive Health Insurance Association Page 8 of 11 In response to Janet, Debbie said there was a section of the secure portion of the website where the Board members were listed. She added that they were not listed on the public portion for security reasons. Jeff added that the Board members were listed in the annual report. Discussion was heard regarding having contact information for an Alaskan Board member on the website. Janet asked that a report and recommendation on this issue be included as an agenda item for the next Board meeting. 36. Discuss further necessary legislative changes for Alaska statutes and discuss extent and timing as well as planning for Juneau visits if necessary [Tab 30]. Cecil, Brian and Shawn will lead a discussion focused on deciding which changes to pursue and a strategy for adoption. The Board discussed possible legislative issues and the timing of drafting any necessary legislation for the upcoming session. Jeff said that he felt that a trip should be planned for the ACHIA delegation to visit Juneau to talk with and educate the legislators during the upcoming session. Shawn agreed, saying that it had been a couple of years since ACHIA delegates had visited with the legislators, and it would be a good time to update them on what has been happening with ACHIA during the ACA transition. He said they should try to go early in the session, and depending on what happened with the CMS bill, they may actually have an issue of importance to discuss with the legislators during their visit. Jeff said they would plan for it, and timing of a visit was discussed. In response to Shawn, Marty said it would be better to submit a standalone bill so that it didn't get dragged down by another issue that it's tacked onto, and the legislature can learn the importance of that particular bill. 37. Review and collect signed conflict of interest policy statements [Tab 31]. Cecil will collect the signed statements. Cecil advised that the Conflict of Interest form was distributed to the Board members. He asked those who were required to complete and return them to him before the end of the meeting. The Board returned to Agenda Item No Review of First Choice and its PPO discounts. Discuss steerage into PPO plans and/or higher deductibles [Tab I]. Discussion led by BMI. Debbie reported that they were receiving bigger discounts with First Choice, and they were a good partner to work with, so the move to First Choice was a very successful one for the program. She said that there had been a concern, although she thought it had been resolved, but there were times when First Choice did not like the idea of BMI being able to edit the billing. She explained the basis of First Choice's resistance to BMI's ability to edit billings, but she said that after threatening to involve Katie and the Division of Insurance in the dispute and pointing out that it was BMI's fiduciary responsibility to ensure correct billing, First Choice had relented. She said that in return, BMI had softened its stance somewhat because there was a PPO contract in place. She said that other than that situation, First Choice was a great partner, and they would move forward. Brief discussion was heard. Cecil advised Peggy that the Board would be reviewing contracts and she could drop off the call. Mona let the Board know she was on the call at 10:34 a.m. Peggy signed off the teleconference, and the Board returned to Agenda Item Nos. 13 through 16. Debbie left the room while the Board considered Agenda Item No. 13 next. Alan also left the room in anticipation of Board consideration of Agenda Item No. 14.

9 Alaska Comprehensive Health Insurance Association Page 9 of Review in detail the performance of the ADMINISTRATOR for 2013 and first five months of 2014 [Tab 16]. Board discussion about the contract beyond June 30, Cecil said BMI was wonderful to work with, and they've been busy. He said they were in a transition because the Executive Director had passed away and Debbie was now the acting Executive Director in Kansas. He said BMI gets the work done, was responsive to his needs, and he had no complaints. In response to Jeff, Cecil said the BMI contract expiration was June 2015, so no Board action was required on their contract today. Discussion was heard. 14. Discuss pharmacy expert services provided by Alan Kellogg and consider any necessary changes to the scope of his duties. [Tab 17]. Consider any further adjustment to his contract for The Board discussed Alan's performance and the benefit of having him and the Express Scripts contract. In response to David, Cecil said Alan's was an annual contract, so Board action was required, and Jeff added that Alan's contract ran from January 15 through December 14 each year. He said that Alan had not proposed any changes, so he assumed the terms would be the same, but they would clarify that with him when he returned to the meeting. The Board tabled action on this item until Alan returned. 15. Discuss actuarial services provided by Peggy Onstott and consider any necessary changes to the scope of her duties. [Tab 18]. Consider with an objective of adopting 2015 proposal from Peggy. Cecil reported that Peggy still struggled with health issues, and she had not raised her rates the last two years. He said she did get the work done, toward the end, that was assigned by the Board and she continued to do good work. He said she had requested a $20/hour increase, and he recommended Board approval effective January 1, 2015, that they extend her contract at the requested increased rate. In response to Chet, Cecil said he believed Peggy would deliver the required work in the fall. MOTION: by Shawn to extend Peggy's contract with the $20/hr. increase effective SECOND: by Marilyn January 1, Passed with 1 nay by Chet 16. Discuss Executive Director services provided by Cecil Bykerk and consider any necessary changes to the scope of his duties. Review his performance [Tab 19]. Consider Cecil s performance and his compensation for the next year. Jeff said that the Chair's job would be impossible without Cecil. He told Brian that as the incoming Chair, he would be well served having Cecil's contract continued for another year. He said Cecil was not requesting an adjustment to his salary. In response to Jeff's question regarding when Cecil's contract expired, Cecil said it was an evergreen contract and was extended each year. MOTION: by David to extend Cecil's contract for 2014/2015. SECOND: by Brian PASSED UNANIMOUSLY Jeff asked that someone call Debbie, Alan, and Janet back into the room. When they returned, Jeff told Alan that his contract was approved for another year, but the Board had asked him to clarify the terms for the next year. Alan said they were the same.

10 Alaska Comprehensive Health Insurance Association Page 10 of 11 MOTION: by Shawn to approve extending Alan's contract for 2014/2015. SECOND: by David PASSED UNANIMOUSLY Cecil said that he wanted to clarify the BMI contract. He said the ACHIA-FED contract expires on June 30, 2015, and the ACHIA contract expires on June 30, Debbie responded to questions regarding the FED pool and the runout status. The Board returned to Agenda Item No Review status of current assessment. Consider timing and amount of next assessment [Tab 21]. Report from BMI with estimation of next assessment timing. Adopt motion regarding next assessment if timing is appropriate. Referring to Tab 21, Jeff said that based on the earlier presentation, he felt that a small assessment would be in order to ensure that they had a cushion for unexpected contingencies between now and next summer. Cecil agreed, adding that it was possible to get a one- or two-million-dollar claim overnight. Jeff proposed a $3,000,000 assessment, and the Board concurred. Cecil said that as soon as the numbers were available from Katie, BMI could send out the assessment. Katie said those numbers were usually available by the end of July. Discussion was heard. MOTION: by David to do an assessment in the amount of $3,000,000 as soon as SECOND: by Marilyn the figures and other data were available from the Department of PASS UNANIMOUSLY Insurance. 38. Other items. All Update on Bob Niebrugge's Condition Cecil reported that the earlier phone call he took was from Gail Niebrugge. He said he had talked to Bob, who was still in hospital. Cecil said that Bob did have a mild heart attack, and he gave an update on Bob's condition. Action Items Debbie reviewed the action items as follows: Draft a communication to the providers advising them that the ACHIA-FED claim filing deadline was one year based on the federal guidelines. A premium holiday notice would be included with the September bills. Debbie would run a report by plan to show all active members who had effective dates on or prior to 3/23/10. In response to Chet, Debbie said the report would reflect the original effective date, any plan changes made at year-end, and the effective date of the plan they're currently on. Jeff asked Debbie to also show in her report those who were not grandfathered but had a plan before 10/1/13 because they could fall under the extension as well.

11 Alaska Comprehensive Health Insurance Association Page 11 of 11 Website Access for Board Members Debbie will send everyone an with instructions on how to access the secure portion of the ACHIA website. Assessment BMI will send out a $3,000,000 assessment as soon as they receive the numbers from the Department of Insurance. Cecil's Annual Meeting Follow-Up Jeff said Cecil would do his annual meeting follow-up as well. In response to Jeff, Cecil said he would send the letter to e-health Network regarding Dallean's appointment, and he would send the letter to Director regarding the Board appointments. Marketing Committee Tasks David said the Marketing Committee would work with Debbie on the letters, review the website, and prepare a report and recommendations to present to the Board at a future meeting Annual Meeting Cecil asked the Board's thoughts and preferences regarding the annual meeting for next year, and discussion was heard. There was a consensus of the Board to hold next year's annual meeting at the Anchorage Marriott in the June/July time frame. Brian said the Executive Committee would announce the date and time after polling the Board for availability and Cecil would arrange for the hotel and meeting room accommodations. Board Travel Reimbursement Cecil explained the procedure for Board member reimbursement of travel expenses. Lunch Cecil announced that lunch would be catered in at noon, and he encouraged everyone to stay and eat before taking off. There was no other business of the Board. 39. Adjourn MOTION: by Shawn to adjourn. SECOND: by David PASSED UNANIMOUSLY The annual meeting of the Board of Directors was adjourned at 11:10 a.m. on Thursday, June 26, 2014.