Minutes from September 25, 2012 Open meeting

Tuesday, September 25, 2012  

Open Board of Directors Meeting

San Bernardino Community College District

 114 S. Del Rosa Drive San Bernardino, CA 92408


Present: Dimitrios Alexiou, Don Averill, Deborah Barmack, Carole Beswick, Tom Brickley, Ann Bryan, Ken Coate, Bill Easley, Dick Hart, Mark Kaenel, Lowell King, Bill Lemann, Temetry Lindsay, Neil Macready, Lou Monville, Charlie Ng, Tom Nightingale, Bev Powell, Larry Sharp, Paul Shimoff, Phil Waller and AJ Wilson.

Guests:  Senator Bill Emmerson, Ronald Freemont, Sue McKee, Michael Nduati, Lizette Navarette, Dean G. Richard Olds and Dr. Peter Plantes. 

Announcements:  1) Invitations will be sent out this week for a reception to celebrate Inland Action’s 50th Anniversary.  Opportunities are available for underwriting this event. The event will be on Thursday, October 18, 2012 from 5:30-7:30p.m. at the San Bernardino International Airport in Hanger 763.  2) The US House of Representatives, Committee on Transportation and Infrastructure, Subcommittee on Aviation will be holding a congressional hearing in Ontario entitled, “Economic Impact and Future Management of Ontario International Airport.”  The hearing will be held on Thursday, September 27, 2012, at 1:30PM at the City of Ontario Council Chambers.  Information will be e-mailed to the membership.   

M/S/P: Minutes of the September 18, 2012 meeting  

Dimitrios Alexiou introduced Dr. Brad Gilbert, CEO, Inland Empire Health Plan. 

Organized as a Joint Powers Agency, Inland Empire Health Plan (IEHP) is a local, not-for-profit, public health plan. They are the leading nonprofit health care provider in the state serving over 570,000 residents of Riverside and San Bernardino counties through government-sponsored programs including Medi-Cal (families, adults, seniors and people with disabilities), Healthy Families, Healthy Kids, and a Medicare Advantage Special Needs Program.  They are expecting to grow to 850,000 members by 2014 when they enter the newly established California Health Exchange. 

Dr. Gilbert discussed the key provisions in health care reform.

  • ·         Financing
  • ·         Individual and Employer mandates
  • ·         Health Plan mandate
  • ·         Medicaid expansion
  • ·         Health exchange 

Individual mandates requiring basic coverage will begin 2015.  Employer Group Mandates require employers to provide basic coverage in 2014 (for those employers with more than 50 employees; those employers with fewer can purchase coverage through the Health Exchange). Enforcement of the mandates will be handled by penalties through the Internal Revenue Service system.     

Health Care mandate

  • ·         2014 Prohibits lifetime benefit limits
  • ·         Pre-Existing Conditions
    • §  2010: No denial for children
    • §  2014: No denial for adults – need individual mandate
    • Medical Expenses
      • 2011: 85% Medical Loss Ratio for Large Employer Group
      • 2011: 80% Medical Loss Ratio for Individual and Small Employer
      • 2014: 85% Medical Loss Ratio for the Medicare Advantage plans

 The time line is as follows:

2011: Medicare tax Increase

2012: Savings from Medicare Advantage (MA) Rate Reduction

2014: Fees on Health Plans (non-profits with 80% revenue from Federal & State are


2014: Penalties from the Large Employer Mandate Coverage

  • ·         Employers with more than 50 employees are required to provide coverage
  • ·         Those with under 50 can purchase coverage through the Health Exchange

2015: Penalties from the Individual Mandate Coverage

2018: “Cadillac” Plan Tax-an excise tax on excessively rich health care plans 

The Medicaid Expansion in 2014 will now include individuals between the ages of 19 up to 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% FPL based on modified adjusted gross income. 

In 2014 an estimated 500,000 or more uninsured residents in the Inland Empire will gain coverage through health care reform.  The largest increases will occur through the Medi-Cal eligibility expansion and individual coverage through the Health Exchange.  Individuals will be required to have basic health coverage in 2014; premium subsidies will be available for those with incomes less than 400% federal poverty level -$92,200 a year for family of four (2012 guideline). 


  • ·         Inadequate supply of Primary Care physicians currently in the Inland Empire
  • ·         Overall inadequate supply of specialists (some variation by region)
  • ·         Overall inadequate supply of inpatient beds (some variation by region)
  • ·         Significant changes in payer mix for providers -Increased Medi-Cal coverage
  • ·         Impact of Health Exchange unknown
  • ·         Concern regarding low-income individual uptake due to cost of coverage
  • ·         Uncertainty regarding small group employer participation
  • ·         Eligibility process
  • ·         Number of health plans participating

 A Q & A period followed. 

Meeting adjourned 8:34 a.m.