our public comment process and I'm going to reference one or two of them one commenter said the filed insurance increase in the small group market are unsustainable for small businesses and their employees if our company has to shoulder such high increases we may cut our percentage of contribution for each employee making the individuals suffer economically most people in the small group already saw double digit rate increases last year another commenter said I want to make a comment about the CSR loading discussion I want to emphasize I think many people know it but I want to emphasize the purpose of this recommendation on CSR load was intended to provide services for small businesses for small businesses for small businesses for small businesses for small businesses on CSR load was intended to rise all boats I'm not sure if that's a good metaphor today given our weather or a bad one but any differential treatment between the carriers will put a drag on one carrier and their rate payers the goal was to give her monitors who get premium tax credits more buying power we have an opportunity to do this hopefully the board will apply the strategy available to it that is most effective at reaching that goal improved affordability in a uniform fashion so I'll go back to a high wire balancing act suggests a risk if we misstep who's going to fall would you join MVP here of course we don't want the carrier to fall but obviously we don't want Vermonters to fall either or to leave the metaphor from our perspective premium increases will price more people out of the ability to afford the care they need Vermonters are counting on us to minimize this when I look at the public comments together and combine it with what we hear from Vermonters every day at the helpline I land at the same question that Eric Schulte asked at the beginning of the day if all the segments of the proposed rate this year and previous years are reasonable how can the result be so unreasonable for so many Vermonters thank you Mr. Hearing Officer and thank you members of the board Thank you Mr. Fisher questions for Mr. Fisher No questions thank you Do any board members have questions for Mr. Fisher sorry I'll just go around Robin do you have any questions No Yes Dave No Chair Foster I do have one or two Mr. Fisher you reference pricing people out of the care they need Do you have information or data reports you can share with the board relating to that issue it's one that's obviously we're concerned about Mr. Chair we I would describe the data that comes to us through the helpline as more of a canary in the coal mine dynamic than a source of data that we can create numbers from amongst the set of Vermonters who are having affordability challenges and know to call my office and what percentage of them know to call the HCA I'm afraid the answer to that's relatively small so what I can say is that it's a regular call it's a regular occurrence where a Vermonter calls us and says I'm trying to figure out how to make it through this thing trying to figure out what plan to buy I'm trying to figure out whether it makes sense and after looking at the data and looking at the options they decide they are faced you know I'll put it that way put it the way I put it earlier the economic decision in front of them takes precedent over the healthcare decision in front of them and it's certainly something we've seen in public comment as well and heard in my travels speaking to the people but I think just for both parties one thing that would be helpful in balancing this high wire act is the best data and information we can get between these potential adverse consequences that we're trying to avoid as you can appreciate the board on both sides we don't want insurers to leave we don't want them to be insolvent and at the same time we don't want people avoiding care or delaying care or shifting down what metal level they're at because that has negative consequences too so just an open request that if there's information that helps us appreciate the risks and how real or likely they may be and to quantify them I know it's like a nearly impossible ask but it helps us on that I think it's very beneficial I think you can all appreciate we don't want any of these consequences I have nothing further and thank you very much Mr. Fisher thank you okay so I think that concludes the well no sorry I always missed this up Mr. Carnegie are there any additional witnesses you'd like to call no sir okay then are the parties ready to move to closing statements yes sir yes and I believe it's MVP goes first that's right well I just want to thank everybody thank everyone on the board and all the witnesses today for their time and attention I think that Chair Foster that last comment he made sums up the whole dilemma I only am responsible part of that dilemma you all get to deal with that balancing act and I don't envy you in the least I do think that we're all on the same page of wanting to make sure that Vermonters get the health care that they need and get the health insurance that they need any decision on a final rate by the board should of course take into consideration all the statutory criteria I'm sure that a reduction on one criterion does not result in a statutorily inadequate rate the board should consistently and reasonably exercise its discretion considering the hospital budget impacts this year based on the testimony today I would encourage the board to think through how we can get this chicken and egg problem but how we can get more information from the hospitals rather than the carriers having to make presumptions about their business to be helpful given the evidence presented the board should not cut MVPs proposed CTR below 1.5% in its regulatory role of making sure that Vermonters have the best health care and the best health insurance possible the board should not ignore MVPs three years of multi-million dollar losses the board should strive to avoid that outcome in 2024 I want to be clear on this because I think it may have been lost a little bit in the testimony today the way we presented this is not an RBC issue it's not an RBC issue if Kellogg's is selling lucky charms like gangbusters and cornflakes are losing money year after year it's prudent for Kellogg's to look at its cornflakes business and look at it independently as a business standing on its own that's our point so when you deliberate on this please remember that we weren't talking about RBC talking about cornflakes it was about this discreet Vermont business and you heard from both actuaries saying that you need to consider these rate filings and consider the Vermont business, the book of business standing on its own standing on its own it's been losing millions of dollars year in year out thank you very much for your time thank you Mr. Schulze sure so you know Vermont law is clear that the task before you isn't defined by a mathematical formula so in some states that might be the case so a valid rate is one could be one that's actually not inadequate and not excessive that's not the case here and Vermont law is unambiguous about that so as Mr. Carnegie alluded to you and Mr. Fisher did you have an exceedingly unenviable task of balancing the needs of your neighbors against actuarial estimates that's what the law demands consider MVP's rate proposals I see you keep just a few things in mind first has MVP proved by a preponderance of the evidence that the rates are affordable promote quality and promote access unless marketing language counts is sufficient evidence I do not think they have second actuaries have presented many estimates today all the estimates presented even if they are specific number points within an actuarially reasonable range which itself depends on the specific professionally acceptable method used to arrange within a range also remember that they are estimates perhaps are best guesses but they are estimates not facts we do have a few facts before us though we have the fact that a series of reasonable and appropriate actuarial assumptions results in the unreasonable outcome of far too heavy a burden being placed on our neighbors we have the fact that premium price growth has far outpaced wage growth and other economic indicators year after year most tragically we have the fact that our neighbors even if they can afford premiums can afford to access care I would like to leave you with three simple questions as you deliberate on this by me what other business increases prices by double digits for second year in a row instead of finding ways to achieve operational efficiencies what good is an adequate network of providers if many of our neighbors can afford to see the doctor lastly can Vermont ever achieve the triple aim if every year fewer of our neighbors can afford to see care thank you thank you so I heard a number of every year we issue a set of hearing follow up questions questions you know weren't able to be answered at the hearing we're going to do the same this year I've been trying to take notes and keep a list I hope you have as well hope to get that on the next couple of days certainly by the end of the week one thing I did hear that I just want to say out loud because it requires consultation with third parties is the question about whether the COVID vaccine for next years in the Vermont vaccine purchasing program like that issue for adults which I think requires some reaching out to VDH maybe Department of Health who runs that program so we will get a set of follow up questions out to MVP shortly and anything else from the parties before we move to public comment just housekeeping the briefing deadline is the same July 28 and the goal is to get transcripts to us by the 21st is that correct yes no additional questions from us okay so we do take public comment at the close of these hearings so if there is any member of the public who's with us who would like to provide a comment if you could please raise your hand or if you're on the phone take yourself off mute go ahead and do that seeing anyone so again if there are any members of the public who would like to give public comment on this filing or blue crosses individual sorry these filings or blue crosses individual and small group rate filings will be having a meeting on the afternoon of Monday July 24th for that purpose and with that I will turn it back to you Chair Foster to adjourn the meeting great just thanks to the parties and the witnesses this is my first rate review hearing extremely informative and professionally done so thank you and hearing Officer Barber really impressive work thank you for all you did for this and to all the rest of the rate review team so big thanks because I know it was a lot of long weekends and everything so thank you and with that I'll take a motion to adjourn if anyone has one and moved second all those in favor aye aye we are adjourned thank you have a nice day and Mr. Foster is there someone I could speak to about getting the verified spellings I can email that to Cassidy oh perfect do I have do you have my email address I do okay was that you that emailed me the executive session yes okay so I'll respond to that executive session email with my list and if there's anything that seems out of order doesn't make sense it could just because it's a very quick phonetic guess request so don't don't let it become an issue or take any time on it just let me know and I can refer back to my notes so I'll send you that list this afternoon great thank you very much thank you thank you for that y'all have a good night thank you thank you Cassidy you're great thank you my pleasure bye for now bye bye bye


Hey everyone welcome back it's Veronica Howard. So we're delving into some slightly more advanced content here. What I'm talking about are some of the variants of differential reinforcement. Differential reinforcement is, as is typically presented by simple textbooks, this idea of reinforcing one thing and extinguishing another. Well previous videos have disabused that. We know that it can be extinction for one thing or punishment for one thing plus reinforcement for something else. But behavior analysts have found a way to really artfully change behavior using some of these variants which will be important if you're going to use differential reinforcement in clinical practice. So when we're talking about these variants we know that there are several ways that you can use this in applied settings. One of them for instance is what's called differential reinforcement of alternative behavior. And that means that we're gonna specify something else to do instead of a problem behavior that we're trying to decrease. So again we're picking something else and we're saying hey we're gonna reinforce that behavior but this behavior we're trying to decrease we're no longer going to reinforce that. We abbreviate this as a DRA procedure. You can also have something called a DRI or differential reinforcement of incompatible behavior. This is slightly different from a DRA.  DRA we said was choosing an alternative behavior, differential reinforcement of an incompatible behavior is something that is both an alternative response but it's something that you cannot do at the same time as the behavior we're trying to decrease. For instance if I'm working with young kids in a school maybe what I'm going to do is reinforcement is available for every 10 second interval that their hands are in their pockets rather than knocking all the locks on lockers. Or maybe reinforcement is available for whispering when we're having circle time but reinforcement is never available for shouting. So you want to choose something that cannot be done at the same time as the target undesirable behavior. If you can't do them at the same time and reinforcement is only available for the incompatible behavior not the target unwanted behavior you're going to see more of that incompatible response. We can also have something called the DRH or differential reinforcement of high rates of behavior. This is when reinforcement becomes available if the behavior happens really rapidly or really fluently. So you want to pick how much behavior you need per unit of time. So maybe a spouse feels most loved when they receive 10 text messages per day and they're feeling ignored if there are fewer than 10. Now we know that the rate of behavior that we need for that day is 10 or more of these responses. This is DRH. You also have the opposite. You can do a DRL which is where reinforcement is available but only if the target behavior is below a certain threshold. Same spouse example maybe the spouse feels harangued if they receive 10 calls from their spouse per day and reinforcement is only available if they call less than 10 times per day. We also have something called the DRO procedure. This one can be pretty misleading because we often say that you can't reinforce the absence of a response. We have something called the dead man test which means you can't reinforce a behavior that is something that a dead man can do. Things like laying or being quiet or things like that don't pass the dead man test. But DRO is one of those interesting exclusions to that rule. It's an exception. In a DRO procedure we provide the reinforcer following a brief period of time where a specific target behavior didn't occur. So conceptually speaking you're providing reinforcement whenever any other response, it could have been anything at all, didn't occur. In the case of maybe a foul mouthed teenager maybe we provide a reinforcer for every hour that they haven't used some form of adult language. We're just providing a reinforcer based on a period of time when the target response didn't occur. These are some of the more advanced conceptual examples of differential reinforcement. You may find yourself using some of these from time to time. These can be confusing so I encourage you to go back, take some careful notes, see if you can find some examples of these. Those can be helpful as well. And let me know if you have any questions.


Nobel Prize is given from 1902 in the field of Physics, Chemistry, Economics, Peace and Physiology and Medicine. Let us see about the Nobel Prize winners from India so far. Rabindranath Thakur and C. V. Raman received Nobel Prizes before independence, i.e. before 1947. After independence, Madartharasa, Amarasiya Sen, Kailash Radyatri, got their Nobel Prizes. All these five mentioned Nobel laureates received their Nobel Prize as Indian citizens. These two on the list, Ronald Ross and Rudyard Kipling, both were born in India, did most of their works from India. But when they received their Nobel Prize, they were having only British citizenship. That makes the number two seven. These four on the list, Hargobidham Korana, Subramanian Chandrasekhar, Venki Ramakrishnan, Abhijeet Banerjee, they were all born in India. But when they received their Nobel Prizes, they did not have the citizenship of India. Twelfth and last on this list is Dalai Lama. While receiving this prize, he was the citizen of India. So there are 12 Nobel Prize winners from India and this is the list.


Hey, welcome back everybody. Jeff Frick here with theCUBE. Where it's Roar Subscribed 2017 in downtown San Francisco. 2,000 people, it's all about the subscription economy and really what the subscription economy does in terms of the relationship between a client and a customer. And that's, I think, what's the important story about the size of the mechanics and the accounting and all the other stuff that's going on. We're excited to have our next guest, Barry Holmes. He is the Chief Revenue Officer of Surf Air. Barry, welcome. Thanks, Jeff, glad to be here. Absolutely, so for people that aren't familiar with Surf Air, give him a quick background on the company. Sure, so Surf Air has been around for four years. It's a membership based club where you save two hours every time you fly. You're flying out of executive airports on smaller executive planes. You get the private experience except it's on a schedule. Everything's on your app, et cetera. So we're really addressing that pain point that your business traveler has in wasting time at big airports to fly short haul trips. So currently we're only in California and Las Vegas. We have big aggressive growth plans to Texas, Europe and the rest of the world because for short haul city pairs like San Francisco, LA, LA, Vegas, et cetera, they exist all over the world. Those big population centers are getting wealthier, busier, more time pressed, yet the infrastructure and the commercial world hasn't kept up. Right, right, but you mentioned the big airports but you're flying to like in the Bay Area, I know you're flying to St. Carlos, right? Well, so that's how we solve the problem is you're still going to the market that you want to go to from the market that you're coming from but you're flying out of St. Carlos in the Bay Area to Burbank or Hawthorne in LA or you're flying into an FBO attached to Burbank Airport. So that's how you save so much time. You show up 15 minutes ahead of your flight. You book everything on your app. You end up, we basically give our members back two hours every time they fly or a whole day if they fly weekly. So every month you're getting a day back and so our members are high powered. They know how to use their time and when they do that they're able to create a life out of the time we give them. And yet, unlike say some of the net jets or some of those things, those are, those are you're actually getting the, it's not a schedule. So you guys have added the schedule component to it and you've enabled that using a mobile app. Yeah, so the schedule basically gives you the frequency that you need and it mitigates the cost associated with typical charter travel. So you're getting the private experience but you're not chartering the flight, paying for dead legs, to charter a flight by yourself to San Francisco from LA is going to be eight to $10,000. Whereas you fly with us weekly it's going to be an average of 650 a flight. Interesting. Okay, so then we're here at Sorora subscribed. So subscription, why did you choose to go with a subscription model as the way to interact with your customers? I mean, so I've been in the membership business or subscription business in several businesses now. And I think there's a distinct difference between the relationship a company has with its members and the relationship a company has with customers. So there's obviously- It's funny, you don't even use the customer phrase. You say members. I don't even use customers. They're members of ours. So when you're a member of the club you're going to get treated differently. And in all honesty, sometimes we get scathing feedback but it's good. We learn from that and improve the business based on how the members use it and how they interact with us because they're part of the family. A customer, if they don't like it, they often leave. You have to come up with surveys and things like that to find out what's going on. But with us, we can see how often a member engages with us, which flights they take, which flights they enjoy. And we have member care people or member management resources that deal with these members every day. So the feedback loop is it really improves the value of the membership and it also improves the business. And clearly a recurring revenue model is good if you put the member first and handle their needs. That's ultimately going to drive your revenue. Right, because you got to keep delivering value over and over and over and over per time period. You can't just rely on that first big pop and maybe a maintenance fee or whatever. No, exactly. We look at it as we don't want to get into the discount game. We want to charge a fair price for what we deliver, but we want to make the experience worth it. And we found that our members really don't blink at the price as long as the experience is there. Because they realize it's a much lower price versus say charter. But if we keep innovating and give them the options they want, the times they want, the service level that they want, then it builds value for us and we put value back in it for the member. That's the symbiotic relationship. And how important was the subscription model to the business of Surfer in terms of the founding? I don't know if you were there at the beginning. Or is it really an integral part of it? Or is it kind of a nice to have that you guys added on after the fact? No, I was not there for the founding, but I do believe it was an integral part because they realized that in order to, in order to create a different business model, they saw the value of subscription business. Anytime you look at business models, knowing that when you wake up on June 1st or July 1st, you've got recurring revenue there, that's going to be more appealing. How you treat those members to grow it is obviously the question. Certainly not an inexpensive business to run, a small airline, so nice to have that recurring revenue. It's a heavy asset business, so you have to get the value right and you have to get the pricing and the usage right. Those are the lessons that we've learned over time. Now we know how often people fly, what they expect and what kind of price that makes sense for both us and them. Right, right, Barry, I got to give you the last word before we have to go. What's kind of your sense of what's going on here as we're subscribed? Water cooler chat, what are you hearing any surprises? What's kind of the feel as this subscription thing really starts to go? Yeah, I mean, I think it's, to think that you've got a conference built around a business model is unheard of. And so that's, so I think it's extremely valuable because when you're talking to people in completely different businesses, yet they serve their members or their subscribers in the way that makes sense for their business, you can actually take a lot back into what makes sense for your business. So, feeding the model, knowing that you've got a base of people that you have to serve the right way, you can really learn a lot from all sorts of businesses. That's what's cool about this. Very good. All right, he's Barry Holmes, I'm Jeff Frick. You're watching theCUBE from Zora Subscribe. Thanks for stopping by. Thank you. All right, thanks for watching.