2. Timeline for Submitting Forms  Open enrollment is October 6 through November 14  Forms must be returned to Risk, Compensation & Benefits by November 14, 2011  You can  Change medical plans  Add or delete dependents  Enroll in voluntary benefit programs  Enroll in the Flex plan  You must enroll each year to participate in the flexible spending account program  Please Note: If you do not want to make a change to your Group Health plan, you do not have to do anything

3. Behavior based – change your habits – Small steps result in BIG CHANGES Proactive management of health – Preventative health services – Wellness Long term approach Develop a plan, work the plan, monitor the plan, CELEBRATE your success Usually no or low cost Bottom Line – live longer, – live happier, – live wealthier

5. 79 Subtract your age = The number of years you have left on the planet

6. 6 How Many Of You Can “Say Yes” to All 5? I am within 5 pounds of my ideal body weight I exercise 30 minutes or more most days of week I eat a healthy diet with 5 fruits/vegetables most days I don’t use tobacco products I have 2 or fewer alcoholic drinks per day

7. Sources: Stampfer, 2000; Platz, 2000; Hu, 2001 71%70% 82% 91%

8. Wellness Key component of your health care –Preventative & Proactive –Works one-on-one and confidential –Supports behavior change, designed to assist each person at their own pace –Many of your fellow employees have been successful Our Wellness Coaches are here to assist with: Stress ManagementWeight Loss NutritionTobacco/Smoking Cessation Disease ManagementExercise

9. Lifesigns A head to toe annual preventive physical exam providing information you need to develop your personal care plan, putting you in control of your health. –Works hand in hand with Wellness Coaches, PCP and Behavior Health Benefits, 100% confidential Lifesigns seeks to complement your relationship with your existing PCP and can forward results electronically to your physician at your request For CH/C participants test results will be sent to Care Coordinators. Hearing and Vision testsElectrocardiogramBlood tests Screening ultrasoundChest x-rayPhysician consult Body fat percentage & BMI Age/gender optionsComplete lab panel 60+ tests

10. Mines and Associates Counseling Problem Assessment Short Term Counseling or Referral Coaching for Behavior modification After-Care Follow-Up Crisis Intervention 24 Hour Emergency Service Workplace Reintegration Child or aging parent assistance Employee Assistance Program

11. Health Quiz III Wellness, Lifesigns, Employee Assistance Program, Preventive health services and some Behavior health services cost each CLV employee? Nothing, these services are free to all CLV employees CONFIDENTIAL11

12. Choose a Family Doctor/PCP Primary Care Physician your “family” doctor –Specially trained to work with you to coordinate your overall healthcare –Understands you and your needs best –Takes the confusion out of what to do next, where to do it –An in-network PCP can help keep money in your pocket by reducing your out-of-pocket expenses –Focus on preventive and scheduled health maintenance services.

13. Live Longer – Live Better Use the tools we have provided to assist you in becoming well and engaged –Lifesigns –Wellness Coaches –PCP and Prevention –EAP –Dental/Vision –Health plan

14. PART II 2012 Group Benefit Plans There when you need it! CONFIDENTIAL14

15. 2012 Changes  By making small plan changes CLV has been able to keep 2012 premiums low – most are at or below 2011 rates.  Sierra PPO Changes – increase Out-of-Pocket maximum  Increase in prescription co-payments  Lower premium rates  C H/C changes – increase Out-of-Pocket maximum  Increase in co-insurance  No change in EE only and EE + 1 premium rates  Dental Plan Changes – increase from $2,000 annual maximum benefit to $2,500 annual maximum benefit  Premium rate increase

16. Rate chart – Employee Bi-Weekly Contribution CDHPSierra PPO HPN - HMO VisionDental EE Only$0 EE + 1$126.79$124.62$74.77$1.01$6.76 EE + 2$256.99$197.00$118.38$3.06$15.69

17. HR Claims Network Pharmacy Providers Care Coordinators 1-877-498-5981 5:30 AM – 6:00 PM PST Monday – Friday Health care is very confusing Call for Help… What will the “Care Coordinators” help me with? Benefits Claims Questions Find In-Network Providers Patient Advocacy Nurse Coaching Single Point Patient Service I can help you with all your healthcare questions. IT ALL STARTS HERE

18. Single2-PersonFamily $1,000$2,000$3,000 $500$750$1,000 80% providers with discounts 60% of R&C with providers without discounts $2, 500 $3,500$4,500 Let’s Review How CDH Works Preventive Care 100% 100% coverage – No deduction from HRA Traditional Health Coverage Coinsurance Maximum Health Reimbursement Account (Annual Allocation) Bridge (Employee’s responsibility) $2500$3750$5000 All employees enrolled in CDH must submit a City of Las Vegas Other Insurance Form

19. 2012 Plan Changes Co-Insurance (without Bridge) Current2012 In-Network90%80% Out – Network70%60% OPM In-Network Employee$2000$2500 Employee + 1$3000$3500 Family$4000$4500 OPM Out of Network EmployeeN/A$6000 Employee +1N/A$7000 FamilyN/A$9000 **in-network accumulates toward out-of-network max

20. 2012 Plan Changes Pre Notification is required for:  Outpatient surgery  MRIs, MRAs, & PET Scans  Oncology services (chemotherapy and radiation therapy)  Home health care and services  Durable medical equipment rentals and purchases over $500  Hospice care  Speech, physical and occupational therapies  Dialysis Prior Authorization is required for :  Transplant services  In Patient services  Gastric bypass surgery Early notification of high cost procedures notifies Care Coordinators to assist patients through a health care event, lowering cost and improving quality. Note: Anytime a pre-notification/auth is submitted, you will receive a confirmation letter from the Care Coordinators.

21. Catalyst Rx  Formulary Advantage Program  Complete Formulary Listing  Price and Save Program - www.catalystrx.comwww.catalystrx.com  You can price and compare co-payments at local pharmacies  Helps you choose lower cost prescription drug options Coordinated Health/Care Pharmacy Benefit

22.  Catalyst Rx offers the Diabetic Sense program at no charge  Injectable insulin and syringes at no charge  Home delivery of testing supplies  Access to Diabetes Educators, Nutritionists and Pharmacists  To access this benefit, you must enroll  To enroll call Liberty Medical at 1-866-896-7303 Diabetic Sense Program

23. Health Plan of Nevada HMO Health Plan Required to have PCP Must stay in-network No Annual Deductible and Out of Pocket Max Co Pays for various services Co Pay for Rx No Out of Network benefit 23

24. 2012 Sierra PPO Plan Prescription Co-Pay Generic$15.00 Preferred Brand$40.00 Non Prefer. Brand$60.00 Deductible In-NetworkOut-of-Network Employee $500 $1000 Employee + 1 $1000 $2000 Family $1000 $2000 OPM In-Network Out of Network Employee $3000 $6000 Employee +1 $6000 $12000 Family $6000 $12000 Please refer to medical plan comparison chart in the 2012 open enrollment for more plan details.

25. Did you know? –Annual dental and vision exams are as important as an annual physical –Dental and Vision exams can detect over 120 disease signs (usually at very early stages) including: Heart disease/Heart attacks Diabetes Respiratory disease A weakened immune system that can slow healing of wounds and reduce a person’s response to hepatitis B and flu vaccines. Cancers Stroke CONFIDENTIAL25

26. Dental and Vision Benefits Dental Preferred Dental Network Increase in annual benefit to $2,500 Vision Vision Service Plan Network 26

27. Section 125 Flexible Spending Accounts Two types of funds (you must enroll annually) Health Care FSA – contribute up to $4,000 to pay for unreimbursed medical costs Dependent Care FSA – contribute up to $5,000 to pay for eligible day care expenses for child or dependent adult Contributions to your FSA are pre-tax –Your taxable income is decreased –Fewer taxes are withheld –Increase monthly cash flow –Use the money when you need it You must budget carefully, governed by IRS use-it –or-lose- it rule. CONFIDENTIAL27

28. Voluntary Life For employees currently participating in The Standard’s Voluntary Life plan, you can increase your benefit level: –$60,000 for employee, up to guaranteed issue amount of $150,000 –$10,000 for your spouse, up to guaranteed issue amount of $50,000 Please update or complete your beneficiary designation. CONFIDENTIAL28

29. 457 plan – Pre tax employee contribution Reduces federal taxes Provides savings for retirement Hartford ICMA Nationwide

30. Voluntary Programs Discounts on Auto and Home Insurance –F. Hayden Ray 702-736-8611 Ext. 58082 Consult with Board Certified doctors on the telephone or via email regarding commonly treated short-term illnesses, such as: flu, allergies, colds, etc. Available 24 hours a day, 7 days a week Can prescribe medications and refill recurring prescriptions For information, contact Lori Wilkerson at 702.877.1177 Pat Johnson or Amy Bechtel Phone - 702-877-6388 CONFIDENTIAL30

31. CONFIDENTIAL31 Stage 1 – Planning, Prevention and Identification Wellness Engagement – Behavior Change - EAP Lifesigns Primary Care Physician – Use available preventative care services, Dental & Vision annual exams Virtually no cost Stage 2 Maintenance, Treatment and Management Wellness Primary Care Physician Specialists Dental, Vision, FSA Bridge/Deductible/Out of Pocket/Co-Insurance Stage 3 – Health, Prosperity, Well Being Enjoying a long healthy happy life HEALTH = WEALTH

32. Information CLV Intranet Site Benefits tab Summary Plan Descriptions Claim Forms Change and Enrollment Forms Provider contacts & web sites Resources Insurance Services Dan Rigato Sandy Ray Mandee Bowler Candace Mbaye CONFIDENTIAL32