1. Managing Growth Successfully 1

2. POMCO Group Overview Company Overview Membership Services Market Operational Team 2

3. 3 POMCO Group Quick Facts Established in 1978 - Founded by Maurice and Robert Pomfrey - Approximately 400 employees today Over 400,000 members nationally One of largest privately held administrators nationally Average client tenure exceeds 10 years Manage over $1 billion in premium equivalents Office locations - NY: Syracuse, Albany, Buffalo, Binghamton, Rochester, Watertown, NYC, White Plains - TN: Chattanooga - CA: Central Valley, and adding other local staff - NV/CA: Western Region hub

4. 4 A Diversified Services Company POMCO Group Clinic Services TPA Risk Management BPO Services Network Services Insurance Services

5. 5 Why POMCO Group Is Unique Diversified services company, highly differentiated value proposition Strong experience with both labor and private-sector commercial business Management experience with CA, Blue, Carrier and TPA environments Western region commitment, investment including M & A interest Network expertise Risk-taking capabilities via owned insurance entity Broad workers’ compensation expertise BPO business segment/exchange launch

6. 6 POMCO Group Service Array Offer a full range of product/service suites built around self-funded and fully insured administration. Primary elements include: Medical (competitive provider networks from access and discount perspectives) Pharmacy (multiple PBMs with flexible service components, competitive networks, full transparency and flexible rebate/discount models) Ancillary products, including dental, vision, and short-term disability/disability income Flex/consumer Directed, e.g. FSA, HRA, HSA (option to have with or without debit card) COBRA, HIPAA administration Consolidated enrollment and group/individual billing (POMCO Group and other coverages) Workers’ compensation

7. 7 POMCO Operational Model Our Promise. (What we commit to do.) Promises are the cornerstone of our success. Our ability to keep the promises we make: Reinforces our commitment to our customers, our community and each other. Relies upon our integrity, our passion and our industry expertise to keep our promises.

8. 8 POMCO Operational Model 3P’s Includes objectives that will measure POMCO Group’s efforts to be a great place to work and the development of our people. Includes objectives that will measure our ability to perform as an effective partner to our clients. It also measures the effectiveness of our vendor partners. Includes objectives that will measure our financial performance.

9. Structured PMO implementation methodology via shareable project framework Real-Time Operational Metrics Visual Dashboard Representation Across Functional Areas Tiered Daily Stand-up Meetings Imbedded Lean and Six Sigma Practioners within Value Streams Account management, medical management, customer service and claims team specifically trained on the client’s health plan(s) Unique customer service number to dedicated unit One call resolution Dedicated 800 # Average employee tenure is 8 years Average client tenure is 10+ years Adhere to top-tier service metrics Certified “Top 100 Call Centers” National service capability and hours of operation Multi-lingual member services Client and Member Service

10. Diversified Client Base 10

11. 2013-2014 Operational Challenges Q1 2013 - QicLink 3.30.30.35 Compliance (5010, PPACA, ICD10 pre-requisite) Technology Missed Opportunities SQL database, Exception Processing, Plan Building GUI, Bug Fixes Anticipated Membership Growth (NYS Exchange: Health Republic Insurance) Control Costs Required weekend cutover 11

12. QicLink 4.20 Upgrade POMCO Group #1 Initiative in 2013 4 Month “Go Live” Initiative 45 internal resources TriZetto Group Support Project Manager – Stephen Weir Technical(conversion, environment build) – Rodney DeClerk Training – Rose Newell Custom Code Updates Citrix Application Server Load Balancing Enhancement – Ron Gripon, Lifeng Xu, Richard Frazier Post Go Live Support to resolve response time issues 12

13. QicLink 4.20 Benefits 5010 Compliant PPACA Compliant Pre-requisite for ICD10 Bug Fixes SQL database – improved data warehouse run from 10 to 4 hours GUI Plan Builder – GUI Format results in Improved Quality  Re-work Reduction Productivity  Simplified Troubleshooting Increased system availability for claims production each day by 6 hours 13

14. NY State Exchange Back-office administrator. Medical claims adjudication and payment Customer service Medical management (UM/CM) ID Cards Stop Loss 2014 Enrollment Planned for 30k Reached ~140k 2014 Weekly Claim Volume Planned for 6k Actual ~32k 2015 Annual Enrollment planning for 280k 2015 Annual Claim Volume Projected @ >3M 14

15. NY State Exchange Challenges State Exchange presented unique challenges compared to our typical business model: Requirement to track Primary Physician Shared accumulators with multiple vendors, requirement for visibility into claims/accumulator details Plans required deductible to apply before Copay Systems ability to scale with increased enrollment 15

16. Challenge Participating provider selection and application of correct benefits An online solution was necessary to satisfy the need of nearly two-thirds of the affected customers. Members who elected the covering plans were required to select a primary physician prior to having services rendered to avoid a co-pay. Member was not limited to changes or specialty within a plan year. 16

17. TriZetto Solution Participating provider selection and co-payment mapping Plan designs included plans with both optional and mandated Primary Physician (PP) selection. The plan designs dictated a zero dollar copay for an office visit when a member goes to their PP. Our Plan Building team worked with TriZetto to find the best solution that would meet the requirements. The Plan Building team and TriZetto recommended use of the HMO module. It was a simple process to install the HMO module and TriZetto also provided onsite training. Housing the participating provider data in Qiclink provides us with accessible data for customer service, ID Cards and reporting. 17

18. Challenge Shared Accumulators Plan designs dictated the ability to share accumulators for out of pocket and deductibles between medical claims and at least the PBM, but also potentially vision and other vendors. Customer service required visibility into the details behind the accumulators, i.e. the pharmacy claims must be visible to POMCO Group’s customer service staff, not just the current accumulator value. System must be robust enough to handle overage reporting, enrollment matching, plan year rollover, and other functional challenges. 18

19. TriZetto Solution Shared Accumulators The POMCO Group Pharmacy interface team performed a gap analysis on the TriZetto ZPBM program and recommended that POMCO Group proceed with implementation of a customized version. POMCO Group now receives daily pharmacy claims files that run through this program and produce claims which keep shared Medical/Pharmacy deductible and out of pocket accumulators in sync. TriZetto provided support to the POMCO Group team during testing and QA, as well as ongoing product support. 19

20. Challenge Appropriate application of deductibles and co-payments System had to account for deductible payments ahead of co-payments. 20

21. TriZetto Solution Appropriate application of deductibles and co-payments In QicLink, a copay is always taken first and then the deductible applies. Plan designs required that the deductible must be met first, and then the cost sharing copay or coinsurance is applied to the remainder of the allowed amount. The POMCO Group team worked with TriZetto on a work- around, however, they had an adverse affect on claims processing and/or claims related extracts. The POMCO Group team proceeded with requesting a TriZetto custom enhancement to provide the needed functionality. TriZetto met the timeline and delivered the required enhancement as an easy to install upgrade. This enhancement was a must have as the services impacted are commonly utilized services like office visits, lab and surgery. 21

22. Challenges and TriZetto Solutions Despite unusual challenges presented, TriZetto was able to provide solutions. Each solution has provided claims and customer service staff with the tools and data they need to efficiently perform their jobs. With support from TriZetto, POMCO Group was able to open customer service lines ahead of schedule and perform all contracted services despite the unprecedented enrollment More to come in 2015…. 22

23. 2014 TriZetto Current Initiatives QicLink 5.0 Upgrade Automation Review QicLink Total System Review BPO Claims Processing ClaimsExchange Implementation Medicare COB Enhancement QicLink User Group Member 23

24. Thank you. Questions? 24

25. Confidential | Copyright © 2014 TriZetto Corporation 25 Workshop Survey We would like to extend you an opportunity to provide candid feedback. During the workshop you should have received an e-mail notification for you to take an on-line survey. If you could take a few minutes to complete at this time, we would greatly value your feedback. For your convenience, the survey will be available throughout the remainder of the conference should you not be able to complete immediately.