1. SUN LIFE FINANCIAL C2 Solutions
July 2017

2. Stop Loss Territory Map
C2 Centric
Stop Loss Territory Map
Marc Warrington Head of Field Sales (Group & Stop-Loss)
Mike Hoefler, Stop-Loss VP
CENTRAL
Doug Gosney
NORTHEAST
Kevin Olender
WEST
Mindy Schulz
SOUTHEAST
Michael Techtmann
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3. Sales Representatives for C2
C2 Centric
Sales Representatives for C2
Brokerage firm
Location
Sales Rep
Holmes Murphy
Kansas City, Iowa and Nebraska
Ryan Slattery
Dallas
Ryan Nystrom
Phoenix
Brady Myers 
Denver
Zach Smith
Scott Insurance
Virginia
Chris Emerick
North Carolina
Brendan Clark
South Carolina
Payton Brady
Kistler-Tiffany
Adam Noce
McGohan Braebender
Joel Albright M3
Kevin O'Neil
The Partners Group
Brian Partridge
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4. 6 2 1 The power of strength th nd # C2 Centric
We have the largest PPO dental network in the U.S., helping our clients control costs and giving our members access to the dentists they want all across the country.2 2 nd
We are the largest employee benefits insurer in the U.S., affording us the scale to offer products and services to meet client needs.1
We are the independent Stop-Loss carrier, providing us with the financial power to manage catastrophic claims risk.3 1 #
1. As a result of the acquisition, Sun Life Financial’s U.S. group benefits business is the sixth-largest group benefits carrier (excluding group health care) in the U.S. based on pro forma combined revenue from an internal analysis of publicly available information. The acquiring entity was Sun Life Assurance Company of Canada, a subsidiary of Sun Life Financial Inc.
2. The Ignition Group, L.L.C. data as of March 2017 based on unique dentist count. For more information, please visit
3. The #1 ranking is based on the National Association of Insurance Commissioners 2015 Accident and Health Policy Experience Report.
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5. Business in force US $3.8 billion1 C2 Centric $0.2B Disability RMS
Dental and
Vision
$1.0B Group Life, Disability, and Absence Management
$1.2B
Stop-Loss
$1.1B Voluntary/ Worksite (includes Accident, CI, Cancer, and Gap)2
Business in force (“BIF”) of US$3.8 billion as of December 31, Includes Disability RMS premium under management.
Also includes Voluntary Life, Disability, Dental, and Vision.
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6. Stop-loss business model
C2 Centric
Stop-loss business model
Channels
Prospects
Key industries
Distribution
Brokers with self-funded clients
TPAs with self- funded clients
Regional partner programs
Self-funded employers with 35‒25,000+ employees
Fully insured employers with 35‒25,000+ employees who are considering self-funding
Manufacturing
Transportation/ commerce
Wholesale/retail
Trade
Finance/ insurance/real estate
Services
Health/hospitals
Education
Nationwide Sun Life Stop-Loss Specialists
Access to home office executives
Consultation with product experts
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7. Sun Life Stop-Loss product snapshot
C2 Centric
Sun Life Stop-Loss product snapshot
Key features
Key resources
No New Lasers at Renewal option with Renewal Rate Cap
Mirroring Endorsement (with review and approval)
Early rate lock (up to 120 days)
Variety of risk levels and contract periods
Sun Life Nurse Consultants
SunResources® specialty-vendors access program
SunExcel® transplant- vendors access program
SunEliteSM plan document review service
Suggested speaker notes:
The Sun Life Stop-Loss solution provides strong Specific protection combined with effective cost-containment programs.
No New Lasers at Renewal with Renewal Rate Cap option for greater budget control (requires plan document review and approval by Sun Life)
Mirroring endorsement aligns the medical plan document with Stop-Loss Specific coverage (requires plan document review and approval by Sun Life)
Sun Life nurse consulting team manages catastrophic claims with clinical expertise, is available as a clinical resource, identifies unnecessary expenses, consults with vendors and specialty networks, facilitates access to SunExcel® transplant Centers of Excellence, and negotiates with providers for out-of-network claims
SunResources® and SunExcel® are cost-containment programs available at no additional cost—you’ll get access to preferred vendor services and pricing that can lower claim costs both before and after a catastrophic claim occurs
SunEliteSM plan document review service is available at no additional cost--upon request, get a review from plan document professionals at The Phia Group, LLC, that analyzes cost containment, federal law compliance (including the Affordable Care Act), and discretionary authority language
The Phia Group, LLC, provides SunElite services and is solely responsible for the content of all SunElite reports. A SunElite report varies according to the plan document. Neither Sun Life nor The Phia Group, LLC, can provide legal advice.
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8. Stop-loss premium history
C2 Centric
Stop-loss premium history
Business in force
Sun Life Stop-Loss information as of each year-end.
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9. Stop-loss premium by employer size
C2 Centric
Stop-loss premium by employer size
14%
199 or less
25%
1,000–2,999
19%
200–499
18%
500–999
23%
3,000+
Source: Sun Life internal analysis as of year-end 2016.
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10. Third party administrator
C2 Centric
Stop-loss premium by administrator
45%
Third party administrator
24%
Blues
15%
United 7%
Aetna 9%
Cigna
Source: An internal analysis of Sun Life Stop-Loss data as of year-end 2016.
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11. Solutions & Specialization

12. Highlight: cash flow Advance Funding
C2 Centric
Highlight: cash flow
Advance Funding
for greater cash flow control
Monthly Aggregate Accommodation option
to reduce the financial impact of monthly claim volatility and improve cash flow
Electronic funds transfer
for quick access
Accelerated ASO Reimbursement
Reimbursements received in an average of only 48 hours
Suggested speaker notes:
Advance Funding
Advance Funding provides you or your administrator with money to pay eligible claims-related expenses.
Without Advance Funding, the employer pays the entire claim amount and receives a stop-loss reimbursement.
With Advance Funding, essentially, we send the employer the money to pay the claim, less the stop-loss deductible. Employer pays the stop-loss deductible and uses Advance Funding to pay the rest.
Monthly Aggregate Accommodation option
This option helps limit your monthly aggregate claim liability by providing an accommodation for amounts that exceed the accumulated monthly attachment point.
How it works: As soon as you exceed the accumulated monthly attachment point, your plan administrator sends in an accommodation request, and we send that amount to you. At the end of the policy period, one calculation will be made (comparing the total aggregate paid claims to the aggregate attachment point) to determine if the employer must refund any portion of the monthly accommodations made during the policy period.
We adjudicate all claims according to the medical plan document and the stop-loss policy. At the end of the policy period, reimbursement of excess accommodations may be required.
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13. Highlight: mirroring Medical plan document Stop-loss policy
C2 Centric
Highlight: mirroring
Sun Life Stop-Loss Plan Document Analysts review plan documents
Medical plan document
Stop-loss policy
Underlying medical plan document
provisions
Suggested speaker notes:
Mirroring:
Eliminates many potential coverage gaps between the underlying plan document and our stop loss policy.
Replaces our Stop Loss policy’s definitions, terms, and provisions with the definitions, terms and provisions of the underlying plan documents.
Simplifies our claims process and interactions with Third Party Administrators.
Ability to adjudicate Stop-Loss claims according to the underlying plan provisions, with the expectation being that if they are covered by the underlying plan, they are automatically covered by the Stop-Loss policy.
Every time there is an underlying plan document change or amendment, Sun Life Plan Document Analysts review the plan document and advise the broker or administrator on the results of review.
Eliminates many potential coverage gaps
Simplifies claims process
Mirroring is subject to exclusions.
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14. Sun Life Stop-Loss service snapshot
C2 Centric
Sun Life Stop-Loss service snapshot
Ready
Inception call for on- boarding new groups
Sun Life Connect website to track stop- loss claims
Mirroring and early rate locks
Active partnership with brokers, third party administrators, case managers, and administrative- services-only carriers
Set
Dynamic nurse consultants who provide opportunities—before and after a stop-loss claim—for improved patient outcomes and cost containment
Dedicated claims analysts who understand how to properly process claims for ASOs and TPAs Go
Seamless reimbursements
Easy access to funds with electronic direct deposit, Advance Funding, Monthly Aggregate Accommodation
Stop-Loss Account Managers who provide direct support to brokers for new quote facilitation, service, and renewal delivery
$2.3 billion and counting
Did you know? Sun Life has:
processed over 105,000 claims and
provided more than $2.3 billion in reimbursements. (Information based on 2012–2015 data.)
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15. Sun Life Nurse Consultants
C2 Centric
Dynamic stop-loss claims management
Manage
catastrophic claims with clinical expertise
Serve
as a clinical resource for case managers and administrators
Provide
a gateway to SunResources® specialty-vendors access program and SunExcel® transplant-vendors access program
Sun Life Nurse Consultants
Delivering opportunities to improve patient outcomes and contain costs
Identify
unnecessary expenses
Suggested speaker notes:
At Sun Life, we have the clinical expertise to manage catastrophic claims through our on-staff registered nurses.
The Nurse Consultant Team acts as a resource, working directly with administrators and case managers to identify unnecessary expenses and so much more. Nurses suggest alternatives that can result in better patient outcomes and significant savings.
Today, our SunExcel® Centers of Excellence program provides transplant patients with access to more than 100 prominent transplant facilities across the United States. It is focused on finding opportunities for improved patient outcomes and significant savings. It adds up to the most effective care at the lowest cost—with substantial savings for Sun Life Stop-Loss policyholders.
Consult
with vendors and specialty networks
Negotiate
with providers for out-of-network claims
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16. Stop-loss claims process timeline
C2 Centric
Stop-loss claims process timeline
Claim received Claim reimbursement request received from administrator.
Claim added to claim system Claim is manually or electronically uploaded.
Decision made in about 7 days If all required documentation is present, claim is paid or denied.
Day 1
Day 2‒3
Day 4‒7
Day 8‒12
Claim process begins
Claim is opened within 24 hours of receipt.
Review completed Claim is assigned pay, pend, or deny status.
Documentation requested We ask for any missing required documentation, and if provided, we complete the review. If not provided, we will deny the claim due to lack of required documentation.
Source: Decisions take an average of 7 business days, based on complete Specific claims as of year-end 2015.
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17. Insights

18. Guidance The latest C2 Centric 2017 Sun Life Stop-Loss Research Report
Sun Life Stop-Loss Benchmark Report 2.0
The latest
2016 Self-Funded Playbook
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19. Stop Loss Program

20. C2 Experience Rated Refund program
C2 Centric
Experience Rated Refund program
When C2 clients have good claims experience they can qualify for an Experience Rated Refund
This program is at the client level and they do not need to worry about sharing in another client’s poor experience.
Customized C2
premium level
$400,000
Sun Life has set a customized C2 premium level of $400,000 for C2 clients to be eligible for the ERR Program
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21. Experience Rated Refund program
C2 Centric
Experience Rated Refund program
This calculation is done 6 months after the end of the policy period
C2 client gets 50% of the surplus premium up to a maximum of 10% of paid Specific premium
C2 clients must renew to be eligible for the ERR payment
Sun Life and C2 have set a shared sales target for 2017 effective dates
When a C2 client exhibits a 70% loss ratio (after netting out commissions) they qualify
70% loss ratio
If the 6 C2 partner firms writes $6m in new business Stop Loss premium and retains more than 75% of current in-force business the maximum ERR payment will increase to 15% of paid premium.
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22. SunElite® plan document review service
C2 Centric
SunElite® plan document review service
Provides custom review by The Phia Group, LLC plan document professionals
Offers analysis of plan language about cost- containment, federal laws, and discretionary authority
Gives an employer the opportunity to better understand the plan and consider making changes to strengthen it
Suggested speaker notes:
Industry is looking for credible benchmarking information, and we’re hearing that this report really meets this need.
Volume of business flowing through Sun Life creates a rich data source:
30,000 unique plans
21,000,000 individual census records
4,900,000 first-dollar claims records
100,000 stop-loss claims
The Benchmark Report is designed to be easily accessible and directly useful to a variety of audiences:
Customized and tailored for each group
Flexible report suite
Data-rich and user friendly
Designed to facilitate an active discussion between the broker and the employer
Using a group’s industry and census, we create a customized Sun Life Stop-Loss Benchmark report. Inside the report, you’ll find the insight you need—as a broker, a self-funded employer, or an employer that’s considering becoming self-funded. Anyone who reads the report will be able to:
Understand the differences between self-funded and fully insured medical plans
Analyze the employer’s actual demographics and risk profile
Gain knowledge of stop-loss coverage trends for industry peers and the marketplace
The Phia Group, LLC, provides SunElite services and is solely responsible for the content of all SunElite reports. A SunElite report varies according to the plan document. Neither Sun Life nor The Phia Group, LLC, can provide legal advice.
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23. New! Plan Document Review for C2
C2 Centric
New! Plan Document Review for C2
Exclusive for C2 Partner Firms for new business
15 Plan Document Reviews for new business cases
Increases as production increases
Increase to
30 reviews
Increase to
25 reviews
Increase to
20 reviews
$5,000,000‒$6,000,000
in new sales
$6,000,001‒$7,000,000
in new sales
$7,000,001+
in new sales
Unlimited Plan Document Reviews for in-force cases
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24. Issued by Sun Life Assurance Company of Canada and Sun Life and Health Insurance Company (U.S.)
Group stop-loss insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 07-SL REV In New York, group stop-loss insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 07-NYSL REV Product offerings may not be available in all states and may vary depending on state laws and regulations. The following services are not insurance and carry a separate charge included with the price of coverage: SunResources®, owned by Sun Life; SunExcel®, owned by Sun Life; and SunEliteSM, owned by Sun Life with services provided by third party The Phia Group, LLC. Sun Life is not responsible or liable for the services or advice provided by any third party vendor. Sun Life reserves the right to discontinue any service at any time. All products, brands, and names are the property of their respective owners.
© 2017 Sun Life Assurance Company of Canada, Wellesley Hills, MA All rights reserved. Sun Life Financial and the globe symbol are registered trademarks of Sun Life Assurance Company of Canada. Visit us at
One Sun Life Executive Park
Wellesley Hills, MA 02481
GSLPPT-6874b SLPC /17 (exp. 12/17)