1. Recommending a Benefits Strategy for Today and Tomorrow

2. What is your Health Care Cost Containment Strategy? for Today and Tomorrow

3. By 2016 Health Care Costs are projected to reach $4.2 trillion This represents 20% of every dollar we spend! Here comes a perfect storm in the workplace driven by three factors. One: Medical costs are accelerating Two: Employees and dependents have more health needs than ever before with an obesity epidemic, tobacco related illness and sedentary life styles Three: A great skilled worker shortage lies just ahead

4. Results of a Healthy Workforce… Productivity goes up Turnover goes down Workplace injuries decline Disabilities decline Work life expands Morale improves Applicants gravitate to a healthy workplace

5. Tomorrows Challenge: Mandating Employee Wellness What is a mandatory Wellness Plan? Requires employees to participate Imposes a penalty if you do not participate Must take a health risk assessment, blood pressure, cholesterol, BMI, fasting glucose etc. If an employee refuses to participate they lose coverage Some plans even assign professional health coaches who will draw up action plans and will follow up to monitor progress Note: An incentive that is conditioned on participation in a health program, rather than achievement of a particular health target or standard, generally is not discriminatory under HIPAA.

6. INSIDE THE PLAN: HIPAA Rewards or penalties cannot exceed 20% of total cost Reasonably designed to promote health or prevent disease Annual eligibility Alternative standards for participants with medical conditions Plan material must disclose alternatives and waiver Mandatory Wellness Plans ROI is from $2 to $10 for every dollar invested in a wellness plan. OUTSIDE THE PLAN Disability discrimination Age discrimination Workers compensation retaliation claims Lawful off-duty conduct Privacy statutes Collective bargaining agreements Retaliation claims

8. Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 0%–14%

9. Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% 30%

10. Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Nonalcoholic fatty liver diseasesteatosissteatohepatitiscirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Osteoarthritis Skin Gall bladder disease Cancer breast, uterus, cervix colon, esophagus, pancreas kidney, prostate Phlebitis venous stasis Gout Medical Complications of Obesity Idiopathic intracranial hypertension Stroke Cataracts Severe pancreatitis

11. Health Risk Factors Matter.. Lets learn about each employees Metabolic Syndrome Risk Cluster HDL Cholesterol Triglycerides Waist Circumference Blood Pressure Fasting Glucose

12. Now lets Graph these Important Risk Factors... Complete a Health Risk Assessment Form Perform Biologics (BP; HDL vs. LDL; Waist Size, Glucose) Recommended Obesity Class I Obesity Class II Obesity Class III

13. 10 Week Program will address: Eating habits Hunger Hydration Exercise Personal health habits