1. Caring For Those Who Serve HealthFlex Plan Sponsor Conference Calls December 7-8, 2010

2. Agenda Health Care Reform UpdateHealth Care Reform Update Wellness Programs UpdateWellness Programs Update Retiree Health Plans UpdateRetiree Health Plans Update Active Plans UpdateActive Plans Update

3. HealthCare Reform Update Small Business Health Care Tax CreditSmall Business Health Care Tax Credit Other updatesOther updates

4. HealthFlex Wellness Programs Recommended Updates for 2011 Screening program improvementScreening program improvement 2011 incentives strategy2011 incentives strategy Communications supportCommunications support 2011-2012 Virgin HealthMiles transition2011-2012 Virgin HealthMiles transition

5. Screening Program Rationale ■ Comprehensive screening panel that does not vary by region or physician ■ Economy of scale for purchasing of comprehensive screening ■ Ease and clarity of incentive administration (unlike wellness exams) ■ Data available for population analysis

6. Screening Program Improvement ■ Improved access for participants/spouses:  Events (Annual Conference, Employee Event)  Local Quest service centers  (Physician verification form—exception) ■ Onsite event improvements  Online/phone scheduler  Plan sponsor administrative access  (Note: only eligible individuals can participate)

7. Screening Program Improvement ■ Greater administrative control and efficiencies:  Phlebotomist oversight and quality control  Data export to WebMD and Ingenix  Expanded aggregate reporting for plan sponsors and HealthFlex

8. Toolkits for New Screenings ■ Administrative Toolkit  Executive Summary/FAQ  Event “How-to” checklist  Physician form—exception instructions ■ Communications Toolkit  Promoting onsite events  Informing non-attendees how to access local service centers  Participant FAQ (including privacy information)

9. 2011 HealthFlex Incentives: Targeted Behaviors Complete Quest screening  Earn $100 HealthCash Complete HealthQuotient  Avoid higher 2012 deductible Take Action Post-HQ! (i.e. Health Coaching)  (Set up for possible future incentives)

10. Incentive Timing: Defined Periods for Each Desired Action ■ Ease of communicating deadlines ■ Screening precedes HQ to allow data import ■ Screening and HQ need to precede coaching ■ Distinct time periods for each behavior; screening close to HQ completion and creation of action plan with WebMD coach ■ HQ completion deadline must be before AE to allow completion data (not results) to be shared with carriers.

11. 2011 Incentives Schedule April-July 2011: Complete Quest screening  Earn $100 HealthCash Aug-Sept 2011: Complete HealthQuotient  Avoid higher 2012 deductible September + : Post-HQ Take Action! (i.e. Health Coaching)  (Set up for possible future incentives)

12. 2011 Incentives: Communications Plan ■ Plan Sponsor Communications Toolkits  Incentives overview (late December)  New Quest screenings (January/February)  HealthQuotient blitz (late June) ■ Participant Communications  Incentives introduction (January/February)  Incentives kickoff/Quest reminder (Late March)  1 Quest deadline reminder (late July)  2 HQ reminders (late July and late September)

13. HealthMiles Objectives for 2012 ■ Enhance incentives:  More directly tied to desired behaviors (avoid engagement “gaps”)  Sustain interest and finances over a longer period  Allow integration with other HealthFlex incentives (HQ, Quest screening, coaching) ■ Improve administration:  Calendar-year program for all individuals, regardless of enrollment date  Messages and incentives same for all individuals

14. 2012 HealthMiles Transition ■ Beginning January 1, 2012, all participants will begin a calendar-year program  Quarterly “tasks” rather than 12 months-levels ■ Shortened earning period for program years beginning in 2011  Anniversary e-mails starting Jan 2011 to inform participants of shortened time to reach target levels

15. 2012 HealthMiles Transition

16. Retiree Health Plans Strategy Proposed 2012–2013 Objectives Changes that allow for:  Reduced/stabilized premium costs and liability exposure  Reduced administrative exposure  Increased flexibility and agility  Increased choice

17. Retiree Health Plans Strategy Proposed 2012–2013 Objectives Multi-year phased approach: by 2013 or 2014, all plan sponsors transitioned to Individual Plans Market optionMulti-year phased approach: by 2013 or 2014, all plan sponsors transitioned to Individual Plans Market option2012 ■ Existing Medicare Companion/Rx Plans (with changes) ; or ■ Individual Medicare Supplement Plans Market (via Extend Health) 2013 ■ Individual Medicare Supplement Plans Market only; or ■ Same two options as 2012 2014 ■ Individual Medicare Supplement Plans Market Only

18. Retiree Health Plans Strategy Proposed 2012–2013 Objectives Business model* for “Individual Medicare Supplement Market” Option: ■ Creates an “exchange” for most available plans in geographic-specific market (Medicare Advantage, Medigap, Dental and Vision) ■ Manages eligibility, enrollment and annual renewals for plan sponsor retirees *Refer to “Retiree Health Plans Solution Diagram”

19. Retiree Health Plans Strategy Proposed 2012–2013 Objectives ■ Health Reimbursement Account (HRA) used for premium and eligible expense reimbursement ■ Lifetime customer service and advocacy provided by benefit advisors

20. Retiree Health Plans Strategy Proposed 2012–2013 Objectives Existing Medicare Companion/Rx plan changes: aligned with transition to new offering; phase out by 2013 or 2014Existing Medicare Companion/Rx plan changes: aligned with transition to new offering; phase out by 2013 or 20142012 ■ Eliminate MC3; increase MC1 and MC2 OOP’s ■ Eliminate FX1; increase FX2/P1/P2 OOP’s (same as with active plans ) 2013 ■ MC1, 2 and 3—no longer offered?? (or 2014 total phase-out) ■ Eliminate FX2 (same as with active plans) 2014 ■ MC1, 2 and 3—no longer offered

21. Retiree Health Plans Strategy Proposed Next Steps Q1 2011Q1 2011 ■ Webconference with HealthFlex and Extend Health with each interested plan sponsor ■ Model impact to plan sponsor: HRA funding, disruption to participants, etc. Q2 2011Q2 2011 ■ Plan sponsor adoption for 2012

22. Active Plans Strategy Proposed 2012–2014 Objectives Trends necessitate changes:  Reduce/stabilize cost exposure for plan sponsors and plan  Greater consistency and equity in shared responsibility across plan sponsors  Streamlining of plans  Changes in plan benefits

23. Active Plans Strategy Proposed 2012–2014 Objectives  Refer to “Active Plans Strategy Summary”

24. 1-800-851-2201www.gbophb.org