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March 280h 2017 City of Miami — City Clerks 3500 Pan American Drive Miami, FL 33133 Contracting Officer: Charles Johnson Jose L Gonzalez SVP, Employee Benefits USI Insurance Services, LLC. 201 Alhambra Circle, Suite 801 Coral Gables, FL 33134 786-454-2080 Direct Line Re: Request for Proposal for Employee Benefit Consulting Services RFP# 678384 On behalf of USI, we are extremely delighted to be considered by The City of Miami in your search for an employee benefit consulting firm to represent your employee benefits objectives. USI is built upon a tradition of integrity, industry leadership, and excellence. We are committed to delivering tailored benefit solutions with thoughtful, strategic planning, valuable professional services, and technology -based solutions that result in sustained customer and employee satisfaction. Through initiative and follow-through, we help our customers find answers, implement solutions, and anticipate consequences. USI has served over 100,000 clients meeting their property & casualty, employee benefit, personal risk and retirement needs nationwide. We have more than 100 years of consulting and brokerage experience through our acquired agencies, with our local office dating back in Miami - Dade County as far back as 1935. USI combines industry leading national capabilities delivered through longstanding, passionate and committed local service teams. USI stands for Understand, Service and Innovate. At USI we work to Understand the specific needs of our clients, to provide an unparalleled local Service experience, and to Innovate with cutting edge solutions so our clients can continue to invest and grow. In this response, we will address all of the items listed in your RFQ # 678384, either below or by reference to another section within this binder. We have also added a flash Drive as per the stipulations of the RFP. Please note the password is Usi2017! (Case sensitive) Please note that some of our answers are general in nature as the consulting approach we take with each client is based on that client's particular objectives and needs. We are prepared to answer any questions thoroughly and specific to your needs so please feel free to contact us. Energecally Yours, Jose L. Gonza ez Sr, Vice President of Employee Benefits 111111 OM moms III .ser woo " Request for Proposals Employee Benefit Consulting Services RFP # 678384 Proposer: USI Insurance Services, LLC. FEIN# 13-3771734 Contacts: RFP Contact: Maria Olivo, 954-607-5217 maria.olivioa.usi.com Liasion for the Contract: Stephen Roche, 954-607-4025 stephen.roche(a usi.com Presented by: Jose L Gonzalez, VP Employee Benefits jose.gonzalez at7usi.com Primary office location: 201 Alhambra Circle, Suite 801 Coral Gables, FI 33134 Business Phone: 305-669-6000 Business Fax: 305-669-6030, www.usi.com I 1 Employee Benefit Consulting Services RFP 678384 2. Table of Contents Section 2. Table of Contents Page(s) : 2-3 Certification Statement Page(s) : 4-5 Pricing Page(s) : 6 Section 3. Executive Summary Page(s) : 7-8 Section 4. Proposer's Experience, Qualifications and Past Performance Page(s) : 9-11 Section 4.2 Comparable Contracts Page(s) : 12-13 Section 4.3 List of Projects Performed ..., Page(s) : 14 Section 4.4 Pending Litigation Page(s) : 15 Section 4.5 Two Letters of References Page(s) : 16-17 Section 4,6 Business Tax Receipt Page(s) : 18 Section 4.7 Subject Matter Experts Page(s) : 19 Section 4.8 Exceptions to the terms Page(s) : 20 Section 5.1 Key Personnel Page(s) : 21-22 Section 5.2 Experience Page(s) : 23-25 Section 5.3 Documentation Page(s) : 26-28 Section 5.4 Job Descriptions Page(s) : 29-31 Section 6.1 Proposed Approach Page(s) : 32- 35 Section 6.2 Operaional Plan Page(s) : 36- 40 Section 6.3 Monitor Performance Page(s) : 41- 42 Section 6.4 Methodology for Compliance Page(s) : 43- 44 Section 6.5 US] Recommendations Page(s) : 45 Section 6.6 USI Value Added Page(s) : 46- 50 Proposed Pricing Page(s) : 51 RFP Response Is Intended solely for the City of Miami and alt Information Is considered CONFIDENTIAL 2IPage Employee Benefit Consulting Services RFP 678384 2. Table of Contents (continued Appendixes (Seperated by Tab Numbers) Appendix 1— Form B Appendix 2— Why USI? Appendix 3- Wellness & Population Health Management Case Studies Appendix 4- Pharmacy Benefit Report Appendix 5- USI 3D Reporting Appendix 6- Sample Benefit Guide and Communication Piece/ Sample Service Calendar Appendix 7- ThinkHR and Online Training Modules Appendix 8- Benefit Resource Center Appendix 9- USI Presentation with Case Studies Appendix 10- Biographies Appendix 11- USI Consulting Group Capabilities Appendix 12- Certificate of Liability Insurance RFP Response Is Intended sofely for the Clty of Miami and all information Is considered CONFIDENTIAL Wage Employee Benefit Consulting Services RFP 678384 Certification Statement Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files, Prices should Include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission, Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (1) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: Please see section 8 We (I) certify that any and ail information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person subrnitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the subrnitter. Please print the following and sign your name: PROPOSER NAME: USI INSURANCE SERVICES, LLC. ADDRESS: 201 ALHAMBRA CIRCLE, SUITE 801 CORAL GABLES, FL 33134 PHONE: 305-669-6000 EMAIL: iose.gonzalez@usi.com SIGNED BY: Jose L Gonzalez TITLE: Vice President, Employee Benef FAX: 30S-669-6030 DA i March 7'h 2017 RFP Response Is Intended solely for the City of Miami and all information Is considered CONFIDENTIAL Wage Employee Benefit Consulting Services RFP 678384 Certifications Legal Name of Firm: USI Insurance Services, LLC. Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Corporation Year Established: Lon Worth Crow Established in 1935 acquired by USI who was established in 1994 Office Location: City of Miami, Miami -Dade County, or Other Coral Gables, Miami -Dade County Business Tax Receipt / Occupational License Number: BT-0000006246 Business Tax Receipt / Occupational License issuing Agency: City of Coral Gables Business Tax Receipt / Occupational License Expiration Date: 09/30/2017 Will Subcontractor(s) be used? (Yes or No) None at the moment Please list all addendum/addenda received. List the addendum/addenda number and date of receipt (Le. Addendum No. 1, 7/1/07). If no addendum/addenda was/were issued, please insert N/A. Addendum No. 1 received March 23, 2017, Addendum No. 2 received March 23, 2017 Has Proposer reviewed the attached Sample Professional Services Agreement (PSA)? Yes Does Proposer acknowledge that the attached PSA is an example of the standard Agreement used in conjunction with the provision of these services? Yes RFP Response is Intended solely for the City of Miami and all Information is considered CONFIDENTIAL Wage Employee Benefit Consulting Services RFP 678384 Line: 1 Description: Proposers are not required to enter a unit price on this line. Proposers shall submit their proposed prices on Form B, Price Proposal Schedule, located under the Header/Notes and Attachments Section of this Solicitation, in the OracleliSuppiier Sourcing System Category: 91800-00 Unit of Measure: Dollar Unit Price: $ $180,000 Number of Units: 1 Total: $ 180,000 *Please refer to Form B on Appendix 1 of the RFP fora price proposal schedule. Please note that US1 has made the necessary accommodations to the pricing as required on Form B. RFP Response Is Intended solely for the City of Miami and all Information is considered CONFIDENTIAL 61Page Employee Benefit Consulting Services RFP 678384 3. EXECUTIVE SUMMARY USI has reviewed the scope of work proposed in Request for Proposal (RFP) #678384 and we are confident we can provide all requested services as well as provide new and exciting solutions to the health and welfare benefit plan. It is our pleasure to respond to the RFP# 678384 for Benefits Consulting Services. USI offers a unique approach with a powerful assembly of resources, creativity, and expertise. We are committed to introducing solutions that will reduce your workload, help you expand your competitive benefits program in order to retain and recruit top talent. We look forward to meeting the needs of the City of Miami and are excited to have the opportunity to present ourselves as your best advocate and business partner. USI has the knowledge, aptitude and resources to address all your benefit needs. More importantly, we will be your advocate and work at all times to promote your interests and help you achieve your goals. USI will help guide you through the many significant changes that may Impact your benefits program via Health Care Reform. Our team will continue to listen to your needs as we build a long-term strategic plan that we can measure against and execute on during the next few years. Like The City of Miami, USI realizes that our most valuable asset is our associates. We believe that adhering to our corporate values and delivering our best to all aspects of our clients' needs sets us above our peers. US1 is committed to continuous improvement and ongoing professional development and we take great pride in delivering the highest quality, user-friendly insurance services. You have our assurance that each member of your account team will strive to exceed your expectations. Since 1994, USI's unique team service model design has ensured that all aspects of our service delivery are met in a timely manner. Our model was created in house and addresses the specific and unique needs of a benefits program. USI provides services in each major consulting practice: health and welfare benefits, retirement plans, compensation, communications, investment advisory and other human resource consulting disciplines. Within the health and welfare practice, USI specializes in providing solutions that mitigate trend without sacrificing quality. We have extensive experience crafting high performing group benefits programs that focus on results. USI's value proposition revolves around USI ONE"', which is a fundamentally different approach to risk management. Combining proprietary business analytics with a networked team of local and national experts, USI is better equipped to understand the City of Miami's healthcare's needs as a client through a consultative planning process that generates targeted recommendations for improving your employee benefit plan, to include financial impact, as well as providing excellent service and bringing new and innovative ideas to you. USI ONE'M Advantage — Our Multi Year Benefits Strategy (Please see Appendix 2) Omni — Proprietary, one -of -a kind tool built by USI subject matter experts which provides a real-time interactive solutions platform capturing the experience of more than 100,000 clients, thousands of professionals and over 100 years of business. Network — Local and National resources networked together to provide best in class solutions to all USI clients. Enterprise — Team based strategic planning with a core focus on building a multi -year benefits strategy aligned with City of Miami's needs. USI's Enterprise team includes resources such as Underwriting and Analytics, RFP Response Is Intended solely for the City of Miami and all Information is considered CONFIDENTIAL 71Pago. Employee Benefit Consulting Services RFP 678384 Compliance Attorneys, Wellness Consultants, Pharmacy Consultants, Retirement Experts, Actuarial, Claims Experts, and Communications Experts, of which all are USI employees, not third party contractors. USI encourages you to visit our website at www,usi.com to learn more about our organization's philosophy and our core business values. From many great individuals USI has become one unique industry leader. USI began in 1994 with a single office of $6.5 million of revenue and 40 associates. Today, US! has over $1 billion of revenue with more than 4,400 associates in over 140 offices across the country. USI has served over 100,000 clients meeting their Property & Casualty, Employee Benefits, Personal Risk and Retirement needs nationwide of which over 128 are Public Entities. We have more than 100 years of consulting and brokerage experience throughout the United States, with local offices dating back in their communities as far as the late 1800s. Our Coral Gables office since 1935 has served our community. USI combines industry leading national capabilities delivered through longstanding, passionate and committed local service teams. The power of US!, and our ability to bring best -in -class solutions and services to our clients and our communities, is achieved through the collective knowledge and experience of our professionals coming together as ONE. ONE also means that we are committed to improving the communities we serve —actively sharing our time, talent and resources with many local non-profit organizations and worthy causes throughout the Magic City and the United States, USI, Insurance Services, LLC with support of our professionals and lead consultants like Jose L Gonzalez, phone: 305-669-6000 will: • Leverage our large book of business during bid and renewal negotiations to procure the very best administrative, claim cost and customer service commitments from the carriers and vendors; • Actively listen to and learn the core values and unique characteristics of City of Miami; • Proactively offer City of Miami creative and timely solutions in the form of a service calendar to control costs and implement policies that will insulate the city from penalties caused by the Affordable Care Act; • Educate and effectively communicate your program coverage, costs, and value to staff and management; • Offer integrated solutions to managing the health risk of your population, including wellness and creative plan design options that have financial impact; • Professionally advocate for your interests; • Protect the interests of City of Miami as they relate to compliance, claims dispute resolution and carrier demands; • Provide best in class wellness consulting with proven outcomes; • Engage our team of Benefit Specialists in our Benefit Resource Center to provide responsive resolution to all staff benefits inquiries; • Create value for City of Miami by offering additional services not listed in your scope and thus exceeding your expectations. (Please refer to Appendix 9 pages 9-13 for a list of 24 proposed solutions that may save the City of Miami close to $6 million dollars.) We wish to convey to the City Management that USI is willing to examine alternative compensation options to those currently in • t may, in fact, be more favorable to the City. Signed x Date: 411,4i RFP Response Is inten • ed solely for the City of Miami and all Information Is considered CONFIDENTIAL 8 Page Employee Benefit Consulting Services RFP 678384 4. Proposer's Experience / Qualifications / Past Performance 1. Describe the Proposer's oreanization history and structures, past performance and state the number of years proposer and/or firm has been in business providing similar service(st Provide the number of employees and the primary markets served A. Organization (Local and National) Local Office: Since 1935 USI Insurance Services, LLC 201 Alhambra Circle Suite 801 Coral Gables, FL 33134-5108 45 employees Serving South Florida Ft. Lauderdale: Since 1982 USI Insurance Services, LLC 2400 E. Commercial Blvd. Suite 600 Ft. Lauderdale, FL 33308 150 employees Serving Florida B. Organizational History and Structure Headquarters: Since 1994 USI insurance Services, LLC 200 Summit Lake Drive Suite 350 Valhalla, NY 10595 4200 employees throughout U.S. Serving the United States Over 140 offices (see map p.10) Founded in 1994 and headquartered in Valhalla, New York, USI is the 3rd largest privately -held independent insurance broker —and the 9th largest broker overall-- in the United States, and the 13th largest insurance broker in the world. We employ more than 4,400 associates in over 140 offices. USI's private equity partner, Onex, is one of the oldest and most successful private equity firms in the world. USI Is a market leader in each of its core business —Employee Benefits, Commercial P&C, Retirement Consulting, Personal Risk Services. USI has grown to its current size and breadth through strong organic development and an acquisition strategy of selecting only firms with significant presence and a long-standing reputation within the local or regional insurance marketplace. Many of our acquired agencies have been established in their respective markets for 50-100 years bringing incomparable breadth and depth to our teams across the country. USI provides both Property & Casualty, Employee Benefit brokerage, Personal lines and Retirement consulting services to our clients, and more than 46% of USI's revenue is derived from Employee Benefit brokerage, consulting and administration services. USI's organizational structure allows us to provide services in each major benefits consulting discipline: health & welfare benefits, retirement plans, compensation, communications, investment advisory and strategic human resource consulting. Throughout each of these disciplines, USI professionals cooperate within highly responsive, client -oriented, entrepreneurial teams. By working in a collaborative manner across disciplines and geographic boundaries, USI has avoided both the complacency and the lack of accountability that can often erode the spirit of large organizations_ USI's teams cooperate on national, regional and local levels to provide the expertise and service responsiveness necessary to meet the needs of clients like City of Miami. Our local office has been operational since 1935 in Miami -Dade County under the name of Lon Worth Crow, then acquired by Summit Global Partners in 2000 and aquired in 2005 by USI. The average tenure in the Coral Gables office is 15+ years. RFP Response Is Intended solely for the City of Miami and ail Information Is considered CONFIDENTIAL Wage Employee Benefit Consulting Services Financial Overview •:• $1 Billion total revenues •:• 13% compound annual growth rate • Strong client retention (90%+) •:• Diversified Revenue Mix: • Employee Benefits (46%) • Property & Casualty (54%) Nationally • 140+ offices nationwide • 4,400 employees • National Excellence Award for Consumer Satisfaction • 3`a largest privately -held independent brokerage in the U.S, • Largest benefits communications and enrollment firm 1.1,14 N �_ ,••,• •1 4?` _ y ` � 1. RFP 678384 USI's Southeast Region and Local • 440 Regional employees and 180+ in South Florida. Our local office has an average tenure of 20+ years. With an average retention rate of 92%. We currently provide consulting services for over 300 clients. • Dedicated analytics, underwriting, wellness and compliance experts who make up the region's Technical Resources Team and available locally. • Regional offices Iccated in Coral Gables, Ft. Lauderdale, W. Palm Beach, Vero Beach, Tampa, Ocala, Jacksonville, Savannah, GA, Columbia, SC, Charlotte, NC, Memphis, TN, Tuscaloosa, AL, Birmingham, AL, Atlanta, GA USI Insurance Services ("USI"), our insurance brokerage and consulting entity, is organized into eight geographic regions, each with a full complement of skilled employee benefit experts providing regional expertise to clients. In addition, USI's Coral Gables office provides local client service and consulting as well as local market knowledge and expertise. To provide a full range of service and expertise to City of Miami, USI will engage the Southeast regional resources. Relationships with rnore than 50 carriers, TPA's and benefit related vendors on a national/regional basis. Because of our national presence and combined book of business, we have preferred relationships with the major healthcare companies in operation today. USI Consulting Group Our Consulting Group (CG) is located in Glastonbury, CT, and is a wholly owned subsidiary of USI Holdings Corporation (USI). For over 35 years, the CG has provided actuarial services & consulting expertise in both the retirement & welfare plan areas. The CG currently provides services for approximately 1400 clients nationwide which consist of public & private sector employees as well as Fortune 500 companies. The CG has approximately 200 employees and their staff includes top professionals with significant consulting, insurance, financial and accounting backgrounds, along with Actuaries, Consultants, Attorneys, AiFs, CAIAs, CEBS, CFAs, CIMAs, EAs, FSAs, QPAs, RPAs* and Benefit Plan Administrators. On average, our senior consultants possess 15 years of hands-on experience. USI Consulting Group has a department dedicated to meeting employers' "Other Post - Employment Benefits" (OPEB) financial needs, including compliance with the accounting standards: FAS 106, FAS 112, RFP Response is intended solely for the City or Miami and aid Information Is considered CONFIDENTIAL 10'Page Employee Benefit Consulting Services RFP 678384 GAS 43 and GAS 45. This dedicated group of associates provides actuarial and consulting services to our 200 OPEB clients. {Please see Appendix 3 for CG Organization Structure.) Y UF`.l1. e • rim until ► re 0 R The City of Miami's Team In addition to our own talented professionals and specialized value-added services, USI has a wealth of resources available to us through our national affiliations. The resources available to us through these affiliations allow us to gain access to regional expertise and leverage in the market. City of Miami will have a dedicated USI team to provide the full array of services requested. The team will provide data analysis and recommendations as needed. As outlined below, each team member will have primary responsibility for a portion of the service delivered to your account. Constant interaction will provide for peer review and escalation of issues when appropriate. ago l� USI Team Members Include but not limited to: Jose Gonzalez, Lead Consultant Stephen Roche — South Florida Employee Benefits Practice Leader Jim Dunn, CEO Southeast Region • Annette Kok- Director of Operations & Team Leader Southeast Region • Dean Hitsos— Account Executive • Raul Sanchez- Account Manager • Jennifer Showers & Cassie Salomone — Southeast Region Wellness Consultants • Joe Plummer— Southeast Region Underwriter • Scott Segal, JD — ERISA Attorney • Patricia Bowen —Pharmacy Practice Leader • Doug Patron, MD or Daniel Samo MD,- Medical Director • Jonathon 2eiger— Vice President, Retirement Services 403(b) • Jessica Quesada — Assistant Account Manager • Benefits Resource Center- Claims Liaisons and Benefit Experts • Debbie Norton — Enrollment and Communication Expert • Ann Ramirez —Analyst • Adeniyi Olaiya —Actuary Experience and Past Performance can be found ahead on the next sections 2 & 3. Pages 11-13 of this RFF. RFP Response Is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 111Page Employee Benefit Consulting Services RFP 678384 2. Provide a detailed list of five (5) comparable contracts (similar in scope of services to those requested herein) which the Proposer has either ongoing or completed within the past ten (10) years. The description should identify for each project: i. Client ii. Description of work iii. Total dollar value of the contract iv. Dates covering the term of the contract v. Client contact person and phone number vi. Statement of whether proposer is/was the prime contractor or subcontractor. If Proposer was the subcontractor, name the prime. vii. Detail Proposer's responsibilities and the results of the project Specify whether or not the scheduled completion time for each project was met; if not met, please provide an explanation. Health Benefit Consulting Services Health Benefit Consulting Services & Actuarial City of Savannah Joy Wilkinson, Interim Human Resources Director P.O. Box 1027 Savannah, GA - 31401 912-651-6925 jwilkinson@ savannahga.gov # of employees — 2000 USI EB Consultants since 2016 Chatham County Board of Commissioners Carolyn Smalls, Human Resources Director 123 Abercorn St Savannah, Ga 31401 912-652-7930 csmallst chathamcountv.org USI Consultants # of employees —1,800 USI EB Consultants since 2016 Augusta Richmond County Contact Name: Timothy E. Schroer, CPA Contact Title: Deputy Director, Finance 535 Telfair Street, Suite 400 Augusta, Ga 30901 Phone: 706-821-1741 Email: Tschroer()augustaga.gov # of employees: 2200 USI EB Consultants since 2010 The GEO Group Contact: Susan Napoiitano One Park Place, Suite 700, 621 NW 53`d Street Boca Raton, Florida 33487 TEL: 561 999 7435 snapolitano@geogroup.com # of employees -- 7,000 USI EB Consultants since 2007 (Miami) Fraternal Order of Police - Lodge #20 Contact: Lissette Priegues-Granado 400 NW 2nd Avenue Miami, Florida 33128 TEL: 305-372-4605 F0P20insurance@earthlink.net # of employees — 2000 USE EB Consultants since 2006 Dade County Firefighters Insurance Trust Contact: Mike Kramer 8000 NW 21st Street Miami, Florida 33122 TEL: 786-437-2560 mkramer@local1403.org # of employees — 2600 USI EB Consultants since 1980 RFP Response Is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 121Page Employee Benefit Consulting Services RFP 678384 Pension Knox County Retirement and Pension Board Contact: Kim Bennett 400 Main Street, Room 371, City -County Building Knoxville, Tennessee 37902 TEL: 865-215-2969 Kirn.bennett a(7knoxcounty.ore # of employees — 2,400 pension benefit recipients, 6,000 active members Commencement of consulting relationship —1980 Eastern Band of Cherokee Indians / Tribal Casino Gaming Enterprise Contact: Adele Jacobs -Madden 777 Casino Drive Cherokee, North Carolina 28719 TEL: 828-497-8235 amadden pcherokee.harrahs,com # of employees — 400 pension benefit recipients, 4,600 active members Commencement of consulting relationship — 2007 The Archdiocese of New York Contact: Art Motegari 1011 First Avenue New York, New York 10022 TEL: 646-794-3045 Art.montegariParcflnv.org # of employees —10,200 pension benefit recipients, 13,500 active members Commencement of consulting relationship —2003 ■ Eastern Band of Cherokee Indians, North Carolina, 4,600 active members/400 Pension benefit recipients — Pension • The Archdiocese of New York — New York, 13,500 active members/10,200 Pension benefit recipients — Pension • The Knox County Retirement and Pension Board, Tennessee, 6,000 active members/2,400 - Pension benefit recipients — Pension Because of the competitive nature of our industry and due to the availability of this RFP via Florida Sunshine Law FL. CHAPTER 286.011 PUBLIC BUSINESS: MISCELLANEOUS PROVISIONS we will provide you with an estimate of the costs for services. Fees are determined based on employee count, services and scope and can range. Information for fees and commission can be found at: https://www.efast.dol.gov/portal/app/disseminate?execution=e1s6 Completion times for all projects were met on schedule and USI/USICG is the Prime Contractor on all accounts listed and resulted in successful consultation, implementation and delivery of similar scopes to the City of Miami's request as stated in RFP 678384, Section 3 for scopes of services. RFP Response Is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 13IPage Employee Benefit Consulting Services RFP 678384 3) Where possible, list and describe those projects performed for government clients or similar size private entities. (Excluding_ any work performed for the City of Miami). In the event that the Proposer has not performed five (5) comparable contracts within the past five (51 years, the Proposer should provide information that demonstrates its ability to_perform the required services. USI, has in its database over 128 Public Entities clients that it is currently doing business with. Please note that the 128 count does not include Private Entity clients, or Colleges and or Universities which have similar size employees. USI consults for these clients in all aspects of insurance from Employee Benefits to Financial Advisory, USI Consulting Group {USICG). USI's employee benefit practice is designed to optimize benefit plans through comprehensive cost containment, best in class pricing, regulatory compliance and superior account service. These projects include those clients listed in question 2, on page 12 of this RFP but are not limited to: • Underwriting & Insurance Analytics — Analyzing data from multiple sources to manage, contain and negotiate plan costs. • HR Services — Administration platforms, call centers and service calendars to ease administrative burdens. • Population Health Management — Plan design, disease management analysis and aligned incentives to improve health. • Compliance/Healthcare Reform —Tools, expert guidance, and policies to prornote compliance with federal and state regulations. • Healthcare Cost Management — Options for members to make more efficient care decisions without sacrificing quality. • Pharmacy_Benefit Consulting —Solutions to increase transparency and minimize pharmacy costs. • Ancillary Benefit Consulting —Competitive marketing and scoring to drive results for other benefit services. For decades, organizations have relied on USI to help their employees successfully plan and invest for retirement and to assist with the tasks required to enroll and administer their health and welfare employee benefit plans. Our team of highly skilled professionals provides specialized expertise in retirement plan design, administration, consulting, investments, legal & regulatory compliance and employee communications for thousands of clients nationwide. Our clients consist of public and private sector employers, not -for -profit organizations and Fortune 500 companies. Our retirement and benefits solutions include: • Defined Benefit • Defined Contribution • Investment Advisory* Health and Welfare Administration Regulatory and Compliance • Employee Communications • Church Plan Solutions Please refer to the detailed list of projects in Section 2 of this RFP on page 12-13. RFP Response Is Intended solely for the Clty of Miami and all Information Is considered CONFIDENTIAL 14IPage Employee Benefit Consulting Services RFP 678384 4). Provide information concerning any prior or pending litigation, either civil or criminal, involving a governmental agency or which may affect the performance of the services to be rendered herein, in which the Proposer, any of its employees is or has been involved within the last five years. USI has not been indicted nor involved in any civil or criminal activity involving a governmental agency. We are in no pending litigation that would affect the performance of the services to be rendered. The City of Miami should feel comfortable that USI and USICG is a leading national middle market broker with over $1.0 billion in revenue. http.//www.usi.corn/investor-relations/ RFP Response Is intended solely for the City of Miami and all information Is considered CONFIDENTIAL 151Page Employee Benefit Consulting Services RFP 678384 5), Provide a minimum of two (2) references on the Letterhead of the client to whom services of a similar nature were provided. The City reserves the right to contact any reference as part of the gualification process. AdrienneArshtCentor ', ....,.,.... , .. �, ,., mot. �.� •; ,w,c.•c i ow. 2017 T:; whorl It may con4;i.;lr, 111s cf cr of ee:,srnrn_ndation is to nilesl Pict Jose s cap le of -ho mast tnatcttfs.l, loy:w,vredgeable cad proles:5€unc pe ;plc in the benefits are: -'cc: €ndla;try. hte has a passion f^• th= d i�a,�,, devoloprr.r• ed_cat€on (.f benefit :�1^..•�5, and s one of my "q:; 0" peop r it rho l lspibricw ird'..lstry. I o hni krro••'rleclg; of the market. urrieI:Iclnding et current a 'I(: p. ;d nc issue..; or J kores tremendously about 1•7. r.Linr-; He can be Falco on -G delve; what ho promises. 3syc•nd h€t role, he is olw' y5 ready to prrA•ido u•Id suoper'. "horn cry .elect pcoplo li orgurricolons who yo.) c::ar• Isusi -o carry resporr:ibi'Iy ord it Lire 'rripertaice 0 C:rJ Jaye 5 o IC cf -I-lose ndi';IJ1.:,ls. Sincerely, Tr'sh I3renrcr•I rif: r Pt ;der-. I lAn :r1 KetOw'Ces '..1n1 !a'ay A Mai. n.art. Mani. -I .r`t.!! Ial:rFraa t!!Lsfli..lI: I hi+ : h 4n !• Ul rrnv.asMccrr er.arg RFP Response is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 161Page Employee Benefit Consulting Services RFP 678384 MONUMENT Gerardo Galo Monument Real Estate Services 5200 Blue Lagoon Drive, Suite 4013 Miami, FL 33134 March 7, 2017 Re: Jose L Gonzalez To whom it may concern - This letter serves to vouch for the personal and professional character of Jose L Gonzalez.1 have known him both on a personal level as well as a professional level and can attest that Mr. Gerzaez is of high Moral character and incredibly professional and proficient in the arena of Employee Benefits. f wholeheartedly recommend Jose as a consultant. He has a take -charge attitude and subtle -yet -confident approach that resulted in being immediately embraced by our Human Resources department wt en we first engaged his services_ Jose is not only creative; he possesses the rare skill of t-erg able to communicate his ideas and theirassociated benefits effectively, which in our case resulted in full buy -in from our leadership. Simply put, he gets us the results we demand. During the time our firm has contracted with Jose, we have seen an increase in profits as well as impnmved morale. We are convinced that both achievements are largely a result of Jose's efforts. He is worth every penny. Please don't hesitate to follow up if I can answer any questions about Jose and his shills. Sincerely, may. r Gerardo Gato Chief Financial Officer 5200 Blue lagoon Drive, Suite 4-00, Miami, FL 33126 (305) 446-0010 RFP Response is Intended solely for the City of Miami and all Information is considered CONFIDENTIAL 17IPae.e Employee Benefit Consulting Services RFP 678384 6). Provide a copy of Proposer's current Business Tax Receipt/Occupational License USl IN8/JR,ANCESERIVICEs FLCRIDA1I'8 V51 ATTN: JEFF R EY J HAYNES 201 ALHAISPA CIR. STE ao1 CORAL. GAELES_ FL33134 rett14-161EPEA1113 PKIPLo.PPECEPTIHALTAipomtaruica CITY OF CORAL GABLES. FLORIDA LOCAL BUSINESS TAX RECEIPT ANNUAL FIRE INSPECTION FEE RECE":F'T THIS IS NOT A BILL -DO NFt7T PAY UST ma a: nes RECEIPT 1 Q. fir-c9nam46 2016-2017 BUSIIVESSN48iE USIINSURANCE SEJZ4/1{ESFLORIDA INC LDGV1ON: 2414UimisRAtya DOA ?INCE US 881 C OSSF1CA710K1 MO.4FiNAIS 11H1r 0EICRIPTICN AMOUNT PAID: f: 4 21 D t INEURANCEAGEhlCY (1 MASON) 2 S 4 S SCRJARE POOTACE OF SPACE: ITT — hb rerrrp1 deal nalmrlstiute ad hairy >abmilei alarailrus K $4, iotoon yawl s WOW 0 0rA Y AT LOCATION FBO','E RECEIPT EXPIRES nsranrlal r RFP Response is intended solely for the City of Miami and al! information Is considered CONFIDENTIAL 18'Page Employee Benefit Consulting Services RFP 678384 7). Describe any relevant industry/subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. USi caters to Public Entities With a long history of partnering with public entities, USI understands that risk management in the public sector is not the same as risk management in the private sector. Effectively managing risk in the public sector requires the assistance of a special consultant who understands the distinct exposures of public entities and one who can work with you in developing a program that best meets your needs. Making sound decisions regarding loss control and risk financing requires balancing the often -conflicting objectives of maintaining a desirable tolerance of risk while still meeting obligations to provide services, and doing so within a limited budgeting horizon and under what can sometimes be a great deal of political scrutiny. USI is prepared to assist you with all your risk management needs whether you are a State, County, City Government, Town or Township, School District or Special Purpose District. As stated in Section 3 of this RFP, USI, has in its database over 128 Public Entities clients that it is currently doing business with. We have thousands of Private Entity clients, Colleges and Universities, Non -Profit, Not for Profit which have similar size employees, similar scope of services and business issues that we service. USI consults for these clients in all aspects of insurance from Employee Benefits to Risk Management as well as Financial Advisory, with our USI Consulting Group (USICG). USI's employee benefit practice is designed to optimize benefit plans through comprehensive cost containment, best in class pricing, regulatory compliance and superior account service. For specific client subject matter expertise please refer back to Section 4. Question 2 pages 12, 13 & 14 of this RFP. Please see a detailed list of clients and services performed. Also, please revisit Appendix 2, for USI's OMNI Solutions detailing our proprietary methodology. USI has also prepared a detailed PowerPoint tailored to answer many of the questions of RFP 678384. We did this in response of the City of Miami's request for a description of our unique proprietary methodology. Our presentation will demonstrate to the reader USi's robust analytics and solutions relevant to the requested services requested in this RFP. Please refer to Appendix 9 of USI's RFP response which details our subject matter expertise, proprietary methodologies, including financial impact, detailed solutions offered with relevant case studies of actual USi clients. The solutions offered also contain company background, key challenges, USi solutions and quantifiable benefit to the organization. Case studies can be found on Appendix 9, pages 52-80, RFP Response Is intended solely for the City of Miami and all information Is considered CONFIDENTIAL 19IPage Employee Benefit Consulting Services RFP 678384 8. Identify if Proposer has taken any exception to the terms of this solicitation. If so, indicate what alternatives) is being offered and the cost implications of the exception(s). No exceptions at this time. RFP Response Is Intended solely for the City of Miami and ail information Is considered CONFIDENTIAL 20IPage Employee Benefit Consulting Services 5. Key Personnel Performing Services RFP 678384 1. Key Personnel Performing Services 1. Provide an organizational chart showing the Proposer's Lead Managing Consultant and all key personnel, including their titles, to be assigned to this protect. All key personnel include all partners, managers, seniors and other professional staff that will perform work and/or services in the project resulting from this solicitation. The chart must clearly identify the Proposer's employees and any subcontractors or sub -consultants. This information shall include the general functions to be performed by key individuals and the subcontractors or sub -consultants. Annette Kok Director Of Operations Stephen Roche 5. FL Benefits Practice Leader Dean Hitsos & Raul Sanchez Account Executive Account Manager . 1..MI.._ Ann Ramirez Marketing Analyst Debbie Norton Communication Expert Jim Dunn Regional CEO Executive Management Jennifer showers & Cassie Salomone Wellness Consultants Jose L. Gonzalez VP, EB Consultant Joe Plummer VP of Underwriting Benefit Rdenly! Olaiya, Resource Center i ASA, MAAA Claims Liaison ] Actuary USICG Scott Segal, JD ERISA Attorney RFP Response Is intended solely for the City of Miami and all information is considered CONFIDENTIAL 21IPage Employee Benefit Consulting Services RFP 678384 More of your team members are listed below but fall under the supervision of the Practice Leader. Based on Scope of Services as described in the RFP there is no need for Sub -Consultants unless a change occurs to the scope of services or it can save additional revenue to the City with the City's approval. USI Team Members ■ Jose Gonzalez - Lead Consultant ■ Stephen Roche — South Florida Employee Benefits Practice Leader • Jim Dunn - CEO Southeast Region • Annette Kok— Director of Operations • Dean Hitsos--Account Executive • Raul Sanchez- Account Manager • Jennifer Showers & Cassie Salomone — Southeast Region Wellness Consultants • Joe Plummer —Southeast Region Underwriter • Scott Segal, JD — ERISA Attorney • Patricia Bowen — Pharmacy Practice Leader Doug Patron, MD or Daniel Samo MD, - Medical Director Jonathon Zeiger — Vice President, Retirement Services 4030b) Jessica Quesada — Assistant Account Manager Benefits Resource Center- Claims Liaisons and Benefit Experts Debbie Norton — Enrollment and Communication Expert Ann Ramirez — Analyst Adeniyl Olaiya —Actuary Please note that more information on your team is provided on section 4 oages 29-31 of the RFP under Key Personnel. Bios on key -employees can be found on Appendix 10. To analyze the City of Miami's business issues and challenges, our benefits team leverages USI ONE', a fundamentally different approach to employee benefits and risk management USI ONE integrates proprietary business analytics with a network of local and national technical experts in a team based consultative planning process to evaluate the client's risk profile and identify targeted solutions. Clients then receive tailored recommendations for improving their employee benefits plan through cost reduction and service enhancement resulting in an employee benefit trend advantage. USI's Employee Benefits network includes hundreds of consultants around the country, local and regional account managers, healthcare underwriters, business analysts, compliance/ERISA attorneys, wellness directors, pharmacy consultants, communications experts, claims experts and other specialty service personnel. These professionals access sophisticated tools and strategic planning to design optimal plans, negotiate advantageous pricing, deliver preferred services and keep clients abreast of market changes. Please refer to Appendix 2 for a synopsis and example of USI ONE` RFP Response is intended solely for the City of Miami and all Information is considered CONFIDENTIAL 22Ipage Employee Benefit Consulting Services RFP 678384 2, Describe the experience, qualifications and other vital information, including number of years of relevant experience on previous similar projects, of the Lead Managing Consultant and all key personnel, who will be assigned to this project. Experience and qualifications is provided in the Section 4, page 27-31 of the RFP under Qualifications and Experience of Staff. Bios on key -employees can be found on Appendix 10 with experience and qualifications. However, USI's approach is a unique approach where a knowledge engine and thus a team of USI professionals as described on Appendix 2 utilizes the USI ONE Advantage which sets us apart from the competition. The Lead Consultant has 17 years of industry experience and has worked on self -funding accounts in all facets from, Claims liaison, Account Manager, Sr, Account Manager, Benefit Supervisor, Practice Leader and Consultant. He has a dear understanding of all roles needed and the knowledge and work involved. He has helped champion strategic ideas and coordinate all necessary resources on similar sized cases and has worked with Unions and Municipalities to achieve results. More importantly the lead consultant will work with USI's network of Consultants who handle a multitude of Public Entity clients in order to develop best practices in order to achieve the goals for the City of Miami. USI's Population Health Management (PHM) Consultant will partner directly with the Lead Consultant and The City to conduct a medical claims analysis for the identification of city -specific cost drivers. Our Lead consultant will utilize findings from this analysis in combination with results of the organizational assessment to develop a targeted, multi -year wellness program strategy for The City of Miami. This detailed USI-proprietary strategy document will include; a list of City -specific business issues, USI solutions to address each issue, post -program goals, specific budget spreadsheet (in cases where client or carrier wellness funds are to be utilized) and a written, step-by-step implementation timeline. By deploying USI's recommended strategy, The City can expect to experience maximized wellness program engagement, broadened program outreach, mitigation of high medical claims stemming from culprits such as, unnecessary emergency room visits, inpatient days, improved compliance for age/gender cancer screenings, gap closure for preventive care specific to those with diabetes and heart disease to name just a few. Additionally, The consultant will provide The City with a U51 proprietary easy to read, year- over -year outcomes report, which will demonstrate whether the strategy indeed yielded desired outcomes. This yearly progress report will also present opportunity to fine tune The City's strategy over time, At USI, we utilize our PHM Consultant who would collaborates with your designated USI-account manager and CIGNA to ensure a "true partnership" is upheld. USI southeast region is amply staffed with bilingual professionals and para-professionals to satisfy the diverse needs of our clients, USI'S PHM Consultants are well versed with respect to wellness programming and compliance. Furthermore, in RFP Response Is Intended solely for the City of Miami and all information !s considered CONFIDENTIAL ?Wage Employee Benefit Consulting Services RFP 678384 cases where out of the ordinary compliance scenarios arise, the USI team has easy access to the City of Miami's dedicated ERISA Attorney. Best practice guidance with respect to precautions related to wellness programing and unions is an added area in which USI is well equipped. USI provides all clients with a monthly wellness newsletter at no added cost while some clients choose to utilize a USI recommended third -party provider for their monthly communications and/or specific -wellness program branding needs. USI's PHM consultants are experienced in health and behavioral survey design. Surveys can often times aid in educating a population and/or provide the tools necessary for learning what will and will not work within a given population. USI Consulting Group is one of the nation's largest retirement and benefit consulting and administration firms servicing mid -sized organizations and is a wholly -owned subsidiary of USI Holdings Corporation ("U51") — the third largest privately -held insurance broker in the United States. USI Consulting Group provides Defined Benefit and Actuarial Services to approximately 500 clients ranging in size from 20 - 40,000 employees. We provide the full array of Defined Benefit Services for all plan categories including, but not limited to corporate, not -for -profit, ERISA, non-ERISA, municipal, state, governmental, religious affiliated, qualified, non -qualified, etc. Our mid -market client focus is delivered through a highly experienced actuarial staff of 20 actuaries (averaging more than 15 years of experience) supported by 45 analysts and technicians, Our team -based service approach provides dedicated resources to you and your plan participants. Retirement & Benefit Solutions For more than 35 years, organizations have relied on us to help their employees successfully plan and invest for retirement and to assist with the tasks required to enroll and administer their health and welfare employee benefit plans. Our team of highly skilled professionals provides specialized expertise in retirement and employee benefit plan design, administration, consulting, investments, legal & regulatory compliance and employee communications for approximately 1,400 clients nationwide. Our clients consist of public and private sector employers, not -for -profit organizations, as well as Fortune 500 companies. RFP Response Is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 24(Page Employee Benefit Consulting Services RFP 678384 Executive Benefits and Non -Qualified Deferred Compensation Plan Consulting USICG has a long history of partnering with organizations to design executive benefit programs, USI Consulting Group understands that a properly designed program can help attract, motivate, reward and retain your key executives. Effectively managing executive benefit and non -qualified deferred compensation plans requires the assistance of retirement plan consultants who understand the unique structure of your organization and can work with you in developing a program that is compliant, cost-effective and best meets your needs. Our executive benefits consulting services include: Non -Qualified Deferred Compensation Plans ► Plan Design, Documentation, Installation and Administration ► Plan Benefit and Funding Modeling Cash Flow, Economic and Accounting Projections Based Upon the Census of Eligible Participants Web Based Account Management Other Executive/Corporate Benefits Supplemental Disability Key Person Insurance RFP Response Is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 25IPage Employee Benefit Consulting Services RFP 678384 3. Provide information or documentation to Proposer's qualifications and experience from which the City of Miami can benefit under this contract. Please refer to Appendix 3, for Wellness & Population Health Management Case studies. Please refer to Appendix 4, for a detailed Pharrnacy Benefit Report that we provide our clients and the City would benefit from. Please refer to Appendix 5, for a breakdown of Claims and Pharmacy through USI's proprietary tool USI 3D. Please refer to Appendix 6, for a Benefit Guide that USI will create for the City of Miami for electronic distribution to all its employees. The document will have barcodes for smartphone/ tablet capabilities as well as a link for Audio and Video play for any employee or spouse to access 24 hours a day, 7 days a week year round. Please refer to Appendix 7, for tools that will be provided to the Risk Management Staff for insight, learning and training In over 200 online courses, 23 Wellness courses and real time assistance in regards to benefit and HR related questions. Please refer to Appendix 8, for 5 case studies from our proprietary Benefits Resource Center which gives access to ail City employees a personal benefit expert, claims liaison and health care advocate. Please refer to Appendix 9, for USI's proposal to the City of Miami for all its services and qualifications with actual case studies. Please refer to Appendix 10, for all qualifications and Experience from each team member in the form of a Biography. Please refer to Appendix 11, for a list of services that the USI Consulting group would provide. In most large companies or municipalities, the health plan consumes the most amount of time, as it represents a significant expenditure for both employer an.d employee. Consequently, a substantial amount of involvement and resources are spent on health plan benefit review, claims analysis and projections including IBNR development and quarterly assessment. USI is amply equipped to handle all your needs as seen in the Appendixes listed above. US1 also provides access to USICG who provides but is not limited to: Health Actuarial Services / Health Benefit Consulting Services - As a standard practice, USI provides monthly reports for our fully insured, self -insured and minimum premium clients over 200 lives. Reporting is a big part of the financial services that we offer our clients. We build our quarterly meetings with clients around the plan financials because medical and dental plans make up, collectively, one of the largest expense items of the client's annual budget. RFP Response Is Intended solely for the City of Miami and all Information 1s considered CONFIDENTIAL 26IPagE, Employee Benefit Consulting Services RFP 678384 Our financial reports track claims and premium by number of lives monthly to see how the group is running. The ASO report tracks monthly expenditures, separating them into fixed expenses (administration charges, network access fees, reinsurance, and claims paid). At the end of each month, we compare plan expenses and claims to plan income/ liability and develop a monthly and YTD surplus or deficit picture in relationship to the accrual rates established at the beginning of the plan year. We also include the changes in employee contribution within our reports, which show the employer's true estimated cost of the plan. The reports are used generally to: • Forecast future funding needs as early as the first quarter of the new year and continue monthly throughout the year, eliminating funding surprises. • Determine the impact of large claimants on current and future funding needs and maintain a history of such claims activity from year to year. • Allows Rx costs and rebates to be tracked separate from FFS claims in looking at the overall monthly and YTD claim picture. • Test adequacy of reinsurance levels and "premium to claim" value of optional reinsurance attachment points. • Maintain funding rate (including all components) and employee contribution history, providing substantiation of COBRA rates. • Determine the impact of enrollment increases or layoffs on plan experience. • Preserve a continuous, historical database (claims, expenses, reinsurance, plan design changes, etc.) of self -funded plans. • Assist in evaluating "Incurred But Not Reported" claim liability on a continuing basis. Experience The GEO Group A national firm with approximately 6,000 employees located in multiple states. They run, operate and manage correctional institutions. They are self -funded through a major health care provider and USI assists in various aspects of the management of the account. Areas of direct involvement have been in the area of: • Funding analysis & projections & ultimate rate development for budget purposes • Evaluating the impact of plan design changes on funding • Evaluating the impact of acquisitions on funding • Assessing the impact of Health Care Reform on plan funding USI evaluates, on a quarterly basis, the "Incurred But Not Reported" Claim liability. RFP Response Is Intended solely for the City of Miami and all information is considered CONFIDENTIAL 27IPage Employee Benefit Consulting Services Health Actuarial Services only FOP Miami RFP 678384 Adeniyi provides actuarial services for FOP Miami, separate from the Healthcare consulting provided by USI. We are responsible for the FOP's I8NR calculation. GASB 45 Consulting The CG provides GASB 45 Consulting to the following clients: • New York State Thruway • Town of Hamden, CT • Sumner County • Town of Oyster Bay Please see Appendix 2 for suggestions that the City of Miami would benefit from on this contract Pension Services Vital to proper administration of the defined benefit plans is financial management, which is provided through actuarial forecasting and a determination of what the future costs of the plan might be — so that performance can be measured in terms of specific goals and timely adjustments can be made accordingly. Our actuarial staff provides these analyses, and other studies, ranging from basic to complex. All actuarial services are not the same. Actuaries often use standard methods and assumptions, or have difficulty customizing and communicating their approach to suit the needs, goals, constraints and special circumstances of their clients. Our approach is different; we take a closer look at data, run alternative scenarios and provide creative and flexible solutions. Our objective is to arrive at more meaningful and understandable results for our clients. RFP Response 1s intended solely far the City of Miami and all information is considered CONFIDENTIAL 28IPage Employee Benefit Consulting Services RFP 678384 4. Provide resumes, if available, with job descriptions and other detailed qualification information on the Lead Managing Consultant and all key personnel who will be assigned to this project. Qualifications and Experience of Key Staff The USI Account Management Team that would be dedicated to the City of Miami is located in Coral Gabies, in Miami -Dade County. In addition, this team will be assisted by associates from USI's Ft. Lauderdale office. The Coral Gables office has 42 employees that are financial service professionals while the Ft. Lauderdale has office has 150. On average, our employees have 20+ years of employee benefit experience and purposefully come from a wide variety of backgrounds. Some come from other consulting/brokerage houses, some from insurance carriers and others from companies where they served as human resource or benefit specialists. All contribute specific expertise and add the knowledge from different viewpoints to assist in proactively addressing the challenges you face. Your team is led by Jose L Gonzalez — VP, Employee Benefits and former Employee Benefits Practice Leader to the Coral Gables office in Miami -Dade County. In this role, Jose directs the team of resources and service providers. He is also responsible for working with the City of Miami to develop a coherent benefits strategy, to select the appropriate benefits products, carriers and services, to negotiate pricing with vendors and coordinate the placement of insurance products, and to coordinate the USE team of communications, administration and service professionals that would provide services to the City of Miami. Jose has over seventeen years of insurance experience and has worked with clients that have ranged from 100 employees to 5000. In the Employee Benefits arena he has handled many complex, self -funded accounts throughout his career and has provided outside the box solutions to insulate clients from penalty and provide substantial premium reductions to assist with the bottom line. The day-to-day contact for the City of Miami will be divided between two of USI's finest. Your Account Executive, Dean Hitsos and your Account Manager, Raul Sanchez. Dean Hitsos has 13 years of insurance experience and 14 years of HR experience. His focus is as a specialist to municipalities and governmental agencies. Dean has his MBA with a concentration in Human Resources. Raul's role is to manage the day-to- day account activities including claims, billing, and carrier liaison. Raul also manages the marketing and renewal process as well as implementation of new benefits and carriers. Raul has 20+ years of experience in employee benefits, The Account Management Team is led by Annette Kok, Director of Operations. Annette joined the USI team in 2014. In her role as Director of Operations, Annette is responsible for the management and servicing of large national accounts. Annette's responsibilities and strengths include how to improve the operational systems, processes and policies in support of organizations mission -- specifically, support better management reporting, information flow and management, business process and organizational planning. Manage and increase the effectiveness and efficiency of Support Services (Account Management, Marketing and Enrollment Communications), through improvements to each function as well as coordination and communication between support and business functions The Account Management Team is supported by Joe Plummer, Vice President, and Senior Underwriter. Joe is responsible for underwriting the medical plans, analyzing claim data, monthly financial reporting, and RFP Response Is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 29IPage Employee Benefit Consulting Services RFP 678384 assisting with strategies to manage the cost of the City of Miami's benefit plans. Joe has over 20 years of experience in employee benefits, on the employer side as well consulting. Stephen Roche, ChHC, RHU is the Employee Benefits Practice Leader for South Florida. He oversees the client management teams, concentrating on developing operational efficiencies, best practices and innovative strategies that bring results to our clients. As the CEO for USI's Southeast Region, Jim Dunn is responsible for leading all offices in the region. Jim's primary responsibility is to lead organic growth by ensuring that clients are delivered the vast array of US1's products and resources while adding new clients that need these services. In addition, Jim partners with like-minded insurance agencies/brokers to join USI and expand their client solutions. Jim brings more than 20 years' experience to his role as southeast regional CEO and will be key in USV's continued push to be the clear leading middle market broker nationally. Your Wellness Consultant, will be Jennifer Showers. Jennifer is a recognized leader and pioneer in the corporate -based health, productivity and wellness arena with 25 years' experience. As the Associate Wellness Director at the University of Miami, Miller School of Medicine for 13 years, Jennifer paved the way to the development of their first employee -based wellness program. This initiative eventually led to the groundbreaking and construction of a 17 million dollar state of the art Medical Wellness Center. She co-chaired the University of Miami's first Integrative Medicine Symposium and EXPO, has strategically developed and implemented dozens of customized corporate health programs and produced and directed a myriad of large-scale sponsor -driven special events. Her formal education includes a Masters of Education in Mental Health Counseling from the University of Miami and a Bachelor's of Science In Corporate -based Wellness and Exercise Physiology from Penn State University. Also assisting on Wellness is our local Wellness Consultant Cassie Salornone. In her role as Wellness Consultant for USI, she develops strategies to help clients contain and avoid costs through the design and implementation of worksite health promotion programs. Bringing her Fortune 100 experience to population health management, she has extensive knowledge of the factors leading to chronic disease and is passionate about educating populations in prevention. Cassie previously worked at Motorola where she helped implement their wellness program. Doug Patron, MD is another addition to the USI Resource team. Since 1994, he has provided his medical expertise to numerous Fortune 100 companies, and has been instrumental in designing, developing, and improving their medical management processes. He has had major involvement in return to work initiatives, has chaired a committee that assessed and reported on hazards with a company's products, ensuring regulatory compliance and corporate responsibility and is currently serving as medical director and providing consulting services for several large companies with extensive international operations. Doug brings a wealth of value to the USI team by being available to consult and negotiate difficult claim and safety issues for our clients, among numerous other services. Dr. Patron received his BA in Biology and Biochemistry from the University of Colorado, and his MD from George Washington University School of Medicine in Washington, D.C. He completed his Internal Medicine RFP Response Is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 30 1 P c Employee Benefit Consulting Services RFP 678384 residency at St. Joseph Hospital in Denver, completed a fellowship in Occupational and Environmental Medicine and earned his MSPH at the University of Colorado Health Sciences Center. He is Board Certified in Occupational and Internal Medicine. Scott Segal, ID has seventeen years of experience advising clients in the area of employee benefits, executive compensation and ERISA, including: the design and drafting, qualification and ongoing administrational issues of defined benefit, 401(k), profit sharing and health and welfare benefit plans; the design, qualification and drafting of nonqualified deferred compensation plans (including plans for limited liability companies and compliance with Code Section 409A); the effect of corporate mergers and acquisitions on benefit and compensation plans; plan transfers, mergers and terminations; fiduciary matters; executive compensation; and ERISA related litigation; Representing clients in matters with the Internal Revenue Service and the Department of Labor. Clients include public and private companies, nonprofit companies and governmental employers. Negotiating, preparing and reviewing agreements on behalf of both management and executives, including employment, severance, consulting, change -of -control, confidentiality, and non -compete and other restrictive covenant agreements. RFP Response is intended solely for the City of Mlami and all Information is considered CONFIDENTIAL 31 [Page Employee Benefit Consulting Services RFP 678384 6. Proposed Approach to Providing the Services 1. Describe Proposer's approach to project organization and management, including the responsibilities of Proposer's Lead Managing Consultant and Proposer's key personnel, and key personnel of subcontractor or sub -consultant, that will perform work in this project. Why USI? USI has remained committed to creating value, managing risk and building net worth for companies and individuals. As we have grown during recent years, we have maintained the philosophy that has long been the hallmark of USI: value in long-term relationships with our partners; commitment to the community; investment in our associates; and a belief in respect and authenticity. The City of Miami would benefit from a national broker with customized service and significant leverage in the local and national marketplaces but staffed locally with a team of local professionals who are committed to your long-term success by creating the best value for City of Miami, Employee Benefits Service Model In order to craft the right solutions, the Lead Consultant makes it a point to first understand your core values, needs and concerns. We pay attention to the details unique to you in your industry. Our proactive approach to consulting is evidence -based with an understanding of City of Miami culture and past benefits strategies. Using our proprietary analytical tools, we take this information to develop a multi -year, easy to digest benefits strategy that combines the needs of the Human Resource team and the financial side of the organization. As part of this strategic plan, we bring reasonable and attainable solutions relative to funding analysis options, predictive modeling of benefit designs, customized wellness programs that are sound and include achievable targeted contribution schemes, as well as comprehensive, customized employer and employee corn munication tools. RFP Response Is Intended solely for the City of Mfami and all Information Is considered CONFIDENTIAL 32IPage Employee Benefit Consulting Services RFP 678384 USI has a proven track record of setting itself apart from the competition in four critical areas: Compliance, Underwriting, Human Resource and Clinical outcomes. Plan Management From an employee benefit perspective, we understand that effective plan rnanagernent means that benefits are not an annual event, but rather a year long process. We often refer to this process as a 360° Service Continuum (see illustration, below) which always begins by working with you to develop a clear definition of the goal of your benefit plans. Employee. Solis action Operations & Product Innovation HR Comm. Resources Lead Consonant & Account Managers On -Going Consulting and Day -to -Day Program Management Lowe; Coil of Core Papulalion Health Manager Compliance Attorney Reduce Frequency of Care / As day-to-day benefit plan management issues arise, USI is available to all of the members of our client's benefits staff, working as an adjunct. Our efforts focus on such areas as budgeting and finance issues, interpretation of plan documents and contract language, federal and state compliance issues, and the resolution of complex or sensitive claims issues. Our recommendations are grounded by financial analysis and full consideration of your organization's objectives and administrative realities. RFP Response is intended solely for the City of Mlanti and all information !s considered CONFIDENTIAL 33Page Employee Benefit Consulting Services RFP 678384 Specialist Knowledge Specialist knowledge requires insight, experience, and access to leading resources. Our professionals understand risk management, benefits tools and meet regularly to discuss current client issues and market conditions. We keep pace with legal changes and market conditions, solve problems, anticipate potential risks and most Importantly, ensure that you are properly prepared for the ever changing health care environment. City of Miami will have direct access to our team of experts with personalized attention to every aspect of your benefits program. Our analytical team shares market trends, carrier knowledge, strategies, creative funding approaches, contribution and reporting offerings with our clients. We will monitor your plan performance monthly and report to you on a quarterly basis to ensure that no "surprises" arise at renewal time due to unfavorable claims experience. Our sophisticated financial analysis capabilities allow us to forecast future renewal costs months in advance, allowing time to make educated and timely decisions. With this insight, based on City of Miami data, USl will lead you to design evidence -based programs to achieve short-term and long-term goals. USI's Benefits Practice is staffed by Benefits Professionals who demonstrate not only outstanding experience and credentials, but also a hunger to be on the cutting -edge of current benefit strategies, concepts and practices. As we provide fresh ideas for our clients we help them more effectively deliver benefit programs to their employees. With the future of uncertainty of Health Care Reform, USI's leadership is alert, aware and influential in the legislative and regulatory arenas both on Federal and State levels. We are working with clients to ensure not only compliance with the requirements of Reform, but also implementation of cost control mechanisms available. Within the framework of Health Care Reform lies the potential for employers to encourage significant improvement in employee health and well-being through the implementation of creative benefit solutions — and USI is in the forefront of this movement. The effectiveness of our Thought Leadership is demonstrated as we educate and encourage healthy employee behaviors, yielding both a lower incidence of chronic medical conditions and significant savings for both employers and employees. it is in USI's corporate DNA to be forward -thinking. This starts with our leaders in our corporate, regional, and retail offices and continues to the consultants and sales professionals on the ground. As we continue our discussions as City of Miami benefits consultant, we will introduce to you the ideas we see forming the landscape of the employee benefits world in the next three to five years. Included with our team of professionals, The Benefit Resource Center is primarily responsible for assisting USl Health and Welfare clients in claims resolution. These Claims Advocates work with your employees to resolve outstanding claim issues in order to facilitate a resolution which is both favorable and in the best interest of the employee/employer. RFP Response is Intended solely for the City of Miami and all information Is considered CONFICENTIAL 34IPage Employee Benefit Consulting Services IJSI Team Approach RFP 678384 USI takes a team approach and integrate highly consultative team meetings with USI's Omni analytics. The City of Miami will always have a broad resource network to build a multi -year benefits strategies aligned with its business needs. USI Team and Synopsis of Responsibilities ' 135E GCHTA.ET A C. CIl';A Underwriting & Analytic& Neaot`ation management to contain plan costs !: 11111111111 HR Services Administraticr platfcrms- cal centers and service calendars to ease your administrative burdens SFrf nor°_R Population Health Management Wellness design, disease management analysis and o5gned incentives to impr:,ve health 0 Compliance! Healthcare Re orm Tools. expert guidance, and Policies to promote compliance ve,,itl federal and state regulations tC.ViEN Care Intervention Options to members to make more elfcier:i cart deci;ior;s without sacrificing quality erterr, C [t4Tr Pharmacy Solutions to increase transparency and minimize pharmacy casts I ;'F.nFtI 'Cps. Ancillary Benefits Comcet,iive marketing and scoring drives results for other p an services Your Lead Consultant will utilize a real-time interactive solutions platform built by USI experts capturing the experience of more than 100,000 clients, thousands of professionals and over 100 years of business activity through our acquired agencies, Providing the City of Miami with an Actionable, Quantifiable Data Engine to Drive Decision Making. RFP Response Is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 35IPage Employee Benefit Consulting Services RFP 678384 2. Provide Proposer's operational plan that clearly indicates how the Proposer plans to provide the services requested in this Solicitation. The Proposer's operational plan must detail how the Proposer intends to fully satisfy the service requirements outlined within Item A, General Requirements and Services to be provided, of Section 3.1, Specifications/Scope of Work, of this REP. A comprehensive PowerPoint will be added to Appendix 9 that will illustrate our operational plan for the City of Miami's employee benefit practice and is designed to contain cost, promote regulatory compliance and deliver superior account service. Our comprehensive plan uniquely specifies the issue, solution, financial impact as well as provide you with a USI case study. We couple this with a USI's client specific customizable service calendar in order to adhere to our critical deliverables and facilitate advanced planning. ▪ Program Renewal Analysis: On behalf of our clients, USI initiates and directs renewal negotiations with each plan administrator far in advance of the renewal date. Our high level of renewal activity makes us keenly aware of industry trends. We rely heavily on previously negotiated cost components and a variety of renewal formulas. Our experience and aggressive renewal posture continuously yields non -recourse savings to our clients. ▪ Contract/Document Analysis: We work with clients and their various plan administrators to determine inadequate or missing documentation for all plans. USI coordinates and reviews all group contracts, plan documents, certificates and booklets. We routinely identify areas where contractual language disproportionately favors the carrier/vendor, and have had success in negotiating more equitable terms on behalf of our clients. In addition, we carefully review "right to audit" language to ensure that our clients can thoroughly monitor the performance of their administrators. • Regulatory Compliance Services: Federal and State regulation of the employee benefits field has created a complex web of rules to which plan administrators must comply. USI assists our clients by providing information on current regulations as needed, and by keeping our clients up-to-date on new legislation, landmark court cases, and other important regulatory developments. • Health Care Analysis: Evaluating health care networks can be complex and challenging, involving many variables that impact an employee's health care experience. Drawing employees into the healthcare process as "consumers" is a rapidly evolving trend that is transforming the healthcare marketplace. Our focus is to assist our clients in defining and implementing the approach best suited to achieving their objectives. An important step throughout the plan year is to monitor plan performance to goals. We will track and measure operational results, clinical outcomes, financial controls, claim/member services, and best practices/quality of services among other key areas, Some of the measurements will come from external sources, although most can be obtained from your data. Additionally, to ensure the vendors are providing the highest levels of customer service, we propose surveying the employee population. RFP Response Is Intended solely for the City of Miami and all information is considered CONFIDENTIAL • 361Page Employee Benefit Consulting Services RFP 678384 The outcome measurements from the program's financial analysis will provide evidence against baseline trends, costs, outcomes and other indicators to compare improvements. Our project outcomes will have a targeted effect that can be measured and adjusted as needed. We will provide reports on a monthly, quarterly and/or annual basis. These reports will assist us in monitoring the plans performance and highlighting any areas that need to be reviewed in future years. The level of detail included in each of these reports varies depending on the amount of claims experience agreed upon during the marketing process but may include the following reports: Monthly Reports • Claims analysis • Budget performance analysis • Inflationary trend information Midterm Reports • Budget projections • Rate promulgations • Reserve adjustment analysis • Actuarial opinions Financial Services/Claims Review Quarterly Reports • Financial overview • Claim utilization • Claim trend analysis • Reserve analysis • Stop -loss deductible and attachment point tracking Year End Reports • Full financial overview • Reserve calculation with actuarial opinion provided • Cost comparisons (historical and industry wide) • Budget and rate update and review • Deficit/surplus analysis Proactive program decisions can only be made when fully informed of the program's current and projected financial performance. USI monitors and tracks costs associated with each plan administrator on a quarterly basis. We provide a quarterly review of claim data and charged expenses measuring the performance of the plans throughout the plan year. our review of claim data allows us to track and assess utilization patterns as well as significant claim occurrences and outcomes. To assist our clients in the task of forecasting benefit budget levels, USI performs quarterly claim reviews that provide the basis for renewal projections. Discussions regarding financial performance begin well before the renewal and continue throughout the renewal negotiations. At the completion of each policy period, we prepare a year-end financial summary report encompassing design, utilization, performance guarantee metrics and the associated financial aspects of the program. In addition, this year-end report focuses on strategic issues relative to plan design and funding which may be considered during subsequent renewal negotiations. Request for Proposal (RFP) r We will work jointly with you to identify potential markets that serve your needs and assist you with analyzing carrier networks for adequate physicians and hospitals In the areas where your employees live. Vendors will also be selected for their quality of service, available funding options, level of claim detail they will provide and their willingness to implement performance guarantees. Your USI team will RFP Response is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 37IPage Employee Benefit Consulting Services RFP 678384 formulate an RFP based around: your objectives and performance expectations, current census, experience, plan design data and a questionnaire addressing each vendor's capabilities in multiple areas. This RFP will help you make informed choices about the carriers and vendors interested in servicing your benefits. The quality of the RFP is an essential aspect of any competitive bidding since it is the primary source of information about each plan. The primary purpose of the RFP is to create a competitive environment and describe "risk" (if any) as clearly and accurately as possible. A quality RFP will clearly delineate and rank the critical objectives of the marketing effort. In our experience, a quality RFP increases the likelihood of receiving a broad range of competitive bids from qualified carriers who fully understand the program requirements and expectations. Proposal Analysis and Carrier Selection We ensure that the carrier selection process Is performed at a level that meets the professional standards of our clients. To this end, USI works closely with our clients to develop criteria upon which proposals are evaluated. We perform our analysis of each proposal based upon criteria developed in conjunction with our client. The result of this comprehensive process is an extensive written report which provides background on the project, describes the process used in analyzing proposals, and applies client -specific evaluative criteria to each of the proposals submitted. We are also available to present our findings in person to members of the client's management team. Such a meeting may include a discussion outline supporting our verbal comments and serving as a supplement to the written report. Coordinating carrier finalist interviews is a standard part of our involvement in the marketing efforts. We are present at as many interviews as deemed necessary by the client and participate as much or as little as desired. Regardless of our level of interaction with each finalist during the review, we prepare an agenda and questions designed to differentiate one finalist from another by highlighting proposal features, inconsistencies, and peculiarities. We are also available to help prepare for, and if appropriate, attend any internal client meetings as support in making final recommendations. Plan Transition and Implementation If a client chooses to work with a new carrier, it is imperative that commitments made during the proposal process be kept during the transition period. We routinely participate in implementation meetings with our client and the selected carriers/vendors. Program Renewal Analysis Upon completion of the renewal negotiations, we provide a thorough renewal analysis report focusing on the financial impact of the renewal to the client, contribution strategies, specific recommendations for contract renewal, and appropriate alternatives. If the terms of a renewal are anticipated in advance to be unacceptable to our client, a competitive marketing will be initiated to secure an alternative cost effective benefit solution. RFP Response is intended solely for the City of Miami and all Information is considered CONFIDENTIAL 38IPage Employee Benefit Consulting Services RFP 678384 Actuarial Services Our actuarial resources enable us to assist you with the development of reserves for incurred but unpaid benefits for all self -insured plans, and actuarial certification of reserves for a VEBA trust, Calculation of COBRA and "working" rates for self -insured medical, dental and vision plans. Employee Communications Review USI's employee communication process will run concurrently to the carder implementation process. Working jointly with your USI benefits team, you will have the expertise and resources to design strategies and materials to effectively communicate your programs, throughout the plan year. USE offers a full range of communication products from traditional print -based products (folders, handbooks, posters, etc.), to web -based communication products (employee communication, enrollment and administration). Each product Is uniquely designed with you in mind and carries your brand, logo and company colors. The USE Consultative Process is very thorough and provides a formal structure to help us monitor your programs. It is quite likely that we would be in various stages of the process when providing guidance on more than one of your programs. USI consultants routinely work with organizations on multiple plans with various challenges. The USI Consultative Process lays the foundation from which we build short and long term strategies to help you better manage your costs RFP Response Is Intended solely for the City of Miami and all information is considered CONFIDENTIAL 39I?Gakr: Employee Benefit Consulting Services Service Calendar & Deliverables RFP 678384 USI's works directly with the City of Miami to establish a working 12 month calendar which specifies timely deliverables by both parties. USI Service Calendar for City of Miami- SAMPLE January 1st 2017 Renewal Date 7 Urccr n'rg Arob/1� fR t ■■■■ 111,. 4W s1'hi tit# Ln'e-F-02g10-1 .' P^,f;r r cy P,t,?ncl.ts OCTOBER NoVEMBER DECEMBER JANUARY FEBRUARY MARCH • Wetness Breast Cancer and Mental Health Awareness • Compliance, Medicare Part D Fin • Compliance Updates • Review/DisInbute Contracts & Booklets • • • Reinsurance Information Submission Reminder Reinsurance Fee Payment USI Holiday 'Thanksgiving Wellness: Breathe Easy Post Renewal Meeting Compliance Updates USI Hcfday• USI Holiday spring Holiday Memorial Day Wetness. • Wetness. Allergy Physical Activity and Asthma Compliance • Compliance Updates Updates Review renewal projections Review Contribution Strategy • USIHogoay Christmas • Wetness: Keeping Calm • Compliance Updates • Wetness. Diabetes Awareness • Compliance Updates • Pre Renewal Meeting • Reinsurance Fee Payment Reminder • U51 Holiday New Years Day • USI Holiday MIX Day • Weliness: Weight Loss • Compliance Updates • PCOR Fee Payment • USI Holiday Independence Day • Wetness. Sun Safety • Request Census • Compliance Updates • USI HoI ay Presidents Day • Wellness: Heart • Wetness. Nutrition • Compliance Heatth Updates • Quarterly Claim and Utilization Review • Compliance Updates • Wetness Dental • USI Holiday Labor Day Huth • Enrollment • Wetness Materials Preventive Care • Finalize Rates Wetness • Renewal Meeting • Compliance Updates • Request/Review S8C • Compliance Updates 201 Albambra Circie, MIatnFDade County 3D54 9.5000 RFP Response !s Intended solely for the City of Miami and all Information is considered CONFIDENTIAL 40 Page Employee Benefit Consulting Services RFP 678384 3. Describe in detail the manner in which Proposer will monitor the performance of the City's self - funded medical plan. USI's underwriting and analytics solutions integrate superior assessment, analysis and benchmarking with expert market negotiation to identify and increase transparency around insurers' profit sources. On a quarterly basis USI will produce a performance monitoring report filtered by benefit plan and total with dashboard, outlining: • Budgeted claims • Actual claims • Fixed cost • Net position to budget (quarterly, semiannually, annually) • Retrospective change (quarterly, semiannually, annually) • Large claim analysis including stop loss reimbursement monitoring • PEPY analysis • Enrollment analysis • Current experience observations USI's independent renewal underwriting analysis identifies cost saving opportunities and provides a basis to negotiate pricing ■ Analyze 15-20 technical components within rate calculation • Create full transparency for each cost component ■ Negotiate each cost component based on best In class industry standard • Establish rate caps and guarantees where appropriate USI conducts an Independent Review to Identify Errors and Carrier Profit Sources ■ Analyze both historical and predicted large claims data and premium cost • Evaluate individual and aggregate stop loss level adequacy through benchmarking and risk tolerance level ■ Negotiate contractual terms and pricing with carve -out carriers USI's independent review and forecasting of Large Claims reduces inflated projections, driving reductions in premium or stop loss rates and claim liability Impact and Benefit: • Elimination/reduction of the impact of high Dollar claimants can lead to premium reduction of an estimated 1-3% • Elimination/reduction of Stop Loss lasers and reduced Stop Loss premium (self -insured) • Increased subrogation and COB recoveries • Ability to target health risk management initiatives • Improved budget forecasts RFP Response is Intended solely far the City of Miami and all Information is considered CONFIDENTIAL 411Page Employee Benefit Consulting Services Request Large Claim Report from Carne*./TRA • ..L,car n • Disuse: cc arc __.;rictc • Ealed c_ve-ed and paic ch<arse: a > CrC-_ Jre Claimant -specific High Dollar Claim Review Obtain from group info. on claimant continued ofbiiity • PeZ1,.:rr. !c work ✓ 2e111err erliflu._ c care. etia'�ifihr • Fer-:aren• c • Cir. Capertatent : ch-; iiirrfir cat dvcrc_i • Oihercn':vr: c:r_yrr.i�vnGi Engage [USJ Medical Doctor and ,Mapes Team • P roes`:; ail claI ru ' J7.% 4 Ing-�ir• • F "CbaL.,i:'f cr cav of :tech -re • Cc,:.. c''e U;.. . rae RFP 678384 Negotiate With in r rs and advise client • InieG:c'_cd cic;rr Icre avi^ in;, r-__rye`;,sal. cat_ul:!ic1-.; • • Reduce codregale cici n tic w`Lt'/' ] e-a-,e ct fir t c'^i:rn laser; • Frcvde redid- cla.-n fJndin; e:r e:fa tic *Please see Appendix 9 pages 15-20 to see in more detail our approach to Underwriting and Analytics. RFP Response Is Intended solely for the City of Miami and all Information is considered CONFIDENTIAL 42IPage Employee Benefit Consulting Services RFP 678384 4. Describe the methodolofiy that will be used in order to audit the plan's compliance with all contractual / regulatory requirements. USI employs a national team of 14 ERISA attorneys to ensure our clientele have all the direction and information they need to get and remain in regulatory compliance. Each attorney is strategically located within a region in order for our clients to have direct access in person or via phone or email to ensure they get the best, most accurate and up-to-date information when they need it. USI provides compliance and technical/legal support to its clients in all areas of employee benefits through a network of in-house professionals with broad and significant experience in the legal and regulatory framework that surrounds employer -provided benefits. This group actively monitors developments at the Federal, State and local levels and provides information, training and support to our consultants and clients on an ongoing basis. Advising clients of national and local trends and emerging trends in the benefits industry is an ongoing service your USI team will provide. At USI, we strive to keep our employees informed regarding industry trends, new products and services and upcoming legislation. In addition, at our stewardship meetings, we provide a report highlighting trends in the insurance marketplace, and summarizing certain industry studies. • Team of Locally Based, Nationally Networked Compliance Attorneys • Monitoring of all Facets of Health and Welfare Guidance, Including Statutes, • Regulations, and Case Law • Health and Welfare Plan Compliance Education • Health Care Reform (ACA) Impact Analysis Tools • Ongoing Articles, Workshops, and Seminars • State and Local Benefits -Related Issues USI provides client specific assistance on compliance issues • US1's local and regional attorneys work directly with clients to provide guidance on specific issues affecting employer sponsored plans ✓ Attorneys work alongside our underwriting, population health and account consultants to recommend client specific solutions Comprehensive Compliance Review • USI's national compliance team identifies exposures and offers remedies to assist clients' compliance with state, federal and health care reform laws ✓ USI's local attorney identifies key areas for compliance review ✓ Reviews status to key federal welfare law compliance issues ✓ Discusses issues identified through the review ✓ Proposes action items to address issues and mitigate potential risks RFP Response Is Intended solely for the City of Miami and all information is considered CONFIDENTIAL 43IPage Employee Benefit Consulting Services RFP 678384 Comprehensive Employer Guides and Toolkits • In-depth analysis and guidance to help employers navigate through complex rules, regulations and plan strategy decisions ✓ National compliance team provides employers with a detailed road map to the multitude of requirements affecting health and welfare plans ✓ Tactical advice regarding implementation and consequence management Legislative & Regulatory Updates • USI's national compliance team monitors, interprets & communicates federal, state, and local legislative developments ✓ Timely Health Care Reform updates and general compliance alerts ✓ Employee facing communications Reporting & Disclosure Requirements • USI's national compliance team regularly monitors and communicates pending compliance filing deadlines ✓ identify appropriate compliance and disclosure filing requirement based on employee size, location and coverages ✓ Interpret and communicate impact and required actions by employers ✓ Timely reminders of filings and fee payments, i.e., PCORI, 5500s, reinsurance fee Workshops, Seminars and Webinars • USI also provides informative webinars and seminars regarding legislative developments and interprets impacts to employers ✓ Regular national and regional seminars and webinars with live and recorded access ✓ Focus on the most pressing issues of the day ✓ identify key takeaways and next steps Please see pages 35 - 41 in Appendix 9 RFP Response Is Intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 44IPage Employee Benefit Consulting Services RFP 678384 5. Describe how Proposer applies the proposed protect approach in comparable contracts to make recommendations to improve programs, and describe the net effect of those recommendations. Please refer to the section in Appendix 9 on Pages 52-80 where USI has placed these approaches in the form of actual USI client case studies where a quantifiable net effect amount is given based on USI recommendations to actual USI clients. As a specific example, please refer to the example on Appendix 9, page 55 the below occurs. COMPANY BACKGROUND A 500+ employee self -funded group specializing in medical diagnostic testing, research and manufacturing, with distribution units in several states and sales teams throughout the United States. KEY CHALLENGES Due to multiple large claims, the Company faced a significant rise in self -funded medical plan costs that would negatively impact profitability and drive a significant increase in employee contributions. The insurance company classified the high -dollar claims as "continuing", and anticipated similar claims in the coming year USI SOLUTIONS OFFERED ▪ USI team obtained and reviewed detailed high -dollar claim data that exceeded 50% of stop loss deductible while protecting personal health Information (PHI). ■ USI team reviewed our proprietary 3D data to evaluate continued risk factors and probability of future claims focusing on employee/dependent status, i.e. active, retired, disabled, age -limit, expected return to work dates, etc. • USI medical director and underwriter evaluated the likelihood of future large claim expenses. • USI tears negotiated removal of one large claim from renewal projections resulting in a lower claim projection. • USI was able to lower the stop Toss deductible (laser), and also reduced specific and aggregate stop loss premiums. QUANTIFIABLE BENEFIT TO THE COMPANY • The Company reduced claim projections by $150,000, eliminated an additional $150,000 deductible, and saved $60,000 in Stop Loss premium. ■ Total anticipated savings were $360,000 on initial renewal cost of $2,500,000, or 14%. RFP Response is Intended solely for the City of Miami and all Information 1s considered CONFIDENTIAL 45IPage Employee Benefit Consulting Services RFP 678384 6, Provide a list of any additional services, not included in this Solicitation, that the Proposer can offer to the City. If Proposer is offering any additional, describe the services in detail. Note that services will be paid at the hourly rates provided on Form A, Price Proposal Schedule. The City has a right to negotiate said price. In order to craft the right solutions, we make it a point to first understand your core values, needs and concerns. We pay attention to the details unique to you in your industry. Our proactive approach to consulting is evidence based with an understanding of City of Miami's culture and past benefits strategies. Using our proprietary analytical tools, we take this information to develop a multi -year, easy to digest benefits strategy that combines the needs of the Human Resource team and the financial side of the organization. As part of this strategic plan, we bring reasonable and attainable solutions relative to funding analysis options, predictive modeling of benefit designs, customized wellness programs that are sound and include achievable targeted contribution schemes, as well as comprehensive, customized employer and employee communication tools. We are able to provide local, customized service and national expertise to City of Miami, while remaining a powerful business partner with significant leverage in the marketplace. We are staffed by a team of professionals who are committed to your long-term success. Our goal is to develop, facilitate and maintain long-term business partnerships. Additional Services that USI can perform: 3. Rx Solution USI has successfully implemented viable programs that manage healthcare costs for a number of our clients. Our RX Solution is one such concept that may prove beneficial to City of Miami. The USI Rx Solutions Analytics Predictive Model Program has changed the pharmaceutical procurement industry with our latest innovation, Average Script Price Guaranteed Contracts. Championed by our Pharmacy Practice Leader, Patricia Bowen. We have eliminated the gamesmanship that PBM's exploit by offering discounts off Average Wholesale Price (AWP). Employers are realizing that discounts are meaningless if the price is not under control. Nowhere else in the Health Insurance system does the party processing the claim also help set the price. The USI Rx Solutions Analytics program will save you money! RFP Response is Intended solely for the City of Miami and ail information !s considered CONFIDENTIAL 46IPage Employee Benefit Consulting Services RFP 678384 2, Benefit Resource Center Additionally, our services include the Benefit Resource Center (BRC), our toll -free one -call benefits information hotline. The BRC was specifically designed to act as a single point of contact for all benefit questions and claim issues, Outsourcing benefit questions and claim issues helps streamline your benefit administration and cut costs, while providing your employees and families with better benefit -related support services. Our Personal Benefit Advocates will be able to: • Answer benefit plan/policy questions • Assist with eligibility and claim problems with carriers • Provide claim appeals information and explain the process • Explain allowable family status election changes (adding newborns, marriage, divorce, etc.) • Provide vendor plan contact information Your USI Service Team will focus on such areas as day-to-day plan management, budgeting and finance issues, interpretation of plan documents and contract language, federal and state compliance issues, and the resolution of complex or sensitive claims issues. Our recommendations are grounded by financial analysis and full consideration of your organization's objectives and administrative realities. 3. ThinkHR USI has teamed with ThinkHR, the leader in live HR advice, to give you answers you can trust. When you call the HR Hotline with your HR questions you will speak directly to SPHR/PHR certified consultants. You can get immediate guidance and best practices advice to handle the toughest HR issues swiftly, and get right back to business. You also have unlimited access to self -paced training with over 200 on -demand employee training courses available. In addition, ThinkHR offers a comprehensive online HR Library which has step-by-step guides for federal and state law compliance, COBRA, FMLA and thousands of invaluable templates, forms, guides and online tools. In addition, your access to our ERISA attorney is always available for complex and specific questions. 4. Verisk 3D — Data Drives Decisions We combine clinical data and analytical expertise using advanced technology and customized consulting to help our clients manage the performance of healthcare. USI 3D software —used in concertwith variety of additional proprietary methods and tools —supplies the insights required to solve complex problems and provide measurable results. USI 3D CREATES RESULTS USI 3D provides a three-dimensional view of claims to offer exceptional insights into clinical patterns unique to a plan's participants. Armed with these insights, we project future risks and costs over time and make recommendations that positively affect future plan utilization. RFP Response is intended solely for the City of Mlaml and all Information Is considered CONFIDENTIAL 47IPage Employee Benefit Consulting Services RFP 678384 USI 3D drives results by: • Accessing and employing a client's actual claims data to inform the future design of programs, • benefits and member outreach and engagement initiatives reflective of the client's unique challenges and opportunities ■ Evaluating the objective cost, quality and utilization of programs and vendors ■ Designing healthcare strategies based on unbiased Insights into drivers of cost, quality and utilization within the client's population • Improving accountability and metrics for all vendors charged with managing costs System Highlights Real -Time Claims Data — A continuous claims feed gives our team of professionals' up-to-date information and facilitates early identification of trends and areas of opportunity. Segmentation — USI 3D offers the flexibility to divide and distill data in a variety of ways, including: experience period, service type, service location, provider divisions/locations, member type and chronic disease prevalence/care, This allows for meticulous analysis of utilization patterns —all within a HIPAA- compliant secure data environment. Utilization Tracking —The ability to see and measure utilization patterns of plan participants, as well as sub- populations within the participant base, helps determine the effectiveness of programs like wellness initiatives and disease management. At -Risk Identification — Using predictive modeling and reporting, we help clients find and highlight trends that indicate potential at -risk populations. We also help locate gaps in care for current at -risk populations. USI 3D enables our team to provide easy -to -understand, customized reports based upon the client's unique needs and plan performance. With this tool and the expertise of our analytical team, we can clearly identify the drivers behind the costs and integrate this information into solutions designed to moderate trends. By continually monitoring plan performance against the stated objectives, we help our clients measure overall effectiveness and make sound, informed decisions for the future. RFP Response Is intended solely for the City of Miami and all Information Is considered CONFIDENTIAL 48jPage Employee Benefit Consulting Services RFP 678384 5.HR Solutions: Account Management • Service Calendar • Implementation & Project Timelines • Carrier Interaction and Accountability HR Tools & Resources • Employee Hotline/Benefit Resource Center • Benchmarking/Benefit Statements • Employee Discount Programs • Employer Websites Benefit Administration Consulting • HR Enrollment Platform Consulting • HR TPA Services Consulting • Private Exchange Consulting Employee Education & Enrollment Services • Customized Benefits Education and Engagement Strategies • Employee Communications including Guidebooks, Meetings, Webinars • Multiple Benefit Enrollment Options (On -site, Telephonic, Web Services) • Personalized Campaigns • Employee Meetings, Websites RFP Response is intended solely for the City of Miami and all information Is considered CONFIDENTIAL 49II'age Employee Benefit Consulting Services RFP 678384 6. Compliance / Healthcare Reform Timely, Comprehensive Analysis USI's National Compliance Team, including our network of in-house ERISA attorneys, provides expert guidance on new developments and ongoing requirements affecting health and welfare plans. We understand that staying in compliance with the constantly changing regulatory landscape is a monumental task. Our experienced team is here to identify risks and offer compliance solutions that align with your business needs. USI's Legal and Compliance team of 14 locally based, nationally networked Attorneys provides clients with a wide range of in-house services including: • Monitoring Relevant Facets of Health and Welfare Guidance, Including Statutes, Regulations, and Case Law • Health and Welfare Plan Compliance Education • Health Care Reform (ACA) Impact Analysis Tools • Ongoing Articles, Workshops, and Seminars • State and Local Benefits -Related Issues • Compliance Guides, Templates and Sample Documents • Assistance with Notice and Disclosure Requirements 7. Access to USI National Stop -Loss Consortium • No New Lasers at renewal with a specific renewal cap • Mirroring riders ensuring stop loss matches the underlying benefit plan • Ability to bind coverage early with an "Early Lock" on underwriting and Claims processing guarantees. • Access to Best in Class Contracts and Underwriting terms Please refer to the Appendixes 2-9 for materials describing all of USI Value Added offerings RFP Response Is intended safely for the City of Miami and ail information Is considered CONFIDENTIAL 501Page Employee Benefit Consulting Services RFP 678384 Proposed Price: Proposer shall state its price for providing all services as stated within this Solicitation. Proposer shall submit pricing stated as a flat, fixed fee per year, which shall include all expenses necessary for the requested services. Proposer must use the Price Proposal Form. Employee Benefit Consulting Services The Proposer shall state the not -to -exceed price for providing all employee benefit consulting services as stated Request for Proposal. The price includes all costs associated to provide these services. The below fee does not include retirement services. Please refer to Appendix 1, For proposed prices as indicated on the RFP under Form B and amounts for USl and USICG. USI has submitted a flat $180,000 per year as a Consulting fee. RFP Response is Intended solely for the City of Miami and all information Is considered CONFIDENTIAL 51IPage What Makes USI Different? USI ONE Advantage® Sets the Company Apart from the Competition. Q• What sets USI apart • as a premier middle market insurance brokerage and consulting firm? • ONE. a simple word with • three powerful elements. The 0 represents our Omni engine; N is for our Network; and E For our Enterprise planning. Each of these elements is unique at USI, and how we bring it all together sets US[ apart from the competition. We call it the USI ONE Advantage, oi' simply — USI ONE"! Why is Omni such a game -changer in the industry? The USI Omni Knowledge Engine gives us something fundamentally different to say. Omni, which means'lall', is USI's one ofa kind knowledge engine, created from all the years we've been solving clients problems (over 100), from all the clients we've served (over 100,000), and from all our professionals (over 4,400 in more than 140 offices across the United States). Omni is real time, interactive, dynamic and evolving, and customized For each client. We are able to bring unique solutions, explain them in terms that are easy to understand and we demonstrate how the solutions can have positive economic impact for our clients. How is the Network unique at USI? Unlike other brokers, at USI we've made a very large investment in local resources and technical expertise that are networked nationally — over 4,400 professionals connected nationwide to build integrated client -centered account teams. USI has more than 2,500 national property and casualty professionals including our personal risk and program teams and more than 1,500 national employee benefits professionals including our enrollment, retirement and wholesale teams. Small firms can't match the breadth and depth ofour local resources on the ground and large firms often keep the resources remotely in national practice groups. As a result of our deep property -casualty and employee benefits expertise we are able to deliver the Omni solutions Ave customize for our clients. What is Enterprise planning and how does it connect to the Omni and Network? At US1 we put you, our clients, at the center ofour world. We access our proprietary OMNI engine for broad and deep solutions customized for each client. We gather our unique Network of nationally connected local expert resources. And we engage in a disciplined, focused analysis centered on OMNI ENTERPRISE Customized, actionable, measurable solutions wien bottom line impact to your business. Lpcal & NaGURaF,q gS�t, Based Sir<S, 9S Client &us, ss sa es & The USI ONE Advantage° our clients' specific issues and challenges. USIs Enterprise planning develops a powerful plan to deliver bottom - line impact to our clients so they can contlnue to invest and grow. How is USI ONE having an impact on clients? We've used the proprietary ONE process to create cost -saving programs and effective risk management plans with many clients and in many different areas — from companies looking to reduce the rising cost ofemployee benefit plans; assess their compliance with ACA mandates; understand their exposure to cyber-attacks; manage natural catastrophe risks; to individuals seeking to protect their personal property and avoid potential personal liability risk. Property & Casualty I Employee Benefits I Personal Risk I Retirement Consulting 432eI5-2'i US. Intkeame ie:v A. 4,i : errs resv.eo About USI Insurance Services US1 is a leading local and national insurance brokerage and consulting firm, delivering property and casualty, employee benefits, personal risk and retirement solutions throughout the United States. Headquartered in Valhalla, New York, USI has over $1.0 billion in revenue, employs more than 4,400 professionals and operates out of 140 local offices serving every state. USI has become a premier insurance brokerage and consulting firm by leveraging the USI ONE Advantage, an interactive platform that integrates proprietary and innovative client solutions, networked local resources and enterprise -wide collaboration to deliver customized results with positive, bottom line impact. USI attracts best -in -class industry talent with a long history of deep and continuing investment in our focal communities. For more information, visit www.usi.com. The USI ONE Advantage® What truly distinguishes USI as a leading middle market insurance brokerage and consulting firm is the USI One Advantage, a game -changing value proposition that delivers clients a robust set of risk management and benefit solutions and exclusive resources with financial impact. USI ONE"' represents Omni, Network, Enterprise —the three key elements that create the USI ONE Advantage and set us apart from the competition. OMNI Vert 31.4arress • USI ONE Advantages I Omni — US!'s Proprietary Analytics Omni, which means "all," is USI's one -of -a -kind solutions platform —real time, interactive, dynamic and evolving, and customized for each client. Built in-house by USI subject matter experts, Omni captures the experience of more than 100,000 clients, thousands of professionals and over 100 years of business activity through our acquired agencies into targeted, actionable solutions. Network — USI's Local and National Resources USI has made a very large investment in local resources and technical expertise, with more than 4,400 professionals networked nationally to build strong vertical capabilities and integrated account teams. Our local and regional experts ensure account team availability, hands-on service, and ongoing diligent follow-through so we can deliver on the solutions we customize for our clients. Enterprise — US!'s Team Based Strategic Planning USI's enterprise planning is a disciplined, focused, analysis centered on our client's issues and challenges. Highly consultative meetings integrate USI's Omni analytics with our broad resource network to build a risk management strategy aligned with client business needs. Our enterprise process is a proven method for identifying, quantifying and minimizing client risk exposures. The USI ONE Advantage —our Omni knowledge engine, with our Network of local and national resources, delivered to our clients through our Enterprise planning process gives USI fundamentally different solutions, the resources to deliver, and a process to bring superior results to our clients. Wellness & Population Health Management Health Risks Drive Cost. The current rate at which healthcare costs are rising is unsustainable, making employee healthcare benefits less and less affordable for employers to offer. On average, 75% of costs are related to chronic diseases linked to modifiable risk factors. USI takes a multi -faceted approach with respect to claims cost reduction strategies. Wellness and disease management consultation is a core component that hundreds of USI clients are taking advantage of across the country. Our Southeast team consists of two full-time wellness consultants. In addition, USI's national team of 18 seasoned experts with over 200 years combined experience, meet on a regular basis to share best practices supported by the Wellness Councils of America (WELCOA), North America's premier resource for worksite wellness. We are leaders in the population health management arena. Municipality (703 FTEs) After years of onsite biometric screenings resulting in no year -over -year change, the organization offered a 20% premium differential to those who completed an annual preventive visit, age/gender cancer screenings and tobacco affidavit. Based on demographics and field -work environment, one might have projected a 30% engagement rate. Instead, during the first year of instituting USI's Core Health Strategy, this employer experienced an impressive 90% engagement rate. Following only 1-year of having introduced USI's Core Health Strategy, the percentage of gaps in care for members with diabetes has been reduced by 7.4%. This is encouraging given diabetes accounts for approximately 11 % of the groups overall claims. Manufacturer (280 FTEs) This manufacturing organization has nine locations scattered across the southeast, which would make onsite biometric screenings logistically challenging if not impossible therefore, with the assistance of USI's wellness consultant, the organization introduced a successful strategy to drive primary care physician biometrics collection/preventive care for early detection. Given this employers particularly high tobacco usage rates, USI also assisted with introducing a premium discount -based tobacco affidavit/cessation program. Financial Institution (1800 FTE's) This Florida and NY -based financial organization with more than 90 locations had no wellness prior to partnering with USI. After 1-year instituting USI's Core Program, 60%0 of enrolled employees earned a 10% premium differential for having completed both an online health risk appraisal and preventive care visit. High claims related to cancers with this group were no surprise since age -gender screening compliance ran lower than the norm. Incidence of diabetes ran well above the norm when compared to similar populations As a result, year two of the program will also include age -gender cancer screenings and tobacco cessation. Hospital System (585 FTE's) Doctors and healthcare workers demonstrate some of the worst health habits of all industries, and have some of the highest rates of obesity, hypertension, and diabetes, A Reuters study found that the average cost of healthcare for hospital employees and their dependents was an additional $538 per year than other similar size organizations. This client did not have a wellness program in place prior to hiring USI yet knew they needed to institute a strategy, which was low-cost yet also positively impactful to the bottom line. USI's wellness consultant immediately devised a multi -year strategy to drive better preventive care compliance, chronic disease management and an overall healthier culture. After less than 1-year with USI, the client now has a premium -differential -based wellness program requiring annual check-ups. They formed a company -wide wellness committee, officially branded the wellness program and launched engaging online challenges tied to their onsite fitness center. Auto Dealer (245 FTE's) Following only a few months of engagement with USI's wellness consultant, this auto dealer launched a premium differential connected to participation in the wellness program. After three years of implementing USI's low-cost/high-impact mode!, 56% of those enrolled in the company's health insurance earned a discount for wellness program participation. Based upon program aggregate data, the number of individuals with 3-4 separate risk factors has been reduced by nearly 50%. This is significant with respect to future cost avoidance given individuals with 3 or more risk factors operate with much greater odds for catastrophic claims via metabolic syndrome. Additionally, the percentage of individuals with elevated Al C levels (Al C is a 3-mo. average of glucose), dropped by an impressive 38%. These outcomes suggest a sizeable reduction in future risk for catastrophic claims resulting from diabetes & heart disease. This r current and its ccntents ere prcpietary to L/S! Insurance Services LLC. USI assurance Services LLC - 201 J. All RIghis Rewrre,d. 101 Pharmacy 3enefit �e for ABC Company Presentec by: USI Analyst Date: 02/17/2017 oort USI STANDARD J ABC Cornr.irty Start Date: 07/01/2017 Retail Network: Broad Formulary: Open Incumbent: Optum Rx Data Date Range: 02/01/2016-02/01/2017 cvs'VPS cARENLAw Deal Type: Traditional Average Annual Cost $1,554,056 Magellan Rx MANABEVIENT. Deal Type: 'Traditional Average Annual Cost: $1,600,280 Magellan Rx k4ANAGEMENT. Deal Type: Pass -Through Average Annual Cost: $1,633,725 ENVIS1 CNIR Deal Type: Pass -Through Average Annual Cost: $1,642,595 Wilny3) Deal Type: Pass -Through Average Annual Cost: 57,725,713 OPTUMRx' Custom Offer: ScriptWorld OptumRx Renewal Average Annual Cost: 51,770,316 Employees: 927 Mail Order Utilization: Low Plan Design: 3-Tier Current Funding: Self -Funded Medical Credit: N/A 21.72% Average Savings 19.39% Aver age Savings 1 7.45% Average Savings 17.26% Average Savings 13.07% Average Savings 10.82% Average Savings SiZOk s4C1,* 52.,k S' Covered Lives: 1,854 Specialty Program: Exclusive Average Annual Costs: $1,985,157 Carve -out Penalty: $6.00 PEPM Current Rebates: $0 LlSIRX.COM 1 INFORXCHOiCE,C011,1 1 (S00) 930-3698 I QUOTE ID 9871 I Page 2 of 9 Retail Generic 30 Discount Retail Brand 30 Dispensing Fee Retail Generic 30 Dispensing Fee Retail Brand 90 Discount Retail Generic 90 Discount Retai Brand 90 Dispensing Fee Retail Generic 90 Dispensing fee Mail Brand Discount Mail Generic Discount Mail Brand Dispensing fee Mail Generic Dispensing Fee Retail &and 30 Discount 1750^%i 17.35% 80.00% 78.00% 79.0C% $0.30 31,10 $1.35 $0.30 $ 7.10 $1.35 51.40 $125 2150% 19.10% 20.00% 20.78 5 16.00% 20.50% 80.00% 78.0015 79.0015 78.23% 77.25% 74.50% 30.00 50,50 $0.75 $0.00 $1.25 $1.20 $0.00 $0.50 30.75 $0.00 $1.25 51.20 15.50% 77.40% $1.30 77.25% $1.25 7450% S1.20 $120 23.30% 24.35% 24.0015 21.20% 24.00% 245015 82,00% 80.0C% 79.00% 80.2015 782515. 77.50% $0,00 $0.00 50.00 $0.00 $0.00 30.30 30.00 50.00 S0.00 30.00 30.00 50.00 Retail 30 Rebate $38.72 $4 4.68 $70.62 $41.00 $27.50 Per Brand claim Per 3r3nd Claim Per Brand Claim Par Brand Claim Par Brand Claim Retail 90 Rebate $38.72 $127 20 $185.32 3' 11.50 $2750 Per grand Claim Per grind claim Per Brand Claim Per Brand Jam Per grand claim Mail Rebate $105.60 $'170,33 $205.18 $124.00 $88.00 Per Brand Clam Per 3rand Claim Per Brand Claim Per Brand Claim Per Brand Claim $100.00 1257.58 $213.28 $98.44 $165.00 Specialty Rebate Per Claim Per Claim Per Brand Claim Per Brand Claire Per Clairn Ad min Fee - $2,85 $4.60 Per Claim PEP41 Truveris Admin Fee Included $0.95 $0.95 50.95 $0.95 Per claim Per Claim Per Claim Per Claim Allowances - Average Annual Savings $ S431,101 S384,377 $346,432 S342.561: $259,4444 $214341 Average Annual Savings% 21.7295 19.39% 17.45% 172615 13.07% 1022% Note: varia:ion5 may exist among each benefit provider's contractual terms (e.g. brand. gener'c). The Financial impact of Such vacations is relected n the Average annual $avings. Rates for pass•[hrough offers may reflect their Network.Performance Certified rates as predicted by Truvens. USIRX..COM f INFO@RXCHOICE.COM I (300) 930-3698 I QUOTE ID9871 I Page 3of9 CVS V pc CARE`IA ,( f One $1,433,337 $13,646 $0 ($78,972) Two $1,547,645 $13,646 $0 {577,828) Three $1,674,092 $13,646 $0 ($77,277) TOTAL $4,655,074 $40,939 $0 (5234,078) Formulary Pharmacy Coverage $2 81,397 $ '83,549 $285,372 $350,318 CVS Caremark is committed to helping our clients reduce their drug Spend and manage drug cost trend while providing clinically comprehensive coverage, A critical tool used by CVS Caremark to deliver on this commitment is our formulary strategy. The development and management of drug formularies is an integral component in the PBM services CVS Caremark provides to plan sponsors. • CVS • Kmart • vsalgr=_ens • Medicine Shoppe • rPlalmart • Suoervalu • Rite Aid • Dominicks Finer Foods • Kroger • Pub1i3 • Target • Independents CVS Caremark Strengths s; ar „ ,,„,,` ate-', - ;: ..•0. . fL15 ien1 rfe prt 8 ? s r sparse arr f rown e r se €tg Oaeeact!-a: sealth r, prer-emerobechea4ti €i+.' errrark is different art oth PE ..T- because at the reau`t'. S we dTTruer . o.. pf von CIS anti members, through an, advanced approach to ctintcat and cam`. g r treogls:Megrater„ e:lai: armi ee,ali pharmacy of eiing. C4-5(aserr=a. k strives [ cortsisie;^thi pro de highs rrtenrbee satisfaction- through aur award wtrmingtexstorr*ee Care centers and tr'ami= g. mark on the web a? wwsu.Caremark.€erm $1,086,614 $1,199,914 $1,325,090 $3,611,618 PM1PYSpend 21.72% $ 1,833,363 $66,744 $1,550,208 $1,980,297 $66,744 $1,577,205 $2,141,310 $200,232 $4,562,168 $5,955,470 $66,744 $1,434,755 Year One tar One p 1r1PA_Pi.,34 Year r'No 68,207- PHARMACIES $399,108 $430,089 $464,105 $'.233302 21.76"-6 21.72' Z 1.6719 21 Year Tr.'ee 54troni Ellsatas.LsSce .s Specialty p9 arrs,a€-- Ben eking gement et prograwrs,and C Pa 4.ssstarce Programs 'Co suppsrt -me' tiers and pal -rem c.,:e., Ended e'agemwr1t: De:lltate .;:r,-arr€Pd-n 4—.go. .rearm • Pat:*5w813 ;c MattageS ever 2_3 roitram its tinder -the USIRX.COMI I INFO@RXCHOICE.COM I (8001930-3698 I QUOTE ID9871 I Page4ot9 Magellan Rx MANAGEM2NT_ 19.39% One 51,494,233 519,2-19 $13,967 (5119,711) Two $1,613,793 519,249 518,974 (5122,375) Three $1,745,372 $19,249 $18,983 {5125,875) TOTAL 34.853,898 557,747 556,924 ($367,961) Formulary Pharmacy Coverage $236,30 1 5238,598 5290,192 5365,59 i Magellan Rx Management believes that its formulary management strategy, with a generics first focus, provides the greatest opportunity for a lowest total cost drug mix, while ensuring that safe and efficacious drugs are included in the formulary. In addition, our expertise in managing specialty utilization across both medical and pharmacy, as well as formulary and rebate management and distribution, allows us to focus on the ultimate good of ensuring appropriate use, loviering casts and improving patient outcomes. • 'lValgreens • CVS Pharmacy • walmart • Rita Aid • Kroger • Target A Smarter Approach ID Pharmacy Care • Medicine Shoppe International • Publix • Costco • Hy-Vee • Independents 11t ''^ lix rid anagereertrwe're pruvidmg.a smarter aficut h r pPartTrao* ben rfic _ 93uv integraed solution combines cue pharmacy benefit and specialty pharmacy expertise inrotone weganiaatiw.„alkmungl.t.yto►everagetaucollective scale and experience in managing total drug spend, ouhife ensuring a dear focus on the specific nee[ of each of our ind ridual customers_ Ey truly underitarrdirng yttur needs, we empower ynu with easy -to -use Words and insightful cost sav ngssooctoets that improve -member health and help vcu make more .ntorrned decisions. -. Our company was built or t't_ experiences learner[ while managing successful health management servfces ever the past -ICJ -years, including; specialty and medical pharmacy, radio og beha coral health, and pharmacy benefit management For cornrnerciai and government sector. Magellan Rx 14tanagement has taken leading; prine1ples and successes Ware its entities to build asoh d and rnnowchve company that offers the stability of a large corporatism with the llexitihty of niche platter. 51, 125,936 $1,241,044 $1,363,038 $3,735,013 PIMPY Spend 566,744 51,479,481 $66,744 $1,596,386 $66,741 $1,724,973 $200,232 $4,800,341 $8S Year One $643 �rtal7atai .,' 51,833,363 $1,980,297 52,141,310 55,955,470 ORIGINAL Year Tail ray Year One _ _. ... lear TN 5354.332 ;383.3' 1 .$4.1 6,337 51.154,530 19.32% i9.39,v 19.44% 19.39% 'fait -Wee € r des rdsrer n,aitMrt4E pAcing sesisew $ pnrsr'rac9 ,4WP.a i`,>a-�edtcar t#ie smrzlIesz parlDge z (shot id ` 'based al fie:.a Fi-e ge s e • FZerail d-P:5 6&T ed dri' e sn1al1V5T pat.:4al;E. c (should to7 tiose,1 Stiteracc ed package steel _ 5773 • 3yearterr • Offien rig alcwetlacrrr-s chain -ids. • trrplement ieatSchedule cr COMA 9E3 days o Fferr Sang,` 60 days • Etc/I le: 45 days USIRX.COM I INFO RXCI-(CICE.CONI j (300)930-3698 I QUOTE ID9371 I Page 5of9 Magellan Rx MANAGEMENT_ 1i ,: 17.45% One Two Three TOTAL Formulary 31,492,133 $1,611,415 $1,743,317 $4,346,966 Pharmacy Coverage $23,876 $23.876 $23,876 $71,627 $75,863 (5145,077) 575,900 (5143,056) 375,934 ($142,120) $227,702 (5430,253) 3286,293 $288,107 3289,675 $364,075 Magellan Rx Management believes that Its formulary management strategy, with a generics first focus, provides the greatest opportunity for a lowest total cost drug mix, while ensuring that safe and efficacious drugs are included in the formulary. In addition, our expertise in managing specialty utilization across both medical and pharmacy, as well as formulary and rebate management and distribution, allows us to focus on the ultimate good of ensuring appropriate use, lowering costs and improving patient outcomes. rtir • Walg _ens • CVS Pharmacy • Walmart • Rite Aid • Kroger • Target A Smarter Approach to Pharmacy Care • Medi;ine Shoppe International • Publix • Costco • Hy-Vee • Independents At Magellan kr @ranagenlent; Were presiding a ssmlarter approach to pharmacy • s. benefits Our integratectsollttian ecnthin ourpharmacy bene 1 andspeeciaity pharmacy experbsein(rstinearganeaicr.a inguatoleverageaucollective scale and experience in rmtanagirg ti tat O.ug venom white ensuring a dear focus an the specific needs of each of our atrdFv deaf corona ri. By truly understand"mng rut needs, we empower with easy-to-uee tools and insigntruf cost savings solutions that improve member health and help you make more informed decisions- Out company was bwlt on the experieetcesfearned white managing sur"i"o ful health management seances outs, the past -:t7years; Irmchudng specialty and medical pharmacy, radi logy behavioral health, and' pharmacy henefis management For carnmertial and government setters Magellan Re Management has taken leading principlesand successes from its entities to build a solid and innovative company that offers the stailifi ty of a large corporation with the !Todd ty of a niche player. $1,160,506 $1,280,023 $1,41 1,332 S3,851,866 PMPY Spend 366,744 $1,513,544 31,833,3631 3320,319 17.-1'4 5666,744 $1,634,879 $1,980,297 33.15113 366,744 $1,767,751 32,141,310 3373,559 17.a5', i 3200,232 54,916,174 $5,955,470 3'.039295 - - 4_3r tiro Yaar One Ytd! Tm: ilia Year Two 66,154 PHARMACIES S'47 Year Prn,• a �Ce'�asc�m[s4tasrges7rpaces�ie�F� • Re'ati*tiei based; of the smallest ;ck g}siTe 1io l on loge T • 34earteaz,-- Mrts a€is:atert crass c'raetre€s 0 Opil na 9'.T rays ct Wry 6or. 6 flays a faro a§ da U51RX.COM I INFO@RXCHOICE.COM I (800) 930-3698 I QUOTE ID 9871 1 Page 6 of 9 ENVISION • One $1,499.398 $23,726 $69,581 (531,637) Two $1,565,220 $23,730 $70,145 ($83,589) Three 51.632,267 $23,732 570,710 (536,179) TOTAL $4,697,385 $71,183 $210,435 (S251,455) Formulary Pharmacy Coverage 1devtF klembe $286.984 5285,632 S233.361 $356,477 Envision's formulary strategy is to create an efficient, cost-effective portfolio of prescription drug products where each therapeutic class has sufficient representation to meet the needs of most patients. The overall strategy is to focus on lowest net cost to the payer and provide educational messaging and other programs to encourage use of lower -cost, high quality products. The prioritization of our formulary criteria is: 1) Safety, 2) Efficacy, 3) Clinical Compliance, 4) Outcomes, and 5) Cost, -iYCh3.1t • Walgreens • cus • Walmart • Rite Aid • Kroger • Target Five Unmitigated Truths: P8IvI Industry • Kmart • r,Iadicine Shcppe • 5uperralu • Dominick's Finer Foods • Publlx • Independents 1.. 1t gnu:: PONE errrpfo+s "sareur pricing or charges the p are YIOEZpil strove what Weir tezve paid f a drug, you aye tAfes payng yew, drugs across the board! .. L If you do riot own and have su 5riited acr_ess to your drug spend claims data. you have placed' nur company in a "no -wen' situation! 3. If trau cannot aunt pair YEW annually with an auditor of "your sore choosing: you will be unabre to accurateh3 s akuFate the true cast of your drugs! tiBM audits without un8rnrted access to pharmaceutical manufacturer rebate corrtracts and network pharmacy contracts are meaningless.and di no iafuet - . ASAP percentrrgzd3scounls da3 not equal dd1ars and do not equal actual saysngs1 Y151t US art our website at $1,224,534 51,239,374 $1,356,668 53,871,077 PMPY Spend $66,744 $66,744 566,744 5200,232 S35 Year One ao Year One 1 7.26% Fimpolf101igifillititaifftbssmiroopowstnt $1,578,262 $1,642,250 $1,980,297 5333,046 S1,707,273 52,141,310 5434,037 54,927,786 55,955,470 81,027,684 51,833,863 5255,501 ORIGINAL PLAN 3.303 - Year Two 5731 13.9»=5 17.07,6 20.273 17.26"5 Year Thres a-67 Yea! Two Year Tc-et 711398 PHARMACIES i 1iecliA6 5 al5finimarn oi 8r:31f s nc r'-'rnpferne'tad ..: — ttwre, as ?a=limuaty ctf 10O 8 � Ihtegratle E=epstnfit6(115 r`r . Nue Cross ftt gia„ FICSC WBS IL,. A tsF OK at!f, L1-'C Waited ttrt4tfiCxe WARR uSIPX.CO#a I INFO@RXCHOICE.COM ( (3001930.3698 I QUOTE ID 9871 Page 7 of 13.07% One 3 ",559,031 122,801 318,967 (560,720) Two $1,673,666 122,303 118,974 (560,083) Three 11,799,554 522,306 513,983 (559,376) TOTAL 15,032,251 168,410 156,924 (3180,6781 Pharmacy Coverage lossiliflasSurerkmelripar., aft7 ParorThrocsis1Umbra 1290,789 31,249,290 166,744 $1,606,323 $1,833,863 I $227,040 i $291,910 $1,363,451 186,744 11,722,105 11,980,297 3253.' 3,2 3292,737 51,438,730 166,744 $1,343.211 12,141,310 S293,100 1875,435 14,101,472 3200,232 $5,177,139 $5,955,470 5773,331 The WellOyneRx formulary provides access to a range of brand and generic drugs. Through flexible incentive plan designs, WellDyneRx offers two formulary options to facilitate the most effective use of the prescription benefit. our Universal formulary, which includes broad access to all FDA approved medications, and our National Preferred formulary that includes limited drug exclusions. Our formularies are reviewed quarterly by our Pharmacy and Therapeutics Committee to include updates on newly approved drugs or indications. • Walgreens • 'Medicine Shoope International • CJS • Dominick3 Finer Foods • Walmart • Publix Pharmacies • Rite Aid • Costco • Kroger • Independents • Target Flexible Solutions and Integrated Strategies Guided by our° knowledge aliensislarr, Welfi]yr el$e eiiverstlemi6lc pirarinaay benellt 5r3htrans that create greater efftaencie and improve the value cd the health imiresystern as a whelk_ We providesuperiorauccwnes ttithose we serve through advanced sok:Mo s, systems and services that prey: rote choice in detislon making_ You tart trust our high level d cwrrmitrnent .n 5nding the right solution for yeti C ery WTI e_ If your goals to trust parr FEW try create the Solution that Sets, we invite you to further explore WeileyrrelUs record of service performance and innovation WeRDy ten 4 is committed m being a partner that for malty works to lover our clients total east atcare by providing dynamic dent and memtler ser+ict. We are advancing pharmacy bene11Lr with thes gel frinovedon and technology to ensure continual positive change within the market PMPY Spend 33 4 ORIGINAL PLAN 1.303 12.33 % 13.0- °'6 }' 13.69' i989 'vex 1'h.ee ia'.9 3-r,� 3T"1 .i s - —77779 Year Or Year Tire Year Three 70,091 PHARMACIES %,T:!!!fDj,, +R/.. _rwci r a ,'bfn"1,3Cii3i; USIRX.COM INFOLa RXCHOICE.00141 I (300) 930-3698 I QUOTE ID 9871 I Page 8 of 9 OPTUMRx- One TNo Three TOTAL Formulary $1,547,896 $21„348 $0 SO $1,677,350 $21,848 $0 50 $1,819,924 $21,349 SO 30 $5,045,170 $65,545 30 30 Pharmacy Coverage • cvs • Wal,,-aans • Walmart • Rite Aid • Costto • Kroger Company Screnaths J l f 10.82% Script World T $295,103 $296,580 5297,709 $889,393 The Op€umRx Select Prescription Drug List is a three-tier open formulary that includes over 1,000 drugs. The formulary includes 275 therapeutic classes and 397 subclasses. Th+s includes most dosage forms and strengths available for each drug with the exception of specialty drugs. The formulary places all generics on tier 1, formulary brand products on tier 2, and non -formulary products on tier 3. OptumRx offers the option to customize the PDLto meet the client's needs. • Target • Medicine Shoppe • Hv-Vee Inc • Meijer Pharmacies • Publix • Independents who the natioresird Finest Pallitftitinir pcpufation • Aggregate Stop U • 9396 member satisfaction • 9696 flrstcan rest:UN=: • 10G96 real-time audit process • 5430Nt Al . t ii. Claims • 28114 rnetnbers s'anted! • 131.2%total generic uti#lzadon • $ t15 ILt in cr. investments • Award -*inning senate aifabEswtth ptczectRvtprograrre $1,274,6,11 566,741 $1,636,488 31,333,363 $197,376I 10.7615 $1,402,619 9666,744 $1,765,943 $1,980,297 3211,354 10.82% 51,543,064 366,744 $1,908.517 $2,141,310 $232,793 10.87% $4,221,323 $200,232 $5,310,947 $5,955,470 S64-1.523 10.32's) PMPY Spend Year One $r_3 Oar One 4SIGt?a.�.L PL0•' tot 7 92 Year Ina - --_^ 65,311 PHARMACIES l.p:sur.-l'r:,<'w..'I', t.`34' In 39e3 Year Three Year Tnree s ie�-*tryAinifIlMuM a'SIi ails :.: i' art- OC r. Crenvr2r Lire Srt3v&dart/' a°. gUrfti.plern n 7 _ d • PSciari-cnimO es With uf'iC 11141111- emci Oipruirir • r. io 3: Capai'6t wit* .3 ra, Artr'..rn, SCE4Pi AL. ECS5 AR, HOES, .V 80$5 ESEt35 f Empire {pars of Anthem Viitellpoint1i'11 F. PCC1C biikethCts we a Capital floe Cr. Cig1T=a, HC5a`#S4.1C IL MT_ finilt OK TA t♦g3Rteii i r :roan a:EIS 1,4 Kintan.a,1)HC limited E1rare ii•,1q USIRX.COM I INFO RXCHOICE,COM I (SO0) 930.3698 I QUOTE ID 9871 I Page 9 of 9 Ao Prepared fbr Book of Business Reporting Period: April 2012-March 2014 Prepared hj USI Book of Business Paid: April 2012 through March 2014 AD Table of Contents 1. Overview 3 2. Utilization Metrics 5 3. Claims Expense Distribution 6 4. Individual Claimant Risk 7 5. Prescription Drug Key Statistics 8 b. Top 10 Prescription Drugs 10 7. Disease Fingerprint 12 8, Wellness Opportunities 13 9. Cardiac 14 10. Diabetes 15 2 Book of Business Paid: April 2012 through March 2014 1. Overview $600,000,000 Total Claims $513,355,079 W 0, 00 0;10 0 ---- 3400,000,000 $300,0)0,000 $2°)0,0)0,003 $110,0)0,010 $0 Apr12 - Mar 13 _Medical Pharma Claims for Members Over Age 65 Mother Kontiis - Member Months $507,141,703 Apr 13-Mar 14 Total Expenses Apr 12 - Mar 1 3 Apr 13 - Mar 14 AD 3 r II Medical ' Pharmacy $431,388,268 $419,898,016 187,966,811 188 043,6882,1 r. $25,664,182 ?i.''P - o 13 Mir 14 MO $16,936,247 -2.7% 0.1% -34,0°/a 1,780,244 1,539,960 -13.5% Medical Pharmacy $242.32 $272.67 $59.96 $71.53 Medical Plan Paid PMPM $350.00 $300.0) $250 0) $ 200.01 $150.00 $100.0) $50.00 $ 0.0 0 A.pr12-Mar 13 Notes Apr 13 - Mar 14 $30.00 $91.00 $7 0.00 $00.00 $50.00 $40.00 $30.00 $20.00 $10.00 $0.00 Pharmacy Plan Paid PMPM 12.5% 19.3% $7153 $59.96 Apr 12-Mar 13 Apr13-Mar 14 1. PN1PM stands for Per Member Per Month and PEPY stands for Per Employee Per Year 3 Book of Business Paid: April 2012 through March 2014 Medical Expense Growth over Time Chang in hreriical Pti1Ph1 Apr12- rvi ;r 13 272 67 Apr 13 - t,1ar 14 Notes Change in Unit Pricing $'event 334.92___ 412.46 Apr12- Mar 13 13 - Llar 14 Change in Utilization events /member months Apr 12- Mar 13 Apr13 - Mar 14 AD ar Changes in unit pricing are typically a function of overall medical inflation, Payor discount power, and the amount of services that are delivered in -network versus out -of -network. Payor contracting is the primary lever to control this cost driver. Changes in utilization are typically a function of the overall disease burden of a population, benefits design and physician referral patterns. Disease and Wellness management programs, rational benefits structuring, and dose network management are the primary levers to control this cost driver. 1, Change in Medical PMPM is product of Change in Unit Pricing ($/events) and Change in Utilization (events/member months) 4 Book of Business Paid April 2012 through March 2014 2. Utilization Metrics $3./0 $250 $200 $1,30 -4 $50 Claims by Place of Service Apr12- Mar 13 Apr13 - Mar 14 Current Employees Current Members Average Age % Male % Employee Paid N Jun Current Year Claims by Place of Service Inpatient 21% - Xf Outpatient I Office Visit 2 Emergency R06111 Pharmacy UM' EIZINZIEfIlla k.lo. Inpatient Outpatient Office Visit Emergency Room Pharmacy 61,473 133,454 35.5 47.7% 13,9% 41421knI4 Tour wodkaiutamiaediON* Inpatient Admits Per 1000 Average Length Of Stay Emergency Room Visits Per 1000 Visits Resulting in Admission Average Paid Per Visit Office Visits Per 1000 Preventive Visits Per 1000 $70.86 $75,79 $56.95 $10.35 58,714 121,220 35.1 48.8% 14.5% 12P Hai 14 35.7 48.3% 17.73/0 AD I Inpatient Outpatient Li Office Visit 111 Emergency Room IA Phu macy 4001ferianCehnivi liener* 1 $77.51 $80.00 $62.03 $11.36 $88.25 $80.68 $55.49 $15.29 $59.35 $70.41 $56-18 j % Claims Paid in Network Notes c La==-Lre. Ti 63.7 3.7 226.6 0.3% $1,232,96 3,845 429.8 --- 12 -14a.13 92.5% V-Varlance finer Mier --71 65.5 70.4 4.0 4.8 *Variance Mee Mena -14r-- 232.4 _ 260.7 0.4%!.4:44_'f.f $1,266.46 $962.83 4,125 4,220 482,7 485.5 13 - Mar 14 93.9% 1. Norm based on Verisk Health's Commercial Normative Database. 2. Emergency Room visits resulting in an admission is calculated using Number of ER visits resulting admission/ Total ER visits. 5 Book of Business Paid: April 2012 through March 2014 3. Claims Expense Distribution 1% 2-5% 6-15% 16-30% 31-60% 61-100% 1,982 7,930 19,823 29,735 59,470 Health Care Spend Percentage of Total Claims Cost $284,273,184 $271,811,404 $247,715,580 $143,123,446 $76,995,969 $143,427 $34,276 $12,496 $4,813 $1,295 79,294 $3,377,199 $43 '-T Claims Expense Distribution Membership Distribution Band Percentage of Total Notes Health Care Spend Percentage of Total Claims Cost 27.7% 26.5% 24.1 °/a 13.9% 7.5% 0.3% 30.5% 27.7% 22.7% 12.1% 6.4% 0.6% PMPM $5,759.65 $1,404.38 $535.08 $222.51. $ 70.31 $3.86 1. Norm based on Verisk Health's Commercial Normative Database. 2. Numbers within the parenthesis reflect the Verisk Health's Norm values. 6 Book of Business Paid: April 2012 through March 2014 4. Individual Claimant Risk $2,000,000 S1,501,090 L) 1,000,0i 1 550 0,000 51 Top 10 Claimants by Total Paid N Total Paid -e- Concurrent RiskScore Top 10 Claimants by Total Paid • 1 Newborn Care 2 Newborn Care 3 Renal Failure 4 Leukemia 5 Intervertebral Disc Disorders 6 Renal Failure 7 Leukemia 8 Complicated Fx of Neck and Trunk 9 Cystic Fibrosis 10 Organ Transplants Top 10 Claimants by Prospective Risk Score 1 Leukemia 2 Renal Failure 3 Heart Valve Disorders 4 Newborn Care 5 Liver Diseases 6 Myocardial Infarction 7 Renal Failure 8 Organ Transplants 9 Renal Failure 10 Misc Cancers Notes - -a- Prospective Risk score Y 0 D Y 0 D Y 56 E Y 31 E Y 54 S Y 31 5 N 11 D Y 3 D Y 6 D Y 30 5 Y N Y N Y Y Y Y 31 64 61 1 49 47 61 39 56 5 E E S D E 5 E S E D $1,582,025 69.07 $1,164,822 $1,164, 649 $1,103,117 $1,057,670 $994,574 $963,914 $949,421 $937,751 $884,648 $1,103,117 $740,485 $ 750,000 $453,225 $93,237 $109,199 $33,511 $743,725 $320,366 $648,454 23.62 29.22 112.86 7.27 45.07 110.28 35.24 44.39 119.61 71.38 61.92 57.91 52.02 52.01 51.70 51.48 50.51 50.45 49.53 ails is!H AD 12.89 4.57 23.72 71.33 5.09 39.22 45.90 21.87 37.64 47.28 Cion*mosil NSW 112.86 90.28 108.81 133.75 168.04 233.88 65.44 80.82 66.54 121.61 1. Concurrent risk score measures current *risk of a population. 2. Prospective risk score looks back at the last 12 months to predict the risk of a population in next 12 months. 3. These risk scores are **normalized to a dataset comprised of over 32 million lives. * Illness burden **The normalizing process entails adjusting each member's relative risk score (RRS = cost converted to a score) to ensure the overall average RRS is 1.00, which represents the average annual cost for a member in a benchmark population. 7 Book of Business Paid: April 2012 through March 2014 5. Prescription Drug Key Statistics Pharmacy Expenses Change in Pharmacy PMMPM 70.41 S11.3. 53.35 Branded 46,35 53.84 16.2% Generic 9�� $g? 22.7% `tr'r 9 % Apr 12-Mir Apr 13-Mar 13 14 Scripts/Member Month Count 1.0 , .' 0.3 4.4s 0,3 0.8 23.5% 74 I' Apr 12-MarApr 13-Mar 13 14 Cost/Script 61.5 _ 61.8 %rhan2. 141.0 Apr 12- Mar Apr13-Mar 13 14 AO B, Changes in scripts per member reflect overall intensity of care and member compliance. Overall trends in volume are less important than the change on the ratios between branded and generic drugs. Changes in cost/script reflect overall pharmaceutical industry pricing trends. This cost driver is best controlled through strong PBM contracting and tight formulary control. 8 Book of Business Paid: April 2012 through March 2014 Apr 12 - Mar 13 Pharmacy Paid PMPM Scripts per 1000 Members Generic Fill Rate Mail Order Pharmacy Paid PMIPMI Apr 13 - Mar 14 124KarL3 $59,85 9,622.0 65.6% 8.9% Too 10 Savings opportunity by Potential Savings iN Expense After Comers ion 11 Potential 5arings LIPITOR hiE(dUh CR.STOR CYMEALTA LE(A,PR,3 A.CIPi1E'i PANTOPPA,ZOL ESOOftJM Lei CELEBIZEN. LANSOPRAZOLE EFFEXORXR Notes i14liar 14 $70.41 10,9.25.9 69.3% 8,0% LIP..OR NEXIUM Norm Korn :Atc.P.k $56,18 11,419.E 79.9% 8.7% SLMVASrATIN Egg $2.739,169 52.145.633 OMEPRAZOLE 52,030,62$ 51,865,548 73.4% 92.9% CRESTOR S1MVASTATIN $1,146,753 $998,5% 69.0% CYMBAL-1A VEHLAFAXINE HCL 51,019,337 5813.367 80.3% LEXAPRO CLTALOPRAM HEIR. $871,974 $691,351 79.3% $592,5s-7 5145,079 $448.156 $200,970 5180,623 ACIPHEX OMEPRAZOLE $559.977 $532.147 95.0% 527,831 PAFITOPRAZOLE SObi11M ` OMEPRAZOLE $532,314 $463,023 87.0%$69,291 CELEBREY NAPROXEN $463,425 $445,063 96.0% $18,361 LAHSOPRAZOLE OMEPRA7C1E 5381,561 S250,801' 65.7% -. $130,760 EFFEXOR XR VENLAFA3DNE HCL ER $461,343 5246.281 53.4% $215,063 1, The Potential Savings are calculated by comparing the Current Drug average cost to the average cost of the Alternate Drug. This can occasionally lead to there being a cost avoidance opportunity from switching. 2. Does not take into consideration any pharmacy rebate information. 3. Statin conversion opportunities account for differential drug potencies and dose sizes. 4. Conversion savings refers to the percent of the plan paid pharmacy expense that can potentially be saved. 9 Book of Business 6. Top 10 Prescription Drugs Top 10 Prescriptions by Total Paid Top 10 Prescriptions by Total Paid LIPITOR NEXIUM COPAXONE ENBREL HUMIRA SINGULAIR CRESTOR ATRIPLA AVONEX PLA'SIX 3,= Average Cost Per script Antihyperlipidemics N GI Add Secretion Reducing Agents - Antisecretory Agents Multiple Sclerosis Agents N DMARD - Anti-inflammatory Tumor Necrosis Factor Inhibiting Agents DMARD - Anti-inflammatory Tumor Necrosis Factor Inhibiting Agents Asthma Therapy - Leukotriene Modulators N Antihyperlipidemics N Antiretroviral Combinations N Multiple Sclerosis Agents N Platelet Aggregation Inhibitors & Combinations N 55,565,434 54,412,931 $3,421,380 53,255,471 $3,033,835 $2,683,516 52,678,204 $2,430,550 $2,394,812 52,246,600 Paid: April 2012 through March 2014 AD a 3r 39,468 20,476 1,155 1,938 $141 $216 $2,962 $1,680 1,949 $1,557 23,587 $114 22,431 $119 1,606 $1,513 713 $3,359 12,899 $174 10 Book of Business Paid: April 2012 through March 2014 8.3,010 70,010 50,030 50,0'30 41,000 .,...._,. 30,000 ., — 20,000 +- 17,0,30 0s AD ,„ Top 10 Prescriptions by Number of Scripts �. titi a .�ae ? a? cn f' 11 N umber of Scripts Top 10 Prescriptions by Number of Scripts w HYDROCODONE- ACETAMINOPHE N AZTNRONYCiN SIMVASTATIN L.ISINOPRIL A 'IOXICILLIN LIPITOR LElOTHYROXINE SODIUM AMLODIPINE BESYLATE METFORMIN HCL HYDROCH!_OROT HLAZIDE Analgesic Narcotic Agonist Combinations Macrolide Antibiotics and Combinations Antihyperlipidemics ACE Inhibitors and ACE Inhibitor Combinations Penicillin Antibiotics Antihyperiipidemies Thyroid Hormones and Combinations Calcium Channel Blockers Antihyperglycemic - Insulin Response Enhancers Diuretic - Thiazides and Related, and Combinations Y $345,989.49 Y $659,827.61 5865,588.57 Y $198,770.47 Y $114,198.94 iV $5,565,434.45 Y $127,709.86 Y $398,580,33 Y $225,369.54 69,873 55,246 50,351 47,205 42,788 39,468 39,439 32,483 31,036 $4.95 $11.94 $17.19 $4.21 $2.67 $141.0I. $3.24 $12.27 $7.26 11 Book of Business Paid: April 2012 through March 2014 7. Disease Fingerprint 1.20 1.15 1.10 1.05 1.0) 0.95 0.90) Relative Risk Score Care Gap Index 1.3 I.30 1.25 1.20] 1-15 A.pr12-Mar 13 Apr13-Mar14 -4-Average Can Current Risk Scare -4-Average Prospective Risk Score i- average Cara M3mt RiakScort Narm 1.1 1.005 1.00 Apr12-Mar13 Apr13-Mar l4 - -A raga Care Gap Riak Stara ---- Nam Average Care Gap Index 1.07 Average Concurrent Risk Score 1.00 Average Prospective Risk Score 1.02 Average Care Mgmt Risk Score 1.01 Top 5 Diseases by # of Members Buck Pain Hypertension Hyperlipidemia Diabetes _ Neck Pain Top 5 Diseases by Paid PMPY Premature Infants Hemophilia Gaucher's Disease Ventilator Dependence Cystic Fibrosis Notes Actual # at Member 15,823 14,431 10,225 7,291 6,865 146 5 13 49 18 7_ Actual Members Per 1000 1.1 0.1 1.14 _1.00 1.00 1.00 116.4 $219,489,495 100.1 $231,281,706 66.4 $135,403,008 58.2 $141,411,154 46.6 $91,864,964 $8,405 $9,120 $7,475 $11,670 $8,238 0.9 $14,840,073 311 2.111 $93,930 0.1 $796,117. $118,853 0.1 $1,817,983-55,512 $46,563 0.5 $5,632,628 .., e$6-2,-407' .$110,656. 0.2 $2,336,451 $62.864 $74,133 1, Concurrent risk score measures current risk of illness burden. 2. Prospective risk score predicts risk in the next 12 months. 3. Care management risk score measures the need for care management services. 4, Average Risk Score are calculated based on individuals risk scores normalized to book of business. 12 Book of Business Paid: April 2012 through March 2014 8. Wellness Opportunities 70.0% a 60.0% 50.0> • 40.0% L 30.^0% = 2.3_3% L 10.0% i Gaps in Preventive Care Coverage vs, Norm Screening 1 Both >=50 years 26,484 4 5 Patients without any colorectal cancer screening in the last 24 months. 6 2 Both All Individuals 121,220 Patients without long office visits in the last 12 months Male >=50 years 11,640 Men without PSA level in the last 2 years. 4 Female >20 years 32,661 Women without pap smear in the last two years. 5 Female >=49 years 10 242 Women without mammogram in last 12 months. Both Al! 99,131 Individuals without any claim in the last 12 months. Notes • % with Gap ■ Norm WWI Gap 43E 72.4% 51.10/0 49.9% 57.2% 14.1°% The key to preventing potentially debilitating and catastrophic claims is timely follow-up with age and gender -related screenings. USI recommends the Following: • Partner with carrier to promote education preventive screenings. • Partner with wellness vendor to promote education of preventive screenings. • Consider eventually moving to a premium contribution differential tied to wellness scorecard that includes completion of age and gender -specific screenings. 13 Book of Business Paid: April 2012 through March 2014 9. Cardiac a pi' 4 0.0 a 3 • 20.0% • 0.0% • 0.0% Gaps in Cardiac Care vs. Norm 7 3 Screening 4 5 L J�113 % with Gap ■ Norm Notes 1 Both Ai 1,995 Patients without lipid profile test in the last 12 months. 2 Both All 1 995 Patients without long office visit in the last 12 months. 3 Both All 1 995 Patients without diabetes screening in the last 12 months. 4 Both All 1,995 Patients without antihyperlipidemic drugs in the last 5-4 25.2°Jo 12 months._ ?': ;') 34.2% 7.6% 41.6% 5 Both Ail 1,995 Patients without ACE or ARB in the last 12 months. 94,3 42.9% 1. individuals who have existing cardiovascular disease are twice as likely to have a repeat event as anyone else is to have a first event. 2. Keys to prevention for a repeat cardiac event include: compliance with medications, no tobacco use and lifestyle modifications, 3, USI Recommends the following: • Intent members with a history of heart disease to complete a semi-annual lipid profile, The secondary tests should be managed by a wellness vendor, with the data forwarded to the PCP and the cardiologist. • Partner with wellness vendor to promote education for cardiovascular disease. • Consider removing all co -pays for prevention -related medications. • Consider promoting tobacco cessation programs. Program components may include: tobacco affidavits, tobacco cessation programs and reimbursement for physician approved tobacco cessation medications. • Consider promoting lifestyle modification programs around nutrition and physical activity. If the company offers an on -site cafeteria or vending area, consider offering a subsidy (discount) for healthy eating options. Additionally, the company may want to support physical activity through walking challenges or gym membership subsidies. 14 Book of Business Paid'. April 2012 through March 2014 10. Diabetes N a 40.0% 1 Both Ail 2 Eorh All 3 Both All 4 Bath All 5 Both All Notes Gaps in Diabetes Care vs. Norm 2 3 Screening # 4 5,406 Patients with renal failure. 5 • `:o with Gap I Nor n1 With Gap 4.5% 4,954 Padents without HbAlc test in the last 12 months. 1,4-3 2 21.4% Patents without lipid profile test in the last 12 4,984 months, 1,72r7) 34 5'.o 29.1% 4,984 Patients without micro or macroalbumin screening 37 3% test in the last 12 months. 4,984 Patients without long office visit in the last 12 4 , 10.3% months. 1. Individuals who have existing diabetes need to manage their glucose in order to prevent complications such as heart disease, kidney disease, blindness and amputations. 2. Keys to managing diabetes include: compliance with medications, proper diet, exercise and no tobacco use. 3. 115I Recommends the following: • Intent members with a history of diabetes or diabetes to complete, at a minimum, semi-annual HbA1c and lipid profile tests. The secondary tests should be managed by a wellness vendor, with the data forwarded to the PCP and appropriate specialists. • Partner with wellness vendor to promote on -going diabetes education. • Consider removing all co -pays for prevention -related medications and all glucose testing supplies. • Consider promoting lifestyle modification programs around nutrition and physical activity. If the company offers an on -site cafeteria or vending area, consider offering a subsidy (discount) for healthy eating options. Additionally, the company may want to support physical activity through walking challenges or gym membership subsidies. • Consider promoting tobacco cessation programs. Program components may include: tobacco affidavits, tobacco cessation programs and reimbursement for physician approved tobacco cessation medications. 15 Book of Business Paid: April 2012 through March 2014 16 Benefits at A Glance eras & Conc t information Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources. MEDICAL: Provider Name Provider Phone Number Provider Web Address DENTAL: Meritain Health (an Aetna Company) 888-257-3628 www.myMERITAIN.com Provider Name Aetna Provider Phone Number 1-800-942-0854 Provider Web Address www.aetna.com VISION: Provider Name Provider Phone Number Provider Web Address Advantica Benefits 1-800-942-0854 www.advanticabenefits,com Page 7 page 8 page 9 LIFE & ACCIDENTAL DEATH & DISMEMBERMENT / VOLUNTARY LIFE page 10 Provider Name Aetna Provider Phone Number 1-800-769-7159 Provider Web Address www.aetna.com SHORT TERM AND LONG TERM DISABILITY: page 11 Provider Name Aetna Provider Phone Number 1-800-769-7159 Provider Web Address www.aetna,com PAYROLL DEDUCTIONS: FLEXIBLE SPENDING ACCOUNT (FSA): page 12 page 13 Provider Name Provider Phone Number Provider Web Address Discovery Benefits 1-800-769-7159 www.discoverybenefits.com efits.com 401(K) RETIREMENT BENEFITS: page 14 Provider Name Provider Phone Number Provider Web Address Portico Benefit Services 1-800-352-2876 www.porticobenefits.orq LEGALSHIELD: Provider Name Legalshield Provider Phone Number 1-800-654-7757 Provider Web Address wrrw.legalshieid.corn/info/standardplan USI BENEFIT RESOURCE CENTER (BRC): Provider Name Benefit Resource Center Provider Phone Number 855-USI-6699 Provider Web Address BRCEast r@usi.biz page 15 page 16 DISCLOSURE NOTICES — (If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage. Please see page 21 for more details) page 17 - 21 Your Benefits Plan ABC Client offers a variety of benefits allowing you the opportunity to customize a benefits package that meets your personal needs. In the following pages, you'll learn more about the benefits offered, You'll also see how choosing the right combination of benefits can help protect you and your family's health and finances — and your family's future. Benefit T �` - fvledical Insurance Dental Insurance Vision = ho-Rays the ober Basic Life and Accidental Death & Dismemberment Insurance Voluntary Life Insurance Short Term Disability Long Term Disability You and the Company share the cost You and the Company share the cost You pay 100% of the cost Company pays 100% of the employee cost You pay 100% of the cost You pay 100% of the cost Company pays 100% of the employee cost Eligibility All Regular full-time employees are eligible to join the. Benefits Plan on the 1st of the month following 60 days of employment. "Regular Full -Time Employees' must be regularly scheduled and working at least 30 hours per week. You may also enroll your dependents in the Benefits Plan when you enroll. Eligible dependents include: > Your spouse, unless you are legally separated or divorced; > Your unmarried natural children, step -children living with you, legally adopted children and any other children for whom you have legal guardianship, who are: ► Under 26 years of age for medical; When Can You Enroll? You may sign up for Benefits at any of the following times: Up until your effective date ✓ During the annual open enrollment period; • Within 30 days of a qualified family -status change. If you do not enroll at one of the above times, you must wait for the next annual open enrollment period. Please enroll for benefits at your earliest convenience to allow time for your ID cards to arrive. HOW TO ENROLL, ► Benefits enrollment is through the ADP website. Please make sure to have all dependent and beneficiary information before you go to enroll. WWW wor'kforcenow.ado.com 4 Choosing Your Benefits You must actively choose any benefit that you pay for, or share in the cost with ABC Client. Your part of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out: > Before your taxes are calculated - medical, dental, and vision > After your taxes aro calculated -- voluntary life and accidental death & dismemberment Making Changes Generally, you can only change your benefit choices during the annual benefits enrollment period. However, you may be able to change your benefit choices at anytime if you have a change in status including: > Your marriage > Your divorce or legal separation > Birth or adoption of an eligible child > Death of your spouse or covered child > Change in your spouse's work status that affects his or her benefits > Change in your work status that affects your benefits > Change in residence or work site that affects your eligibility for coverage > Change in your child's eligibility for benefits > Receiving Qualified Medical Child Support Order (QMCSO) If you do not notify Human Resources within 30 days of a family status change, you will have to wait until the next annual enrollment period to make benefit changes unless you have another family status change. When Coverage Ends Coverage will stop on the last day of the month in which employment with the company ends. r Why do I pay for benefits with before -tax money? There is a definite advantage to paying for some benefits with before -tax money: Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes. .;DID YOU KNOW 2?1: eTrql o r Key nereiit `: nr.s s COBRA - A Federal iaiv tnat a 1ow's werkers and e r sc ats who ,, lose their medical, dental, or vision coverage to continue any of these 1coverages foe a specified length - f time by electing and paying for continuation benefits. Coinsurance -The per ;cn:age cf the medical or dental charge that you pay after the deductible has been met Copayment -A fiat fee that you pay for medical services, regardless of the actual amount charged by your doctor or another provider: - This is generally applies €c physicians' office visits and orescnptian - drugs. . ,. Deductible - The amot nt you pay to4va dice arid donut] expenses penses each calendar year before the plan begins paying benefits I Out of Pocket Maximum - The maximum amounty`oiswill pay in coinsurance during the calendar -year i . Getting Hegith Member Resources 24-hour access to tools you can really use at www.myMERITAIN,com. The Meritain Health member website, www.myMERITAIN,com, is designed to provide a secure, user and family -friendly, one -stop - shop for you to access the account and claims information you can use to manage your health and wellness. We're committed to providing you with all the basics you expect, along with added features to support a healthy lifestyle, assist you with medical decisions, and give insight into the maximization of your healthcare dollars. Go to myMER1TAIN.com to log in to our secure site. New users can create an account by following the easy instructions. You'll need your health plan ID Card the first time. Return users, just sign in using your username and password. The first time you access the site, you will be prompted to re -register with a new username and password for enhanced security. Then take advantage of the smart, safe resources your health plan offers, right at your fingertips. Privacy Regulations. Members over 18 years of age have partially protected information according to HIPAA Privacy Regulations. Members over 18 having difficulty creating an account with their SSN, please contact Meritain Health Customer Service at: 1.800.925.2272. At myMERITAIN.com you can: • Look up health and wellness topics in cur online medical library. ✓ Find the status of a claim. • Find network doctors, clinics and hospitals. > Look up prescription and over-the-counter drug information. • Order ID Cards. ME RITAIN HEALTH Prescription Drug Benefits at a Reduced Cost — Did you know you can obtain prescription drugs at local retailers at a reduced cost and sometimes even free? Publix offers a variety of generic Oral Antibiotic medications to you absolutely free. Bring in your prescription for an approved medication and receive it FREE, up to a 14-day supply. Publix recently approved a medication for diabetes. CVS, Target, Walgreens & Wal-Mart also offer ever 400 generic prescriptions for $4 and a 90 day supply for approx. $10 , Remember DO NOT show your Meritain ID card to receive these benefits, or you will be charged your Meritain drug rate. In addition to the network of physicians, hospitals, emergency rooms, and urgent care clinics, you also have the option of going to the convenient care clinics located within some grocery and drug stores, for minor illness such as ear aches, colds, flu and so on. By selecting one of these providers, you pay only the regular office visit copay; a significant savings over the emergency room and urgent care copayments. Please visit the various websites for locations, hours of operations and scope of services, CVS Minute Clinic: w'vw.cvs.com Publix Little Clinic: www.Publix.com Walgreen's Take Care Clinic: w',w.walgreens.corn rFrequently Asked Questions About Your Medical Plan Q. What should I do If I have a problem getting a claim paid? A. Start by contacting the carrier's member services number to determine the nature of the problem. If the issue is the way the doctor or other service provider has billed the claim, then contact your doctor or Claims Advocate at USI. If the insurance company has an eligibility issue, contact Human Resources for assistance. Q. What is the difference between brand formulary, brand non -formulary, and generic drugs? A. Brand formulary is a prescription drug the is listed on the formulary (Le., a list of prescription drugs covered by he plahjr se .; re protected by a patent issued to the original innovator or: rr,§rl eta and non -formulary d F.a re patent protected but are not listed. A generic equrvale, t: drug can become availab when the patent protection runs out, and is deemed eqi. in therapeutic power to e brand name originals. Q. When should 1 go the Urgent Care vs. Emergency Room? . For non -life threatening injury/illness after normal doctor's office hours. 6 ABC Client offers 3 medical plans from Meritain Heafih, a Bronze plan, a Gold plan, and a Platinum plan, All plans have In -Network benefits only. To find participating providers go to wpm/ my,,l_RITA'N corn and click on 'Benefits, View Plan Information', then'PPO Links' and click on 'Aetna Choice POS II(Open Access)". On the Aetna Doc Find Home Page, you can select from the categories on the bottom (i e. Provider Types, conditions, or procedures) or at the top box you can type and search by name, specialty, or Zip code. Click on the Search button, and then select the plan. The chart below provides a brief comparison of the plans. This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage. If the below illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail. It is recommended that you review your exact description of services and supplies that are covered, those which are excluded or limited, and other terms and conditions of coverage. Bronze = j Gold Platinum IN -NETWORK: Calendar Year S5.000 / $10,000 $8.350/ $12,700 Annual Deductible, copayments and Coinsurance (includes Rx) Unlimited 80% Calendar Year $2,000 / $6,000 $5,000 / $10,000 Annual Deductible, copayments and Coinsurance (includes Rx) Unlimited 80% Calendar Year $1,000 / $3,000 $4,000/ $8,000 Annual Deductible, copayments ano Coinsurance (includes Rx) Unlimited 80% Plan Year / Contract Year Basis Deductible (Individual / Family) Maximum Out-of-Pccket (Individual / Family) Out -of Pocket Max Includes Lifetime kilajor Medical Maximum Coinsurance ROUTINE PREVENTATIVE SERVICES: Covered 100% Covered 100% Covered 100% Wellness Immunizations Mammography/Colonoscopy CO -PAYS: Open Access $30 copay $60 copay Covered 80% after Deductible Covered 80°/0 after Deductible $400 copay $75 copay Open Access $30 copay $50 copay Covered 80% after Deductible Covered 80% after Deductible $300 copay $50 copay Open Access $25 copay $45 copay Covered 80% after Deductible Covered 80% after Deductible $250 copay $45 copay PCP Required / Open Access Office Visits/Consultations for Illness/Injury Specialist Visits Inpatient Hospital Outpatient Surgery Emergency Room Urgent Care OUTPATIENT DIAGNOSTIC SERVICES: Covered 100% Covered 100% Covered 80% after Deductible Covered 100% Covered 100% Covered 80% after Deductible Covered 100% Covered 100% Covered 100% after $250 Copay Lab Services X-Ray Services Complex Diagnostic PRESCRIPTIONS: $15 / $35 / $75 2x Retail Copay $15 / $35 / $75 2x Retail Copay $15 / $35 / $75 2x Retail Copay Retail (30 day supply) Mail Order (90 day supply) OUT -OF -NETWORK: No Coverage No Coverage No Coverage Deductible (Individual / Family) Maximum Out -of -Pocket (Individual / Family) Lifetime Major Medical Maximum Coinsurance [Dental Ins ych aetrk ABC Client offers two dental plans through Aetna. Both plans allow you to use in -network or out -of -network benefits. If out -of -network dentists are used, you will be responsible for paying the difference between Aetna's allowed amount and what the dentist may charge. ,�., r- r - - Aetna -_- .-1 , i i?lar��- c'R'?C-k t .+�K �1' FYI[•: Deductible Individual Family In -Network $50 $150 Out -of Network $50 $150 In -Network $50 $150 Out -of Network $50 $ 150 Annual Maximum Individual $500 $1,250 Diagnostic & Preventative Exams Cleanings Fluoride X-Rays (Bitewinas Only) Deductible Waived 100% Deductible Waived ° 100/o Regular Restorative Services Amalgam Fillings Sealants Endodontics Periodontics Deductible Applies $0% Deductible Applies 80° �° Major Services Crowns Bridges Dentures Not Covered _ Deductible Applies 50% Orthodontics Appliances and Related Services Lifetime Maximum Ace Limitation Not Covered 50% $1,000 Children Only 8 is on Insurance. ABC Client offers a vision plan through Advantica. This vision plan provides coverage both in and out of network. The chart below provides a brief overview of the plan. A : . _,_ .. _„,„_. _,, ._.. , -- _ r-Advant9ca _ Vision .„... Planw. ADVANTICA _ In -Network Out -of -Network e.e. srrtqc. Live.' Lenses Single Vision Lined Bifocal Lined Trifocal $15 copay $15 copay $15 copay $20 allowance $40 allowance $00 allowance Contact Lenses Prledically Necessary Elective $250 allowance $125 allowance $60 allowance Frames Up to $125 after $15 Copay (copay waived if included with lenses) $40 allowance Exams $10 copay $40 allowance Frequency Exam Lenses or contact lenses Frame Once every 12 months Once every 12 months Once every 12 months 9 Basic Life Insurance ABC Client provides life insurance to all active full time employees. The chart below provides an overview of the plan. Basic Life insurance Aetna Employee Definition Class 1 Benefit Outline Class 1 Guarantee Issue Age Reduction Schedule Waiver of Premium AD&D All Full Time Employees 1 x earnings to maximum of $50,000 All Amounts 35% at age 65 50% at age 70 Prior to age 601 totally disabled / premium waived untie SSNRA Included - Equal to basic life Voluntary Life Insurance ABC Client provides ale active employees working 30 or more hours per week with the option to purchase voluntary life coverage. The chart below provides an overview of the plan. Voluntary Life surance ,Aetna Employee Life Guarantee Issue Spouse Life Dependent Life AD&D Benefit Reduction Schedule Waiver of Premium Benefit Convertible Portable Increments of $10,000 up to $500,000. $130, 000 Increments ,... $ ,00000. GI —30,000 ofupto $5,000 or $10,000 Not included 35% at age 65 50%atage70 Prior to age 601 totally disabled / premium waived until SSNRA Included Note: Please designate your Beneficiary in ADP. The only time you can enroll in guaranteed issue voluntary life insurance, is at the date you first become eligible to enroll. If you do not enroll then and later decide that you would like to enroll, you will be required to complete a medical questionnaire and go through medical underwriting. The insurance carrier reserves the right to decline coverage based on medical information obtained on the medical questionnaire. 10 jJisabijity}nstirance, aetna Disability Income Benefits Short -Term Disability provides you with a source of income in the event you become disabled and cannot work, from a non work -related injury or sickness. You are not eligible to receive short-term disability benefits if you are receiving workers' compensation benefits. ABC Client provides all employees the option to purchase Short Term Disability coverage through a group plan. When you enroll in short term disability you pay the full cost through payroll deductions.. Voluntary Short Term Disability Employee. Definition Benefit Percentage Maximum Weekly Benefit Elimination Period Duration of Benefit Pre-Existina Conditions All eligible employees 60% $750 14 days for both Accident & Sickness 26 weeks 3112 Short Term Disability Premium Rate (Rate is per $10 of Insured Payroll) $.51 per $10 of Weekly insured Benefit Example: $30,000/52 = $577 $577 x 60%=$346 $3461$10 = 34,6 34.6 x $.51 = $ 17.65 Monthly Premium ABC Client provides all active employees working 30 or more hours per week Long Term Disability coverage through a group plan. The chart below provides an overview of the plan. Long Term Disability Employee Definition Benefit % of Monthly Covered Payroll Monthly Maximum Elimination Period Own Occupation Definition of Disability Benefit Duration Mental Illness Limitation All eligible full-time employees 60% $5,000 180 days 24 months Unable to perform at least one material duty of occupation and unable to earn up to 99% of pre -disability earnings SSNRA 24 months • 11 f Dec ( .lions The Charts below show the hi -weekly payroll deduction amounts for each of the benefits offered. Medical PLATINUM GOLD BRONZE Employee Only $128.20 $85.00 $35.00 Employee + Spouse $305.12 $200.00 $110.00 Employee + Child(ren) $235.88 $155.00 $85.00 Family $399.98 $260.00 $1 45.00 Dental -. CORE BUY UP : Q Employee Only $4 55 $7.45 Employee + Family $11.60 $18.50 Vision SIPIN Employee Only $3.38 1 Employee + Spouse $6,76 Employee + Child(ren) $7.16 Family $11.28 Voluntary Life Insurance Rates vary based on age, tobacco/non-tobacco use and amount of coverage. Please see the online enrollment form for Bi-Weekly payroll deduction amounts.. 12 ex ble Spending Account iscovety Benefits ABC Client offers both a Health Care and Dependent Care Flexible Spending Account to all active employees working 30 or more hours per week. You may elect to have both types of accounts and contribute separate pretax dollar amounts to each. These accounts are kept completely separate; for instance, you could not be reimbursed for dependent care expenses from the health care account. Health Care Accounts A health care FSA can reimburse you for eligible medical, dental and vision expenses, up to the amount you elect to contribute for the plan year. Typical Eligible Expenses The following is a partial list of typical expanses eligible for health care FSA reimbursement. A complete list can be found at ww`N irs gov. •Deductible for group health and/or dental plan •Copayments for group health and/or dental plan •Many charges that are not covered by health/dental plan are also eligible for FSA reimbursement, such as: Eye exams, eyeglasses, contact lenses; Hearing exams, hearing aids, Physical exams and mammograms in excess of one per year; Medical expenses of a dependent not covered by a health plan Orthodontia Vision corrective surgery (such as Lasik) Smoking cessation programs and related prescription drugs Your Contribution The IRS limits the amount you may contribute to $2,550 per plan year (July 14 — June 30d'). This amount will increase in future years to reflect cost -of -living increases. You may rollover up to $500 from your Health FSA Account to the following plan year. Any amount over $500 remaining in your account as of 6/30/16 will be forfeited. Dependent Care Accounts A Dependent Care FSA is a great way to pay dependent care expenses and lower your taxable income. Dependent Care Spending Accounts are pre-tax, payroll deduction accounts established to reimburse employees for out-of-pocket dependent care expenses. To be considered eligible, dependent care expenses must be incurred by an employee who must arrange for care of an eligible dependent in order to work. For married employees, dependent care must be necessary so that both spouses can work. Qualifying Dependent A qualifying dependent is: •A tax dependent of yours who is under age 13, or -Any other tax dependent of yours, such as an elderly parent, who is physically or mentally incapable of self -care and has the same principal residence as you •A spouse who is physically or mentally incapable of self -care and has the same principal residence as you Your Contribution The Internal Revenue service limits the amount you can contribute to a dependent care FSA, up to: •$5,000 per year, if you are married and filing a joint return, or if you are a single parent •$2,500 per year, if married and filing separate federal tax returns Estimate what your daycare expenses will be for the year, and allocate enough from your pay, up to the allowable contribution, to cover those expenses. Just remember this: Dependent Care FSA dollars are 'use -it -or -lose -it" funds. Dependent Care account balances cannot be carried over from year to year. If you have unused funds at the end of the plan year, or at the end of any applicable grace period, those funds will be forfeited. That's an IRS requirement. So estimate the amount you want to contribute to your Dependent Care FSA carefully. 13 Retire ent Savings Plan To help you prepare for the future, ABC Client sponsors a 401(k) Retirement Savings Plan through Portico, Eligibility All employees age 21 and over are eligible to participate in the 401(k) Retirement Savings Plan at employment. Contributions Eligible employees may contribute up to the IRS maximum ailowed for 2016 of $18,000. Employees age 50 and older may contribute an additional catch up contribution of 56,000 fora total of $24,000. You will always be 100% vested in your contributions to the plan, What is the Employer matching contribution and how is it allocated? Matching Contribution, In 2016 the company match is 3% if you have 3 or more years of service and are contributing. The Plan will not match any catch-up deferrals. Where do I find additional information? You can find out additional information and enroll on line, through the ADP website, Quicklinkslretirement. 14 Affordable, high-powered legal protectionfor you and your family. Why Would You Ever Need an Attorney? LegalShield attorneys can help with all sorts of issues like traffic tickets, wills, financial issues, IRS Audits and so much more. From the trivial to the traumatic and everything in between, our attorneys will always be there to offer advice or assistance. Why Lega1Shie1d? LegalShield has over 40 years of experience providing legal protection to more than 1.4 million members. And our paid -in -advance partner law firms are ready to serve, not bill, with access to over 1,100 dedicated attorneys with 19 years average tenure. When necessary, you'll also get access to over 5,000 additional attorneys, all ready to offer advice or assistance LegalShield Benefits (Covers Member, Spouse. Dependent Children Up to 21 Living at Home, College Students Up to 23) • Unlimited Personal or Business Advice • Letters and Phone Calls Written on Your Behalf • Documents and Contract Review (Up to 10 Pages) • Comprehensive Will Preparation, Living Will and Health Care Power of Attorney • Representation for Minor Moving Traffic Violations • Representation for Major Traffic Violations such as Vehicular Homicide, Manslaughter, Negligent Homicide (not drug or alcohol related) • Up to 2.5 Hrs of help with Driver's License Assistance, Personal Injury or Property Damage • Mortgage Document Assistance • Up to 300 Hours of Protection for Civil Lawsuits or Job Related Criminal Charges. • 50 Hours of Representation in an IRS Audit. • 24 Hour / 7 Day a Week Access for emergencies • Receive a 25% Discount on any services not otherwise covered by your plan benefits Identity Theft Plan (Covers Member & Spouse) ▪ Credit Monitoring with Activity Alerts • Credit Report with Score and Analysis • Fraud Alerts • Credit Report Consultation • Consultation to Help Prevent Identity Theft • COMPREHENSIVE RESTORATION SERVICES • By Kroll Advisory Solutions Add Children Under 18 with Safeguards for Minors Option for $1 additional per month. LegalShield Family Plan LegalShield with ID Theft Plan Legalshield with ID Family ID Theft Plan (Member & Spouse) ID Theft Single $15.95 Per Month ($7.981bi•weekly) $24.90 Per Month ($12.45 biweekly $30.90 Per Month ($15.45 biweekly) $18.95 Per Month ($9.48ibi•weekly) $ 8.95 Per Month {$4.481bi-weekly 15 Resource Center Ser i s •^'{i=` ram. Benefit Resource Center 85543.M99 (TcO.Fra BRCFast usi.'ciz Mcrday -Friday 8:CO AM • 5:CO PM 5ST • Frigidity • Ilan Isms aith [anima • Mgr gkaalyStatus •Obi onbcr tint Yt ane-tan benefits inflaming' Imam Toll -free benefit call center available to: • Answer questions regarding your hearth and other benefit plans • Network: Is my doctor on the plan? • Plan Coverage: Does my plan cover this? • Billing: 1 received a bili from my provider, do I need to pay? Once you've tried, but need help understanding how a carrier paid your claim Specialist support to help you with complex claims issues • Medical appeals information and support • Life event (family status) rules — what changes can I make? • Life Insurance Beneficiary form requirements • How do I complete an Evidence of Insurability form and where do I send it? • What happens if I have coverage under two different medical plans? Benefit Resource Center 855-USI-6699 (Toil -Free) BRCEast@usi.biz Monday - Friday 8:00 AM - 5:00 PM EST - Benefit Elections Benefit Plan/Policy Questions Eligihity - Claim Issues with Carriers Change in Farmly Status - Plan Contact Information Your one -call benefits information hotline 16 tRec aired A -mud Em [Notices The Newborns' and Mothers' Health Protection Act of 1996 The Newborns' and Mothers Health Protection Act of 1996 prohibits group and individual health insurance policies from restricting benefits for any hospital length of stay for the mother or newborn child in connection with childbirth; (1) following a normal vaginal delivery, to less Than 48 hours, and (2) following a cesarean section, to less then 96 hours. Health insurance policies may not require that a provider obtain authorization from the health insurance plan or the issuer for prescribing any such length of stay Regardless of these standards an attending health care provider may, in consultation with the mother, discharge the mother or newborn child prior to the expiration of such minimum length °Islay. Further, a health insurer or health maintenance organization may not: 1. Deny to the mother or newborn child eligibility. or continued eligibility. to enroll or to renew coverage under the terms of the plan, solely to avoid providing such length of stay coverage; 2. Provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum coverage; 3. Provide monetary incentives to an attending medical provider to induce such provider to provide care inconsistent with such length of stay coverage; 4. Require a mother to give birth in a hospital: or 5. Restrict benefits for any portion of a period within a hospital length of slay described in this notice. These benefits are subject to the plan's regular deductible and co -pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information. Michelle's Law The law allows fcr continued coverage for dependent children who are covered under your group health plan as a student if they lose their student status because of a medically necessary leave of absence from school. This law applies to medically necessary leaves of absence that begin on or after January 1, 2010 If your child is no longer a student, as defined in your Certificate of Coverage, because he or she is on a medically necessary leave of absence, your child may continue to be covered under the plan for up to one year from the beginning of the leave of absence. This continued coverage applies if your child was (1) covered under the plan and (2) enrolled as at student at a post -secondary educational institution (includes colleges, universities, some trade schools and certain other post -secondary institutions). Your employer will require a written certification from the child's physician that states Ihal the child is suffering from a serious illness or injury and that the leave of absence is medically necessary. loyee Disclosure Women's Health and Cancer Rights Act of 1993 The Women's Health and Cancer Rights Act of 1998 requires ABC Client to notify you, as a participant or beneficiary of the ABC Client Health and Welfare Plan, of your rights related to benefits provided through the plan in connection with a mastectomy. You, as a participant or beneficiary, have rights to coverage to be provided in a manner determined in consultation with your attending physician for: 1. All stages of reconstruction of the breast on which the mastectomy was performed; 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3. Prostheses and treatment of physical compilations of the mastectomy, including lymphedema. These benefits are subject to the plan's regular deductible and co -pay. For further details, refer to your Summary Plan Description. Keep this notice for your records and call Human Resources for more information. Patient Protection: If the Group Health Plan generally requires the designation of a primary care provider who partidpates in the network and who is available to accept you or your family members. For children, your may designate a pediatrician as the primary care provider. You do not need prior authorization from the carrier or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in the network who specializes in obstetrics or gynecology. The health care professionals. however. may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre -approved treatment plan or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, or for information on how to select a primary care provider, and for a list of the participating primary care providers, contact the Plan Administrator or refer to the carrier website. It is your responsibility to ensure that the information provided on your application is accurate and complete, Any omissions or incorrect statements made by you on your application may invalidate your coverage. The carrier has the right to rescind coverage on the basis of fraud or misrepresentation. 17 Required Annual Emp ofices Continue Statement of ERISA Rights As a participant in the Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 ("ERISA"), ERISA provides that all participants shall be entitled to, Receive Information about Your Plan and Benefits • Examine. without charge, at the Plan Administrator's office and at other specified locations, the Plan and Plan documents. including the insurance contract and copies of all documents filed by the Plan with the U.S. Department of Labor, if any. such as annual reports and Plan descriptions. • Obtain copies of the Plan documents and other Plan information upon written request to the Plan Administrator, The Plan Administrator may make a reasonable charge for the copies. • Receive a summary of the Plan's annual financial report, if required to be furnished under ERISA. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report, if any. Continue Group Health Plan Coverage If applicable, you may continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the plan as a result of a qualifying event You and your dependents may have to pay for such coverage. Review the summary plan description and the documents governing the Plan for the rules on COBRA continuation of coverage rights. Prudent Actions by Plan Fiduciaries In addition to creating rights for participants, ERISA imposes duties upon the people who are responsible For operation of he Plan. These people, called 'fiduciaries" of the Plan, have a duty to operate the Plan prudently and in the interest of you and other Plan participants. No one, including the Company or any other person, may fire you or discriminate against you in any way to prevent you from obtaining welfare benefits or exercising your rights under ERISA. Enforce your Rights if your claim for a welfare benefit is denied in whole or in part, you must receive a written explanation of the reason for the denial. You have a right to have the Plan review and reconsider your claim, Under ERISA, there are steps you can take to enforce these rights. For instance, if you request materials from the Plan Administrator and do not receive them within 30 days, you may file suit in federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $ 110 a day until you receive the materials, unless the materials were not sent due to reasons beyond the control of the Plan Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, and you have exhausted the available claims procedures under the Plan, you may fife suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan's money. or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may Fie suit in a federal court. The court will decide who should pay court costs and legal fees. if ycu are successful, the court may order the person you have sued to pay these costs and fees. If you lose (for example, if the court finds your claim is frivolous) the court may order you to pay these costs and fees. Assistance with your Questions If you have any questions about your Plan, this statement, or your rights under ERISA, you should contact the nearest office of the Employee Benefits and Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits and Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. Section 111 Effective January 1, 2009 group health plans are required by Federal government to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extensions of 2007's new Medicare Secondary Payer regulations. The mandate is designed to assist in establishing financial liability of claims assignments. In other words, it will help establish who pays first. The mandate requires group health plans to collect additional information, more specifically Social Security numbers for all enrollees, including dependents 6 months of age or older. Please be prepared to provide this information on your benefits enrollment form when enrolling into benefits. 18 uireci Annual Ernp offices Continued HIPAA Privacy Policy for Fully -Insured Plans with no Access to PHI The group health plan is a fully -insured group health plan sponsored by the 'Plan Sponsor". The group health plan and the plan sponsor intend to comply with the requirements of 45 C.F.R. §164.530 (k) so that the group health plan is not subject to most of HIPAA's privacy requirements. No access to protected health information (PHI) except for summary health information for limited purpose and enrollment! dis-enrollment information. Neither the group health plan nor the plan sponsor (or any member of the plan sponsorworkforce) shall create or receive protected health information (PHI) as defined in 45 C.F.R. §160.103 except for (1) summary health information for purpose of (a) obtaining premium bids or (b) modifying, amending, or terminating the group health plan, and (2) enrollment and dis-enrollment information. IL Insurer for group health plan will provide privacy notice The insurer for the group health plan will provide the group health plan's notice of privacy practices and will satisfy the other requirements under HIPAA related to the group health plan's P-IL The notice of privacy practices will notihy participants of the potential disclosure of summary health information and enrollment? dis-enrollment information to the group health plan and the plan sponsor. IIL No intimidating or retaliatory acts The group health plan shall not intimidate, threaten, coerce, discriminate against, or lake other retaliatory action against individuals for exercising their rights , filing a complaint, participating in an investigation, or opposing any improper practice under HIPAAA. IV, No Waiver The group health plan shall not require an individual to waive his or her privacy rights under HIPAA as a condition of treatment, payment, enrollment or eligibility. If such an action should occur by one of the plan sponsors employees, the action shall not be attributed to the group health plan. Notice of Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for That other coverage (or if the employer stops contributing toward your or your dependents' other coverage). However, you must request enroilment within 30 days after your or your dependents' other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. Further, if you decline enrollment for yourself or eligible dependents (including your spouse) while Medicaid coverage or coverage under a State CHIP program is in effect, you may be able to enroll yourself and your dependents in this plan if: coverage is lost under Medicaid or a State CHIP program; or you or your dependents become eligible for a premium assistance subsidy from the State. In either case, you must request enrollment within 30 days from the loss of coverage or the date you became eligible for premium assistance. To request special enrollment or obtain more information, contact person listed at the end of this summary. Premium Assistance under Medicaid and the Children's Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you're eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren't eligible for Medicaid or CHIP, you won't be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit w'aw.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for eitherof these programs, contact your State Medicaid or CHIP office or dial 1-877-K1DS NOW or www.insurekidsnow.gov to find out how to apply. It you qualify, ask your state if it has a program that might help you pay the premiums for an employer -sponsored plan. ff you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren't already enrolled. This is called a "special enrollment" opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance, If you have questions about enrolling in your employer plan, contact the Department of Labor at'N'N'N askebsa.dcLeov or call 1-866-444- EBSA (3272), 19 ,_Recuirei Annual Employee Disclosure. -Nofices - Continued -r a s tea. if you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2016. Contact your State for more information on eligibility -- ALABA,MA — Medicaid GEORGIA — Medicaid Website: wM.v.m'ra!h!po.COm Website: http:: dC^_veCr ;a.aa'r: Phone: 1-855-692-5447 - Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone:1.800-869-1150 ALASKA — Medicaid INDIANA — Medicaid Website: http- health.hss.scale.ak.usrdoaorogramsimedica!dl Website: httptwww.in.govlfssa Phone: 1-800-889-9949 Phone (Outside of Anchorage): 1-888-318-8890 Phone (Anchorage): 907-269-6529 COLORADO — Medicaid IOWA — Medicaid Medicaid Website: hrc:dmim'v.colarado.gov'hcof Website: www.dhs.state.iausih!ppi Phone: 1-888-346-95662 Medicaid Customer Contact Center. 1-800-221-3943 FLORIDA — Medicaid KANSAS — Medicaid Website: Mips:_:qr.vvv.fimedica!otclrecovenr.;,om; Website: http:liw w.kdheks.govihcf; Phone: 1-800-792-4884 Phone: 1-877-357-3268 KENTUCKY — Medicaid NEW HAMPSHIRE — Medicaid Website: http: ichfs.ky.govldms;defauit.htm Phone: 1-800-635-2570 Website: http:/1www.dhhs.nh.gov/oii/documentsihippapp.pdf Phone' 603-271-5218 LOUISIANA — Medicaid NEW JERSEY — fvledicaid and CHIP Weosite: http:r/wmv.ianipp.dhh.louisiana.gov Phone: 1-888-695-2447 Medicaid Website: http:;Jwww.state.nj.us,humansenrices, dmahs/c€tents,/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org;'index.html CHIP Phone: 1-800-701-0710 MAINE — Medicaid NEW YORK — Medicaid Website: http:Rwww.maine.gov.'dhhs'ofiipubiic-assistanceiindex,html Phone: 1-800-977-6740 TTY 1-800-977-6741 Website: http:1/iNwN.nyheaith.govfhealth_careimedicaid/ Phone: 1-800-541-2831 MASSACHUSETTS — Medicaid and CHIP NORTH CAROLINA — Medicaid Website: hap:liwww.mass,gowMassHeaith Phone: 1-800-462-1120 Website: http-/fwmma.ncdhhs.gov'dma Phone: 919-855-4100 NIINNESOTA — Medicaid NORTH DAKOTA — Medicaid Weosite: http:+iwww.dhs.state.mn.usiiid_006254 Click on Health Care. then Medical Assistance Phone: 1-800-657-3739 Website: http:liwww.nd.govldhsrservices m medicalserv'edicaidl Phone: 1-800-755-2604 MISSOURI — Medicaid OKLAHOMA — Medicaid and CHIP Website: http://w,vw.dssimo,gov/mhdi'participants;pageS,hipp.htm Phone: 573-751-2005 Website: httpa/www-insureokiahoma.org Phone: 1-888-365-3742 MONTANA — Medicaid OREGON — Medicaid Website: http:!/medicaid.mt.govimember Phone: 1-800-694-3084 Website: http://www.cregonhealthykids.gov http://www.hiiossafudablesoregon.gov Phone:1.800-699-9075 NESRASKA — Medicaid PENNSYLVANIA — Medicaid Website: wmw.ACCESSNebraska.ne.gov Website: http:/iww'N.dpw-state.pa.usrh!pp Phone: 1-800-692-7462 Phone: 1-855-632-7633 NEVADA — Medicaid RHODE ISLAND — Medicaid Medicaid Website: http:?id"Nss.nv oov/ Website: www.ohhs.ri.gov Phone' 401-462-5300 Medicaid Phone: 1-800.992-0900 SOUTH CAROLINA — Medicaid VIRGINIA — Medicaid and CHIP Website: http:!/www.scdhhs.gov Phone: 1-888-549-0820 Medicaid Website: http:awww.covers.orgrprograms_premium_assistance.cfm Medicaid Phone: 1-800-432-5924 CHIP Website: http:llwww.covens.org/programs_premium_assistance.cfm CHIP Phone: 1-855-242-8282 SOUTH DAKOTA - Medicaid WASHINGTON — Medicaid Website: http:fldss-sd-gov Phone: 1-888-828-0059 Website: htto:,'tw w.hca.wa.gov medicaid.orem!umpymtcages; index.asox Phone: 1-800-5662-3022 ext. 15473 TEXAS — Medicaid WEST VIRGINIA — Medicaid Website: https:/IwvvN.gethipptexas.com/ Phone: 1-800-440-0493 Website: www.dhhr.wv.gov/bms/ Phone: 1-877-598-5820. HMS Third Party Liability UTAH — Medicaid and CHIP WISCONSIN — Medicaid and CHIP Website: Medicaid: http://health.utah.gov/medicaid CHIP: http://health.utah.govlchip Phone: 1-866-435-7414 Website: https://www.dhs.wisconsin.gov/badgercarepius/p-10095.htm Phone: 1-800-362-3002 VERMONT— Medicaid WYOMING — Medicaid Website: http:. www.greenmountaincare.orgi Phone: 1-800-250-8427 Website: http:/lheallh,wyo.gov;healthcareftn,egualitycare Phone: 307-777-7531 To see if any other states have added a premium assistance program since lanua 31, 2016, or for more information on special enrollment rights, contact either: US Department of Labor US Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services www.dol.doviebse www.cros.hhs.gav 20 1-866-444-EBSA (3272)I 1-877-267-2323. Menu Option 4. Ext 61565 _i e_q ir d Annual Employee Disclosure_ Notices - Continue° Medicare Part ID This notice applies to employees and covered dependents who are eligible for Medicare Part D. Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Meritain Health about your options under Medicare's prescription drug Plan. If you are considering joining, you should compare your current coverage including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. 1. Medicare prescription drag coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plan (like an HMO or PPO) that offer prescription drug coverage. Ail Medicare prescription drag plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. Meritain Health has determined that the prescription drug overage offered by the Welfare Plan for Employees of ABC Client under the iVleritain Health option are. on average for all plan participants, expected to pay out 3S much as the standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage. you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. You should also know that if you drop or lose your coverage with Meritain Health don't enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in Medicare prescription drug coverage later, When can you join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15'h to December 7'^. However, If you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What happens to your current coverage if you decide to join a Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Meritain Health coverage will not be affected. You can keep this coverage if you erect part D and this plan will coordinate with Part D coverage. If you decide to join a Medicare drug plan and drop your current Meritain Health coverage, be aware that you and your dependents will be able to get this coverage back. When wilt you pay a higher premium (penalty) to join a Medicare drug Plan? You should also know that if you drop or lose your current coverage with Meritain Health don't join a Medicare drug plan within 83 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the tollowing October to join. For more information about this notice or your current prescription drug coverage... Contact our office for further information (see contact information below). NOTE: You'll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Meritain Health changes. You also may request a copy of this notice at any time. For more information about your options under Medicare prescription drug coverage.., More detailed information about Medicare plans that offer prescription drug coverage is in the 'Medicare & You" handbook. You'll get a copy of the handbook in the mail every year from Medicare, You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: > Visit www.medicare.gov > Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number) for personalized help, • Call 1.800•MEDICARE (1.800.633.4227). TTY users should call 1.877.486- 2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800.772.1213 (TTY 1.800- 325-0778). Remember: Keep this notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, you may be required to provide a copy of this notice when you join to show that you are not required to pay a higher premium amount. Date: Name of Entity/Sender: Contact-PositicniOffrce: Address: Phone Number: January 1, 2017 ABC Client Human Resources 290 Main Street Tampa, FL 33607 813-555-5555 21 22 23 The information in this Benefits Summary is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Summary was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Benefits Summary and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about this summary, contact Human Resources. Presented by: USI Service Calendar for City of Miami- SAMPLE January 1st 2017 Renemai Date Ltrderoottng & Analytic • Wellness: Breast Cancer and Mental Health Awareness • • • Compliance: Medicare Part D Filing Compliance Updates Review/Distribute Contracts & Booklets • USI Holiday: Spring Holiday Wellness: Physical Activity Compliance Updates Review renewal projections Review Contribution Strategy HR Seri ces • Reinsurance Information Submission Reminder Hecitn Managen^eni Reinsurance Fee Payment USI Holiday: Thanksgiving Wellness: Breathe Easy • Post Renewal Meeting Compliance Updates • USI Holiday: Memorial Day • Wellness: Allergy and Asthma • Compliance Updates • USI Holiday: Christmas • Wellness: Keeping Calm • Compliance Updates Cen•piance Core Intervention • Reinsurance Fee Payment Reminder USI Holiday: New Year's Day USI Holiday: MLK Day • Phcrrrccy FEBRUARY • USI Holiday: President's Day Wellness: Heart Health Quarterly Claim and Utilization Review • Wellness: Weight • Compliance Loss Compliance Updates • Wellness: Diabetes Awareness • Compliance Updates Pre Renewal Meeting Updates PCOR Fee Payment USI Holiday: Independence Day Wellness: Sun Safety Request Census Compliance Updates • Wellness: Dental Health Enrollment Materials • Finalize Rates • Renewal Meeting • Compliance Updates Anciilcry Benefits Wellness: Nutrition Compliance Updates It=1 • USI Holiday: Labor Day • Wellness: Preventive Care Wellness Request/Review SBC Compliance Updates 201 Alhambra Circle, Miami -Dade County 305-669-6000 PROTECT YOUR BUSINESS STRENGTHEN YOUR TEAM LEARN PRO More than 200 online training courses that ensure compliance., reduce risk and drive employee engagement. Plus an intuitive admin dashboard, robust reporting and Quick Start course tracks. COMPLY Comprehensive resource center with al! the forms, checklists and tools needed to maintain compliance. Workplace Pro is an integrated suite of HR knowledge, content and training solutions. LIVE Certified HR experts answer questions, render advice and follow up with research to resolve issues. Accessible 8am-7pm Central each business day INSIGHT AR the news and analysis HR professionals need to stay current and compliant with changing regulations. Login at http://usi-southeast.thinkhrlive.com Think Call the ThinkHR Live team at 877.225.1101 G AN EXPANDED PORTFOLIO OF WORKPLACE PRO -711 I \TRODUCI N PRODUCTS FCC welcome back, &.5l Submit Your MR Question I,tl11 OW Pe wIVC 1. 50-State Employee Handbook Builder Q&A Database HR Audit Checklist Health Care Reform Checklist Job Description Builder Compliance Guidelines Compliance Calendar Ali important federal compliance deadlines and key event dates in one place alerts to ensure you never miss deadline again. Mobile App witim Novv employers and HR professionals can access the resources of ThinkHR Workplace Pro from anywhere through our mobile app. uides enable rapid izatton Performance Review Tool Employee Onboarding Checklist HR Compliance Checklist Salary Benchmarking Employee Termination Guidelines White Paper and Webinar Library Login at http://usi-southeast.thinkhrlive.com Think* Call the ThinkHR Live team at 877.225.1101 EXAMPLE HRQuestions SAMPLE OF THE TYPES OF ISSUES WE RESOLVE DAILY ON THE HR HOTLINE • Discrimination - EEO, ADA • Employee Relations • Performance • Policy and Proce jeres • Recruiting and Hi: • Leaves of Absence - FMLA, PCB • Wage and Hour, Equal Pay Act • Workers' Compensation • General Benefits Compliance COBRA, ERISA, HIFAA, PPACA SAMPLE QUESTIONSMSSUES ANSWERED ON THE HR HOTLINE flhIi1L1HR The Right Answer, Right Now. • Statutory Cornpliance • Conflict Resolution • Terminations • Workplace Safety • Unlawful Harassment Our business is headquartered in one state, yet we have field sales rep employees in other states. Which state disability insurance & paid family leave information should those employees outside of our HQ state receive? ✓ We recently advised a client that they should keep PHI filed separately from other employee data. While we have this recommendation in writing from our attorneys to us as a BAA I am not able to find documentation that as a plan sponsor en employer should also follow this practice. Please confirm that: 1) we were correct in advising the client to follow this process, and 2) Is there an official notice we can refer to? /When an employee is on FMLA leave, what is the employer required to do with their other benefits? Which benefts need to be continued and what should we do if the employee does not make his copayments while out on FMLA? ✓ Can we terminate an employee from our group plan since he will be Medicare eligible? ✓ What are the ERISA rules about nondiscrimination in benefits plan designs to assist with creating benefit class carve -outs? ✓ Our client has an employee who went out on 24 hours suicide watch. Should the employer allow the employee to return to work? ✓ I need some information on exempt employees and time off. Can you submit for unpaid time when an employee is absent and has used all their sick time? What are the guidelines concerning unpaid and paid time off for exempt employees? ✓ We want to put a policy in place regarding what expenses can be reimbursed and what cannot be reimbursed for telecornmuting employees. Specifically, we have telecommuting employees and want to know if the company has to reimburse internet and electricity expenses since the employee is working from home doing company work. ✓ Can nonexempt employees waive lunch breaks? What are the requirements for the two rest breaks for an 8 hour shift? If the company is closed for Labor Day on Monday, and an employee who works on Sundays wants to take Sunday off and work on Monday while the business is closed, is this ok? ✓ How can you determine whether a worker is an independent contractor or employee.? ✓ I have an employee stating that he is going to quit but hasn't officially given his resignation. Can we terminate the employee now on grounds of anticipating his quitting the company? ✓ To be in compliance with the 1-9 requirements, does an employer have to re -verify an employee's driver license once it has expired? ✓ Who in our company, besides HR, should have access to background checks and drug screen records for a new hire? ✓ I just received an EEO complaint, and the EEOC examiner is calling to discuss mediation. I am not looking for legal advice but just wanted to talk with you about the process and get practical advice based on your experience with such complaints. ✓ We just set up a corporate Facebook page. We would like all our internal employees to "like" our page from their own FB account. What type of social media policy can we implement? / We would like checklists and sample letters for new hire, COBRA, leaves of absence and terminations. ✓ We have an employee who is no longer disabled under workers' comp and is able to return to work. However due to business need we laid off several employees and his position has been eliminated. Are we legally required to return him to work? / We have an employee on disability with a worker's comp claim, and he came back to work on restricted duty. However, we cannot accommodate the restrictions. We need him to work a full 40 hour a week shift. He directs truck traffic in our yard, and the doctor's restrictions require that he not stand for long periods of time. Can we terminate his employment because we cannot accommodate the restrictions? / What do I do if an employee tells you that he/she is being sexually harassed but does not want you to do anything? How do I conduct a proper investigation? 0027.0312 © Copyright 2012 ThinkHR Corporation I www,thinkhr.com 1 The. Rrg7t AnS.v. R Now. 7-....4i4S.5" •••••i• a•r. " 0 V. M. e •44PS - ThinkHR Training Access Instructions To access the full e ection of online training courses, login to your ThinkHR Live website and click on the blue HR Training Access icon Frain there you will ise provided witn tools and prompts to create a training program for your employees. If you have any questions, please cI tne HR Hotline at 877-22.5.i 101 to speak with a training specia/ist. - E%1PLOYM-7_,`. -.its and Leave Commensation • ' •• Ciscrimin.irion • . = • __ • . . - . . _ tYLoriogement Per'o•- Ince -Potion • ' • Staffrg3 Training Crecnirg _ E• • , o Poiforrience-Ted-ni,Z CUStr..7,117 Scr . Al I -Trot. arorm, • .oz . °A5 rsai Z.,Ccirmi•MNE-c..0 z • tat, - tiGim Mout ia Manage °raki,-is,: g hem ts• Manage Tone Wisely • a Guide -or E•roloyem • ivEMii P.M IV/111"g Solis for Superratra Suls-Wrat %my Supotasiers iM•criages mitr-rsin s ',resat.=4lrTtas ars" Tath, for iipe•-mor's _ . rTh.%, Sc.:se-Mat _••s'snAqi•i.„1,22. J_ . • .-,.-,,zrsonirkwor.";..iA"-..gnai,18 E.-..',/!ROI‘4%1ENTAL CONPIAANCE Air Contaminants ter/ - •••• '"•••=e1 • Hczarzo r c Asbestos iiieszatess Chemical Hygiene -Wro Hazard Communication • = Hazardous Mlacta • •:,_•zori Tairlrg 3.-3"71.,^ • WCE • .„ ERA:: C.7.1-rt,N s F`ar t's Stern -meter i•ineargi oune Storage tonics - , . _ C RVICE Craliciiii.r.g Sires:ions •-ssleci-a•s - - . _ Cnsz•Amer •.=.orn rniA nico 'non.. Cos:, -or 2 2 nagement • S • •s s Cat -.Vim:sr.: Msy-s -2_scomo- Lr•,*. rig a ne-s• • iraiace Sir& . 2 r "E-C1.7ye=t 5 co g •.=...stom.ar Care Staff = _ Par‘rairmsrr•-•,-z-risiam,ta. _ • '-•tte" Erizeflert m•slcie Amor g Sc-=•ri - .p.s arc Tal-16 fa- ice-.1scrs tre 1 acre's, • • .. Aanae f•o- Mai -aces 'AninAp lace don Iness -‘eorokt Ar,icreigaK:g irjt.rtr -NEW! Bene.ixety Balar7rgi2icre ard Monne Crii4rrWielirms FmarcialWel-s Farms fcir22 1-ivsari of &venoms - Mom m Herl'rlf '3•GviG H4itivSleepHabits HeartHaartn Keareg risoself-ard 'tact ..3rPly--P.Ealtre Enro^nrinirs arie*iesmid kaar-acenrert • m Abuse,' [re Arcir+rilacc-itii- EiimOroyeris Need SO 4,7•Ab SLC25ft.f leNeicrt• weit-ers ern air, Mkat Neiad .TU &-cm aarri-iinni,c,e. WORKPLACE SAFETY Construction - Emergency Manning & Response 'er no: E•e•-•••,?,2-nizi •P•:i •,• • - dra--, • .."•.i"..," F.-'•••••=12,. '1,4-2, 72", P'er,--,1: or -,A r•socio-c Proric-P,•-oi.i•iori =or ',Lc Er. sc.- itite•r...i.ern. • Lrra,cart• EqUIC P ". IL.,5 Ai 427/ Hazardous Substance & Matanals ar-icirtirs-Gaznes abeP2:arc,mble --yo=srs Os, • _ Pi-2S IS <- - •-•••• -;to Net ors Health E,reA • . 'Ir,.•=4 1-nary 5iA.:e 7`e Cr, at ' eee'41•]Kc =sZs'.•••-, zrac_ce 9 crkc:.e•iidi Erco3,cif. liteec to K^ot, ••,• ••,v ir iii-erc•Vzric-.1.=--Poist•DMItyaesalpesd K-cin EnoersAl • A Ccncincrs Personnel Safety •_a• "L'efe, • • git••ye 7:s-rector • 'v.-scam Fails I:Scar-m.1 2 z•-•. Paisonal Ps-At:sw Safary Management - - _doors syc tie -es' to. <ro•ai Nen Ernpoiraz Sake; '24n., tat-Cr 7-wing the Te-nce Winci•ess Coompenrevor.-Vvliat jeCenk"t Rinvie Worgfaite Safety Or EmOGye...,-V_ Wio-iz-litteSetety'oriSmacktftess-Scareh4 Dcfoe ilirarmaantrotkin :-M-a fLe "tic, koationuaie 5pene.-: %ions Memelm CenersneDeinro-Correnerizal Motor *rides Soarer) OCT AV-nal and Dig lizstirg Rios -Mt at 1..-,9•Cr,5 Need 70 KII.LIV 14.1,”•ie...01datrial•STrarscer.2.x.r, kier-doss MationcisTersceriaticr 0025.0.112 www.thirikhr.com 1 877• 225-1101 Think-'.,x,---- i M LEARN COURSE CATALOG Customer Communication Customer Service Fundamentals: Building Rapport in Custorner Rala:ionships • Custome- Service O'er the Phone Developing Your Customer Focus Customer Relationships • The Angry Caller:'What's Your Plan? • Creating and Sustaining a Customer -focused Organization • Customer Advocacy: Communicating to Build Trusting Customer Relationships > Customer Service Confrontation and Conflict Customer Service Fundamentals: Building Rapport in Customer Relationships Customer -driven Process Improvement: Identifying Customer Needs Essential Skills for Professional Telephone Calls Shaping the Direction of Customer Service in Your Organization Disciplinary Action • A N.laeager's Guide to Discipline and Documentation > Rightful Employment Termination Diversity > A Nilanager's Guide to Diversity, Inclusion, and Accommodation > Bullying and Violence in the Workplace Diversity on the Job: The Importance of Diversity and the Changing Workplace Global Diversity Managing Workforce Generations: Working with a N lultigenerational Team Employment Law EEO and Lawful Hiring HIPAA Privacy Essentials HIPAA—Priva_y Rule for Business Associates HIPAA—Privacy Rule for Covered Entities • HIPAA—Security Rule for Business Associates HIPAA—Security Rule for Covered Entities HIPAA for Non -Medical Employers Privacy and Information Security Rightful Employment Termination > Union Awareness Wage. and Hour Awareness for Managers Wage and Hour for Employees Workplace Management: Employment Laws and Regulations thinkhr.com ; 877.225.1101 Think, LEARN COURSE CATALOG Environmental Compliance > Asbestos > Environmental Regulations Overview > Laboratory Safety > Lead Awareness in Construction Lead Awareness in General Industry > Mold A.>iareness Ethics > Business Ethics > Code of Conduct Awareness —Higher Education Edition Compliance Impact: Business Ethics —Adjusting the Figures • Ethics at V or!k: Monitoring and Program Improvement > Financial Integrity > Global Conflicts of Interest > Integrity in the Workplace Harassment > Bullying and Hazing on Campus > Bullying and Violence in the Workplace > Conducting Investigations Based on Unfair Treatment or Harassment Claims > Preventing Harassment in the Global Workplace —Employee Edition > Preventing Harassment in the Global Workplace —Employee Edition (Spanish) > Preventing Harassment in the Global Workplace —Manager Edition > Sexual Harassment Prevention for Employees > Sexual Harassment Prevention for Managers and Supervisors —California AB 1825/2053 > Title IX for Higher Education Workplace Harassment Prevention for Employees -version 2.0 (Title VIl) > Workplace Harassment Prevention for Managers —Multi -State Edition, version 2.0 (Title VII) Hazard Communications > Crane Signaling and Communications > Decontamination (HAZWOPER) > Emergency Response and Spill Control (HAZWOPER) > Fire and Explosion Hazards (HAZWOPER) > Globally Harmonized System of Classification and Labeling of Chemicals (GHS) > Hazard Communication (HAZWOPER) > Hazard Cormunication: An Employee's Right to Know > Hazard Communication: An Employee's Right to Know (Spanish) > Heat and Cold Exposure Management (HAZWOPER) > Personal Protective Equipment (HAZWOPER) > Regulatory Overview (HAZWOPER) • Safety Data Sheets > Site Safety and Health Plan Procedures (HAZWOPER) > Site Control (HAZWOPER) > Toxicology (HAZWOPER) thfnkhr.com 877,225.1101 2 Think LEARN COURSE RSE CATALOG Hazardous Waste Biosa ety Hazardous Waste Handling and Dis✓osal • Hazardous Material Ha -filing and Storage > Hazardous Waste Ge -orator (RCRA) Regulatory Overview (HAZWOPER) Site Control (HAZWOPER) • Storm Water Pollution and Prevention > Universal Waste Rule Training > Waste Minimization and Pollution Prevention for Employees HR Compliance > A Manager's Guide to Diversity, Inclusion, and Accommodation > Campus Security Obligations Under Federal Lary > FERPA for Higher Education > Promoting a Substance -free Workplace > Rightful Employment Termination > Wage and Hour Awareness for Managers > Workplace Manage.men.t: Employment Lars and Regulations Leadership A Manager's Guide to Discipline and Documentation Achieve Your O'aj_ctii;es through Effective Delega-ion • Being an Effective Team Member • The Benefits and Challenges of Engaging Employees > Building and Leading Teams EEO and Lawful Hiring > First Time Manager: Understanding a Manager's Role > Leadership Essentials: Motivating Employees • Loading Tearns: Building Trust. and Commitment Leading Teams: Dealing with Conflict Leading Teams: Developing the Team and its Culture Leading Teams: Establishing Goals, Roles, and Guidelines Leaves of Absence FMLA Leave and More: An Overview of Legally Protected Leave Meetings > Dealing with Common Meeting Problems > Managing Effective Business Meetings Preparing for Effective Business Meetings > Leading Teams. Managing Virtual Teams > Leading Teams: Motivating and Optimizing Performance > Management of People: Tal-ent Acquisition and Retention > Retaining Your Talent Pool > Strategies for Successful Employee Onboarding: Assessing Program Success Strategies for Successful Employee Onboarding: Getting Started > Tele::ommuting Basks: Communication Strategies for the Remote Employee > Wage and Hour Awareness for Managers > Workforce Planning and Employment: Orientation, Onboarding, and Exit Strategies thinkhr_corn i 877.225.1101 3 Think, LEARNCOURSE CATALOG OSHA & General Safety Accident Investigation and Reoorting Aerial Work Platforms > Benzene Awareness Behavior -based Safety for Supervisors Bloodborne Pathogen Awareness • Bloodborne Pathogen Awareness (Spanish) Chemical Process Safety > Chemical Process Safety Management > Cold Stress > Compressed Gas Safety > Confined Spaces > Confined Spaces (Spanish) = Contractor Safety Crane Signaling and Communications > Electrical Safety • Emergency and Disaster Preparedness Emergency and Disaster Preparedness (Spanish) Fall Protection > Fall Protection (Spanish) > Fire Safety and Prevention > Flammable Liquids > Forklift Safety Awareness = Global Safety Principles: Indoor Hoisting and Rigging • Globally Harmonized System of Classification and Labeling of Chemicals (GHS) > Hand and Power Tool Safety Hand and Power Tool Safety Impact: Pneumatic Tools > Hazard Communication (HAZWOPER) Hazard Communication: An Employee's Right to Know Hazard Communication: An Employee's Right to Know (Spanish) > Hazardous Material Handling and Storage > Hazardous Materials in the Workplace > Hazards to Outdoor Workers > Heat Stress Recognition and Prevention > Hydrogen Sulfide Introduction to Industrial Hygiene introduction to OSHA > Job Hazard Analysis > Laboratory Safety • Ladder Safety > Lead Awareness in General Industry > Lockout/Tagout • Lockout/Tagout for Authorized Persons • Lockout/Tagout for Authorized Persons (Spanish) ▪ Machine Guarding > Mold Awareness • NNNFPA 1600 DisasterfEmergency Management NiFPA 707E Electrical Safety in the Workplace 2015 Edition > Office Safety > OSHA 300 Recordkeeping > PPE: Personal Protective Equipment • Regulatory Information > Rigging Equipment and Inspection > Safety at Work: A Systematic Approach > Safety Data Sneats • Safety Data Sheets (Spanish) > Scaffolding and Ladder Safety • Scissor Lifts > Slips, Trips, and Falls > Slips, Trips, and Falls (Spanish) > Spill Prevention and Control Spill Prevention, Control, and Countermeasure Plan Storm Water Pollution Prevention > Trenching and Excavation Safety > Warehouse Safety > Welding, Cutting, and Brazing > Workplace Inspections > Workplace Safety Orientation > Workplace Safety Orientation (Spanish) IC. 12 thinkhr.com 1877.225.1101 4 Think. LEARN COURSE CATALOG Performance Management = Human Resource Development: Performance Appraisal and Talent Management > Monitoring and Improving Performance > Performance Appraisal Essentials: 360-degree Appraisals Performance Appraisal Essentials: Conducting Traditional Appraisals > Performance Appraisal Essentials: Planning for Appraisals > Planning for Performance > Strategies for Successful Employee Onboarding: An Introduction > Workforce Planning and Employment: Orientation, Onboarding, and Exit Strategies Persona! Protective Equipment > Hearing Conservation > Personal Protective Equipment (HAZWOPER) > PPE: Eye and Face Protection > PPE: Foot and Leg Protection > PPE: Hand Protection > PPE: Head Protection > PPE: Personal Protective Equipment > PPE: Personal Protective Equipment (Spanish) • Respiratory Protection Respiratory Protection Impact: Donning and Doffing Personal Safety > Back Safety and Injury Prevention > Back Safety and Injury Prevention (Spanish) > Benzene Awareness • Bloodborne Pathogen Awareness • Bloodborne Pathogen Awareness (Spanish) > Cold Stress > Electrical Safety > Fall Protection > Fall Protection (Spanish) > Fire Safety and Prevention > First Aid: Basic > First Aid: Medical Emergencies > Flammable Liquids > Hazards to Outdoor Workers > Heat Stress Recognition and Prevention • Industrial Ergonomics > Laboratory Safety • Ladder Safety > Office Ergonomics > Portable Fire Extinguishers > Preventing Identity Theft > Workplace Security Awareness th;nkhr.com 877.225.1101 5 Think•` LEARN COURSE CATALOG Transportation Accident Procedures Involving Large Vehicles , Collision Avoidance Defensive Driving = Defensive Driving (Spanish) Defensive Driving Fundamentals Defeersive Driving Fundamentals (Spanish) = Defensive Driving: Truck Safety > Distracted Driving > DOT 1; Hazardous Materials Table • DOT 1: Introduction, Classification, and the Hazardous Materials Table > DOT 2: Packaging, Labeling, Marking, and Placarding > DOT 3: Shipping Papers > DOT 4. Loading and Storage DOT: Air Brakes = DOT: Drug and Alcohol Awareness > DOT: Hours of Service > DOT: Inspections • DOT: Security for Shipment of Hazardous Materials ▪ Emergency Situations While Driving > Ergonomics and Injury Prevention for Commercial Vehicle Operators > Flagging Safety > Flatbed Cargo Securement > Forklift Operation 1: Safety Inspection and Maintenance > Forklift Operation 2: Stability and Capacity > Forklift Operation 3: Load Handling Wellness > Optimizing Your Work/Life Balance: Maintaining Your Life Balance > Optimizing Your Work/Life Balance: Taking Control of Your Stress > Pandemic Flu Awareness Forklift Operation 4: Traveling and Maneuvering = Forklift Safety Awareness = Hazardous Materials: Infectious Mate.rials Transportation by Ground > Hazardous Weather Driving for Commercial Vehicle Operators IATA 1: Hazard Class Identification/Classification IATA 2: Marking and Labeling • IATA 3: Packaging • IATA 4: Documentation IATA 5: Limitations and Shipment Review > INIDG 1: introduction, General Provisions, and Classifications • IMDG 2: Dangerous Goods List, Special Provisions and Exceptions IMDG 3: Packaging, Marking, Labeling, Placarding, and Documentation IMDG 4: Loading, Unloading, and Offering Dangerous Goods > Loading Deck Safety > Negotiating Hazards for Commercial Vehicles Packaging Small Quantities > Safe Vehicle Backing > Trailer Coupling and Uncoupling > Urban Driving thinkhr.corn i 877.225.1101 6 Think • LEARN COURSE CATALOG Workplace Skills Are You Listening to Your Customers? > Basic Presentation Skills: Creating a Presentation > Basic Presentation Skills: Delivering a Presentation Basic Presentation Skills: Planning a Presentation > Business Writing: Editing and Proofreading Business Writing: How to Write Clearly and Concisely > Business Writing: Know Your Readers and Your Purpose Communicating Across Cultures > Communication Methods that Make Sense —and Make Your Point > Creating a Compelling Job Description Creating a Positive A:titude > Emergency Response in the Workplace > Essentials of Interviewing and Hiring: Conducting an Effective Interview Getting Results without Direct Authority: Persuasive Communication > Handling Difficult Conversations Effectively > The Internet, Social Media, and Electronic Communication Interpersonal Communication: Being Approachable Interpersonal Communication: Communicating Assertively Interpersonal Communication: Communicating with Confidence • Interpersonal Communication: Listening Essentials Interpersonal Communication: Targeting Your Message > Interviewing: Doing it Right Listening Essentials: Improving Your Listening Skills > Listening Essentials: The Basics of Listening > Listening to Improve Conversation Management Essentials: Confronting Difficult Employee Behavior > Mlanagement of People: Total Rewards > Solving Problems: Framing the Problem Techniques for Communicating Effectively with Senior Executives ▪ Telecommuting Basics: Communication Strategies for Remote Employees • Time Management: Analyzing Your Use of Time > Time Mlaragement: Avoiding Time Stealers > Time Management: Planning and Prioritizing Your Time • Training and Development > Using E-mail and instant Messaging Effectively The Voice of Leadership: Effective Leadership Communication Strategies > Waste Minimization and Pollution Prevention for Employees • Wortki^g with Difficult People: Dealing with Microrranagers Working with Difficult People: How to Work with Aggressive People bVorking with Difficult People: How to Work with Mlanipulative People Working with Difficult People: How to Work with Negative People > Working with Difficult People: How to Work with Procrastinators > Working with Difficult People: HOW to Work with Self-serving People > Working with Difficult People: Identifying Difficult People > Workplace Conflict: Recognizing and Responding to Conflict > Workplace Conflict: Strategies for Resolving Conflicts tn;nkhr.corn 877.225.1101 7 Think • LEARN COURSE CATALOG ENGLISH COURSE NAME SPANISH COURSE NAME Driving > Defensive Driving > Defensive Driving Fundamentals > Hazard Communication: An Employee's Right to Know Harassment Conduccion defensive > Principios fundamentales sobs conduccion defensive > Comunicacion de peligrns: el der -echo a saber del empleado > Preventing Harassment in the Global Workplace —Employee Conocirniento sabre el acoso sexual de los emplea-dos Edition OSHA 10-hour General Industry > Confined Spaces > Hazard Communication: An Employee's Right to Know > Safety Data Sheets > Slips, Trips and Falls Espacios confinados ▪ Comunicacidn de pelicjros: el derecho a saber del empleaclo > Hojas de duos de seguridad > Escarregol:es, tropeces e quedas Personal Protective Equipment • PPE: Personal Protective Equipment > EPP: equiuc+ de protection personal Personal Safety > Back Safety and Injury Prevention Bloodborne Pathogen Awareness Workplace Safety Emergency and Disaster Preparedness > Fall Protection > Lockout/'Tagout for Authorized Persons > Workplace Safety Orientation • Pro cccion de la espalda y prevencidn de lesiones > Consciencia sore patogenos hemototransmitidos • Preparecid•n pare emergencies y desastres • Protection contra cai—des > Bloquea/etiquetado por personas autorizadas • Orientation pare la seguridad en el lugar de trabajo thinkhr.com 877.225.1101 8 Think • IJSI Benefit Resource Center " t B n ti Rurce C rter Your one -call benefits information hotline Ocsoaj,emple‘jee3 expe-lence situations requlring an expert to resolve. Our Personal 3neflt At1-4.?...cates ae expets 0- yo-r yOJr carriers and a.-e- committed to assisting employees in resolvHg those complex iss_les. Wit tlic2 ess I dminkrrtft devf opeLl the Resi:ili-ce Center. Our told-fr,:e speifically Cyried tas a L.i for all benefit que'stiotis and claim Henhtsluesti,‘ns and. claim StP,2,1til benctli.aJm in i,4!ra.'ilon and cu: voLir em;-.1ove-ei, and support 1:7." :•: t ore. .‘.= 7- • ..'" E- Ceiiter is wii:llexpierienced ayc ct • set.% ie arid partisip-mi Our Perstmal ELa:21it wes will be al•le to: iwir incrietit it q1i As,ist claim i-irohlems carriers Pro,. ide claim appeal:, i,iil,rinatior. and evlain the priicess allowable stau' eletion (adding ne.who ills. marriage, divorce: etc.) Provide \ endor plan contact information The Benefit Rrc Ceiter in ‘Yith your Account to ensur,Li voiir health and welfare plan is operatinz, efficiently. TiheDRC reporzinz sysreni track; trends. whidl enbles communication,i arid work Lill the carrier to corre,:t benefit ccinfusion and claim errors. lThis shared with your [..I to farther assist ‘vitil desigitiwr a targeed and eecti‘e employee communication campaign. Benefit Resource Center Service Summary Services Eligibility Support Confirm Plan Eligibility with Carrier Assist In Resolving Eligibility Issues Explain Plan Eligibility Based on Life Events Plan Support Answer Questions Regarding General Plan Inquiries for Health and Other Plan Benefits Provide Ernployee Advocacy Services - Transfer and Facilitate Calls with Insurance Vendors/Carriers Confirm and Explain Plan Coverage Including Medical, Dental, Ancillary and Supplemental Benefits Specialist Support for Complex Issues Provide Carrier Contact Information Answer Questions on HSA and HRA Plans Guidance on Disability Claim Filing and STD to LTD Transition - Explain Long -Term Plan Benefits and Verification of Status Requests Discuss FSA Plans and Eligible Expenses Medical Appeals Information and Support Explain Beneficiary Form Requirements Coordinate Evidence of Insurability Process for Life and Disability Provide Contact Information for Other Benefit Service Providers Locate Nletwork Providers Plan Support - Pharmacy Educate Participants on Prescription Drug Plans Help with Issues Obtaining Prescriptions at the Pharmacy with Appropriate Overrides Locate Lower Cost Sources for Prescription Drugs Provide Information on Generic Drugs Claim Support Research/Resolve Claims Denials and Processing Errors Provide Payers with Additional Information Required to Pay a Claim Research Patient Out of Pocket Expenses Benefit Resource Center: Client Success Stories BRC Overcomes Carrier & Clinician Push Back For Vulnerable Member Problem In early 2015 a member was in need of genetic testing because of her ancestry and predispositions. The member had all of the genetic testing completed. When the claims were presented to the carrier, the carrier denied all of the claims. In very late 2015 the Account Manager contacted the BRC for help with what was described as a "hopeless case". The lab tests in question totaled more than $5,000 and the member was distraught over this financial burden. The carrier had denied all of these claims as "not medically necessary". The BRC made multiple attempts to persuade the doctor to initiate a peer to peer with the carrier, The doctor had a fierce gate keeper, her office manager. To further complicate matters, the doctor, an obstetrician, was truly never in the office, she was busy bringing new lives into the world. Solution Undaunted, the BRC persevered and decided to try a new tactic. The BRC contacted the carrier Appeals Department to see if we could take a different approach. The Appeals secretary agreed to reach out to the doctor with a clinician on the phone. Success! The doctor "was in", and the spontaneous peer to peer review was completed. This resulted in the carrier overturning their denial and agreeing to pay all claims. The last piece of negotiating was not completed until the spring of 2016, a process spanning more than six months, when the provider finally refunded the member for the all of the services the member had paid for out of their pocket. The end result was a very happy client, member, and BRC. 1 Benefit Resource Center: Client Success Stories BRC Resolves Policy Cancelfafan for Disfressed Member . . Problem In the spring of 2016 a member was out on disability, very seriously ill and in need of some assistance in dealing with a letter received from his employer's life insurance carrier. The letter was notification that the member's life insurance policy had been cancelled. An Account Manager e-mailed the BRC asking for help to resolve the issue. The member became disabled while he was working. He was very seriously ill and had been on disability. During this terrible time, our member's wife received notification that the life insurance policy, purchased through work and paid for with payroll deductions was termed due to a missing document. The BRC went to work right away. The next day, in shock, the member's wife called and informed the BRC that her husband had died. Without his work life insurance, she said she had no money. Solution The BRC contacted the Account Manager and explained what had happened. At the Account Manager's suggestion, the BRC reached out to the carrier to see if there was a way to get the policy reinstated. The carrier said that if they received medical documentation, the documentation would be reviewed. If the medical documentation supported the fact that our member was completely disabled, the policy could potentially be reinstated. The member's wife sent the medical records to the BRC, who then organized and sent off to the carrier on her behalf, with our fingers crossed. Success! Several weeks later the BRC received notification from the carrier that after reviewing the medical documentation, the carrier concluded the policy should be reinstated. The carrier emailed the BRC, notifying the Benefit Specialist that the member's wife had been issued a life insurance check in the amount of $140,359.78, equivalent to 4 times our member's salary. The money meant some semblance of financial security for the member's wife. It was nearly six months and more than 80 distinct interactions from the first email to the issuance of the check. The BRC rejoiced about the amazing outcome. 2 Benefit resource Center: Client Success Stories BRC fdentifees Missing Prior Authorkailon to Help Employee Save over 90% Problem Employee called advising he had to have surgery on his shoulder, The surgery was a success; however, the insurance company had paid nothing. Faced with a bill totaling over $20,000, he called the BRC. The employee expressed to the Benefit Specialist that he could not afford the bill and that he was facing bankruptcy because of it. Solution Working with the carrier, provider, and attending physician to gather the necessary information, the BRC Benefit Specialist determined that prior authorization had not been obtained for the employee's shoulder surgery. Success! Realizing this, the Benefit Specialist drafted and submitted an appeal with supporting documentation gathered on behalf of the member, a task often performed by the BRC to assist US! account teams. Following the appeal submission, the claim was paid, reducing the employee's out of pocket costs to just under $2,000 - less than 10% of the original claim amount. 3 3enefit Resource Center: Client Success Stories SRC Advocates for Employee's Disabi1 y, T Canter Overturns Denied LTD Claim Problem An employee received notice his disability claim for long term disability (LTD) benefit was being denied, as the member was not meeting the definition of disabled according to the carrier. The employee decided to call the BRC for assistance after becoming aware of the denial, A BRC Benefit Specialist submitted an appeal, along with additional chart notes regarding the member's condition, but the denial was still upheld. Solution The Benefit Specialist then submitted a second level appeal with additional documentation that had not already been submitted. In the appeal letter, the Benefit Specialist requested that if the carrier was set to deny the claim again, that we would like them to send the employee to one of their physicians, at their cost, to be evaluated. The carrier agreed, and soon after sent the employee to one of their physicians for evaluation of the employee's disability. Success! After the clinical evaluation, it was determined that the employee truly was in fact disabled, and the carrier's physician approved the disability claim. As a result, the employee was paid retroactively back to the date on which the original LTD claim was submitted. 4 Benefit Resource Center: Client Success Stories RRC Discovers Complex Flan Exception, Saves Chronically !11 Member Thousands Problem A member diagnosed with end stage renal disease (ESRD) undergoing dialysis, reached out to the BRC to understand why his insurance carrier was not paying for any of his treatments. The first dialysis bill was nearly $19,000, the next was over $22,000 - and the member was being held 100% responsible for treatment costs. The member soon realized if the carrier was not going to allow coverage for his extremely costly treatments, he would have no choice but to forgo treatment, resulting in a terminal diagnosis. Not knowing what to do, the member called the BRC for help. Solution After extensive research, a BRC Benefit Specialist was able to clarify the reason why his carrier was able to hold him to these charges. As it relates to dialysis treatment, guidelines state a member is not required to elect for Medicare until the 30 month coordination is complete. Realizing this, the Benefit Specialist looked into the guidelines, and was able to clarify the specific exception of the plan that required a member to elect for Medicare long before the 30 month timeframe ended. This exception was the reason behind why the carrier was able to disallow coverage for the member's dialysis treatment. Success! Through this discovery, the Benefit Specialist explained to the member if he elects for Medicare, all the treatment charges would be processed and the member would have no patient responsibility. Soon after being informed of his options, the member moved forward with signing up for Medicare coverage, wiping his balance clean with his dialysis provider, and able to continue on with his treatments free of disruption. 5 EMPLOYEE BENEFITS CONSULTING SERVICE USI Insurance Services, LLC. FEN!! 13-377134 - Jose L. Gonzalez, VP Employee Benefits www.usi.biz Wham Makes USI Different? Today's Agenda • About USI • The USI ONE Advantage® • City of Miami All Employees Business Issues and 'Challenges ■ Employee Benefit Solutions • Next Steps I2 • - ' • ''' 4 " • " A • - k r rrk - • a. • r UsI VIZz, to:4 4-1441Pa‘' kr:* • 0.22212.. A. , - „ • - .11 '45-6•--%i a :A'AltalitT11440::R=161 • 2; .22 .rerst;:‘,44 .`"' • 1, 1-44 ; •41, ,".11 USI Brings National Capabilities & Local Expertise LEI is a nalional insurance brokerage and consulting firm with more than 140 local offices connected across the U.S. and a leading market position in all core businesses. The Coral Gables orrice has been serving our local community since 1935. Leading middle market broker -$1B in U.S. revenue Commercial P&C Personal Risk . 0 ketirnm, USI's Southeast Region • Over '1500 (--rnployces Nalionally, 440 1:(?crior rally and over 100 ill South Florida. Our local ol has an average tenure of 15 years. • Dedicaled unalylics, underwi Hit 1C1, welines uric compliance experts who make up lhu region'', Technical Resources Team and available locally. - Regional offices located in Coral Gables, Ft. Lauderdale, West Palm Beach, Vero Beach, Tampa, Ocala, Jacksonville, Savannah, GA, Columbia, SC, charlotte, Nc, Memphis, TN, Rirrnincillarn;:AL,.,Mlarita, GA USI's South Florida Offices • • 'Employs 68.industry exPerts with an average of 10.years ot insurance expellence. - • $18 Million in revenue 3 What Makes USI Different? US1 ONE ADVANTAGE`' Our Multi Year Benefits Strategy USI ONETM, is a furidan-nenlally different approach to risk management, integrating proprietary business analytics witli a networked team of local and national experts in a consultative planning process thal generates targeted recommendations for improving employee benetil plans. C�rv1N1 NETWORK USI ONE t:Wm-do et A !; ?1 O1 client customized, actionable, n iut.tui able: ° elutions with bollona Brie iIY1pact to your business through cost reduction and coverage enhancernenl resulting in an Employee Benefit trend advantage. Client Business Issues 8 Challenges • 4 pia •Y 1-••••,..1 • • war US( ONE-rm OMNI Provides Robust Analytics and Solutions _ A tea -time inleraclive solutions platform built by USI experts capluring Ihe experience of more than 100,000 clii:-nts, thousands of professionals and over 100 years:of business activity through dui-- acouired agencies. • Proprietary Analytics One -of -a -kind tool built by.USI subjectirnatter experts , • ActionableSolutions Engine .,• • o "Kt0111 Codflos 11 0 broad and deep ..i3 knowledge of USI specialists into poloao.6040,40514,01,4.4:,70.4..7zavermaguis Thousands of actionable risk „ . rnarlagorTlent solutions across 100 11V10.10410.114.401110P4r.711•0411.0.410.004.10.0601000M1111.1111 10216109111141010111 111110101P010000 1111111111111111111103111111111MWOM =viiitaktianlIen V 0 • industry verticals • Real Time Analysis Continuously refreshed to rriec, current market condition:, • Quantifiable Financial Impact , Solutions focusod on economic impact lo your business' Actionable, Quantifiable Data Engine to Drive Decision Making • • • ,•••: •: ' litlihf ••••44? 1 ;••I "`•1111: 1f I 5 Et- .46 lit 4 Mira* k , NEFtyt V. USI ONE-rmNetwork Provides Deep Expertise Dedicated technical experts networked nationally and embedded in local offices with over 4,400 professionals nationwide to build integrated client centered account learns. 300 f' Consultants JOSE. GONZALI 450+ Account Leads RAUL SANCHE JrcYcA QUESADA 85+ etwr I ters & Analysts 10f PF UNIAM R CornpkInce Attorneys & "'xper SCOrl SI GAL 204 • Wirtes$, Directors J[NNWEF! SI-ICY/FRS •tqledical ec tars LA, DANIEL SAMO,MD Pharmacy C:onsultdnt PAIRICIA BOWEN 10+ Clams Experts BE NWT RESOURCE CENTER 10+ Cornms Experts DEBBIE. NORTON 30+ Practice Leaders N ROCk 4E. • Over 1,500 national employee benefits prolossionals hi -home oxpoi1, loc.-any based, ensure your full including enrollment, retirement -and wholesale account learn is always available • 300 ER professionals within US 1 Southeast • Hands-on service and ongoing diligent follow-through Unmatched Middle Market Breadth and Depth of Employee Benefit Resources 11All ritiltiz, E: 6 USI ONET1 Entorprise Provides Strategic Planning Highly consultative team meetings integrating USI's Omni analytics with a broad resource network to build a multi year benefits strategy aligned with your business needs. Employee. Satisfaction Oporcilinns X. rioduct I IR r RmsrutircE-“, Funding & Plan Design Strategy 'Consultant Account Mgmt CLIENT BUSINESS ISSUES & CHALLENGES t Inderwrifinci Ar :COI; sto•i .1 Coh '4*11.3gifAhMeolotk Lower Cosl of Cale ,01! Population I lea1111 fvtoi lager Moeraii' • Complionco A I Foi nny • Discipline Structured round table analysis. on a`weekly schedule deliversconsistenl. execution of our team strategy • Collaboralion Integrated team of local & national experts lo evaluate critical tisk issues and create alignment with proposed solutions • Advancement Test conclusions and makeirnprovemenls based on client input & risk dynamics • Accountability Clearly assigned tasks and deliverables within the agreed timeline Proven Process for Iderilifying, Quantifying and Eliminating Exposures to Your Business 17 USI usi oNElm Employee Benefit Solutions USl's employee benefit practice is designed to contain cost, prornoie regulatory compliance and deliver superior account service. We focus on seven primary employee benefit service areas. Underwriting & Analytics in (.:nnictin plan cosiF, I-1R Services Hal !aims, call cc:ilters and service calendars to easc., your administrative burdens Population Health Management Wo1Iness In, disease incimniont analysis und aligned incenlivos lo improve health _ ree7r1rfroltir L Compliance/ Healthcare Reform c:1( vio (And pf It 1,c) prornoto corriplionce with ledercri and slcile rc)gulations Care Intervention Options I o; mciko Tip decisions without sacrificing -quality .orr-y Pharmacy ! S010101-1'.; 10 111,l1f incmoso 1 and mininlize phorn lacy costs A Comprehensive, Holistic View of Your Employee Benefits Plan Ancillary Benefits 'rind drives results for ot1)1::q plan servic..:s 8 USI brings broad and deep expertise to City of Miami All Employees having provided risk management solutions to clients in the Public Sector. Leveraging our USI ONETM process, we work to understand your company and your challenges so you can focus on growing your business. Issue / Category Solution HR Services___...-----._.._. • SpouSat.Coverage Strategy �rpact Ludy (See Appendix) -$1,181,250 Pharmacy • PBM Confiraci Review • $918,000 Population Health • USI CORE HEALTH Strategy • $815,400 Management Underwriting & Analytics • Comprehensive Underwriting • $720,000 Review 24 Solutions Generating up to $6m Savings Over. Current Plan Costs with Increased Services . _ issue / Category Soluliott Ancillary Benefits • Packaged Ancillary Program .Savings hnpact Caro SIudy (Sec Appendix.) • $543,750 HR Services - Benchmarking of Benefil Plans - $540,000 Care, Intervention • Transparency Pricing Tools • $372,000 Underwriting & Analytics Proprietary Stop Loss 0 $360,000 Design/Pricing Underwriting & Analytics • Large Claim Review and • $237,150 Forecasting ve' !/- 24 Solutions Generating up to $6,055K Savings Over Current Han Costs with Increased Services r,-riI I 10 - • _ •-•_ ^^. Issue / Category Solution Care intervention • Telemedicine Imtrx...10 - $129,744 Ancillary Benefits • Negotiate Ancillary Multi -Year • $67,969 Rate Guarantees HR Services • Benefit Resource Center • $36,000 HR Services • Communications and • $36,000 Education Campaigns HR Services • Benefits Administration • $15,000 Consulting Case Stu •C.Sc?.0 Ap 24 Solulions Generating up to $6,055K Savings Over Current Plan Costs wilh Increased Services 1 11 issue / Category Solution impu( Compliance / Healthcare • Client Specific Assistance on • $12,500 Reform Compliance Issues • Compliance / Healthcare Reform review Compliance / Healthcare • Comprehensive compliance $12,500 • Comprehensive Employer • $10,000 Reform Guides and Toolkils Compliance / Healthcare • Leaislafivo & Regulatory - $10,000 Reform Updates Compliance / Healthcare - Reporting and Disclosure `,;10,000 Reform Requirements Cimu., Study (See Appendix) 24 Soluliom Generating up to $6,055K Savings Over Current Plan Costs with Increased Services 1 12 Calego y Compliance / Healthcare • Workshops, Seminars and Reform Webinars fr•R` ptrE.t. $10,000 HR Services - Enrollment Guides & r 1)6,000 Customized Brochures Underwriting & Analytics • Actuarial Valuation of Retiree - $5,000 Health Plans Underwriting & Analytics • Certified 1BNR Analysis • $5,000 HR Services • Annual Service Calendar - $2,000 Case Study (Sci:' Appendix vf 24 Solutions Generating up to ` 6,055K Savings Over Current Plan Costs with Increased Services I Ira 1 Ii91 Inr.i i,;irn .a.arAll Fl yi d,�.. jrvr •I 13 E m poyee ietit Solu-ions 1 14 s+w1¢owt'rN�rp•vRIn3 rmirsT.'R 1iu ri4 ' onveasair.'"r1 ,v.. Wsr *arwr... . 4Mag.ae+w},'�'Err� J";� Yhv y;.'"S%'i +' 1 .h s j• ' Y •M7.`. . N T ram!""x PQ r i r: . :'.l F ( u ihC $m.l &s i,...1 0�,...- -.... . •ll vaQ F3 . ' m ^? is l4 04 IiIIP 'ilYail;i. ' 1 rr.al l._ L+ t,�i h . '.7.71404 ti,fortkikoilizmo,.4 �a. r a- acel { S s k t.,a h:1 + 1- �'� W a z superior assessment, jiy and USI's underwriting and analytics solutions integrate analysis and benchmarking with expert market negotiation lo ideni increase transparency around insurers' profit sources. Utillsanan Menlo, RI NI 10111 MI 4. lndlvldual Claimant Risk 113.4-11 1 r. fir-•,- ,•-,..nr»,....,.serenmmwrwr-�rrwrr+--,-n.--,w 1 e51 F.+,^^.... . ... . All 122.2.2 .2142 NN 'Fr Ir • 85+ In-house Hnancial Analysis and Undotwrtors Nationwide • . Renewal Projections & Funding Analysis • Claims Cost and Risk Assessment • Trend Milic_jalion • Plan Design 8, Contribution Analysis • Benchrnarking • -Predictive Modeling ▪ Ancillary Analysis • ,Intetnalional Exposure Analysis A Customized Well Designed Plan at a Highly Competitive Price 15 UNDERWRITING & ANALYTICS Actuarial :Valuation of Retiree Health Plans USI Consulting Group's actuarial team performs valuations of employer sponsored retiree health plans to meet financial accounting standards. • rAS11/GASB standards require separate and disiint-1 cult rly.i, of future oblicialions for retiree benefits horn e_ac._:tive emplc-)yee bOr1Cfils • Measurement must include valuation of future retiree beriefils • USI performs actuarial valuations 10 analyze impact of plan design strategies and changes to long-term liabilities • Consult to ensure plan design is consistent with Human Resources' 0bieciives and potential liabilities are consistent with linaric:ic_7l objectives Pott'tetftefneft OPEN Far Fiscal Year I. Net Periodic Post -retirement Benefit Cost (NPPBC) II. Estimated Benefit Payments III. End of Year APBO Impact on: Year End APBO (3/31/2010): NPPBC (2009 - 2010) with Curtailment: NPPBC (2009 - 2010) without Curtailment: "5r .014 :3010 LP,' I. .ratio++ fierv.ci_s. Ail riynts reserorect Current (S134,78a) 5464,899 84,209,323 Option 1 (55.096,877i S438.984 53,212,36E Option 2 Option 3 [ 55,117,072) 5389,010 I $2,902,464 05,208,4471 S320.858 51,379,133 Option 1 Option 2 Option 3 (5996,955) 151,306,1359) (52,330,130) (S4,962,000) (S4.502,000I (55,074,000) $234,570 B214.570 $122570 Impact and benefit: • failure to properly identify retiree benefit liabilities can negatively in pact invesic:7i rcalinc_ s and credibility for financial results • Appropriate reporting reduces exposure to investor lawsuits Man Bing Benefit Retirement Liabilities l 16 USI Consulting Group's actuarial team performs Incurred But Not Reported (IBNR) analysis of benefit plan claims to meet actuarial standards practices. - Auditors often. require cer.ltification.ot self -funded plans' rcserves for medical, proscription; denial and vision plans - US' Consul ling Group actuaries review plan dt-:sign, historical claims and enrollment characteristics to determine IiabililiS:s of self -funded plans to meet financial reporting requirements • Provide written actuarial certification • Essential to review for plans transiiioning lrorn fully insured to self -- funded r oho., nm irl y1nt114Pt111!nitil 11,0 .•1111111,Wf!I 11 TI1.' 111am 111A'f t1r1,IIIA +'Ih1na. IIvt iV Intl1 ,If, „1 A11111•nl 1,1111fIrA,1, Iris ;rI)4111y C 1 U5I ConultIn6 Group 1m tool from the wt..1s .LTBIS.A 1n rim I t .41.4 heart I and B rnrnlf.a•r r+l Tho hmrr.. i, A+'n.lwlm; mf T✓IImrl«1 said meet th.` 11mi lltfe ;Rion 41:TnlIaR{<ol tla•_ North nn A :,diertty of Arum, n•a t1110114.4 the al luarisl 1 gn10.011 r nn[nlrt.li Ii.+rpin, iei.asr` motor t nit• If yOel h+tv.. any gl,.••tk11n. 1711 :....I.1:1iun+ 11..gnrth, iatl''01 I......:11.'rot J`�:I A.luf111 _ II1.7 ,R, if U',I IfiS:II .111-,, Impact and benefit: ▪ An appropriate. crslirnalion of IBNR liabilities is required for lax compliance ▪ Cornplianl with Financial Accounting and Actuarial Standards su.,nlnar�o(n,jylt. The lrsulls o1 rollsvnluallur, et. sumnsallzell L+Inver Total 06/39/16 PP ` l.1I11 51,11,11,111111 510.11011 ::f••1,11t'11 I nllllnyrl.u� 14,Ir{rynn., nu11 l._ Krug 11cr t1,l,llll' .0 o r��.11scsl. „1rvl MINI, ke•4r1V„ rho .subs we,aunUerl lathe me0141fhulnuntl 1.1114,1111u .Teheh.siVe Undeiwiting • Review USI's independent renewal underwriting analysis identifies cost saving opportunities and provides a basis to negotiate pricing • Analyze 15-20 technical components within rate calculation • Create full transparency for each cost component • Negotiate each cost component based on best in class industry standard • Establish rate caps and guarantees whore appropriate Alic compltty. Me(holl Pler1 ) newel "ErUrnite " Mr* Perlo+11 I1arIew Al r':I Inn JI.l1 27114 - June 201F. Uny.- Peoo.I Jwluary - Ile[eAl1t et 2111.1 . Avel ade MondNV ure,nrer Acle Amer AgC 1A0.,1,dy Maxr.ber) 11Hx1 I...nitro 1 Man., 1 n1Al Mnrnbnr Morphs 4911 1,1)11 9. b11 1303E 41xt 1 1r1! 711.17 1'1,P15 4i+1 1.1d1 bl7 1b.:, 935 54Jn111 u Inwlled elanuo 4+1,5+M 1:r41r,yo Adluaktlen[ np11.n1r11, 1•M.x.axars 17111c4 A010511nc0e5 Arorde,1 r,Imxns .. b Pnr,lnd 1:Ix95n 1511Ou - 1.I111nIln1) • AnI)'Metl Inl:llrr l (AIMS d 41MIUIk17 21111.201r. UF,1Ir9s1rrance rvlrr'.. Ali rights rr^;e 54 1111: f 43 r9J1.111101 1J7/ 1[11 511 50 44,0(17,i:07 451, 7d7 7J7r S7.8471.11)0 100 0% SUr3.H01 Sn <11 slr S0 SA1..r,11r Sn %nil 0117 tut 09e 34 A 15.`-111 11)21.PIUH1 44/ 1e11 5411? 71i1 .n S4 50 50 S49 St) bn 711544 1 Iri r41 772..?.?71 9 Si1i19,2°•.F 9 7 (Illr. El ltieri 011 I ;ate cipvel[1 1r11P111 109 0% 47B.71 A 79. 1 L10 54 211,2 g r. 5511141.11SH1 $1 av,r 'r7! $4724 S4l58,2 HH 54 6ti0.ti11 S51113 P11 1111°y S4 45V (1 Sil It q"a 59't,9 19r40 1 7<e !H41 14 ft% 54 2211 099 Sri11401141 74,1171; 099 St159.299 19 484,379 Sr>firl1.913 0.0°i 5S, 484,379 11 t4e541511 Rate r.h,Mls 9.24e }H4% 1114°E SC 6.71 19? 51,144 77l: SA.7.1/SPI 1 Impact and Benefit: ■ Eslimated premium reduction of 3-6% • Independent validation of premium cost, rates and trend analysis • Lowering future cost (1-3 years) through rate caps.and guarantees Independent Review to identify Errors tied Carrier Profit Sources 118 1 IONn� •?,t, V.yl-9: 7, t 11 C��frry t 1 1TI1UG & ANALYT1CS • ropnetary Stop Loss Design/Pricfr'i ,:kst4 ryy.��4iffY7!o' " USI pre -negotiates best in class terms & contracts based on your historical/predicted claims and risk tolerance level Analyze both historical and predicted large claims data and premium cost • Evaluate individual and aggregate stop loss level adequacy through benchmarking and risk tolerance level ▪ Negotiate contractual terms and pricing with carve -out carriers 1'4 for tuq .ropc Lon,' tJit«ny FYitAUF AMY •�tVEpi7Y tlHRNO TOTAL: : 4t �L I F : .,r to r .p-car ftri unr^rr, I'X "`�'I>:'anc 4'1 Irvwnw y1 IfI r d1r•I f; ;> a 4}I b02441‘,01, prrMl. x�r..due Fl FI r:a•nntl Impact and Benefit: ■ Save up to 20% of fixed insurance cost, or an estimated 1-3% of total program cost ▪ Enable client to decide appropriate stop loss level based on claims frequency data Best in class contractual provisions Aggressive ',ricino.'vr,+ith best in Class Coverage and Terms 19 UNDERWRITING• & arce Claim Review and Porecasi ig USI's independent review and forecasting of Large Claims reduces inflated projections, driving reductions in premium or stop loss rates and claim liability Claimant -specific High Dollar Claim Review Request Large Claim Report from Carrier/TPA ▪ ,• r,•i• • • I ••• • I. • rl .• r, r r 'rr 111 •Ir• • I ••. rvvr( l• -( r It It I 1 tit I I•-•)•• (:( Obtain from group info. on claimant continued eligbUlty II:, • ..1( • • 1•• • I le ir• )1. •T 11 • 11%, 1111 1 ilrry.11r(incr.0.•, .S.•?rVIC!Frg. All r1r6hisre5ervcd •Ehgdge HSI Medical Director and Analytics Team • ••••vir••••,,,./ i•ill ro r• r.ri•••••'• r .rr ••• .11 •01ir t-,t 50ir Negotiate With insurers and aavisv • 1111' • ' • • • II' I • r i • • • I; • ' • r••• 1, • • • •• • • . • r 1111 III . •I.".r• 11, • • • • •r• • •• -II I, I r• 11: • : 1, 1: .•• • r • rry,I.1. trr•-•• • 1 ' •••• •• • r • • r, Pr(' • r• sr• 1r...• r•r; •• 1:' • 1 r• •• ••• r• Impact and Benefit: • Eiminalion/reduction of I ho impact of High Dollar claimants can lead to premium reduction of an estimated 1-37. - Elimination/reduclion of Slop Loss lasers and reduced Stop Loss premium (self -insured) Increased subrogation and COB recoveries • Abilily to forgot health risk management initiatives improved budget forecasts Eliminate Errors artd Carrier Excess Profit I 20 14 WV # 1' d 1 I �r xn is )14 iv d USI's suite of Human Resource solutions will improve employee experience, alleviate burdens from the HR team, dive efficiency and ensure accountability. COIlRA/ Itrrnrrit tailor tit teni{'nt� Empll yro Communicution [Icon .1dvo ;try Consolicinli.d kliliing &)tiling' Elic{1lif1C'l lr ,'{il4 a11F, l_I I Ir:r'.ua a:v ,,�,-rv.,. n.i� u�.11 •l: r,:;U ,;,,I 1: suployeo nofit Pot t "t ACCOUNT MANAGEMENT • Service Calendar • Implementation & Project Timelines ■ Employee Hotline - Carrier Interaction and Accountability • Coordinate USI Team EMPLOYEE EDUCATION SERVICES - Employee Communications - Guidebooks. Meetings, Webinars • Total Value Statements - Online Er rollrnent Strategies • Customized Campaigns Driving the Value of the Employee Benefit Plans 12 1 US1's identifies opportunities to reduce expenses related to spousal coverage through contribution surcharges, carve -outs or buy-out incentives ▪ The Affordable Care Act provides opportunity for all spouses to obtain coverage -through public exchanges and specifically doesn' I require employers to offer spousal coverage ▪ USI offers strategies to reduce cost based on claims analysis while providing in a responsible transition to employee/dependent only coverage USI 3D database Cohort Statistics: Total Paid SPOU Lin $1,121,828,876.47 :' s „ i r . . I: w .- . f Orel CItil 11'; $ 3,924,557,773.25 28.58% Total Medical Paid $933,292,961.23 $ 3,291,238,274.86 28.36% Total Pharmacy Paid $188,535,915.24 $ 633,319,498.49 29.77% No. of Members 123,625 650,497 19.00% Removing 1 spouse coverage will save on average $4500 per year I: 1 Impact and Benefits: ■ Spouses typically represent 20% of members but 30% of claims cost ■ Through increased contributions or spousal attrition, savings range from an estimated 3-10% of tolal program cost Changing Landscape of Coverage Expectations Due to ACA I 22- USl's benchmarking allows clients to understand where they are positioned along side competitors in the marketplace. ▪ Identity benchmark group based on size, industry and geography ■ Conduct comparison on benefits type and level, rates, contributions, and eligibility ■ Conclude and communicate key differences from benchmark Kind agree on actions to reduce/increase covcrag Annual Individual DettuetilrC& (G5-tietwnel+r The following than lnchcntes the nnnunt Individual &dlunhle insane Ihnl Ilw nrnphwee is respnnsi+le tar HMO POS PPO Triple Option 6111 IM1hn 1•14r NI MIS. .. 11141i 11 11 i!J^F I, 116111, SI $F1Ni fN let: 1)0u11. 2 FII00'i 1 21 .11he 14 11 n11', ll $11111 5. IINV1 1111Nr,• r1 It ION, 11 IN 1491, I! II IIII', II 5101.11-3141N1 I000% 1 IUDC% 0 1,164% v 11(10.11, it 14 (4411 5,I11.1(1 11r note 1 lie Mrs1 L. met, d 11U11'y $J0U I.S.;4N1 000r4 11 1(1111°n U 91114Iu N t1III 1"9 (1 S:'4IlI 5IINNI 111111+. 11 n n1ok, II 4 r.!.4s 4 1111'P'k 11 144C01.$11,1111 0 (1f1W1 U n 1,114. n 11 I'n% 0 0 fan % (1 !s`,r11.5d1441 4n Ull'ti, I H(41,6 0 4 .1," l UlIlI , 11 $1(101.$4,00 0110'IF 11 II11h); (1 11110'S, 0 (11,11% [1 04r411 $4'gel 011tr41. 11 ll 4111'ti. 11 1111I1,a 0 011114, ll S',,1100 or mare 0.0096 0 25.12,04 0.0096 4 0A0%. 0 DY.r.N Tout: 100.09% (0 (00,00% 4 100,011% $6 1Q0.0011 0 Overall Average Deductible, {620.00 $1,025.00 61,496,40 i0,00 Total minus No LI.duellbl.. 900.00^'. 5 140.00 . 4 100,00'4 57 100,00".s G Av.rno• minus No Deductible.: 51.650.00 51.925.00 51.731.55 f0A0 ' ztill -1 1.l=,I Ir .1 i111• .1: il,d �, Impact and Benefits: • Compare your benefil program to similar organizations M Understand the local and national trends in benefit programs w Ensure alignment of pion incentives and design with company strategic goals ■ Savings are case specific based on client's strategic goals tl�l&r' Enha e Benefits Sir y Based an Peer Analysis 6 23 USI's Benefit Resource Center (BRC) provides individualized support for employee benefit plan interoci ions ▪ USl employees provide resolution for elevated claims, billing and eligibility issues ■ Answer benefit plan/policy cfueslions - Assisi with eligibilily and claim problc-ms will, carriers - Provide claim appeals inlorr11alion and process - Explain allowable family status election changes • HIPAA Compliant - All inquiries die documented ir1 a call tracking system • Utilization reports generaleci quarier-1y -r 2�114 :'1i 11rU - Ir erncri .;cgr vices All rights reserved rved Critical Incidents: 10 Inquiries: 159 Foliow-Up Notes: 180 Our BRC Saved You: 130. 75 Hours Average Hourly Salary: $50.00 Per Hour Our BRC Saved You: $6537.5 Impact and Benefits_ ▪ Reduce your cost of employee benefits administration. Avorctgo saving of $2,00 per month per employee ▪ Relieve HR staff from time sport on administration to focus on slralocjic HR functions ▪ Increased employee satistaclion and awareness of benefils plans ▪ Quarterly reports provide insight on critical communication improvement opportunities Reduced Adriristr five Time & increased Employee Satisfaction 124 t t (44 41•'--4.' •:. '6a4 .2k r" A USI's Communication Services team creates strategies to promote Ihe employee benefit plan and engage employees • Assess effectiveness of multiple communication channels (e.g., Mobile, internet, 'print) for a key message regarding • A change of plan or setting of care • A new wellness campaign - A change of law is Managing qualifying events • Design a strategy that defines key messages, audience, and tactics ▪ Provide on -going benefit communications to reinforce key messages and drive behavior changes • Brochures • Recorded Presentations • Webcasfs • Mobile Applications • Wellness Fairs • Lunch-n-learn • In Person Meetings • Electronic Packets • Client Websites 2011 Iniinnn All 11‘.1`,Vill'' Impact and Benefits: • Gain the full value ot changes implemented lo reduce healthcare cost • Prevent costly employee misunderstandings regarding changes of coverage status • Relieve HR staff from time spent on administration to focus on strategic HR functions (average 10-20 hours per event) Effective Communications, Educated Employees 25 USI evaluates online enrollment vendor capabilities to meet client specific needs for benefits administration and enrollment • As technology and social media proliferate, employers demand resources to communicate and enroll their benefit plans in the most cost effective and efficient mariner • USI's technology consulting resources evaluate the full spectrum of solutions in the market, as well as design and assist in the REP process • USlrs account management team coordinates communications between vendor and relevant insurance carriers Employee Cer mmol w------ ter---,= EMM.1,ex122. »....,«.a...,vr '.1.s-MM,. ,. A...r ... __ r.. --_--, a.w R...�. .»..tee. _.., *LW RI Igi » r....... .........r ..,....»..r,.w..w.,...- -"� P114 :;Uli1 li ;I Insuinnre ➢etvr..rs All ugh rsaarui-nl impact and Benefits: ■ Ensure appropriate vendor selection and financial investment to meet specific goals and objectives - Reduce HR burden for vendor selection - Improve enrollment experience, accuracy of administration, consistent communications to employees Evaluate Tochnolot y Solutions to improve Efficiency I 26 t USI deploys multiple tools to communicate the plan design, contribution options and appropriate disclosure notices • Customized communications including corporate' rrrc�ssacte and branding ■ Produce Benefit guides, annual benefit statements, wobinars and on -demand er uoflmeni meetings via E3rainshark, electronic or print copy ■ include federal and local disclosers, e.g., COBRA. FMLA and other notices affecting employee rights F.M.tunnk i tkra[ F rr , I.raMDI,rrdlNr LWOW. :`201.I., rI I9• LtSI Irrcu1;vo..1 :.r-I C" %ilh uah9F 1,1, nv.+•i Impact and Benefits: ■ Significantly reduce HR manager lime and resource in managing enrollment - improved quality, accuracy and compliance elernonl of communica lion documents - Turn -key new hire enrollment Contrnunicalion ro men rFtin1caB on to Engage Employees 127 - ' • )41 ;•( • t ' USI's client specific calendar documen[s critical deliverables and facilitates advanced planning • Idenlify and agree on objectives as a team - Develop timeline and key deliverables - e.g:, Claims review and forecasting; Compliance Analysis; timely delivery communication pieces; Wellness strategies • Measure to ensure completion and quality of deliverables • Provide appropriate adjustments based on emerging issues during the year +,111.1, I' 111;11q.:• t 11114, 11,,,ti McATEMI EMEMERE IMBERE Impact and Benefits: • Alignment of expectation and deliverables of USI team and clients • Documented process provides accountability and improves efficiency • Ensure timely delivery of key rnileslones N Incorporates multi -year objectives into current action plan 'Aligned Objectives and Accountability 28 .."44•MIN. 4-•••-• -.. • 2.1 • ' • r 4 . . 7 4441i, 1"1. " r .N( A health -promoting environment attracts top talent, reduces medical costs and -absenteeism. USI.Populafion Health Managers evaluate data and recommend solutions that improve employee health status. N's) • Anc.11ysis (Ind 1. - • • k :)ttk tt1(,( ISUE • Tr ilk )r, pr o9r am , or cosult% ccrrirnonications • lipn key • Vendor Seloclion • Inrentivos • .1(1r cle.IE-d ro(JfaTIli • (1)MN • : 117) • ; Pk it Inir • -lean-) of Locally B6sed, Nationally Netwoikeci Wellness Consultants • Slraterlies to improve Engaciernent • Wellness Program Feasibility Analysis • Program Design, Implementation, Reporliticl • Targeted Communications to Improve Engagement ▪ Prodiclivo Modeling & Large Claims Analysk • Disease Managernont:Stratogies Engage.d, Healthier, Productive Employees & Lower Medical Costs 1 29 USI's multi -year CORE Health Strategy delivers claims savings through incentivized physician engagement, targeted disease management and comprehensive reporting. • 70°%; of Ihe US population dons not have an active wiinary relationship • Promoting primary care physician relationships facilitates lower cos i interactions within the healthcare system and encourages proactive healthcare management • Physician engagement helps to promote early dcic_:ciion of polential catastrophic claims • USI assists with the design oI liriaricial incentives for rnernbers 10 engage witty their primary care physician Lnyloyeef • rmco5.. one .nauaw• . r;q;q.zwr. U l fnst.iranct+ All nghrs su•Geryrrl rr 0,610,o:eaf ane.rrl.n Impact and Benefits. • Estimated cosl avoidance can rancid Irani 3-5% of annual prerniUM and significantly reduce long -form trend • Cost neutral incentive design ■ Mitigate emergency room visits and inpatient days ■ Early detection and avoidance: of catastrophic claims rly Intervention Significantly Reduces Long Term Cost 1 30 USl's strategy to incentivize employees to engage with their primary care physician reduces high cost drivers and improves employee health. ■ Less than 30% of US population has an active primary care relationship ■ Determine current physician engagement level ihiougFi carrier and tiSI proprietary analytics tool • Design financial incentives around plan & contribution structure) to increase primary care utilization • Use data to evaluate the program's effectiveness and provide future program direction PCP Impact on ER �u Inpatient Utilization 11.11PI'4 di, ^N.I it! JtYt'.. 11]?UI'. u!i,+!'. '•a JE r, +,^' u, Impact and Benefits: ■ Employees wilts active primary care relationships experience 40% lower rate of ER services and 33% lower inpatient admissions, resulting in an estimated 1-3% reduction of lolal program cost • With proper incentives, 70-95% cat participants establish active primary care relationship within 12 months Low Cost, Hi Irn apt Cc�s# .antalnm^ent Strategy 131 USI's strategy to incentivize spouses to engage with their primary care physician reduces high cost drivers and improves spouses' health. ■ Spouses typically account for 20% of thr population but incur 30% of total healthcare claims • Determine current physician engagement level Ihrough carrier and USI proprielary analylics tool ■ Design financial incentives through plan and contribution structure; to increase primary care utilization • Uso data to evaluate the program's effectiveness and provide fulurn program direction IA,i PCP Impart an lit St 1rIImtismt lltiliaatlt t 1.1 ,114 ,t)tat1 4a 2014 J 1.9 WI; i I_i°:1 Frktrr:n)P;e Seurms.ea-. AI{ r!ghti r03ervrn) te71?I114 ) kr;tt', ?h'O'. .it) /It1ti )r) /USn 1' ��i'f5 ..ii-. Il tt���l i•lil Impact and Benefits: ■ Members with active primary care relationships experience 40% lower rate of ER services and 33% lower in-paliont admissions, resulling in an estimated reduclion of total program cosi ■ Wilt) proper incentives, 60-80% of spouses establish active primary care relalianship within 12 mot r l hs Lew Cost, High Impact Cost Containment Strategy 32 fl � USI's proprietary "Take Charge" programs provide a low-cost, high impact solution to promote effective .diabetes and cardiac condition management. • High blood pressure, high cholesterol, and diabetes are the most prevalent chronic conditions. Cornbine:d they account for 10-20% of total healthcare claims. Generic disease management programs unaffiliated with primary care have little to no impact on managing those undorlyinq conditions. • Within the USI CORE Health Strategy, high -risk employees are inconfivizcd to adhere to disease management protocols. Annual Ikea Costs Healthy InWlividual vs. Managed Diabetes vs. Unmanaged Diabetes 2014 7015 21)16 1[I12 2111k S9.e641 S11{)r, 511,6Wl SI).W,1 i 14,111 —I11--qManaHorl 56,160 Sia, 1i6 Slr4y.l 'CH.1I4 5'4l1!`7 57;'�11 1flddieru 54)1141 Sgr,)n 5r;[pt2 5't.rno Source: implementing -intensive control or Mood glecose'eoncerT 111un end' "blood pressure In Sype 2 nennetes In Engl Ind: cos` nnn{ysis (UK1'US 13): tJMJ 2002:325:860.1), I lnsi:rnrlca Susvdcw,a.. Af r�'dI SO 50,764 )ir11 )11)11 5,1 5 Il;713 S1,441 impact and Benefits: ■ Carrier based DM programs typically cost 1,504100 PEPY, yet reach only VA', of the population • Eslimated total program cost savings of 1-3% assuming $700 cosi avoidance pet engaged Imic.rh-risk individual wiilm diabeles and $2,000 per cardiac: patient ■ Significantly increased ..adherence to DM protocols vs. using -a generic 'DM prograrn v 'd Adherence through Effective Member ti 133 ,, A�+c Yf f ''IY. P'f1V USI's extensive reporting and analysis quantifies program effectiveness and directs future program changes. ■ Measure program parlicipalion and impact on year over year utilization r11c1rics: e.ci., ER vi5its, inpatient visik, ht!ulll7 shirrs ■ Analysts ot data identities areas of irnprovomcnt allowing us to propose program design enhancements to meet desired criteria nil ,,•., Impact and Benefits: ■ Demonstrate ROI of CORE I-loalth Strategy through roduced utilization of high cost services • Quantify improvement of employee health ■ Clear guidance for future program focus with Iaclical items Castormixed Analysis to Tailor CORE Strategy & Measure Progress 134 USI's National Compliance Team, including our in-house ERISA attorneys, provides expert guidance on new developments and ongoing requirements affecting health 'and welfare plans. Rh lath...., Ny.ntl f it ♦i mi . ■ Team of Locally Based, Nationally Networked Compliance Attorneys ■ Monitoring of all Facets of Health and Welfare Guidance, Including Statutes, Regulations, and Case Law • Health and Welfare Plan Compliance Education ■ Health Care Reform (ACA) Impact Analysis Tools ▪ Ongoing Articles, Workshops, and Seminars - State and Local Benefits -Related Issues Compliance Guides and Sample Documents ■ Assistance with Notice aand,Disclosure Requirements Timely, Comprehensive Analysis I 35 USl's local and regional attorneys work directly with clients to provide guidance on specific issues affecting employer sponsored plans • USI compliance attorneys are embedded in local client service teams, know our clients and the challenging issues they face - Attorneys work along side our underwriting, population health and account consultants to recommend client specific solutions It le y ,"y,..kM1MMNM. ier Lla .n+,+... All;hjhlS r.-PgPy=+j Impact and Benefits: • Included in our standard service offering • Real time, comprehensive recommendations • Networked compliance Loam across the country for additional breadth of knowledge uire Khowlec geable Experts in your Corne 36 COMPLIANCE Comprehensivempliance Review USI's national compliance •learn identifies exposures and offers remedies to assist clients' compliance with state, federal and health care reform laws - USIts local atlorney identifies key areas for compliance 1-c7,viow - Reviews status with regard to key toderal welfare low compliance issues • Discusses issues identified through the review • Proposes action items to address issues and mitigate potential risks Summary Review_ Fedeial Health and Welfare Corupllanue Issues ,. , •, • I 1:662r"'"; �r:,.r �....,... - 2O 4.P1f U I livesir1ncn4irs;vii:us AII'i7gl'dx.k+F:.:ryod, 106.1110 • r.,.m., u[ xun 14011 w.eim.. r...i,!.,,! i„u1[r., Impact and Benefits: • Identity exposures 10 penalties II7a1 can be up 10 several hundred thousand dollars under various b nefi l related laws including ERISA, ACA, and HI AA • Provide strategics and procedures to milicjale existing and eliminate future exposures ■ Review process is included in our standard service offering COMPLIANCE Comprel andTo ln-depth analysis and guidance to help employers navigate through complex rules, regulations and plan strategy decisions • National compliance team provides employers with a detailed road map to the multitude of requirements affecting health and welfare plans • Tactical advice regarding implementation and consequence management - - • I ..triVe • crp 21i 14 2{1111 ( I SI I, in uroTire Storvic:en,Allrights .e4;erittd ( 1 1. • .. • • 1 1111110111111EMNIMMI • 11 L • . • , . , . , . • Heal*, I: me P,Ivnlm -ruroya Shared Fir[hp0,11,bo.1, INSfy.1.113.1 Impact and Benefits • Substantially reduce HR team's lime investigatina complex issues • Timely, relevant and accessible mc.)lerial written and inlerpreted by our in-house a I loi ney team • Provide comprehensive and practical analysis • Recommend specific action items for employers and employees Comprehensive Guides for Complex Issues 38 USI's national compliance team monitors, interprets & communicates federal, state, and local legislative developments ■ Timely Health Care Reform updates and general compliance alerts ■ Employee fcicing communications ni buvIeq Or, %F? Fer du Fr.ugh 1 iITh r ::01 1..w i n n I I,,cl Ir r'urnnc:E, `1. q,grn[... AIbrw.lhf c rn;ny`"d 4S nterpret Complex Issues, Provide Practical Solutions Impact and Benefits: ■ Substantially reduce f-IR learn's time investigating complex issues ▪ Tirncly, relevant and accessible material written and interpreted by our in- k -louse attorney Icar'n • Provide comprehensive and practical analysis of fcederal and stale IogisIative developments ■ Recommend specific action items for employers and employees I 39 USE's national compliance team regularly monitors and communicates pending compliance filing deadlines • Idc.)nlily appropriale compliance and disclosure filing ieauirement based on employee size, location and coverages • Inlerpret and communicate impact and required aclior is by .employers - Timely reminders of filings and fee paymenls. i.e., ['CORI, 5500s, reinsurance 1(.0 Farm 5500 "the Etasice ofa he Annual Repartma Requirement for E R ISA Welfare Benefit Piens !ErT;q,11„, R oar p110,1 Reptnthrin Setainy lo•If Li....mftem t ..44.•,.......ar.o•n.n.rieone4 ecrwo.... re, 401n. um.no bont his • ••••P•ral,•••••.....e•-••• ao. s....11Inennt•••• • rmaA11,11,.../.0.1 nal rorn Medicare Part fl Reqturements. 110.1141104.114..K.M.1.1.4.1.M1..1,1•10,011, • popm....n.1.4.14".•. ..... .1,04011. IWIILIM111001VP 21i11--iO1'i I Ir4,111.1rwe wces. Ali rights iFtst,no.3.1 VV.t..V:m, IS I •-• inirg=31111.011110111illisinet=1111•1111.. • r=t7t--7. Impact and Benefits: • Reduce or avoid significant penalties (e.g. $1,100 per day (5500)) • C.onlinuously support HR staff wily updated requirements and model notices • Comprehensive, easily understood tools and communications NAonitor, Inform and Manage Disclosure Requirements I 40 US1's national compliance team provides informative webinars and seminars regarding legislative developments and interprets impacts to employers ■ Regular national and regional seminars and webinars with live and recorded access • Focus on the most pressing issues of the day • Identify key takeaways and next steps er7 WI; UM, •211} 4.2.II16l1`sl Irsioln'i All ioylII tf+vRr3yd Impact and Benefits: • Question and answer sessions will i our compliance experts to provide cleur understanding of the issues ■ Timely and informative y and Critical Issues 141 • USI's team of consultants and clinical experts provide detailed analysis and deploy innovative solutions to reduce healthcare cost without sacrificing quality of care. 9. Cardiac Gaps in Cardiac Care vs. Norm 11.1h r1.41, Both AP 2 Each nil 3 nth Both AP 5 554, 5.11 •Nterco any D,...hesis. without lipd pcfl .p.t. ;11 tine 35S months.. 3,9 Pobenks wirthout long an. vim,. maritils4 350 Niter* ertheuic diabetes screening in the last i?. months, Paberam withot.$, mitt 555ellip4 demic drugs in the lest 1z onceths, 3 SG P.,1,ents without ACE ot ARP, rOm 1...st• 12 tronihr. 21114 .211 1I irIirsinor.: Service$_,A11 1i5hI. rer;erterell r 9,1 • Focus on Reducing Unit Cost/frequency for Care • Alternative Reimbursement Strategies • Reducing Gaps/Risks in Care • Alternative Settings of Care • ROI Analysis and Modeling • Constant innovation to Reduce Cost and Improve Quality Creating Cost Management Solutions 42 USl°s implementation of consumer pricing comparison tools can reduce member out of pocket expense and overall claims cost • The third -party payer system creates a lack of understanding of quality and of price sensitivity on behalf of consumer/members ■ Leverage transparency tools to improve employee awareness and reduce expense in conjunction with high deductible plans f BiI1u Cm S1re45 Test ININIMONM 5- 551.3 51 tia LunhWar MRI (uu-cw. rudl) 010000.1000. ow. 15Mrq 01.1.101.1.1110 MINE ENNrN it .. 111111.11.11 tlailirnvlrraity ?`j 4 rwr 51141 ^ f AciH1y F1a59d Sipep Study $1.111141 •r, Impact and Benefits: • In -Network pricing can vary by up to 300% for certain procedures III Typical estimated employer savings using transparency tool range frornl -3% of overall claims cost 50% reduction on employee out of pocket expense for applicable procedures Cost and + u tlitV. o s for Inf rmec ecisinn Making 43 USI's analytics team evaluates the cost savings opportunity to redirect members to a telemedicine solution and away from high cost alternatives • Routine or self diagnosed issues can often be resolved by a phone call to a physician; eliminating need to miss work or ER visit ■ Analyze eligible charges to perform projected ROI calculation • create communication pieces to increase employee understanding Where Member would) . vtstts have gene Primary Care Physician Specialist Urgent Care Clinic Emergency Room No Treatment Total Consultations 188 38 186 24 45 Average Nit) $132.00 $162.00 $169.00 $1,558.00 $0.00 $40.00 $40.00 $40.00 $40.00 $40.00 457 $17,296.00 $4,636.00 $23,994.00 $36,432.00 -$1,800.00 $80, 558.00") Yti 2O14-'20 %i; H.! lnmuirinre Se?rvr, All nuhls-vreervad impact and Benefits: ■ An estimated 50% savings in eligible charges or 1% reduction in total claims • Increased employee productivity by eliminating 1 sick day per employee per year • Increased employee safisfaction by improving flexibility of bonelil plan Cost-effective. and Convenient Alternatives 1 44 1.*tc-z% Lai 11111114111. "Y‘ 117 -,rowtouttotfrAre NA.:scr:ar, USN Pharmacy tools provide cutting edge, transparent, cost management capabilities to reduce pharmacy spend and enhance employee offerings. tElly II• x ...•••••11:•••••••• EiII$4.1Ir;111;-;:"'14IF•.-/It • .• ••• 1,,,,. .,,, eI=14411.1.41... ; gwy.,,,, 43r4,1*Irvos,I.Ire 11Irn ., , I I ; ',II:II • I" •-I r rrd.hariatrathr.1 q I I ,t14.1.q. .+ I .- • rr..Iq., In ..0,1 wrIal m1,1..104 innot, law IWO claratail awl rot • Client Specific Pharmacy. Trend and Benchmark Analysis • Performance Analysis • Rx Pricing Strategies • Rx Program Management Strategies - Specialty Program Review Eliminate Excess Cost & Reduce Pharmacy Trend I 45 Negotiate PBM coniract language 10 ensure favorable definitions, appropriate pricing, and rebate sharing. - Pharmacy costs are unique in lhcrt carrier/Phaim acy Benefit Manager (PBM) typically earns profit in the cost of the C1cthr c.:rs opposed to II o cost of insurance or administration ■ Contract review is applicable; to both embedded carri()r pharrnac:y solutions and carve -out plans - USI provides a 7-point contract review to facilitate negotiation of Iavorable terms and pricing. Includinc bul nol limited to rebate terms, AWP discounts and brand definition Impact and Benefits: ▪ Savings of 10-1 S % of pharmacy cost • Zero disruption to members Reduce Carrier Profit Hidden & Embedded in Claims Costs 146 11114-20I1, I Itii b�•nu;rni'r� `.. US I reviews ancillary benefit programs to manage and measure plan effectiveness, maximize value and employee satisfaction Define Customer Needs Competitive Marketing Managing/Measuring Vendors ▪ ROI on Administration Programs ▪ Achieving Superior Discounts ▪ Finding "Bestin class" Vendors and Carriers Goals- e> Establish. Performanc Monitor Results Ancillary Benefit Programs • Disability, Dental, Life, STD Roturn Work Strategies • Supplemenial and VolUnlary Plans • Aggressive Negotiation and Strategic Plan Design 1 47 },.f�tit+itYxjB,�'`Ak.;�la'y,�e Ht ,�rwmatr 1144011}' p VW • US11s aggressive marketing and packaging of multiple coverages with a single insurance company creates efficiencies and cost savings • Many carriers offer a full range of ancillary coverage and discounts when multiple coverages are purchased • USI analytics team aggressive annual markeling of benefit plans creates a competitive environment resulling in best in class pricing Volume Life Rate per $1,000 AD&D mate per $1,000 Monthly Premium Total Annual Premium Total $30,222,500 $0.098 $0.01 G $3.445 $41,344 Unum Now Pacriagio at $30,222,500 $0.110 $0.010 $3,808 545.696 LTD Rates Unum Gurrunt • ;r, Unum New Package Ratew Volume LTD rate per $100 Monthly Premium Total Annual Premium Total Monthly Premium Total $3,144.483 $0.580 $18,238 $218,856 $21,583 Annual Premium Total $260,200 1,1 ,1716 1 i911r,_awar I9. erviceP, etll rlyhls r+ r; rv,;t $3,144,419 $0.520 $16,351 $196,212 $20,159 $241,908 Annual Savings Amt $18,292 Annual Savings % 7.0% Impact and Benefits: ■ Multi -line discounts range from an estimated 1-3% per line of coverage • Consolidating coverages creates opportunities to add additional free services such as EAP, approximately $2 PEPM of value • Ease of billing administration and claims processing with a single carrier ed Cast, Improved Efficiencies 148 USI secures multi -year rate guarantees to simplify employer budgeting and reduce long term cost • USI's underwriting and analytics team negotiates with multiple carriers for the most favorable pricing and long terrn guarantees • USI monitors experiences and market trends for opportunities to further reduce rates in second or third year Effective Date of 111 Currant Plan with Carrier- A; ROnewal with Carrier A Carrier D Plan :I." Life and AD&D Benefit Guarantee Issue Amount Reduction Schedule Waiver of Premium Rate Guarantee $200,000 $200,000 Reduces to: 65% at age 70; 55% at age 75; 25% at age 80 6 month elimination period; If disabled prior to age 60, benefits extend to age 70 1 Year $200,000 $200,000 Reduces to: 65% at age 70; 55% at age 75; 25% at age 80 6 month elimination period; If disabled prior to age 60, benefits extend to age 70 3 Years $200,000 $200,000 Reduces to: 50% at age 70 9 month elimination period; If disabled prior to age 60, benefits extend to age 65 3 Years Life mid AD&I Raiff('"'. Volume Life Rate per $1,000 AD&D Rate per $1,000 Monthly Premium Total Annual Premium Total $ Change From Current % Change From Current Ciitrent #ftit'Carrie $26,638,138 $0.190 $0.030 $5,860 $70,325 N/A NIA $26,638,138 50.160 $0.025 $4, 928 $59,137 -$11,188 -15.91% $26,638,138 $ 0, 090 $0.010 $2,664 $31,966 -$38,359 -54.55% I,; I. Fr: ,,,• •�i Impact and Benefits: • Mitigate annual trending increases of an estimated 3-5% of premium • Improved employee satisfaction due to stable contribution amounts Stable and Favorable Pricing for Ancillary Programs 1 49 Next Steps Our Commitment to You USI will deliver cost containment and avoidance strategiesleveraging robust analytics and deep expertise to ensure That your benefit plans meet both your needs and budget. • Review and sign contract iI selected as winner of 11-1(.,:.. REP • Initial Meeling/Benefil Audi! vi 1 h Cily ol Mi(.-trni IR leam • Discuss Service Calendar • /0,?,•1 \NW' Cily of Miaiiii!!, TPA vcinclorsieslablish expecicilions • Markeling of Ihe berielil program if riot on conlmct • Develop Communicalion Sltalaiy • Develop and rnainlain ;y Al; 1 50 Appendix Case Studies Detailed Analysis Pe Team Biographies 5 1 �ID UNDERWRITING & ANALYTICS CASE STUDY Certified IBNR Analysis COMPANY BACKGROUND The Company is a telecommunications firm that is an advanced technology leader in the areas of wireless communications and aerospace systems and engineering has more than 850 employees. USI SOLUTIONS OFFERED • USICG's Actuarial team performed an IBNR analysis that met the requirements set by the auditors and is compliant with the current Actuarial Standards of Practice. KEY CHALLENGES QUANTIFIABLE BENEFIT TO THE COMPANY The Company had a fully insured health insurance plan and implemented a self -funded health insurance plan. As a result of introducing a self - funded, the Company now had to include an IBNR analysis with their financial statement. ?trill ;111 i, I V71 Irs.inanr:c };r-rvrucrls. All r iyl its ved Analysis met the requirements and expectations set by the auditors. 152 W. UNDRWRITING & ANALYTICS CASE STUDY pqmpeltemaris 4 `..:..`Axi1 Actuarial Valuation of Retiree Health Plans COMPANY BACKGROUND A global Company, specializing in flavors and fragrances, has 436 plan participants. KEY CHALLENGES The Company's health plan included retirees. The Company was not aware that they had to recognize the full obligation for their retiree group on their balance sheet and as a result the Company was out of compliance with current financial accounting standards. USI SOLUTIONS OFFERED ▪ USICG's Actuarial team performed an Other Plan Employe: Benefits (OPEB) valuation and provided a report reflecting both the retiree medical obligation and expense. • USCG provided further analysis of various design changes to reduce the cost to a manageable level. ■ The valuation provided the Company with the required information to make their financial statements compliant with their applicable accounting standards. ■ USCG worked with the Company and its auditors to finalize the appropriate entries in its financial statements. QUANTIFIABLE BENEFIT TO THE COMPANY • The valuation was compliant with Accounting Standards and provided the Company with information needed to assess the long-term cost of the plan and to modify the design of the plan to mitigate the cost. 153 UNDERWRITING & ANALYTICS CAS STUDY Proprietary Stop Loss Design/Pricing COMPANY BACKGROUND A 182 life group specializes in the manufacturing and distribution of food sauces and marinades. KEY CHALLENGES The Company spends $2.9M annually on their health plan and needs to reduce cost. The cost per employee is very high as they have rich benefits and heavy dependent enrollment. The Company has been on a self -funded plan for over 25 years. r`. 7O14• 201( 4JSI htsurnnce SHA411:u$. All rights reserved USl SOLUTIONS OFFERED • USI evaluated the existing plan that included a bundled Administration, network and insurance solution from a large national insurance company USI's stop loss benchmarking analysis determined that an increase in the specific stop loss deductible level would be appropriate = USI's proprietary stop loss program offered the following benefits: - 90 day rate lock ▪ 2nd year rate cap ▪ No laser on renewal QUANTIFIABLE BENEFIT TO THE COMPANY ▪ Premium savings of S86,800 due to market competitiveness and $26,000 due to specific deductible increase. - Additionally, the new carrier reduced aggregate claim liability by $181,000 or roughly 10% of total liability. • In total the client reduced maximum cost by $293,800 or 10% of total program cost. The early renewal process allowed.the client to secure final pricing well in advance of open enrollment and allowed adequate time for planning. 1 54 toreftiin. inn& lo NADA 114111171- Large Claim Review and Forecasting COMPANY BACKGROUND A 500+ employee self -funded group specializing in medical diagnostic testing, research and manufacturing, with distribution units in several states and sales teams throughout the United States. KEY CHALLENGES Due to multiple large claims, the Company faced a significant rise in self -funded medical plan costs that would negatively impact profitability and drive a significant increase in employee contributions. The insurance con-Ter:1y classified the high -dollar claims as "continuing", and anticipated similar claiMs-in the corning year. ?'.1-1.6 :OS I I r t;01 • USI SOLUTIONS OFFERED ▪ USI team obtained and reviewed detailed high -dollar claim data that exceeded 50% of stop loss deductible while protecting personal health information (PHI). • USI team reviewed our proprietary 3D data to evaluate continued risk factors and probability of future claims focusing on employee/dependent status, i.e. active, retired, disabled, age -limit expected return to work dates, etc. ▪ USI medical director and underwriter evaluated the. likelihood of future large claim expenses. ▪ USl team negotiated removal of one large claim from renewal projections resulting in a lower claim projection. ▪ USI was able to lower the stop loss deductible (laser), and also reduced specific and aggregate stop loss premiums. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ The Company reduced claim projections by $150,000, eliminated an additional $150,000 deductible, and saved $60,000 in stop Loss pl emiur n ▪ Total anticipated savings were $360,000 on initial renewal cost of $2,500,000, or 1 4%. 1111■1111111MOMiltiMai J11,4(MTIM wookr-14,:6 144euiN :vet r aiLi.. . t "�Yl fivSiti' Comprehensive Underwriting`Review COMPANY BACKGROUND A 470 life medical technology Company with core expertise in neuromodulation. KEY CHALLENGES The Company changed carriers at their prior renewal and was facing a 23.7% renewal increase from the new carrier. Based on the short time and limited experience data (five claimants over $100,000 in the first 5 months), the Company did not feel the renewal was justified but was also not interested in changing carriers again. Cr2014-2'U1U trs3 Inuti anre.'Sartit07a, All riclhts reser eid. • USI SOLUTIONS OFFERED ▪ USI's Underwriting & Analytics Team had a full reporting portfolio established which enabled the Team to review and assimilate all available data. • Both prior and current carrier report claims on an incurred basis. This made for a seamless integration of both carriers' claims data into a rolling 12 month analysis. ▪ Large claimant information was available from each carrier. An exhaustive analysis of claimants' diagnosis and procedure codes was completed. This revealed that there were eight carryover large claimants from the prior carrier to the current carrier. ▪ The Team's analysis revealed a dramatic decline in pharmacy claims due to cr hic-rh priced drug not being in the incumbent's experience. QUANTIFIABLE BENEFIT TO THE COMPANY The USI team's renewal projection was a 9.2% increase based on a complete 12 months of claims, maximum large claim credits and an aggressive position relative to carrier retention. Carrier profit was reduced. The carrier ultimately provided a revised renewal of an 1 1.4% increase. The Team's knowledge of the client, data analysis and aggressive position were instrumental in saving the client over $776,000 in renewal premium. 156 HR SERVICES CASE STUDY irm Spousal Coverage Strategy COMPANY BACKGROUND A 300 life maintenance supply company that specializes in wholesale distribution of hardware and building supplies for the multi -family property industry. KEY CHALLENGES The Company was spending almost $3M annually on its health plan and needed to reduce costs. Historically, the plan design changes were restrained in order to reduce employee disruption, however given the risingcosts., that mindset was changing USI SOLUTIONS OFFERED • The USI team assessed the dollars being spent by covered dependents. The team observed significant claims generated by spouses on the plan - almost 40`; • The team presented two options designed to address the cost of working spouses on the plan: • 1) Working spouse carve out with signed affidavit • 2) Working spouse surcharge with signed affidavit • The client selected the working spouse carve out with signed affidavit, which resulted in the removal of 26 spouses -from the plan. QUANTIFIABLE BENEFIT TO THE COMPANY • Over the last 18 months, the total dollars spent on spousal claims were down by almost 8%. This savings was directly tied to a reduction in the number of spouses accessing coverage through the employers' plan. • The. USI solution represented an annual savings of $78,000. • When reviewing total claims to the group, spousal claims now. represent 35 4 of the total cost of the program. 157 HR SERVICES CASE STUDY Enrollment Guides & Customized Brochures COMPANY BACKGROUND A 260-life law firm in Ohio specializing in corporate law and commercial litigation. KEY CHALLENGES The firm has separate benefit plan designs for Partners, Attorneys, and Staff. The HR team was heavily taxed with the burden of collecting, cornmunicating and maintaining the numerous materials needed support these plans. Getting and keeping the attention of the Partners and Associates was very challenging. ",:, ycl•k4-:,'U'16 Util 6esL to 5er;iCHs. All rgp,t, USI SOLUTIONS OFFERED ▪ USI created customized benefit guides for each class of employee. USI gathered all the relevant information far each plan and created clear guides for use at open enrollment and throughout the year. The Benefit Guides included all required notices in one easy -to -read document. ▪ USI created recorded open enrollment webinars, including links to relevant documents, to be emailed to employees and spouses to watch at their convenience. This toot was also used for new hire orientations. ■ USI worked with the HR team to create customized monthly communications to highlight key information to help the employees become better informed consumers of the benefit programs available. QUANTIFIABLE BENEFIT TO THE COMPANY • The Company saved an estimated 10 hours of HR time in preparation for open enrollment, improved the experience of the employees and drastically reduced time spent answering follow up questions from employees unable to attend meetings. The. Company saved an estimated 5 hours per month on an ongoing basis with the introduction of the benefit guides and the pre-recorded new hire presentation. l 58 HR SERVICES CASE STUDY Communications and Education Campaigns COMPANY BACKGROUND A restaurant chain with 89 locations from New England to Virginia and approximately 350 employees enrolled in the health insurance plan. KEY CHALLENGES Reaching employees at 89 locations ---many of whom had no access to computers at work. The Company decided to limit the enrollment meetings to just one at the corporate location Plan design changes took a long time to finalize. USI SOLUTIONS OFFERED ▪ The USI team developed a customized strategy to reach the largest number of employees and their dependents, providing them with the information needed to make enrollment decisions for the corning plan year. • The approach included multiple mediums of communication: • Mailings to employees homes • Web based portal for enrollment • On demand meetings via Brainshark • Mobile technology application QUANTIFIABLE BENEFIT TO THE COMPANY • As a result of the communication campaign, the employer was able to: • Deliver 85% ID cards prior to the effective date • Increase high deductible plan enrollment by 30% • Update 79% of beneficiary designation forms • Increase voluntary enrolfrraent from 8`,' to • USI created the open enrollment book:lc:t,,the client -branded website,. and the'on- demand video presentation, savinca the client approximately =l0 hours of HR time, cat an estirnated value of $6,000. 159 Benefits Adminisfrotion Consulting COMPANY BACKGROUND A 300 life supply company headquartered in CT that provides products and services to clients across the Commercial Building & Facility, Healthcare, Food Service, Hospitality and Recreation industries. KEY CHALLENGES The administration of the Company's benefit program had not kept pace with other technologies in their business. The Company was unwilling to add a much needed HR staff and the CFO was looking for similar efficiencies in HR administration they had seen in procurement and distribution. e")2014-YUlti Incur ulce Services. lt!1 n�llil•. i :::..•� ,�: : USI SOLUTIONS OFFERED ▪ The USI team identified the enrollment process as a key driver to simplify the administration of the benefit plans. ▪ USI worked with the HR and Senior Management Team to identify additional priorities to simplify their administration platform. • US1 evaluated the capabilities of several vendors with respect to their client's needs and identified the vendor with a customized solution to meet their plan enrollment, benefit administration and communication needs. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ The introduction of the Benefit Administration services allowed the client to centralize enrollment, electronic eligibility, employee self-service and carrier billing and payment services in one application resulting in greater efficiency. ■ As a result they did not have to hire an additional benefits specialist resulting in a net saving of over 540,000. 1 60 HR SERVICES CASE STUDY ogkgN Benefit Resource Cen COMPANY BACKGROUND A township in the Northeast with 1,100 active employees and 200 retirees covered under their. group health plans. The group has 9 separate union contracts and 15 different plan designs. KEY CHALLENGES To reduce costs, the Company decided to move many of the active employees to a high deductible plan HR staff was not equipped to answer hundreds of incorrin questions regarding changing to the high deductible pion. t, _ ,14,7g71k 17SI 11154'.f I US1 SOLUTIONS OFFERED ■ USI implemented the Benefit Resource Center to operate as a singe point of contact for benefit questions and assistance regarding plan choices during open enrollment and throughout the year. ■ USI Designed customized communication materials to meet the needs of retirees in this transition process. QUANTIFIABLE BENEFIT TO THE COMPANY ■ The USI Benefit Resource Center received 725 incoming inquire-s r(ppresenting 150 hours of saved HR staff time. ■ An outside vendor had proposed a similar service for $2 PEPM or $31,000 annually. j 51 Benohmarking of Ben&fi "Plans COMPANY BACKGROUND The Company is a 300 life technology company located in 15 cities throughout the Midwest. KEY CHALLENGES The Company spends $3.6M in fully -insured premiums annually and seeks to offer a rich benefit plan as a recruiting tool for top talent. Due to financial constraints the Company was seeking to make benefit reductions but unsure of the effect on employee retention in several key offices. t:J _�trk4 Ulu :yhlx USI SOLUTIONS OFFERED ■ USl Account Management team used proprietary benchmarking tools to evaluate the Company's benefits offering as compared to other companies in the technology sector in similar cities. USI determined that the client was offering several 100% employer paid ancillary benefits not available at competitive firms. • USI recommended a change to contributory plans for life, LTD and dental. ▪ The Client was pleased with the recommended changes and was reassured that their benefits were competitive in their efforts of attracting and retaining key employees. QUANTIFIABLE BENEFIT TO THE COMPANY = The employee contributions of 25% towards the cost of these ancillary programs amounted to a 590,000 savings for the employers. ■ HR did not experience any negative feedback in the new hire process regarding the contributory benefit plans. 162 HR SERVICES CASE STUDY COMPANY BACKGROUND The Company is a 700-life pharmaceutical Company with locations throughout the United States. KEY CHALLENGES This Company has grown rapidly from a start-up in 2001 to a major player in the pharmaceutical industry. The Company offered a benefit plan reflective of their start-up roots and needed a careful evaluation to transition to a. program.that could sustain growth and achieve sharehoEder ' results for the long-term. USI SOLUTIONS OFFERED • USI conducted a complete analysis of the Company's benefit programs, premiums, and employee contributions and compared each program with regional peers. • USI identified gaps in the current program and recommended solutions through additional group and voluntary coverage's. • US1 identified areas of the prograrn in which the Company was providing benefits far in excess of peers and worked with the Company to create a 1-year transition strategy to modify existing plan designs to create a competitive and comprehensive package_ QUANTIFIABLE BENEFIT TO THE COMPANY • The incumbent administrator had not adjusted fees to account tor the Company's rapid growth. USI benchmarking of administration fees provided leverage to negotiate a reduced fee of $12 PFI'!v1 or over $105,000 per year. • The additional rredical plan option and change to employee contributions saved $342,000 per year while maintaining a program that exceeds peer company "benchmarks. TIr Company chose to re-•alk ccrte muc h oI These:savings to new dental, short-term disability, and life insurance benefits for -the firsttime, thereby improving the benefit .package for employees at no additional' cost to the employer. 163 [usi HR SERVICES CASE STUDY COMPANY BACKGROUND A 375 employee rapidly growing Bio Technology company in the Mid -West. KEY CHALLENGES The Company offers a rich benefit plan in order to compete for top scientific talent, and the costs were spiraling out of control. The Company had struggled to implement critical solutions as it had no formal planning process and management lacked the time needed to consider and:. communicate strategic solutions r, 2'11 '1.O1 USI !title Se:rvlcrrs. All 11c,01s ri rr tg: USI SOLUTIONS OFFERED In consultation with USI the client identified the solutions they wanted to implement and the time frame for each of them over the next 3 years. The service calendar then defined the annual and monthly activities necessary to execute the plan: - Mid- year planning and review - Early renewal - Form 5500 Filing - Total value for employees - Communication and education campaigns QUANTIFIABLE BENEFIT TO THE COMPANY ▪ As a result of this formal planning process, the client implemented a high deductible plan (CDHP) and converted to self -funding. 1 st year savings achieved from converting to self -funding resulted in savings of 8` or $300,000. • Estimated savings over a 3 year period from implementing a CDHPlan is approximately 3% in trend mitigation with a cumulative savings over the 3 year period of over $350,000. • USI increased leverage with the carrier by negotiating an early renewal, and reducing renewal rate increase from +12% to +3%, the largest reduction from the carriers renewal target the client had ever experienced. I 64 POPULATION HEALTH. MANAGEMENT CASE STUDY #z .1 '1r• '71 ...:Al 1. , _ Y /'f.RJ p f USI CORE HEALTH Strafe COMPANY BACKGROUND A West Coast -based manufacturing Company with 625 employees on the health plan. KEY CHALLENGES The Company spends $7.2M on the fully insured health plan and was regularly experiencing numerous high cost claimants and above average claims trend. The Company is looking for alternatives to -control long term. r cost other than: cost shifting to employees. I,I i hisnrpr��;er SCorvi�u�.-,All rkijr11s iG7h11s,Ll • USI SOLUTIONS OFFERED ▪ USI identified above average disease prevalence, gaps in care, and higher than norm emergency room visits and in -patient hospitalizations. • USI implemented the CORE HEALTH strategy to address the issues in a comprehensive manner. • Company implemented a 15% premium differential incentive for employees and spouses to complete theft annual primary care visits. • USI engaged a third -party Disease Management vendor. • USI provided detailed annual tracking and reporting. QUANTIFIABLE BENEFIT TO THE COMPANY • The Company experienced a 60`� increase in preventive visits, which are vital to identifying potential high -cost claimants. • The number of non -admitted ER visits dropped from 55% to 41 `,'u, i.e. 25% reduction in non -critical ER visits due to primary care relationship • Average renewed increases dropped to less lhan.5% in the past 3-years from over 10% iri the preceding '2'years 'for an approximate savings of More than $1,100,000. l 65 POPULATION HEALTH NVA ifikGEM NT E STUDY. tagu i. Srhvr:.��i,,• .121,6; J .' + , _ 1,.. letc v, i ncentivized Physician Engagement COMPANY BACKGROUND The Company is an international land and shallow water geophysical service companies with 725 domestic employees on the medical plan in multiple offices. KEY CHALLENGES The Company spends $8.1 M on the self -funded medical plan and has seen higher than average increases over the past 2 years. With a diverse geographic employee base the Company has struggled to implement an effective wellness program. r1-6 ttrisuetau[ss ti6.66v1i6.6666 AU rights resurv:.d. USI SOLUTIONS OFFERED ▪ USI's Population Health Management team reviewed the company's data on preventive care utilization and noted low compliance with physical exams and recommended preventive screenings. • USIcreated a step-by-step communication guide to help employees find an in - network primary care physician and access preventive care at no cost. ▪ USI recommended a employee premium contribution differential {discount) of $50 per month/$600 per year to incentivize employees to see a physician for a preventive visit_ QUANTIFIABLE BENEFIT TO THE COMPANY • The company experienced a 50% increase in preventive visits with 69;') of employees participating. ▪ Asa result emergency room visits have decreased by 15% and in -patient days by 220. 66 ,14 tip nn;1!y:: �-1 • lncentivized Physician Encagement for Spouses COMPANY BACKGROUND An 1,100 employee group in Central Missouri. This regional medical center provides comprehensive medical services. KEY CHALLENGES From 2010-2012, the Company experienced double-digit healthcare increases despite implementing a results -based, on -site screening program. The Company plan members' main chronic conditions inctude✓d obesity, high cholesterol, low back pain, and diabetes. USI SOLUTIONS OFFERED • USI's Population Health Management team reviewed the company's data and noted severely low compliance for spouses with preventive physical exams and recommended screenings. • USI created a communication guide to help employees and spouses find an in - network primary care physician and access preventive care at no cost. ▪ USI recommended employee and family differential (discount) of 20% to incentivize preventive -care physician visits. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ In 2013/2014, 94% of the employees and 86% of spouses participated in the company's physician engagement wellness program. • As a result, emergency room visits have decreased by 17.5`,' , in -patient days by 30% and spousal claims by $117,000. l 67 POPULATION HEALTH MANAGEMENT CASE STUD: COMPANY BACKGROUND An 1,100 employee group in Central Missouri. This regional medical center provides comprehensive medical services. KEY CHALLENGES Obesity and sedentary lifestyle are contributing factors to the high prevalence of high blood pressure, pre -diabetes, and high cholesterol. Consequently, the Company has a significant risk of diabetes and cardiovascular disease. -2 1tt".tltil irtxor:tnca All sbgttts resovt:d . USI SOLUTIONS OFFERED ▪ USI implemented the CORE HEALTH strategy in the first year of engagement with this client. The initial phase of CORE HEALTH focused an connecting employees and their spouses to a primary care physician, ▪ USI implemented a targeted disease management program in year two to provide secondary testing to those individuals with pre -diabetes, diabetes or heart disease. The Company covered the cost of the secondary testing. ■ USI's preferred vendor connected the results of the secondary testing to the primary care physician, specialist, and the patient. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ 26 individuals participated in the secondary testing. = The projected cost avoidance to the company by properly manacling diabetes is $7,000 per participant per year. ▪ The projected cost avoidance to the company by properly managing heart disease is $2,000 per participant per year. POPULATION HEALTH MANAGEMENT CASE STUDY ���It , • r i a'''" lka • n a 1 v#S 1 ;r PHM Program Analysis and reporting COMPANY BACKGROUND An 1,100 employee group in Central Missouri. This regional medical center provides comprehensive medical services. KEY CHALLENGES It is estimated that 70% of the Company population is overweight or obese, which is a major contributor to high blood pressure, high cholesterol, low back pain, and diabetes (up to 25% of claims are tied to Diabetes) USI IrtSurar:r.a.tiervlc:nY., r!ghlr. USI SOLUTIONS OFFERED ▪ Based on client's data, USI recommended the client implement a premium differential incenting employees to visit their Primary Care Physician and complete a tobacco affidavit ▪ In year two, USI recommended the company: Expand the program to include benefits -eligible spouses - implement a chronic disease management program - USl provided a detailed impact analysis of the plan design and wellness program. ■ USI implemented an audit to identify key opportunities to target obesity. The CEO launched a two-year program, such as removing unhealthy options from the cafeteria and offering Weight Watchers classes, aimed at improving the health status of the employees. QUANTIFIABLE BENEFIT TO THE COMPANY • By implementing a low-cost, targeted CORE wellness strategy, the impact analysis illustrated how the company saved over $500,000. Decreased ER Utilization by 28%'Decreased 'Inpatient Utilization by 40%. I 69 Workshops, Seminars and Webinars COMPANY BACKGROUND 800 employee Manufacturing company predominately in California & Texas. KEY CHALLENGES The Company has 2 different insurance carriers in 2 different markets. Texas has 300 full-time employees that were not eligible for the plan. California had 120 employees on a Private Exchange with individual plans. 3 ;1r11rt :+01 USI 4sisirrr+rrra Sorvlcgs.. A14 ritthrs.rasp:rveJ USI SOLUTIONS OFFERED ■ Prior to engaging USI, this Company was invited to regularly occurring. USI Compliance Webinars regarding compliance issues under the ACA. ■ USI legal professionals worked with the Company regarding their existing plan designs where it became apparent that issues such as reimbursing individual policies, discrimination testing performance and ineligible full-time employees needed to be addressed. ■ In addition to other factors, Company was impressed with US1's local approach, as compared to their current national resources with no direct access. The Company hired USI and altered benefit strategy to conform with ACA rules. QUANTIFIABLE BENEFIT TO THE COMPANY The Company avoided up to $4.4M in potential penalties by dissolving the practice of reimbursing individual health insurance coverage. ■ Avoided negative tax implications on participants and the employer through discrimination testing and alterations of the plan. ■ Addressed the uncovered full-time employee population by offering a meaningful , low cost plan thus removing a potential $1.54M employer mandate liability. 1 70 COMPLIANCE / HEALTHCARE REFORM CASE STUDY COMPANY BACKGROUND A 300 employee group that specializes in the design, manufacture and distribution of medical equipment. KEY CHALLENGES In USL's new client review, it was determined that they had never filed a Form 5500, but they had been over the 100 plan participant ERISA threshold for 16 years. In addition, they did not haye a Wrap SPD, so each line of coverage was considered its own plan. ngnt_ ra 'newt osure Requiremen USI SOLUTIONS OFFERED ▪ USI collected Plan and Schedule data, and assisted in the preparation of the delinquent 5500 filings for the 16 plan years. • Because a wrap Summary Plan Description was not in place for the group, each of their lines of coverage was considered its own ERISA plan. Therefore, 4 separate 5500s had to be prepared for each delinquent plan year. • Using the Delinquent Filer Voluntary Compliance (DFVC) Program, USI helped the company to limit their penalty liability to $4,000 per plan. ▪ USI also provided sample Wrap SPD documents so that the company could work with their legal team to wrap their plans into a single ER1SA plan, and 5500 filing going forward. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ Federal penalties for delinquent or non -filed Forms 5500 are up to 51,100 per day, per plan, per plan year with no cap ▪ Under the DFVC Program, penalties per plan are $10 per day up io a $2,000 cap for one plan year, or a $4,000 cap for multiple plan years filed together: • A DOL audit could have resulted $55,000,000 penalty per plan, or $200,000,000 total. With USI solution, the penalty was capped al $16,000. • The wrap SPD document allowed for a single Form 5500 filing in the future. 71 COMPLIANCE / HEALTHCARE REFORM CASE STUDY Legislative & Re COMPANY BACKGROUND A 100 life company with a fully insured plan and a health reimbursement account (HRA). KEY CHALLENGES The Company faced penalty exposure due to the fact they were not receiving timely notification of compliance deadlines. CJ $014-'1l7i1i tlsl Irisormnce. Sulv[tie5 !"Jl rlgh45 nah.tNl:c1 r s USI SOLUTIONS OFFERED USI provides timely reminders of key compliance deadlines and upcoming requirements as part of regular legislative and regulatory updates. ▪ The Company was unaware of upcoming PCORI fee deadline, bui received a reminder email from USI after opting into our disiribution list. ▪ The Company reached out and learned that while insured on the medical side, their self -insured I -IRA was subject to this nominal fee and needed to be paid. - The Company was happy to receive a timely reminder, as well as, the knowledgeable account staff that assisted in this process and directed them to appropriate forms and tools. QUANTIFIABLE BENEFIT TO THE COMPANY • Timely complied with the PCORI fee filing requirement. • Failure to do so may result in penalties (the amount of the tax) and interest on a late payment. 172 rA Comprehensive Employer Guides and Toolkits COMPANY BACKGROUND A 3,000 life fishing company across several locations in the Northwest, with 1,500 employees covered under the health plan. KEY CHALLENGES With limited benefit experience among the HR staff, the company invested valuable time and resources to understand rules and regulations regarding employee benefit plans. The Company was unsure of the impact of the employer shared responsibility, provision of the .Affordable Care Act particularly given a high nurriber of seasonal employees. e:t2014-20143.1151.11 is: u;e Al) rights raservixi.. USI SOLUTIONS OFFERED ▪ USE provided the employer with several guides regarding COBRA, FMLA, and the employer shared responsibility handbook, which summarizes key requirements of the "pay or play" iaw. ▪ In follow up, the account manager and compliance attorney met with the client to conduct impact analysis and addressed additional questions and concerns. ▪ The employer regularly refers to the handbooks as their "playbook" helping them to develop their "pay or play" strategy with relevant vendors, including a new payroll system. QUANTIFIABLE BENEFIT TO THE COMPANY The employer mitigated costly external compliance fees as well as 80+ hours of internal research time by referencing the USI guides. The employer avoided penalties of at least.$6,000,000 by re -designing their benefit offering based on USI "pay or play" strategy analysis outcome. 173 COMPANY BACKGROUND 350 life employee manufacturing company in the Northeast. The group had been fully insured with the same carrier tor over 5 years KEY CHALLENGES The Company has limited HR resources devoted to the employee benefits plans The Company has not maintained plan documents and has failed to meet some notification requirements tl14 ?fl76Utii icf$ Etince Services All tights i-i setve:l. USI SOLUTIONS OFFERED • Upon engagement with the client, USI conducted a comprehensive compliance review and identified several gaps, including old or non -existing plan documents, lack of appropriate COBRA and FMLA notifications, and delinquent Form 5500 filings ▪ USI provided template CRISA wrap and wrap SPD documents, as well as sample notification letters ▪ USI assisted in the completion of delinquent filer forms to mitigate non --compliance penalties ■ USI invited the client to attend our quarterly compliance update webinars to stay abreast of new relevant compliance requirements_ QUANTIFIABLE BENEFIT TO THE COMPANY ▪ Potential penalties levied by the DOL and IRS for the absence of plan documents and other gaps USI uncovered could have exceeded $150,000. • By completing the voluntary delinquent filer forms, USI was able to cap the penalties to $4,000 per plan. 174 COMPLIANCE / HEALTHCARE REFORM CASE STUDY Client Specific Assistance on Compliance Issues COMPANY BACKGROUND 1500 employee aerospace manufacturing company located in the Mid -west. KEY CHALLENGES The group currently offers mental health and substance abuse benefits, and their prior consultant had indicated there is opportunity to reduce expense in these areas. While cost savings from reducing these benefits may be available, the group was not aware of the potential compliance issues such a decision may create. USI SOLUTIONS OFFERED ▪ USI sales team presented the issue to compliance resources who identified potential violations under the Mental Health Parity and Addiction Equity Act (MHPAEA). This act mandates that when provided, mental health services and substance abuse disorder benefits are covered on the same basis as other medical benefits. ▪ Dropping these benefits from their plan would also trigger a loss of granclfathered status, so it was important to review vNhether there was a value in maintaining that status. ▪ Compliance also pointed out the potential for issues under the Americans with Disabilities Act that should be reviewed by employment counsel. QUANTIFIABLE BENEFIT TO THE COMPANY • The company elected to maintain mental health and substance abuse benefits after consultation with USI and their counsel. ▪ Failure to comply with MHPAEA may have resulted in penalties, including $100/per affected participant per day_ The company elected to pursue other avenues for cost containment recommended by USI, I 75 CARE INTERVENTION CASE STUDY COMPANY BACKGROUND This Company is a 600 life group that owns and operates retail eye exam and eyeglass stores around the country_ KEY CHALLENGES The Company spends $3.1 M annually and was facing a layoff due to business climate issues. The alternative was to drastically reduce the employer healthcare costs through significant contribution increases or reduction in, coverage. r 2t}i:{.?tfl i tiS! InswSotvico;, AV1 rigs reiserve!i. ,% USI SOLUTIONS OFFERED • USI identified a claim savings opportunity of 13% by moving to a high deductible plan and offered transparency tools as an additional service to reduce employee's exposure to overcharging by providers. • The employer reset the employer contributions based on the new plan and offered employees the option to buy up back to the traditional plan. • USI initiated aggressive implementation and communication campaign to explain the high deductible plan and demonstrate the value of the transparency tools. • After several meetings and many email communications, over 80% of the employees elected the high deductible plan. QUANTIFIABLE BENEFIT TO THE COMPANY • The projected claims savings for the high deductible plan were $20,000. The cosi of the transparency tool is $36,072 per year, for a net savings of $284,000. • Employees reported strong satisfaction with the high deductible plan in part due to the clarity of expenses provided by the transparency tools. 176 r.- ;usli CARE INTERVENTION CASE STUDY TeIemedic ne COMPANY BACKGROUND Arizona based property management company with approximately 200 employees nationally KEY CHALLENGES The Company was facing a relatively large premium increase due to poor claims experience and is seeking plan changes to off set this added expense. The carrier reported higher than normal emergency use as a key driver of renewal increase. 2014-:7018 Util.fii:jorrihcQ`aii vi�xi s. A11 rlglNs: re crvuii: USI SOLUTIONS OFFERED USI identified increases to office visits and emergency room copays that reduced the requested premium increase from 22% to 16%. ■ USI implemented a telemedicine solution with $0 copay as an alternative for members needing basic primary care. • USI communicated the new offering to employees through the open enrollment process and email correspondence. • USI performed an ROI calculation to illustrate the savings opportunity. QUANTIFIABLE BENEFIT TO THE COMPANY ■ Initial premium savings of 6% due to plan changes. ■ There was a 38.5% decrease in the utilization rate for outpatient professional emergency room visits and a 1.1 % decrease in the utilization for outpatient physician office visits. ▪ These reductions in utilization and lower net cast for services generated savings' of over $1 40,000 and requested increase: of. only 5% in.fhe toifowing year. 1 77 PHARMACY CASE STUDY COMPANY BACKGROUND The Company is a supplier of building materials in Arkansas with 500 employees enrolled in multiple locations. KEY CHALLENGES The Company spends $2MM (or approximately 30%) annually in pharmacy plan costs. Plan costs were rapidly increasing without a clear explanation as to the cost drivers. ., _STt•i :".?le, 1J51 tresurance S, r u es. Ai/ rirJnts rksrr�u3 USI SOLUTIONS OFFERED ▪ USI identified significant improvements in contractual terms to reduce costs without modifying member benefits. ▪ USl negotiated more competitive renewal discounts off of Average Wholesale Price (AWP) for the Company, including higher discounts for retail claims. ▪ USI negotiated 100`.3f, of the rebates be passed through to the client in lieu of their current rebate credit. ▪ USI narrowed the definitions of generic and brand name drugs to ensure greater adherence to guaranteed discounts. QUANTIFIABLE BENEFIT TO THE COMPANY = By negotiating more competitive discounts off of AWP and receiving actual rebates in lieu of a rebate credit with the current insurance company, USI produced savings 5178,000 with no benefit changes to the pharmacy plan. 78 ANCILLARY BENEFITS CASE STUDY 4H Packaged Ancillary Program Savings COMPANY BACKGROUND A 130 life group specializing in the review of clinical and drug manufacturing research. KEY CHALLENGES The Company is receiving a 12% increase to their medical premium and needs to find ways to reduce expense for other benefits programs. The Company currently has 3 carriers for their Dental, Life, and Disability -plans and is looking to consolidate carriers. P�lrrS4.-,(11C,. 1 tik-lrn,i u,,n+b'ti0.+'vr x,r,. r\EI rights rt1ti,•svau. USI SOLUTIONS OFFERED ■ US1 team reviewed current ancillary benefit package and determined it would be beneficial to consolidate all products with one carrier for ease of administration and to offer package discounts. ■ USI team worked with multiple carriers to obtain the most competitive benefits package through an aggressive marketing plan. The RFP process also included an analysis of the consolidated billing features of the quoting carriers. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ By combining a!1 ancillary lines with one carrier, the Company saved 1 6% in annual premium equating to $18,000. ■ By packaging all lines with a single carrier, US1 was able to negotiate a 3 year rate guarantee on the Line and Disability and a 2 year rate guarantee on the Dental. ■ The program also includes a free.EAP program with the Lonq Term.Disability plan, so the Company was able ko remove their stand alone EAP .and save $2,000 per year. 179 ANCILLARY BENEFITS CASE STUDY Negotiate And 11 COMPANY BACKGROUND 650 employee pubic sector employer with Union involvement. KEY CHALLENGES The city had one opportunity during the collective bargaining process to set employee contributions for the following 3 year agreement. Unfortunately, the group had experienced several years of steady increases to their ancillary plans and were being told that a shrinking group size was compounding the problem. c-i �01�1 :tiilu 4 iSi issturjnue Servi�gy. 1 t!t}h[ti rent i d i-Year Rate Guaran USI SOLUTIONS OFFERED ▪ Upon engagement with the Municipality, and as part of the initial due diligence, the USI team knew of a reduction in staff from the prior year that had improved the age demographics of the group. The incumbent dental carrier initially delivered a 15.4% renewal increase and an option of an 1€3% increase and a two-year rate guarantee. Both options were based on the experience and an old census from the Municipality_. ▪ The USI team convinced the carrier that the utilization and claims would improve drastically based on a detailed analysis of the departed staff. As a result, the team was able to renegotiate the renewal including a two-year rate guarantee for a 5.5% increase. QUANTIFIABLE BENEFIT TO THE COMPANY ▪ The first year saving due to the renewal reduction amounted to $54,000. ▪ The second year rate cap helped the employer to successfully negotiate the collective bargaining agreement in good faith.' 180 Jose Ls Gonzal USI Vice President, Employee Benefits Coral Gables Jose L Gonzalez is the Vice President for USE Insurance Services, LLC. In his role, he is primarily responsible for consulting with executive management as it relates to carrier employee benefit negotiations, underwriting and claims analysis, optimization of wellness programs to maximize ROI, as well as compliance to ERISA, HIPAA and the Affordable Care Act. His practice also involves industry benchmarking. financial budgeting and planning, benefit enrollment implementation, and the design of effective employee communications strategies. During his tenure, he served as the Employee Benefits Practice Leader ensuring the delivery of high -quality insurance services and financial products to over 200 clients as well as serving as a coach and resource for the professional development of his clients' personnel. Jose has led several community projects on behalf of USI in South Florida. He has a commitment in sharing his time, talent and treasure with the communities we serve. In the Magic City, he supports and volunteers his time to local schools, promotes education, assists with health and human services, and cultural organizations. Mi-. Gonzalez also sits on the Arts and Business Council of1N[iami and values the promotion and growth between the partnerships of the corporate and cultural communities within Miami -Dade. He has over 17 years of experience in the insurance industry and has consulted and managed a wide variety of clients in various industries. He holds a Bachelor of Arts Degree from Florida International University and a Life, Health and Variable Contracts Insurance License in the State of Florida. www.usi_com 'US1tns Account Manager, Employee Benefits Coral Gables Raul has 22 years of employee benefit experience both on the carrier and broker side. This unique blend provides Raul with a high level of knowledge in client management and an unwavering commitment to customer service, with the ability to build productive business relationships, resolve complex issues and win customer loyalty. Responsible for the overall management of his accounts, Raul provides a consultative approach when resolving employer group benefit issues. His responsibilities include plan marketing, collecting and analyzing plan data, building presentations, cost analysis and providing professional support for Human Resources through proactive solutions and innovative resources and technologies offered by USI. Raul graduated with a Bachelor of Arts degree from Florida International University. He maintains a 02-14 insurance license for Life and Variable Annuities, and a 02-40 license for Health, from the Florida Department of Financial Services. He is also fluent in Spanish. Scott D. Segal mergers and ERISA and Employee Benefits Counsel Over 20 years of experience advising clients in the area of employee benefits, executive compensation and ERFSA, including: the design and drafting, qualification and ongoing administrational issues of defined benefit, 401(k), profit sharing and health and welfare benefit plans; the design, qualification and drafting of nonqualified deferred compensation plans (including plans for limited liability companies and compliance with Code Section 409A); the effect of corporate mergers and acquisitions on benefit and compensation plans; plan transfers, terminations; fiduciary matters; executive compensation; and ERISA related litigation; Representing clients in matters with the Internal Revenue Service and the Department of Labor. Clients include public and private companies, nonprofit companies and governmental employers. Negotiating, preparing and reviewing agreements on behalf of both management and executives, including employment, severance, consulting, change -of -control, confidentiality, and non -compete and other restrictive covenant agreements. Examples of Specific Client Matters: • Designed health and welfare programs and summary plan descriptions including cafeteria plans, self - insured health programs, and VEBAs tailored to the unique requirements and objectives of each employer. • Assisted employers with compliance and regulatory issues of aft types related to their health and welfare plans, including COBRA, FMLA, and HIPAA. • Advised public client regarding the non-discrimination rules affecting insured medical plan and possible correction for violation of the rules. • Advised client with respect to freezing defined benefit plan, including reporting to the Board of Directors regarding the impact of freezing the plan. • Advised public and private companies on the impact of Code Section 409A on their nonqualified deferred compensation arrangements and amendments needed to comply with Section 409A. • Prepared employment agreements, equity awards, incentive awards and deferred compensation plans for newly formed public company. Merged two 401(k) plans into newly amended and restated 401(k) plan and submitted 401(k) plan to IRS for a favorable determination letter. • Drafted profits -interest (type) plans for limited liability companies. • Amended qualified benefit plans and summary plan descriptions to comply with federal law. • Drafted employment, consulting, change of control and severance agreements for companies and executives, with complete analysis of golden parachute, 409A, 162(m) limit, restrictive covenant and other legal issues. • Prepared documents related to qualified plan merger, including plan amendments, board resolutions, updated summary plan description, blackout notice, and related administrative forms. www us1 coo I @USlins Producer/Underwriter Mr. Plummer has over twenty years of successful, progressive, and diverse professional experience in client development, sales, service, healthcare analytics and underwriting. Joe's underwriting responsibility is to work directly with the US! Producers and Account Executives in the preparation of statistical analysis to negotiate successful renewals with insurance carriers. Predictive modeling tools will be utilized to develop timely pre - renewal projections, benefit plan modeling, contribution strategies, and annual corporate budgets. Prior to joining USI, Joe spent seven years as an Executive for a regional employee benefits advisory firm responsible for healthcare analytics, underwriting, sales and service Previous successful experience in national accounts sales as Vice President of Client Development. Prestigious clients include Weyerhaeuser Paper, CBS Viacom, KC Communications, Revlon and Ford Motor Company. Joe holds a Bachelor of Business Administration Degree in Finance from Pace University, New York, NY. Employee Benefits Practice Leader, South Florida Steve is the Employee Benefits Practice Leader for the South Florida offices with USI. His role is to manage the operations for our four South Florida offices (Ft. Lauderdale, West Palm Beach, Vero Beach and Coral Gables) and support the team in delivering USI's service model. He brings a broad scope of expertise in all areas of Employee Benefits. Steve holds designations as a Chartered Healthcare Consultant (ChHC) and Registered Health Underwriter (RHU) with The American College. Prior to joining USI, Steve was a Vice President and Employee Benefits Consultant, and later Employee Benefits Practice Leader, with Brown & Brown. www.usi.corn 1 @USllns Director of Operations Annette joined USi in June of 2014 bringing with her 30 years experience in employee benefits. As an Account Executive Annette provides her clients with strategic benefit consulting and helps develop comprehensive, cost- effective and sustainable employee benefit programs. Over the years she has focused on the large group market consulting with employers in various industries, including automotive aftermarket, healthcare, government, hospitality, manufacturing, non- profit, and service sectors on both a fully -insured and self -funded basis. For her clients, Annette evaluates claims experience and utilization, oversees the RFP process, conducts renewal negotiation with carriers, completes renewal projections, and has up-to-date knowledge of Federal and State regulations and legislation affecting employee benefits, including but not limited to COBRA, HIPAA, FMLA, ERISA, and Healthcare Reform. In addition, her experience includes assisting clients with communicating their benefits through employee meetings, developing communication materials, coordinating health fairs and implementation of wellness programs. Prior to joining USI, Annette worked in the third party administration arena and as a benefits consultant for Mercer, and Hylant. Account Executive Dean Hitsos brings over 13 years of group health and welfare experience to USI. Primarily working with Bob Anderson, his - responsibilities focus upon customer service, compliance, benefit renewals and marketing, open enrollment meetings and f'' A I r: 1 1+' �' 1 y communication processes. His group benefit experience includes rf. at4 ', \;t:`: s.t self -funded programs as well as all fully -insured plans. 1lY� , i � ri'. lj`}�'�"' Before joining USI, Dean was employed as a Client Service Director for Gallagher Benefit Services, and a Benefit Analyst for Jordan Dynamics, Inc. Prior to entering the benefit brokerage industry, he worked as a Human Resource Generalist for various companies including Computer Associates International, Allied Signal/Bendex, Rexall Sundown, and Kids In Distress. His 14 years of H.R. experience include manufacturing, service, and non- profit organizations. Dean received a Master's in Business Administration degree from Adelphi University with a concentration in Human Resource Management, and a Bachelor's of Science degree in Business Administration, with a minor in Economics from St. John's University. He is fully licensed and authorized to conduct group Life, Health, and Variable Annuity transactions within the state of Florida. www.usibiz J @ US tns Wellness Director Jennifer Showers is a recognized leader and pioneer in the corporate - based health, productivity and wellness arena with 25 years experience. As the Associate Wellness Director at the University of Miami, Miller School of Medicine for 13 years, Jennifer paved the way to the development of their first employee -based wellness program. This initiative eventually led to the groundbreaking and construction of a 17 million dollar state of the art Medical Wellness Center. She co-chaired the University of Miami's first Integrative Medicine Symposium and EXPO, has strategically developed and implemented dozens of customized corporate health programs and produced and directed a myriad of large-scale sponsor -driven special events. Her formal education includes a Masters of Education in Mental Health Counseling from the University of Miami and a Bachelors of Science in Corporate -based Wellness and Exercise Physiology from Penn State University. Prior to joining the University of Miami, Jennifer pioneered a grassroots health and wellness initiative for the Miccosukee Tribe of Indians of Florida. Through grant -writing, post -Hurricane Andrew, she obtained funding to transform an abandoned warehouse into a Wellness Center and site for Indian school health education. Her accomplishments with the tribe were recognized by the US Department of Health and Human Services, Wellness Consultant, Employee Health and Wellness Cassie Salomone currently serves as Wellness Consultant for USI's Southeast Region. Before joining USI, Cassie designed and implemented employee -based wellness programs for Motorola nationally. Her 5-part series entitled, Fitness Foundations reached employees nation-wide. She understands the importance of creative marketing, such as social media use, to drive highest levels of member engagement. Cassie holds a Bachelor's Degree in Exercise Science with minors in Biology and Chemistry from Illinois State University. She is also a certified Personal Trainer and Group Exercise Instructor through Aerobics and Fitness Association of America (AFAA). Cassie currently resides in Fort Lauderdale with her dog, Mojito. In her leisure time, she enjoys training for half marathons and reading. Vice President /Employee Benefits Consultant Patricia Bowen has been part of the USI team since January 2004. Patricia has over 20 years experience in health insurance design, She provides Senior Consulting to USi's local and national accounts on a fully -insured and self -funded basis. Her mail responsibility is to educate clients and introduce new clients to the USI philosophy. Responsibilities and Strengths: o Analyze, design and implement total benefit strategies o Communicate trends and marketplace changes to educate clients with updates in the healthcare industry o Perform analysis of renewals, claims experience, plan performance and budge projections o Underwrite carrier proposals for competitive alternatives, negotiate with carriers o Deliver client education including recommendations for plan design changes, funding alternatives and contribution strategies o Audit, edit and coordinate contracts with carriers and clients o Coordinate and analyze employee enrollment and health fair data for market position a Provide updates to human resource personnel in plan design changes, new benefit implementations and insurance carrier administration capabilities Prior to joining USI, Patricia was a Senior Consultant for Mahoney & Associates. During her ten year tenure at M&A, Patricia was responsible for the retention, and development, of large Commercial Accounts. Patricia is dedicated to maintaining quality relationships with her clients and providing her skills in offering recommendations based on the ever -changing and challenging healthcare marketplace www.usi.biz I @IJ$UUns Southeast Region CEO As CEO of the Southeast Region, Jim Dunn is responsible for driving organic growth by ensuring that proven solutions are delivered to USI's existing and new clients. In addition, Jim identifies and acquires strategic partners with like-minded leaders and integrates exceptional talent into USI's growing platform. Jim's experience includes fidelity and surety underwriting positions with Chubb and Ohio Casualty where he was responsible for evaluating financial, operational, and human capital risks. In addition, Jim was The Willis Group's first leader in Florida and lead their expansion from start- up status to multi -city locations over his 21 year career as Regional Partner. During this rapid expansion, this global brokerage firm was diversified from a construction specialty group with one location to a leading positions throughout Florida in Health Care, Real Estate, Manufacturing, Financial Services, and Employee Benefits. Jim also lead the integration of Willis with HRH following that 2008 merger. USI's Southeast Region currently includes 10 offices. USI's southeastern niches include Real Estate, Industrial Casualty, Health Care, Country Clubs, Auto Dealerships, Life Sciences, Logistics, Manufacturing, Financial Services, Technology, Construction, and Employee Benefits. USI's position as the 8th largest US broker is unique in that our client base is nearly equally weighted between employee benefits and property/casualty risks. www.usi.com J @USllns VP & Actuary USI Consulting Group Adeniyi Olaiya is the Associate Vice President and Actuary in USI Consulting Group's OPEB Department, which consults on retiree welfare plans for approximately 200+ clients. Prior to joining USI Consulting Group, Adeniyi worked as an Actuarial Manager with a major managed care carrier in the Northeast region. His professional experience includes FAS106 , FAS112 and GASS 45 Valuations as well as Life Insurance Valuation and Group Life and Health Care reserving and pricing. In addition to performing OPEB Valuations, Adeniyi assists the practice leader with the actuarial assumption studies, morbidity studies, plan design and pricing, cash flow projections, plan comparison studies and also provides actuarial support to USI Employee Benefits Consultants. Adeniyi is a graduate of the University of the West Indies with a degree in Applied Physics and is currently an Associate Member of the Society Actuaries, a Member of the American Academy of Actuaries and he sits on the program committee of the Actuaries Club of Hartford and Springfield. INTRODUCTION The success of any retirement and employee benefit program de ends on the comprehension, participation and appreciation of the employees enrolled. That is why quality ccrnmunication is vital to the successful implementation of any benefit program. You may be communicating, but do your employees understand? Errtployers can spend upwards of 30% of an employees compensation cn benefits. Do you communicate t''i3 1•11'_i. to your employees and are they receiving the ^--233.3_' a.e`I-designed communication campaign can rase a -}is and, most importantly, help employees _ ers:.a tei. L iza and appreciate their benefits, WHAT WE DO retire _ ci".! -mpioyee benefit plans. hai t s'. bj=:t ma ter eaeeios, copy writing stills and enducteri capabilities to help yea communicate benefits and ether human resources issues effectively to your employees. Our communication pr_`esstonais will work with you to develop a customized comreemication program to suit your i,vork force, project and budget. Our expertise enables us to deliver inn vat ve comrnuni _e:on solutions to any size employer viithout the casts normally associated with larger firms. THE IMPORTANCE OF ONGOING COMMUNICATION We believe effective communication is more than a one-shot effort. Staying in touch with employees requires year-round planning, not just during the open enrollment process. On an ongoing basis, regular communication such as newsletters, messages from management and benefit statements serve to promote employee morale and reinforce management's commitment to staff. OUR SERVICES pride ourselves on our flexibility in structuring a re'a:'onship that best meets your needs and the needs of your employees. Our strength is in providing a wide range • CONSULTING GROUP of materials to keep employees informed, remind them of important issues and keep the Imes of communication wide open. Our series include, but are not limited to: • Highlights brochures • Announcement letter • Posters • Postca; ds • i!Ie,ivsletters • E-mail campaigns • Promotional items • Comprehensive benefit statements • Printing and fulfillment What sets our communication services apart from other consulting firms? • Our communication strategy and plan outline • )Are develop content for any type of communication geared to any type of audience • Vie design and execute professional materials in a cost- effective manner • We will implement the right strategy and materials that will be most effective for your employees Understand. Service. innovate. Our experts understand retirement and benefit plans and have successfully communicated these programs. We have. won the respect of our clients due to our superior service. We partner with your plan administrators, human resources professionals, benefits brokers and financial professionals to provide innovative communication campaigns. Your employees can make informed decisions about their benefits; selecting adequate, but not excessive coverage and helping you achieve your benefits goals. 95 Giastnnbury Blvd, Suite 102 Glastonbury, CT 05033 850 633.5283 www usicg corn INTRODUCTION 'Id?have been pro ,'lingD=- 'dBenefitlActuaria!servicesfor over 35 years. Yee ha,? a staff of professionals dedicated exclusively to define., administration and consulting, as 5,'r_'l! a; a separate _ :.,p of proiessianars dedicated to c r.str etirement aeej . ;:employment compliance. We admeT.3ter oregeo—s :a the country, ranging in size from 30 t r cry ter. 3 rnployee5 and have the experience ant! c _.:._', t.e :ere /7.1 With outstanding service. Most -7'0 b4a _ e ..e _-mar!°-. C gl' _3:'onS 'with a br_ac: ref see,-:_ ?-e s? t73_, a :-.. re,',, only the largest firms Co'_.':' e fou ,kill benefit from 72rton, a creative approach to problem-s•oiving and a trc-ra h understanding of your actuarial needs. OUR SERVICES Our Defined Benefit j Actuarial services include: • Defined benefit plan valuations • Plan termination and withdrawal liability calculations • U.S. GA.A.P under ASC 715 (formerly FAS 87/38/132) • International accounting standard under IAS 19 • Government plan accounting standard under GAS 67/63 (formerly GAS 25/27) • PBGC and Form 5500 filings • benefit calculations and projections • Plan design/cash balance plan and conversion studies • Non-discrimination testing and compliance • Participant benefit statements • Nlerger and acquisition studies • Postretirement medical and postemployment liability studies (ASC 715-60/712-10, GAS 43/45) • Labor negotiation consulting • benefit and funding revision studies • Asset/liability projection studies • Web -based benefit calculation programs ▪ Participant call center and administration support CONSULTING PROJECTS Our professional consultative approach leads to a partnership that allo.,vs for the best possible plan design, financial impact and emplci e appre_iat:on. We work with you to ensure objectives are clear and will strive to maximize results. We embody the a:<p_rtise to manage the following challenges: • Asset/liability studies, cleeeeitnistic, stochastic and Liability Driven Investment (LDI) • Plan design studies and cost/benefit analysis • Risk management • Plan terminations • Harmonious pension plan, retirement and total compensation programs • Acquisitions and spin-offs • Compliance PENSION ADMINISTRATION FullAoministrabon and Benefit Service Center We have ,the technology to provide a simple, automated approach to managing many of your day-to-day administrative requirements. Our team of highly trained and skilled benefit administrators is committed to providing superior customer service and will work closely with you to ensure each facet of your pension plan's needs have been met. Our services at both the plan sponsor and/or the participant level include the ability to: • Collect, maintain and track all plan participant data for efficient recordkeeping • Calculate retirement, terminated, vested, disability, survivor, Social Security and Qualified Domestic Relations Order ("QDRO') benefits • Provide aperde ate forms to oa _ica^ts • Prepare d3t3 files rep red for i^'ar-rai/e,tern.a us. (e.g , ability to produce a recorncil=d data tie far etc.) • Prepare and mail 31's".13i employee. statements d r'at!'" t: participants • Distribute summary annual reports, Summary Plan Descri;, tdons (:'SPDs") etc., directly is pa nacipant- • Scan and retain participant communications, benefit ca'cula=ons and retirement forms • Customize administrative reports to manage research and call back status requests, and to ensure timely payments are made (e.g. , approaching age 65 and age 7054 notifrcati.cni, etc.) • Coordinate m3in'ten lane d- retiree information with the paying agent Ce , tax, and EFT changes, death notifications, eta.) • Import/export data t a"d from arty source (payroll, etc.) • Prepare government and management reports • Perform discrimir ation and cornpl a-ce t_stT.n • Coordinate benefit d.str;buttons with pay!cia. ?_ent, including a f_r7r3 for pnaper comp'_ -.gin and appropriate decu: ".'_;n • Answer participant tall -free calls concerning earned and projected benefits, conip1eioc:n of various forms, benefit pa', rut options and data changes • Field miscellaneous questions, provide retirement planning. information and plan irtarpretation • Field retiree calls regarding missing checks, data changes, general questions, etc. BENEFIT SERVICE CENTER WITH SELF-SERVICE INITIATIVE overall administration of your .._ e plan urier the furl -service model above., „ = a; D c-er value-added services through our self-service option. The se'` -service initiative is an innovative approach to not only er-:-pace the administrative services we provide, but also increase participant appreciation of your overall retirement benefi.5 program. Through Internet access to our defined benefit solutions portal, participants can: • Gain immediate access to all types of information about their defined benefit plan (e.g., relevant pension data, required administration forms, SPDs, etc.) • Use our proprietary benefit calculation system to perform web -based modeling and review different "what -if" scenarios based on various retirement dates ~t the pia^ sooescr can. • Generate reports to provide informaton s: - 33 tre frequency of'r'ieb-based benefit Ca : 3t ` use by employees • Pro'iide Seierai lose i or user t_!".,ra, ..3 ". cased on client - defined security settings OTHER POST EMPLOYMENT BENEFITS ("OPEB") Our consultants have been providing Other Postemployment Benefits ("OPEB") actuarial services since the effective date of F.AS 4106 in 1993. Y, e have a department dedicated to meeting employer' OPEB financial needs, including compliance with applicable accounting standards. This focus on OPEB gives us vast e:tperience in all aspects of the required accounting and plan design issues. We have assisted a majority of our clients in some sort of sensitivity analysis or projection scenarios, each time delivering results with both fiscal and personnel issues in mind. We have over 200 OPE3 clients, including over 150 government ernpta'/ers. Our clients range in size from tvio to more than 2,000 plan participants, Regardless of your organization's size, our actuaries and consultants•wiill provide yOU 'Nth the highest quality service and the a: entivn you expect and deserve, We have gained a reputation of providing cost-effective consulting and aa-i-r,r,stratie solutions that meet our clients' benefit plan goals and objectives. Our dedicated team of group health and pension actuaries, 3;countants and health care consultants can assist you in meeting your compliance challenges by: • Performing ASC 715-60:712-10 actuarial valuations • Performing GAS 43/45 liability and funding assessments for public sector organizations • Assisting with the collection of valuation data • Assisting with the setting and sensitivity of actuarial assumptions • Analyzing the potential impact of these standards on financial statements • Consulting on plan design to ensure consistency with human resources' objectives and mitigating your ASC 715-60/712-10 liability • Evaluating financing and pre -funding alternatives 95 Glastonbury Blvd, Suite 102 j Glastonbury, CT 106033 1860.633 5233 www.usicg cam • CONSULTING GROUP :,:`11 211 Annuity Contracts OVERVIEW USE Ccns_eting Gre .p, we are • 33:__, to offer our clients the oppoetu^;ty to ,purchases , : annuity contracts through a roe^ T'-.:s service is ideal for clients 3„3_:3..a3 r,'th theirpens'on a 3^ :3 _ : 3..e;1 transacto,ns 3'e uric _; :. ea _ :. a =:... 23 3 -3 _. :•, productconsi.dtants a,-- e to ass"..:. _ __ ., . _ _ r. :s and/or limita-e^s of a s 4 = prere6urn anrwi:• p'urcnas. :heir specific C3323. WHAT IS A SINGLE PREMIUM ANNUITY CONTRACT? 5 ]-., ]-� _ .. _ / e _ . es referred to as a t,... .. ; - 3 3' a_ _ _ : : to transfer the promise to 3- _. eres fro.- = a' '37 to a qualified insure^ce :re reraesee.te c - __ed, t-'_ in3'j'a, _ 3-_ :i CQit?33J-E r•_ = (i.e., a 3 ^?; 3 Th3 premium a-eciunt is r; _--'. __. u„n. •,vriting practces and toy r, a - .., .. ma" .:: ,O.">>_ pension plants liability. WHY DO PLAN SPONSORS PURCHASE SINGLE PREMIUM ANNUITIES? Plan Termination ^ ..^ c ;%^a', n is a common reason for an annuity . _ ..se u: tee e---_ or the termination, the trust Fund will no iceee __ ::: and pay pension benefits. In this case, the respoesib :J ea- be passed to an insurance carrier, thus, allowing. the trust to cease operations. Once the premium is paid to the insurance carrier, the p': is no longer obligated to pay the benefits. Eliminate Mortality Risk Pension plans pay benefits until retirees and their beneficiaries are deceased. Thus, the plan must continue to monitor the adequacy of its trust assets to fulifl this promise if retirees live longer than expected (mortality risk). Many plan sponsors would rather transfer the. mortality risk out or: the pension trust, thereby eliminating the requirement to fund any mortality losses due to increased longevity. From the plan sponsor perspective, retiree mortality risk may be greater than the investment risk. Investment Return Guarantee' Peesice t.- d assets e re ra to certa n investment returns to sustain the ccnnnued p e—^elts tinder the pia-. Prudent and ongoing investment mai a; --rely i; required to increase the probability for s'.ICce;sfUI ,r", ';.'^'� .:...I'^5. At various tames, the annuity market provides internal rates of return in excess of those that may be achieved by parts of the current pension plan assets. By taking 0 a van raga of c r umstance5 in tech annuities provide these excess re:e rn. s• a.- reckir g ra , _ o r3:a3 of return, investment risk _: 33 3 _. __ . -- assets and liabilities One-time FAS 88 Income The annuity purcnass rrsy a `ovv for' (Tie release of some urrec^nizsigti^. l:,, : c is ? Fiscal y,v year. In some cases. there C.. e _ a I0:3 a _.r,henor,^y e, could increase ',`,_ . _ _ _ _ ?.. _ _ _ _ . ./ as_ on the plan S�': 's Asset Allocation Strategy 3.^oul4 •.i3__._. sr ntoens...er-.epoc'yma.<_;sense In :-E"•, v.< g 3 1 iia'bilities. For example, a pension plan retirees only era, .-n. bee _l't from an asset allocation of 1CO 6 stocks, s -.:e i"::s:ss: -,"Come and liquidity are needed to crease cash Ear r. _eti~'y pension payments. Fixed income investments are import., ^? s,, . fund.ng, yet they are difficult to manage due to the interest rs:s r-is ts:s' volatility. An annuity purchase may elim,r3 r e e3:j3:e'i associated with having to actively manage tl-e piar's =:<_c i',come portfolio by selling those assets in favor of the a:r:; u :r I: this approach is taken, it is important to revise the investment policy in order to ensure proper asset classes aye in place to anticipate the emerging liabilities for the active emp'oye-si that w'll re~re in years afar the purchase. HOW DOES USI CONSULTING GROUP CREATE A MARKET FOR MY PENSION PLAN'S LIABILITY? We help plan sponsors identify the most appropriate plan participants to transfer as part of the purchase. In most cases, this will be the current retiree population and perhaps the terminated deferred vested employees. After these employees are selected, their payment data and plan specifications are forwarded to our select group of h - quality annuity insurance providers for their consideration. Es::". Insurance carrier is directed to submit their most competley, _ b ti or a specific date. This approach creates a market for your plan's pees en h on the bid date. Depending on the spreads ca:A :"-- and lowest offer, the bid of each carrier can. 3^ti n'.3y eetr=a;e to achieve the most efficient market value on that Pay HOW DOES USI CONSULTING GROUP ASSIST IN THE FINAL INSURANCE CARRIER SELECTION? ,r' e y3`et''/, Price. and 5e ri:e.. 1. Safety: ??ins:ra^ce:a• _s "- __ `, ',.s __."=a: )3-1. F ^,dpra5 2. Price: By r_re3 -, a t+.rya'., _ _ .,''3. =7 Pr::- 3.3'c :n.y is ac"., r•_:. 3 " ter 7 a^ to 3' 3 f1oJn: of assets for re--3- Ilab;l 3 : : _ : _se. Using actuarial 5OFt ' 3'a •- • c'ai r-j. 0' return on the premiu,.. C . _'i 37'. w_ ' C^,, 311flitie; were priced 323" is a insurance bro'cers c'D 3. Service: A`:er t"_ _ :,- s - in Cf&, ; the s _ .:. :.. ca 7 HOW IS USI CONSULTING GROUP PAID FOR THIS SERVICE? Ina- _. - c:: v , and a consulta-: r`iH "- :3 b`r .'s2!°:.:.i Insurance c 5 .3 _ _ 73 3i 3Cc"--33_ { -- standards r to the s _: _ . _ „ , be disclosed in our propOs3 L3 you. SUMMARY OF ANNUITY PURCHASE SERVICES • Review %, 33 _ D 73775 ancl . =vJ.` specifica'.ins and assumptions to be ii;_. by . Collect and prepare part!:ipant data in the proper farrra and cor e .. for t _ -a-ce Provide, via a:.- a •• a! C• :"e a'ac•,e --`-3tIon to r"_3;.r insurance companies market. Provide a co^^o-e'^c,-; •, - .-' et s=a-: v i; and respond't0 carrier que5:ions a5 nee:ied to properly price the placement. • Review eerier pr0posa;3 r0r accuracy and work to explain any deviations from each at-ler. • Our actuarial s_n , F3',2-_d bids through a valuation 3''i3:e ' to deco _ _._;? 3o'e^ess and pricing assumptsani 3-f :3 - 33- -- -- a,'3:13a 3 3 r • 23, - . 3=-3= 3j' .: .. 3^Cr 3_.23y r :. _., :- "_ D3:3 e:er from pilau • Provide _,'o=t5day e zed•tec!ca et�s._-;,::7tall- _ _ ccir ..-3773;71,1troducing THE ANNUITY PLACEMENT PROCESS • On Glace—. _ - _.3. , .;:23s ere i°;e:; around .12 30 p.m 3=d e.<o "e _. 3 3 _ ..n-2 - _ Er- ... s:e "'-nt day • ,tC^ap H.-: _.-. IS H3' 1". Atmci,the VariCUS i,—a. O= ..., -. ' - -:.. :-' - '3 C2company. ,:., _ " the p"c_ss end t-he a'a^ _ :rise.Of C!'u-i. o" 5 by - - - .' 3:._ _ _ ._ ".> Ala-er',i.:e Service, and com.oan, _. s a,- D--_ o-: _y • hen a g`ou 5.,�'a_ an Silty Ca; :r act is received sere "a . _ _,,. the contract isreviewed to _ ,s ... 3 =^a: had been agreed upon. 0.r7r ""e'Oars. 711^ been able to save many clients Srgiificant a ' _ of r-- : _ :'ue tO gars ::c := in strivrn,g to secu- :" " _. .. _ : _ - -;`.city price aJa:i3 e (in relation to the carrier q.ia:icy) f rp :_.ce of annuity companies on any given day. OTHER INSURANCE PRODUCTS The in �..r3nc 'Oduc._ emerged: _ 7 e premium btk`j i� ` f r Z'3ducts to na H =-._- .•! clna respect ka ` :y Please contact our ('ai{ :rani+er, 8� ^lit.'..-: ` din•a f?';Oca.: office if you Y,n, ':. <e to know more about these products and their features. g•: r ,ties 6a>er ^pn C" 3 s p;y'n; agility of the issuing insurance company 95 Glastonbury Blvd, Suite. 102 I Glastonbury, CT 105033 ! 850.633 5233 ' WWN usicg corn CONSULTING GROUP rat- 2a3 INTRODUCTION Our regulatory and c nno''ance consulting department provides orients wvith ire -is: r:nal analysis and assistance, as well as or��.i'; a:.'1',rli;trative and informational support. We. • r.:v-'.e t^cse services in connection with ctheA US! Ccr, -; Group service areas (such as 'our actuarial and defined contribution depar ,r.ents;. _ an independent service. de , _ 'it;: Ire on your b opera ! - you infarf 3d oF l= s-..,re a ongoing d 3-Ius9:o cornrnu ca:roe Ins:_; ° i 3 _ t = - OUR SERVICES Transactional and issue -Specific Support Our regulatory a -id c r 3, _3 sr -, .. 'g professionals provide a wide re.,-= 3_.':vor` a :,s. wluding: • P.esearch. and a,73l-is:s on pertaining to retirement, compensation, and ; and 'welfare programs (as applied to specific_ :umstances and issues) • Assistance in evaluating arid maintaining, benefit plan compliance and helping you a.hieve+ your retirement and benefit program goals • Consulting and support with respect to: — Plan design, implementation and administration of pension, profit sharing, employee stock ownership, deferred c0mpe.nsation, cafeteria, flexible benefits and Flexible spending account plans — Plan termination — Plan design and tax qualification defect corrections — l Jrl'_ _!:s:.orsand order evaluation Plan dvc.' e , arre determination iet;ar suldrnission summary plan description e ' - favorable aopilcai,:n preparation and Merger and Acquisition Due Diligence Consulting Reti_ . 3 1,3y e rN is__,es arise at every stage of a _ .: `ate me_rg r or a _ , ..:,'''On. As buyers conduct cl - and-negat3:e the purchase terms, It Is Critica to , ., _ y potential e.eposure to liabiIides that may ac e , edrement and benefit plans involved. d.; :7 =! developing solutions before closing C3' se. _ ant costly litigation and streamline the merger!a ::; `a ' process. Once a transaction is complete, smooth p s;;cis promote positive employer - employee re'a-'_ns. Cy ^ra_`•.,i;•..e due d''".g rite consulting services designed to: • Help define benefit components that impact a particular transaction and recommend appropriate language. for the purchase/sale agreement • Uncover potenbal buyer liabilities associated with tax qualification, ERiSA fiduciary duties, prohibited transactions, and reporting and disclosure issues • Develop strategies to deal wv th the seller's benefit plans: plan spin-off, merger, assumption and termination • Determine If pre -transaction amendments are required to meet the buyer's/seller's goals • Assist in the design of an employee relations oriented communication strategl to affect a smooth benefits transition Government Audit Support L t3a.r of e(cie e._e �" fir' c�7' ., L,. :_ 772 ore,: ahO:7 of correcrre re;olL'tton p( _'3 'a 6-2vernrnei.t. agencies. Why US] Consulting Group? Within USI Consultirg Gre::ti's Lega; have assembled a group of attorne s and cciniultants with more than 80 '•i_ari GF c0ilectve e e ience in all aspects of enp11',ee .osign and compliance. compliance cOn3J'.t3 3,. ,;: .or* Srl _.!t' GrganizE'.0 . •!?3`s c rti?`.df. _ 1 _ changing, complex rules to in"w'o.t3' . rco-ate beiri programs in a creative.. business or manner. '.eases___. s.= 3`. i', _ 3"_r1-2yi3r3nctyour legal ':.. ._ 3. a 113, _t>.._ rr our at rr'u r, ;-• ...; r iege Working Nith your = ". added value t.a = i-JOractiCalMannerba.-' beret orvgra : : L ; : r the IRS cor.cernu g ^ tax liaedi',, unless oche r;_ . -; rfarnra^ provided r- . r intended toe , ' u.,r; .., -. ? } , _ f,; g f _ .a ; : ' , :. - . sing t_ .o_�s._.f.l' re another party any mar..-2`, 1the document Iry 95 Glastonbury Bhvd Suite 102 Glastonbury, CT 05033 350 633 5233 'rr+,Yro usicg.cam CONSULTING GROUP INTRODUCTION USI Advisors, l^c. c.,vhed s'.:i'd i,"/ cf USi Consulting G'__.c: Investment Advisor cue• rig , _, _ - 3. 1; to retirement programs and end; , _ -_ e _3 ; des Implement and evaluate retirement plan iro ;r •=dies according to your Investment Policy 5t3te:.;1e. Our organizational strut:...:'g ,es you tne r._.(:oll,t-, to either choosy advisory services, or to L_ a ., :!n any of USI Consulting Group's other cirepa-t, _"ts% -pees. TODAY'S CHALLENGES In an in , ,_ -- s , crfd you need the guidance a .; s_.rc-jrt cf mar than ever. Today, you face t- _ en = 13nge of u',•'_! rig an investment program to meet the _ s demands v`yc..r participants. For plan sponsors a c! mica benefit plan, designing an efficient arse: aThca"un' s'.'a':c._•j in accordance with plan liabilities can c_ a da. l task. Another challenge. is the selection, r-: : --ng and reporting of diversified portfolios from m'..' - _ _- -ra. TON1ORROW'S SOLUTIONS From the start, ,,,,, partner+, r` you. A; your hands- on investment adiis7r, we can assist in designing and implementing retirement plan investment strategies consistent with your invest`i'.e"t a"1 r'usiness objectives; recognizing that there is no: a sing = s:lution for all of our clients nw?ds. Our investment cons.; :3 its provide you with the perspective, counsel and support you need to fulfill your fiduciary obligations, INDEPENDENT PROFESSIONAL ADVICE We. provide ;pendent, professional advice; we are not money ma g-ars and do net offer proprietary funds. Our 3pproa'ch is to manage the money managers) Using a rigorous due diligence process, 'Pik idontifj, recommend and mo- ,:s., _ s 37Yng;_ respected i,nvestrient organ 'si7 o -s a ;o =1'3' , upon the e ctensi,ie data, ana ,; > 3 ;' ,r-eai•-fr capabilities of Morningstar Direct', a investment know-how. OUR SERVICES At US - 3 : od to helpin_ ? du design a -t --a-' lay/2 c r a wide range of customized see•, :;; for .s help you fLE nil , > - :cost- effective r^a- ra`1 ;: a,. i Ili eit:15H;hi a prop a? s= i s: :..'ems to h;L: (;Ui Investment program benchmarking • Providing ii,viirten ana°ysis of existing investments • Assessing the number of investme.nt managers represented in each asset class • Ice ::`,' esset classes that are over or under -nin the existing, program • Compa-irz. y- plan to similar plans in order to illustrate how peer plans are addressing the challenges of toda'y's market and business environments • Providing investment recomr endat:ons designed to meet your plan's cbjectives and risk profile IPS development • Heip with de'ielopingtupdating the appropriate investment;aide through an in-depth consultation involving t-e Ce'/ie'ri cf current objectives, establishing performan:e benchmarks and risk tolerance • IPS serves as an important compliance instrument upon vihich we base is l:alcle iniestment rec -r'rnendations Defined Benefit Asset/Liability Analysis Despite t=._ :;;', headlines that focus on investment performance, the initial, and historically the most important decision is asset allocation. Through defined benefit plan asset allocation, we: • Take the plan liabilities into account + Provide. both deterministic and stochastic analysis • I`:1ade1 where the plan is headed over 20 years and at what probability level Our investment strategists will partner with you to determine whether your current asset allocation strategy is consistent with your financial circumstances, actuarial assumptions, future plan liabilities and risk tolerance. We will model the expected impact of various asset mixes on pension expenses, funding ratios, the. level of projected contributions and their volatility over the long run as we seek to determine and document which asset allocation strategy best fits your objectives for the plan. Manager due diligence • Developing an investment profile and recommending an asset allocation model based upon this profile • Evaluating investment managers relative to peers, benchmarks and expectations Manager searches • Assisting you in selecting "best -in -class" investment managers across all asset classes • Assisting in the hiring decision and the subsequent transition and implementation process • Providing ongoing manager and investment due diligence Ongoing monitoring • Preparing detailed periodic investment review reports • iNleeting with plait sponsors or Investment Committees as needed BUNDLED SERVICES (provided through USI Consulting Group) Retirement plan services and cost analysis • Assessing your current third -party vendors in areas such as asset management, recordkeeping, customer service, administration and participant education • Assessing whether plan expenses are competitive within the marketplace and match the value of the services you are currently receiving Regulatory & compliance services • Providing education and assistance regarding fiduciary liabilities and compliance with regulations • Researching and analyzing laws and regulations • Providing government (IRS/DOL) audit support • Providing periodic legislative and regulatory updates Diversification and asset allocation do not guarantee against a Ross, nor do they g..orantee that a diversified and/or asset allocated portfolio will outperform a non - diversified and/or non -asset allocated portfolio. U51 Advisors, Inc. does not offer nor exercise di r r account; however, the film will prod de recommendations, pursuant to a written investment advisory agreement and in ac,ordsnce with tile Lioroved inv ntment policy statement. .tr..fC_'-�.:191""'��� --�•----�.Yi3tlM`�9lih:F+i£+�•4e+an�sA-�iieiY.h:�.ffiF�ari-si'A-.�.ES?igant.:0.�:\Pd�V r.� tt_aa�.'s=.:L4Y:.��. '�tieNFrll'�P!L4 Securities offered Through U5i Securities, Inc M?mber 1=INRA/S PC Inistrnent .Advice for Enstituronal ac .::ur,l; IS arav+ded oy USi Advisors. Inc., 95 Glastonbury Blvd , Glastonbury, CT 06033, a6a 652.3239 CONSULTING GROUP 95 Glastonbury Blvd, Suite 102 Glastonbury, CT 06033 860.633.5283 www.usicg tom INTRODUCTION The success er a ;y retirement and employee benefit program depends cn the comprehension, participation and appreciation of the employees enrolled. That is why quality communication is vital to the successful impiementatior of any benefit program. You may be communicate, but do your employees understand? Employers can spend upwards of 30% of an employee's compensation on benefits. Do you communicate this va!'.ue to your empoyees` and are they receiving the !-ne,sage? A well -designed communication campa gn can raise a'Nereness and, most importantly. help employees understand, utilize and appreciate their benefits. WHAT 4'/E DO We un to -stair retre: gent and employee benefit plans. a have- the s= __: matter experts, copy writing skills and production capabiiities to help you communicate benefits and Other human resources issues effectively to your employees. Our communication professionals will work s,vith you to develop a custorni7.d communication program to suit your work force, project and budget. Our expertise enables us to dam' ,er innovative communication solutions to any size t.,,`:aut the casts normally associated with larger firms. THE IMPORTANCE OF ONGOING COMMUNICATION e believe effective communication is more than a one-shot effort. Staying in touch with employees requires year-round planning, not just during the open enrollment process. On an ongoing basis, regular communication such as newsletters, messages from management and benefit statements serve to promote employee morale and reinforce management's commitment to staff. OUR SERVICES pride ours ! yes cn our flexibility in structuring a relationship that best meets your needs and the needs of your employees. Our strength is in providing a wide range of materials to keep employees informed, remind them of important issues and keep the lines of communication wide open. Our services include, but are not limited to: • Highlights brochures • Announcement letters • Posters • Postcards • Newsletters • E-mail campaigns • Promotional items • Comprehensive benefit statements • Printing and fulfillment What sets our communication services apart from other consulting firms? • Our communication strategy and plan outline • We develop content for any type of communication geared to any type of audience • We design and execute professional materials in a cost- effective manner • We will implement the right strategy and materials that will be most effective for your employees Understand. Service. Innovate. Our experts understand retirement and benefit plans and have successfully communicated these programs. We have won the respect of our clients due to our superior service. We partner with your plan administrators, human resources professionals, benefits brokers and financial professionals to provide innovative communication campaigns. Your employees can make informed decisions about their benefits; selecting adequate, but not excessive coverage and helping you achieve your benefits goals. 95 Glastonbury Blvd, Suite 102 Glastonbury, CT 05033 850.633.5233 www usicg com CONSULTING GROUP DEFINED BENEFIT IP,ctuarjai Services INTRODUCTION tirVe have been providing Defined Benefit J Actuarial services for over 35 ;. We have a large staifof professionals dedicated exclusively to defined benefit administrators and consulting, as well as a separate group of professionals dedicated to postretirement and posternployrnent compliance. We administer programs across the country, ranging In size from 30 to more than 30,000 employees and have the experience and capacity to provide you with outstanding service. Most importantly, v^ve provide middIr-market organizatians L'ittf! a breadth of service and expertise that, until now, only the largest firms could offer, you will ber Fit from indi l!du lne—,,non, 3 crea":'ee approach to problem -solving and a trcroug.a ur7derstanding of your actuarial needs. OUR SERVICES Our Defined Benefit J Actuarial services include: • Defined benefit plan valuations • Plan termination and withdrawal liability calculations • U.S. GAAP under AK 715 (formerly FAS 87/333/132) • International accounting standard under IAS 19 • Government plan accounting standard under GAS 67/53 (Formerly GAS 2S/27) • PBGC and Form 5500 filings • Benefit calculations and projections • Plan design/cash balance plan and conversion studies • Non-discriminabon testing and compliance • Participant benefit statements • Merger and acquisition studies • Postretirement medical and poste.mployr:nent liability studies (ASC 715-50/712.10, GA3 43/45) • Labor negotiation consulting • Benefit and funding revision studies • Asset/liability projection studies • Web -basal' benefit calculation programs • Part:.: _ _3 center and administration support CONSULTING PROJECTS Our pry approach lea's to a partnership that allows for In- b : ccss'' `_ plan design, financial impact and employee 312 '_ =. = work with you to ensure objectives are dear and Lw;l strive to maximize. resell s. We embody the e;xpertise to manage the following challenges: • Asset/liability studies, de`'_rrninstic. Driven Investment (LDiI • Plan design studies and cost/Deng • Risk management • Plan terminations • Harmonious pension plan, retirement and total compensation programs • Acquisitions and spin-offs • Compliance PENSION ADMINISTRATION FA Administratforl and Benefit Service Center 'Na have .the technology to provide a simple, automated approach to managing many of your day-to-day administrative requirements. Our team of highly trained and skilled benefit administrators is committed to providing superior customer service and will work closely with you to ensure each facet of your pension plan's need; have. been met. Our services at both the plan sponsor and/or the participant level include the ability to: • Collect, maintain and track all plan participant data for efficient recordkeeping • Calculate retirement, terminated. vested, disability. survivor, Social Sacur ty and Qualified Domestic Relations Order ("QDRO") ben _fits • ?ro.i de ap, ;ate forms to part.=;-331,ts • Prepare d3`3 -s reo._Tir3r forir',terr'ara"herbal l.se (e.g., ab lit'y to prod�:e a reconciled data fJ_ for the estuary, etc,) • Prepare ar'd m3;1 an id emplytee, state ~ie+nt5 drrectl'/ to participants • Distribute s'ur1ma,'y a1n_I31 report;.. Su i'" arty PI3rt • Scan and retain participant communica'nons: be of calculations and retirement forms • Customize administrative reports to manage research and call back stabs requests, and to ensure timely payments are made (e.g, approaching age 65 and age 70 4 notifications, etc.) • Coordl.nate maintenance of retiree informations with the paying agent (e.g., address, tax, and EFT changes, death notifications, etc.) • import/export data to and from 3,71 5ource (payroll, etc.) • Fre. 3 management reports �+ • Perform�' 7:. _. Sr'_, ,:; comp,.. _._ testing • Coordinate .J ors v3, 'g agent, including a re; c c.aripletion and appropriated=_- • Ans,,v_," a t w': ant toll -free galls concerning earned and pro:_ --- ' _ _ _ .s. completion of various forms: benefit pa•,,c1.:t pt ens a -1'di data changes • Field n7 s-: _°!landaus questions, provide retirement planning informs -: n and plan interpretation • Field retiree calls regarding missing checks, data changes, general questions, etc° BENEFIT SERVICE CENTER WITH SELF-SERVICE INITIATIVE In addition to handli,n t,"e overall administration of your ne t. plan under the full -service model above, l:e a s oc' _' 'ia'LJe-added services through our self-service initia i re option. The self-service initiative is an innovative approach to not only enhance the administrative services i,ve provide, but also increase participant appreciation of your overall retirement benefits program. Through internet access to our defined benefit solutions portal, participants can: • Gain immediate access to all types of information about their defined benefit plan (e.g., relevant pension data, required administration forms, SPDs, etc.) • Use our proprietary benefit calculation system to perform web -based modeling and review different "what -if" scenarios based on various retirement dates At t-a plan s •s(..;cr Ie°ie . W.e can: * G-2nef3'_e r_ _.rts to provide information s'.+:r: a: trig frequency of ' cti-based benefit caicu s:ter use b employees • Prcvi,de ;eye a! 131ieis e user functioraiity, base defined security sarongs OTHER POST EMlPLOYMIENT BENEFITS ("OPEB") Our consultants have been providing Other Postemploy anent Benefits ("OPEB') actuarial services since the effectivie da:e of FA.S 14106 in 1993. We have a department dedicated to meeting employers' OPEB financial needs, including compliance with applicable accounting standards. This focus on OPEB gives us vast experience in all aspects of the required accounting and plan design issues. We have assisted a majority of our clients in some sort of sensitivity analysis or projection scenarios, each time delivering results with both fiscal and personnel issues in rind. We have over 200 OPEB clients, including over 150 government employers. Our clients range in size from two to more than 2,000 plan participant;. Regardless of your or 7-;ization's size, our actuaries aryl cor'.suitant;'will provide the highest quality ser',':e aid the attention you expect 3". J. a _serve. We have g3'"= ±. 3 reputation of providing cost-effeciTie consulting and ad-- -',a solutions that meat our c e-"_s' benefit plan g:3..; 37d objectives, Our derj=._cd team c =3 _ a' cc.._ a f'Ja' 3- i hear care. ns'_. :3':3 333 ,_ y _. in compliance challenges 'v, • Performing ASC 715-60/712-10 actuarla. v'u-a-' gin; • Performing GAS 43/45 liability and fund.rig assessments for public sector organizations • Assisting with the collection of valuation data • Assisting with the setting and sensitivity of actuarial assumptions • Analyzing the potential impact of these standard; on financial statements • Consulting on plan design to ensure consistency with human resources' objective; and mitigating your AK 715-60/712-10 liability • Evaluating financing and pre -funding alternatives 95 Glastonbury Blvd, Suite 102 1 Glastonbury, CT 1 06033 1 860.633 5233 1 w', w.usicg cam CONSUL11NG GROUP remium Annuity Contracts OVERVIEW USi Ce a_''ting Group, we are pleased tr.: -ee ca.' clients the :o, purchase srng'e pre ium 3`.: _: :rates through a = 3.nce ca`' e s TH _ e3° for clients .-a _-_ ringthelia'ciiitya's,__ 3.-_ r tiens'isn pl.ai to a I.S: r3nce Company. Reason; i.._ i.,.; i_-.:.a are unique_, :rent. Ouractuaries and dn. a:, are trained t_ a s 3: c.'ents on the me-ts a slngle _ annuity purchase for t;al' es. WHAT IS A SINGLE PREMIUM ANNUITY CONTRACT? .'` 5 CCr-'s--. c.,!'re3 referred to e5 a ce+. .. -° • CO ."act, is an ag _. _ .. to tars _ ., _ 2 from a pension hian. to 3 ..,1 =: :mice _err _. t-ansacricn is corn .; =:_., _ _ Asset Allocation Strategy :s rase_ _ zaara .__ e :_.. 1_ re plans ha' .. _ 's . _nehts. Tn s _ _ L_ ; 3 :, As par. 2, 1 r-,3132.5 iµ- market pray, . __ :=rnai rates of return in X 3S5 0" r^.pie that may a,:n eyed arts of the current p- s .. _ 3. 3t,.., 3, to <:ng a : a- :a g?. c:: . c.:mstances in which a~ _ __ iacress re. .- in fa°1orao e rates o{ re:ar,, it+, 5,: r',k C3(1 Ge ?° s: as plan sponsors r J Cn as, and Ha;,:l a: One-time FAS 88 Income ;chase may a.lo„ lc -.the re'_ .. o` s. 1= _ ':-5. _,r .'C:. a.._ 3 _' .. _ ease C t •e �v_ _ 1 _. ec; _ _e ( , a s`- 'a p`� .. -°. T'_ 3 .�.,..: is r _„ _..53:...- id.+t, 31:�_ C _:a:=_. n: C3- > •___ and fl' =C "C ._ n llaCa°.._.. -?{_! 3 -, or n3- WHY DO PLAN SPONSORS PURCHASE SINGLE PREMIUM ANNUITIES? Plan Termination . rn e of the t o t _ :: o- and. pay pe: c_ _ :: E t-•scase, t'e passed to an !r. U`3 ' 3 53 . tn.15, the trust to cease operations. Once the , is pa.d to tns insurance Ci`n :' P 3n is no longer:�- Eliminate !Mortality Risk Pennon plans pay benefits until retirees and their beneficiaries are deceased. Thus, the plan must continue to monitor the adequacy of its trust assets to fulfill this promise if retiree.; lire longe.r than expected (mortality/ risk). Many plan sponsors would rather transfer the mortality risk out of the pension trust, t`1?reby eliminating tine requirement to fund any mortality losses dae to increased -;e.vity. From the plan sponsor perspective, reciree mortality risk •.:, be greater than the investment risk. • Investment Return Guarantee' P5 ' i assets g3_ner3:e certa n Inv aiatrnent re.:,ern; to 5^u5t3;n t-e C': '. sd payments under the plan. Pruden: and ongoing it ;tn-e management is re.ouArad [C increaie r.ne _orOCdhillt-y For S'jccessful investment returns. At V3r2d+.ls ti`�'»'r tannuity w _ not benefit frc:-- a' __:3 _ _ groNth s-__:. s'nte interest income and liquct , are re_ded to create cash for monthly pension payments. F:re.d irco.-n:e investments 3'_ important to pension 1. -1. na ye: to manage die. ::. _e_ interest rate purchase may eiimira:e the heav=.:r_ asset at,.. to actively manage the plan's fixed into e . . : those assets in favor of the annuity. If tnis =e: rt a: - important to revise the investment poll:, ir G: .. :raper asset classes are in place to anticipate the ernerg'r7, _; for the a:t ,s eir,7 .yeees that will retire in year; a`.s..re. HOW DOES USI CONSULTING GROUP CREATE A MARKET FOR MY PENSION PLAN'S LIABILITY? We help plan sponsors identify the most appropriate plan participants to transfer as part of the purchase. In most cases, this will be the current retiree population and perhaps the terminated deferred vested employees. After these employees are selected, their payment data and plan specifications are forwarded to our select group of high quality annuity insurance provid "s f.;` their consideration. Each insurance carrier is directed to most compete ive bid on a specific date. This 3.n.^ :-: _ s_.:_s 3 market for your plan's pen5Hcn on t e on the spreads be:,1e_ t 5;'-._ 3'2 "" r^- _ . each carrier can, and may. decrease to 3:'ri : r.n, ' ;- = ,,'art mar{(et value on that day. HOW DOES U51 CONSULTING GROUP ASSIST IN THE FINAL INSURANCE CARRIER SELECTION? Th-2-'e -e mor C.'.."),'".;H::---'37.7`.".5 .r.-'€•••• Prlce 1. Safety: A a cOr'' your bus'ness —•„5-. 7 te fC as eP, le Ded3-7.7e-it )5-1. 1 rev-e,..v 1.7.e carrlerscie and dcc rig. 2. Price: By cr.eat:r.g a --,arl<2r. id,- your plan's of assets ,ts t:-He 1:i.ernal rate of return on !Ti-d corLirm that premium liabilities -.e THs is a value-added service typical irs...rance 3. Service: A:Tr `.-e: r'eed to know their forrn.,- be a'-_:,soe-2C2 best possibe se -vice ir de 2 r'=2.' cr C31 point 3:e 3 0" HOW IS USI CONSULTING GROUP PAID FOR THIS SERVICE? Prid a cp—sita-t. a-e S-2!&:ctecl ins ce-r,er; .2;5_.7.•3 comr.i_;o- e.ifton, we. rra'r iC !. 2. 223CO'llpi:-1,37.3" forms of rerni_.--.-at,pc hrryn .c.osia.imes pursuant to Fts---enits he v, "..:7e b.-15;n?.-35 '0: are techn'T.3 23.2is,s.rarice contra::; 22e:t 3: `,7?. '3 be establisreP with -.:i be disclose:1 in 0urpr0p052 SUMMARY OF ANNUITY PURCHASE SERVICES amendments and pre.pare. quotation 52 Lised by the carrie.rs. dan in Inc proper format and Por.re-.-_ Fpr t•oe a:tuari al pricing programs. ▪ Prov de. e- 3 :1' C.' ir;:"orr...:v2'or1 to maor 2372:1-.-E-5 cs-arket. • Provide a compre.hens.-ie r--a.-lcet search to solicit bids and resooneto carrier questions as needed to properly price the plac.ernent. • Review carrier proposals for accuracy and work to explain any devlations from each other. ▪ Our act.Jarial staff will run favored bids through a valuation systprn to determine reasonableness and pricing assumptions used. • t.) pspoosa's, -ct .;3i.;=•/ a`/373.3 oPtar rnost • CO:! baied acceota-ce -r cr,--.-a:ts • Pe.storrn. g-oup a ty contracts, foi, .,ved by :Ors-:: prOCESS.. • Assist Virr'.-:;-; carrier with takeover of participant data to initiate reJT:''.'.'/e pa.clerits and issuance of annuity certificates 3„."!-_.^,-3]. 3 to plan actuary to be deleted from plan vai,32-3. • 23 t free • con- cation g r'..;,-m-7-ce. company. THE ANNUITY PLACEMENT PROCESS C o•-.17.e,--ert.2i3y cost d..die:s are re,:el%edl around 1230 p.rr ato•-e 2: 3 33 p. 7- L., pac:.errient C—.3 3 - es r7st one • A .3 p323,-Ed Srfthe ins;Jrance comparly f7.--..7}: is prepared documenting the process a- an sponsor's due (in case of questions by DOL. or the Internal Revenue Service, and company ci -ectors and/or other officers). • Vihen a group slng!.e premium annuity contract is received (-vhich may ffc,2.5v.erai months), the contract is reviewed to make sure it with all that hat!a:'ee3 upon. Over the years. bee-. a22 to savc many clients significant arro,_ints of rro-.ei. -s23.2 '2 our pers:stence in striving to secure the most favono • price. available {in relation to the carrier quality) from a ..c! companies on any given day. OTHER INSURANCE PRODUCTS The in s...rance i3 products have emerged: separate account 5223 f".:1EM nuity contracts, single premium buy -in contracts, and irsured liaddity driven investing products to name a few. Each product has specific characteristics with respect to risk transfer, administration and revocability Please contact our office if you would ilk.e to know more about these products and their features. .FM!*/ tli.-1•1,::q payilg 3C11,ty of tile ,:0mp3ry 95 Glastonbury Blvd, Suite 102 ; Glastonbury, CT 06033 1 350 633 5233 www usicg corn CONSULTING GROUP Consulting INTRODUCTION 0.lr rea a ,d comp i e consulting department provides nts With issue -specific transactional analysis and rises::ante, as well as cr:_ n7 administrate -re and informational support. We pa _ r ae these services in connection with ether USl Consulting Group service area; (such as Our a:tuarlal and defined contribution d'ep.a-taarent;), or ea an independent service. We. t._e-^ ._ .', ` i on leg e i regulatory d_,_ t.epot_ i-•aac:archangaon your b. a.E.c ;ria-',a-._lb_tsi,ness %,ve i<eaaa aouinformed of 13; .'3-•, a-:i r, is through on,,,i:- c: ;:.,33'0:73 newsletter and r_cn rr" oa.p a^ , far attendant bias -mess 1,,..=s an -a OUR SERVICES Transactional and Issue -Specific Support Our regulatory and compliance consulting professionals provide a wide range of support services, including: • Research and analysis of laws and regulations pertaining to retirement, compensation, and health and welfare program; (a; applied to specific client circumstances and issues) • Assistance in evaluating and maintaining benefit plan compliance and helping you achieve your retirement and benefit program goals • Consulting and support with respect to: - Plan design, implementation and administration of pension, profit sharing, employee stock ownership, deferred compensation, cafeteria, flexible benefits and flexible spending account plans — P13n termination - Plan design and t3x qualification defect corrections - Domestic relations issue; and order evaluation - Fiduciary responsibility • Plan document, amendment, summary plan description drafting and internal Revenue Service favorable determination letter application preparation and submission Iblerger and Acquisition Due Diligence Consulting Retiremeat employe_ benefit issues s s_ a: ovary stage of a cccacrate me' er or 3 - : . As buy= s conduct d„_ a _`?'_ .> rna'•r a .. nr _ a I :L,,•-‘7. closing cansa, ,aaaa -a, ant costly litigation and str_3.r-fiinethe rnerger/a•_:; s :cn process. Once a transaction is: —npiete, smooth Yea:- transitions promote positive employer - employee relations. - We offer comprehensive due diiig�ence consulting services designed to: • Help define 'benefit- components that impact a particular transaction and recommend appropriate language for the purchase/sale agreement • Uncover potential buyer liabilities associated with tax qualification, ERISA fiduciary duties, prohibited transactions, and reporting and disclosure issues • Develop strateg es to deal with the seller's benefit plans: plan spin-off, merges, assumption and termination • Determine if pre -transaction amendments are required to meet the buyer's/seller's goal; • Assist in the design of an employee relations oriented communica:icn strategy to affect a sM 0•oti benefits transition Government Audit Support Our team of e»<per - e:', :a-tcme.ys and .s have assisted man', _l r3rg3"ng r compliance Issues teat ` _ _ :n the GJ."`.'r. De.p3-trent of La 0` - 3 hi, Yr e h 3: _ numerous clients in . e r eparation and corrective a,_r^.licatc,3 ,' 13r the V3'1Jtli cC1^ 3,c_ resJlit'Jn grog. -a ; a _,_-'{ C'j ga,: ., et._ reg.;!e ' .! agencies. Why USI Consulting Group? Within USI Consul?irg Grorup's Legal department, have assembled a group of attorneys and consultants with more than 80 years of collective experience in a'I aspects of employee benefit program design and compliance. P.e a-.{ _;s of yr ;-.. ..` {:e an.y. C" :z: .r.h t, rrttre.3 _ Or!p i J- r{��,.r'..e'i,r`.� 3 .4i_� �`:- ,. torv: org37'_.'.'...., compliance 3... ,ta .-,.:-.1 and support. Working 'r'r'tn 'r __, s' = e<_.,u`._ g}:ur , you - benefit specl,a i;t or !e 3' counsel, we bring to '!'3 organization '!ea a or exprer{encE_, in a,pc yino cons_1 -- . changing, complex rules to Important corporate c_".e'17. programs in a creative, business -oriented and pr3:::a manner. Plea:a that cur :3e;L,I?terry and oIr. r1 e Consulring artcrneys are not your legal counsel and may no; a. -enter Y:r'rll"gel alder 3tt r ey c,ient pr'yil.,ge. rPinrk;ogg'N••h senor s .? :3 !our organ{zat ,n :n a _, _a;r, _, cus;ness-or:en,ed and ;,rarrcal r,n _•; 3;ed On year; :r In addition. to ccriply ,y.th regular;ons issued by the IRS con:ervn; !he pravis{cn ,: A, •.,.l .::•leis 7ther4r{se e(pres ,v e-'a r rhe,..em, any xritt�n infarmariJn pr3 aib.e _,. "ybu by Our "-- -3 -. h? used and cannot be used.. by an,,one for the purVI.F.e g ' 71, .a - = . ary matters addras,sed ,n the document. anP.^... ,a4..sxrvx" n! mrwmv.veeiawswSPOW ?3wraE.4.,4v , .4 a ;•:mac 95 Glastonbury Blvd, Suite 102 Glastonbury. CT 0603 '.2.31tax . •efed 850.633.5233 w•rv%nr a"sl:; tom CONSULTING GROUP INTRODUCTION USI Advisors, inc. (a „ fed subsidiary of USI Consulting Groupi fs3 Regis+,,r.2d In',est"1 _'t Advisor offering ire,e- advice prima - to rietirennent program and endo"e5r vn:i '!i e can design, Implement and evaluate retirement pia _s:ment portfolios according to your Investment Polio; 5: a n. nt ("IPS'). Our organizational > _`CtJr? gives you the reYibllity to either choose UUS se advisory s. rvices, or to coen'ulf? Our services „ any or USI Consulting Groups c r =r departments' 32, vices. TODAY'S CHALLENGES In an increasingly difficult, c:,'plex and litigious world, you need the guidance and s_: eaort of consultants more than ever. Today, you face the c- i _n.ge of building an investment program to meet the growing demands of your participants. For plan sponsors with a defined benefit plan, designing an efficient asset allocation' strategy in accordance with plan iabilities can be a daunting task. Another challenge is the selection, monitoring and reporting of diversified portfolios from mult'n e Investment managers. TOMORROWS SOLUTIONS From the start, we partner with you. As your hands- on Investment advisor, we can assist in designing and implementing retirement plan investment strategies consistent with your investment and business objectives; recognizing that there is not a single solution for all of our clients needs. Our investment consultants provide. you with the perspective, counsel and support you need to fulfill your fiduciary obligations. INDEPENDENT PROFESSIONAL ADVICE Vie provide independent, professional advice; we are not money managers and do not offer proprietary funds. Our approach i3 to manage the money managers.' Using a rigorous due diligence process, Nye identify, recommend • and monitor inv_strr .s -i . _ - _ _ respected investment organizations. We 3.:_ _. 7„ can the extensive data, analysis and research _'' h?j of Morningstar Direct'; a recognized leader in ire., know-how. OUR SERVICES At USI ?� to h�I71n� y�Lld,si design 3 +,'%e 3.1 ,_.. .. e G':n ern, _ 3 Yid." racmlc_., �_, , -� _ ,n r plan d'_s'g"ed to h you t',' r _friary resv_r• c;. `ies in an efficient and co.st- ef ective. r" .. ii!i e C31 a s : assist yoij in e-;: ll5hi ' a program',~,':- : ,es:"' _ . 3e'':,:- st/'_3_tu.'e_i ._ _ic y: , employees a - -.,e their re r-errent gn31s. Investment program benchmarking • Providing written analysis of existing Investments • Assessing the number of investment managers represented in each asset class • Identifying asset CIa;;es that are over or under represented within the existing program • Comparing your plan to similar plans in order to illustrate how peer plans are addressing the challenges of today's market and business environments • Providing investment recommendations designed to meet your plan's objectives and risk profile IPS development • Help with developing updating the appropriate investment guide through an in-depth consultation involving the review of current objectives, establishing performance benchmarks and risk tolerance • IPS serves as an important compliance instrument upon which we base suitable investment recommendations Defined Benefit Asset/Liability Analysis Despite today's headlines that focus on investment performance, the initial, and historically the most important decision is asset allocation. Through defined benefit plan asset allocation, we: • Take the plan liabilities into account • Provide both deterministic and stochastic analysis • Model where the plan is headed over 20 years and a' what probability level Our investment strategists will partner with you to determine whether your current asset allocation strategy is consistent with your financial circumstances, actuarial assumptions, future plan liabilities and risk tolerance. We will modal the expected impact of various asset mixes on pension expenses, funding ratios, the level of projected contributions and their volatility over the long run as we seek to determine and document which asset allocation strategy best fits your objectives for the plan. Manager due diligence • Developing an investment profile and recommending an asset allocation model based upon this profile • Evaluating investment managers relative to peers, benchmarks and expectations Manager searches • Assisting you in selecting "best -in -class" investment managers across all asset classes • Assisting in the hiring decision and the subsequent transition and implementation process • Providing ongoing manager and investment due diligence Ongoing monitoring • Preparing detailed periodic investment review reports • NI€•. - :. p iii sponsors or Investment Committees as needed BUNDLED SERVICES (provided through USI Consulting Group) Retirement plan services and cost analysis • Assessing your current third -party vendors in areas such as asset management, recordkeeping, customer service, administration and participant education • Assessing whether plan expenses are competitive within the marketplace and match the value of the services you are currently receiving Regulatory & compliance services • Providing education and assistance regarding fiduciary , liabilities and compliance with regulations • Researching and analyzing laws and regulations • Providing government (IRS/DOL) audit support • Providing periodic legislative and regulatory updates 'Diversification and a location do not guarantee against a loss, nor do they ?guarantee that a diversified and,or asset allocated portfolio :veil outperform a non - diversified and/or nor -a, . t allocated portfolio. USI Advisors. tor_ l _ e, offer nor exercise discretion in any client account. however, the firm will provide recommendations, pursuant to a written investment advisory adreeme.." 3ccardance with tie terms of a client approved investment policy statement -._-Tt.514R.1P0®G-�'�saSifF ci!'_4T.fxoprfiim:S.'�.�r. 't,t �9h fs�'F�-�'PlYa1P�-'��•�/p-11E"YRkIY�'!k1CY�11496YitlY�1r RM+WYNWa`�T=vsl•glirYMl�--�'+16ilTA'✓:IJPY4.�S��1'a4"M> n.�"cs�tW.Yy USI thrmugh USI Securities, Inc. Member FINR,A/SIRC Ind-; n'a:et Advice -::r r ir.turn_nai a-- -_ ,.s s provided by USi Advisors. Inc., 95 Glastonbury Blvd., Glastonbury. CT 06033. 360.652.3239 CONSULTING GROUP 95 Glastonbury 81vd, Suite 102 Glastonbury, CT 06033 860 633.5283 wwP: usicg corn Client#: 1420259 DEANWORM1 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 12/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI 2711 N. Haskell Ave., Suite 2000 Dallas, TX 75204-2914 NADMEACT Lynn Owen PHONE 203 FAX 634-5921 INC, No, Est): (NC, No): EMAIL USl.com ADDRESS:L Ynn.Owen @ INSURER'S) AFFORDING COVERAGE NA1C # INSURER A: XL Specialty Insurance Company 37885 INSURED Onex USI Holdings Corp. 200 Summit Lake Drive Valhalla, NY 10595 INSURER B : INSURERC: INSURER °: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES QF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WV() POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMAISES (Ea occurrrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO. JECT II LOC PRODUCTS - COMP/OP AGG $ 5 AUTOMOBILE LIABILITY SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT {Ea accident) S BODILY INJURY (Per person) $ BDDILV INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) S S UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS•MAOE EACH OCCURRENCE $ AGGREGATE $ DEO RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) if yes, describe under DESCRIPTION OF OPERATIONS below Y! N N I A PER STATUTE 1OTH- TIER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liability (E&O) ELU14790516 12/31/2016 12/3112017 $10,000,000 per claim $10,000,000 aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attachedif more space le required) Professional Liability / E&O Liability coverage is extended to all subsidiaries and dba's of Onex USI Holdings Corp. / USI Insurance Services LLC. All USI employees are covered under this policy for the work performed as directed by USI. RE: USI Insurance Services LLC CERTIFICATE HOLDER CANCELLATION Evidence of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE 7 �1 • wW our",./6- 0 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S19444704/M19441775 LAOHD Client#: 1420259 DEANWORMI ACORD.,, CERTIFICATE OF LIABILITY INSURANCE DATEIMMlDDlYYYY) 12/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI 2711 N. Haskell Ave., Suite 2000 Dallas, TX 75204-2914 CONTACT Lynn Owen PHONE 203 fi34.5921 FAx [A/C, Na, Ex!):(AIC, No): EMAIL nn.Owen Ly@USI.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: XL Specialty Insurance Company 37885 INSURED Onex USI Holdings Corp. 200 Summit Lake Drive Valhalla„ NY 10595 INSURER B : INSURERC: INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL INSR SUBR WVD POLICY NUMBER POLICY EFF IMM/DO!YYYY) POLICY EXP IMMIDO/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 E S (RENTED PREMISES (Ea occurrence) ROW 8 CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PRO. JECT PER: LOC PRODUCTS • COMP/OP AGG $ $ AUTOMOBILE LIABILITY 1_ SCHEDULED i COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY VNJURY(Per accident) 5 PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB — OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS` LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERJMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N N f A PER STATUTE OTH- ER E.L. EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A Professional Liability (E&O) ELU14790516 12/31/2016 12/31120/7 $10,000,000 per claim $10,000,000 aggregate DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Professional Liability / E&O Liability coverage is extended to all subsidiaries and dba`s of Onex USI Holdings Corp. 1 USI Insurance Services LLC, All USI employees are covered under this policy for the work performed as directed by USI. RE: USI Insurance Services LLC CERTIFICATE HOLDER CANCELLATION Evidence of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) 1 of 1 #S194447041M19441775 0 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LAOHD MONUMENT -REAL ESTATE SERVICES - Gerardo Gato Monument Real Estate Services 5200 Blue Lagoon Drive, Suite 400 Miami, FL 33134 March 7, 2017 Re: Jose L Gonzalez To whom it may concern: This letter serves to vouch for the personal and professional character of Jose L Gonzalez. I have known him both on a personal level as well as a professional level and can attest that Mr. Gonzalez is of high Moral character and incredibly professional and proficient in the arena of Employee Benefits. I wholeheartedly recommend Jose as a consultant. He has a take -charge attitude and subtle -yet -confident approach that resulted in being immediately embraced by our Human Resources department when we first engaged his services. Jose is not only creative; he possesses the rare skill of being able to communicate his ideas and their associated benefits effectively, which in our case resulted in full buy -in from our leadership. Simply put, he gets us the results we demand. During the time our firm has contracted with Jose, we have seen an increase in profits as well as improved morale. We are convinced that both achievements are largely a result of Jose's efforts. He is worth every penny. Please don't hesitate to follow up if I can answer any questions about Jose and his skills. Sincerely, Gerardo Gato Chief Financial Officer 5200 Blue Lagoon Drive, Suite 400, Miami, FL 33126 (305) 446-0010 AdrienneArsht Center FOR THE PERFORMING ARTS OF MIAMI•OADE COUNTY March 61h, 2017 To whom it may concern, This letter of recommendation is to attest that Jose L. Gonzalez is one of the most thoughtful, knowledgeable and professional people in the benefits practice industry. He has a passion for the design, development and education of benefit plans, and is one of my "go to" people in the insurance industry. He has knowledge of the market, understanding of current and pending issues and cares tremendously about his clients. He can be relied on to deliver what he promises. Beyond his role, he is always ready to provide help and support. There are select people in organizations who you can trust to carry responsibility and believe in the importance of accountability, and Jose is one of those individuals. Sincerely, Trish Brennan Vice President, Human Resources 1300 Biscayne Boulevard, Miami, FL 33132 Telephone 786.468.2000 Fax 786,468.2001 www.arshtcenter.org