HEALTHY INCENTIVES PLANS

Presented By:

• Starmark Healthy Incentives PPO and Indemnity Plans

• Starmark CDHP PPO and CDHP Indemnity Plans

• Express Connect

• Website

• Healthy Foundations

Agenda

Goals of Portfolio

• Save your clients money with self-funding while maintaining traditional health benefits for their employees.

• Lower price points through available benefit options

• Ease of selling with consistency in benefits

• Flexibility in plan design to meet employer’s needs

Starmark Healthy IncentivesPPO, Indemnity, CDHP PPO and CDHP Indemnity Plans

Two series. Four plans. Thousands of combinations.

Healthy Incentives Ideal for

PPO => RobustCDHP PPO => networks

Indemnity => NoCDHP Indemnity => networks

PPO and Indemnity Plans

• Traditional PPO and indemnity plans

• Familiarity in benefits with copays and a prescription drug card

• Flexibility to customize coverage

• Freedom to choose any provider

• Attractive options

Ease in Selling PPO and Indemnity

• Consistency in:- Deductible*- Coinsurance- Coinsurance Limit- Office Visit Feature

*Available on a calendar or plan-year basis.

Flexibility in Plan DesignPPO and Indemnity

• Office Visit Feature– Lab Choices:

• With labs (diagnostic)• Without labs

– Encounter Fee Choices:• $20, $30, $40 or no office visit feature

– Up to $500 per office visit covered at 100%

– Balance subject to deductible and coinsurance

Lower-Cost OptionsPPO and Indemnity

• Lab Card Program

– Included with all Healthy Incentives PPO and Indemnity plans, whether or not labs are selected with the Office Visit Feature

– Outpatient laboratory testing covered at no additional cost when testing is directed to a participating Quest Diagnostics laboratory

– www.labcard.com

Familiarity in BenefitsPPO and Indemnity

• Prescription Drug Card

– Choice of separate prescription deductibles:

• $0, $250 or $500 per person• Deductible does not apply to generic drugs

– Choice of copay combinations:

Retail Mail Service$10/$30/$50 or 30%* $20/$75/$150$15/$45/$75 or 30%* $30/$110/$225$20/$60/$100 or 30%* $40/$150/$300

* whichever is greater, up to $200 per prescription

CDHP PPO and CDHP Indemnity

• Qualified HDHPs (high-deductiblehealth plans) that are HSA-compatible

• Lower premium alternative to traditional plans

• Flexibility in plan design

• Attractive options

• Freedom to choose HSA administrator

Streamlined BenefitsCDHP PPO and CDHP Indemnity

• Consistency in:– Deductible*– Coinsurance– Coinsurance Limit

*Available on a calendar or plan-year basis

Aggregate vs. Embedded Deductible

• Aggregate

– Benefits are payable once the entire family deductible is met by one or more family members each year.

• Embedded

– Benefits are payable for a member once either the individual deductible is met, or for the entire family once the family deductible is met by one or more family members each year.

Prescription Drug DiscountsCDHP PPO and CDHP Indemnity

• Price Assurance Program

– Included with all CDHP PPO and CDHP Indemnity plans

– Prescription drug discount program

– Benefits include:• Lowest price available in that store, on that day• Generic drug savings• Drug utilization review• Potential for discount on noncovered prescription drugs

Lower-Cost OptionsCDHP PPO and CDHP Indemnity

• Lab Card Select Program

– Outpatient laboratory testing at significant savings when testing is directed to a participating Quest Diagnostics laboratory

– Lab Card Select program applies to all deductibles

– www.labcardselect.com

Consistency Across Both Series

• Preventive Care Plus Option

– Available on all products

– Choice of benefit levels:• $250• $500

– First-dollar in- and out-of-network benefits for select preventive care services (i.e., routine physicals, child wellness visits) per year

– Balance subject to deductible and coinsurance

More Consistency Across Both Series

• Therapies– Speech, occupational and physical

• 60-visit limit per therapy per year

– Manipulative• $1,000 per year limit

Consistent Options and Coverage

• Supplemental Accident Option

– First-dollar benefit of $500 per accident

• Maternity Option

– Payable same as any other covered service

• Covered Services• Hospital & Provider• Other Services & Supplies• Therapies

• Mental Illness• Organ Transplants

Quick. Easy. Express Connect.

Applying for health insurancejust got easier.

Express Connect. Advantages.

• Reduces paperwork – no paper applications for employees

• You receive your offer faster – generally within four days

• Employees simply call a toll-free number during a scheduled time

• Calls are confidential

• Non-English interpretation assistance is available

Scheduling the Call

• Select preferred time frame based on:

– desired effective date– Employees’ availability (multiple days for calls, if needed)

• Multiple employees can call Starmark simultaneously

• Calls are quick – approximately ten minutes each

• To ensure privacy, your client may designate a secure space within their facility from which employees can call

Easy as 1, 2, 3 for Employers

1. Distribute Express Connect Application Guide for Employees to all eligible employees, including:

– those waiving coverage– new hires in waiting period– COBRA/state continuation eligible

2. Ask employees to:– read through agreements and notices that must be

acknowledged during the enrollment call– review worksheet included in the Employee Guide

3. Inform the employees of enrollment time frame and toll-free number at least two days prior to enrollment

Three Easy Steps for Employees

1. Have all information ready

– Streamline the process by using the Employee and Dependent Worksheet to gather information prior to the call

2. Acknowledge agreement and notices located in the Employee Guide

– The call cannot proceed if these statements are not read by the employee prior to the call

3. Call the toll-free number during the scheduled enrollment time frame

Completing Enrollment

• Receive and review the final rates once all employees complete their calls

• Sign the offer

• A copy of the completed enrollment application will be mailed toeach employee’s home upon issuance

Website

• New website design– New look, easier navigation– Enhanced information

• Online HSA management– View HSA information in conjunction with medical– Choice of HSA administrators:

• HSA Bank• Charles Schwab Trust Company

• www.starmarkinc.com

Healthy Foundations

• Featuring

• HealthAtoZ• Hospital Comparison• Rx Price Comparison• Treatment Cost Comparison

• Demo available on the website

• www.starmarkinc.com

• Flexible plan design … achieve lower price points

• Ease of selling with consistency in benefits

• ; a unique telephone enrollment process for employees

• Simplified employer applications

• Expansive network availability

• Online healthcare decision support tools

• Personalized service clients deserve

The Starmark Advantage

Questions?

S669-213 HLTHY INCENT-PROD 10-07

Healthy Incentives PPO and Indemnity, and CDHC PPO and CDHP Indemnity Plans Producer Presentation Talking Points

Slide 1 Introducing Starmark Healthy Incentives plans.

Slide 2 Starmark is thrilled to introduce to you its Healthy Incentives plans. These plans offer consistency in benefits and options for increased plan design flexibility. This presentation will discuss: • The goals of the portfolio • The plan design offerings • The advantages of Starmark

Slide 3 Starmark designed Healthy Incentives plans with multiple goals in mind:

1. To help you save your clients money by using this self-funded product while being able to maintain a traditional health plan for their employees.

2. Providing you with more mix-and-match options

allowing your clients to create a truly customized benefit plan design, with an opportunity to achieve lower price points.

3. Providing consistency in benefits for ease of sale. 4. Providing plans that are flexible to meet your clients’

needs.

Slide 4 Starmark’s Healthy Incentives portfolio offers two distinct series: What are the target markets? • Healthy Incentives PPO and Indemnity — offers

traditional PPO and indemnity plans that provide a familiar health plan with great flexibility.

• Healthy Incentives CDHP PPO and CDHP Indemnity — includes a choice of a PPO or indemnity plan that can be paired with a health savings account for tax advantages.

Within each series, there are two separate plans: • PPO – which features separate accruals; one for in-

network and another for out-of-network services. Perfect for clients in areas with robust network access.

• Indemnity – which features a combined accrual for in- and out-of-network services. Ideal for clients in areas without access to network providers.

Slide 5 The PPO and Indemnity plans offer the richest benefits and gives your clients a health plan they’re familiar with. Plus, employers have the most flexibility in plan design, enabling their employees to take advantage of an office visit feature and lab program, and first-dollar benefits, such as Preventive Care Plus and supplemental accident coverage.

Slide 6 Each of the plan offers a choice of deductibles, coinsurance, coinsurance limit and office visit feature. Plans can be set up on a calendar or plan-year basis. Slide 7 The PPO and Indemnity plans office visit feature includes charges for the visit, necessary x-rays and non-surgical injections performed at the same office visit and billed by the attending physician.

Additionally, two laboratory testing options are available when the office visit feature is chosen: • Labs included under the office visit feature • Labs not included under the office visit feature

When labs are not included under the office visit feature, they are subject to the plan deductible and coinsurance. All Healthy Incentives PPO and Indemnity plans include the Lab Card Program, whether or not laboratory testing is included under the office visit feature. Rates for the office visit with labs are generally 1-2 points higher than the office visit without labs. Slide 8 The Lab Card Program offers covered outpatient laboratory testing at no additional cost when testing is directed to a participating Quest Diagnostics laboratory, Provider collection and handling fees may apply, and are subject to health benefit plan provisions. For more information, visit www.labcard.com. Slide 9 Another feature of the PPO and Indemnity plans is the Prescription Drug Card. Your clients can tailor their plan by selecting a separate prescription deductible. The deductible must be met in full every year by each member, but does not apply to generic drugs.

Your clients can also choose the co-pay combination that best suits the needs of their employees. Choosing the co-pay combination of $20/$60/$100 or 30 percent retail co-pay offers a lower-cost alternative. To encourage the safe and appropriate use of prescription drugs, Starmark has implemented quantity limits and prior authorization for certain drug classes covered by the prescription benefit. This ensures proper prescription utilization and clinically appropriate quantities. Slide 10 The CDHP PPO and CDHP Indemnity plans give consumers more control over their healthcare spending decisions. They can pair a qualified high-deductible health plan with a health savings account for tax advantages. HSA funds can be used for a variety of services, including prescription drugs, prescription eyewear, and some over-the-

counter medications. Plus, these plans offer flexibility in plan design. Slide 11 Similar to the choices available on the PPO and Indemnity plans, the CDHP PPO and CDHP Indemnity plans provide your clients with a range of deductibles, coinsurance and coinsurance limits. Plus, your clients can choose an aggregate or embedded deductible when selecting a deductible of $2,500 or higher. Slide 12 To help you understand the difference between an aggregate and embedded deductible, I have provided a definition of each. Slide 13 The Price Assurance Program, included with all CDHP PPO and CDHP Indemnity plans, provides prescription drug savings at thousands of participating pharmacies nationwide. When plan participants present their ID card at a participating pharmacy, they receive: • The lowest price available in that store, on that day • Generic drug savings • Drug utilization review

Quantity limits and prior authorization (discussed earlier) are included in the Price Assurance Program. Slide 14 All CDHP PPO and CDHP Indemnity plans include the LabCard Select Program. LabCard Select is a discount program that offers outpatient laboratory testing at significant savings compared with other labs when testing is directed to a participating Quest Diagnostics laboratory. For more information, visit www.labcardselect.com. Slide 15 Available on all Healthy Incentives plans, Preventive Care Plus gives members first-dollar coverage for select preventive care services, such as a routine physical and child wellness visits.

Depending on the selection, either the first $250 or $500 of covered preventive care services per year is paid at 100 percent. Additional covered charges are subject to the plan deductible and coinsurance. Slide 16 More consistency can be found among Healthy Incentives plans regarding therapies. All plans cover speech, occupational and physical therapist’s fees. This coverage is limited to 60 visits per therapy per year.

Manipulative therapy is also covered with a $1,000 per year limit. Slide 17 Healthy Incentives PPO and Indemnity and CDHP PPO and CDHP Indemnity plans offer consistent benefits such as:

• Supplemental accident coverage to help prepare members for unexpected accidental injury by providing first-dollar coverage.

• The first $500 of covered charges per accident is paid at 100 percent.

• Additional covered charges are subject to the plan deductible and coinsurance.

• Maternity option in which normal maternity and nursery care covered charges are payable the same as any other covered service.

• Most covered services, exclusions and limitations, etc., are consistent across all Healthy Incentives plans.

• Starmark’s plan design flexibility allows employers to select benefits to suit their business needs and budget, and attract and retain valued employees.

Slide 18 Express Connect makes health plan enrollment easy by providing a paperless medical underwriting and enrollment process. Slide 19 Using Express Connect reduces administrative paperwork allowing your client to receive their offer faster. On average 4 days. Starmark has redesigned employer applications for ease of doing business. Simply print a copy of the GroupStar proposal that indicates your client’s requested plan design, and submit the proposal along with a completed Participating Employer Application and Agreement. Employees need only call a toll-free number during a scheduled period of time to answer enrollment and medical information questions for themselves and their dependents. For additional information, see the Enrollment Guidelines for Employees (S655-26). Safeguards are in place to protect employee privacy. We also have interpretation assistance available for non-English speaking employees. Slide 20 The employer schedules a preferred time for his employees to make the calls based on the groups desired effective date and the availability of their employees and the Express Connect staff. Employees are able to call simultaneously versus one at a time. Best of all, the calls are quick. Due to privacy issues the employer may want to designate a secure space within their facility from which to make calls.

Slide 21 Express Connect Enrollment Guides for Employees should be distributed to all eligible employees at least one week prior to the scheduled enrollment period. Eligible employees include those waiving coverage, new hires in their waiting period and those eligible for COBRA/state continuation. Eligible employees should be informed of the enrollment period at least two days prior to the enrollment. Slide 22 Ahead of time, the employees should review the Enrollment Guide for Employees and complete the worksheet, if applicable. Be sure employees read the agreements and notices on page three and four of the guide as they will be asked at the beginning of the call as to whether they have read and understand these agreements and notices. The call

cannot continue with out this acknowledgement. Lastly, employees should call during the scheduled time period. Slide 23 Once enrollments are complete, the underwriter will review the case and provide the offer to you, the agent. Once the offer is accepted (offer signed) and any outstanding requirements received, Certificates of Insurance will be sent to the employer. Certificates will be shipped five business days after either the offer acceptance is received or the day Starmark receives the initial premium check, whichever is later. Each employee will receive a copy of his or her completed enrollment application at his or her home once the group has been issued. Slide 24 Starmark has an extensive suite of tools on their website that provide the employer with information regarding the health plan selected, administrative forms for day-to-day plan administration and access to reporting capabilities if an HRA is incorporated as part of their health plan. The website also provides members with around-the-clock access to their personalized health plan information as well as the added convenience of being able to refill their mail service prescriptions and check the status of their prescription online. Members can locate network providers and hospitals and access consumer directed healthcare information. In addition, they can review their HRA activity or HSA balance online when the employer has incorporated the Starmark HRA or an HSA through one of Starmark’s recommended HSA custodians as part of the health plan. Slide 25 Healthy Foundations provides members with access to online resources and tools that not only help them take control of their healthcare, but may also help them lower their healthcare spending. Health AtoZ – Health information and interactive healthy management tools, such as detailed fitness, nutrition and safety guidance, and information about medical conditions and how to monitor them. Hospital Comparison – Hospital comparisons by procedure or type of care according to member criteria and based on the hospital’s experience with the type of treatment. Rx Price Comparison – Lower cost alternatives for more than 200 prescription drugs for chronic, or ongoing conditions. Treatment Cost Comparison – A range of cost estimates for in- and out-of-network providers based on ZIP code for a variety of diagnostic test, lab tests, and treatment of common medical conditions. Slide 26 As you can see, Starmark offers you and your clients many advantages:

• Selling ease because of consistency in benefits and flexible plan designs

• Telephone enrollment o Starmark is a pioneer of this quick,

convenient and paperless way to enroll employees.

• Simplified employer applications • Network options including:

o Regional and national network options o PHCS Healthy Directions provides in-network

benefit levels and PHCS-negotiated discounts for members with a PPO network other than Private Healthcare Systems when out-of-area for travel, school or residence.

• Online tools to help your clients with their healthcare decisions

• Personalized service o Customer Contact Specialist for new

business - personal welcome calls are made to all new groups within two weeks of the group being issued. Assistance is provided in answering questions about plan administration, new procedures and materials to help them introduce Starmark to their employees and much more.

o Account Management for renewing business - focused exclusively on group retention; renewal packets featuring tools and information, such as rate illustrations and alternative plan quotes, to help you renew business.

Slide 27 Question and answer session