Cleveland Clinic MyConsult® Second Opinion Program

Program overview Special arrangement with Cleveland Clinic for access to electronic second opinions through their MyConsult Online Medical Second Opinion program Designed for employees with serious and life-threatening medical diagnoses Provides access to the Cleveland Clinic’s expert specialty physicians Eliminates time and expense of travel Helps confirm a diagnosis or a treatment plan or offers alternatives; provides recommendations Convenient and secure; all personal health information is kept confidential Maximizes employee engagement in their care Improves health outcomes and reduces medical costs 1

About Cleveland Clinic Located in Cleveland, Ohio One of the country’s most respected hospitals Rated one of the top hospitals by U.S. News & World Report Cleveland Clinic physicians are recognized as experts in their fields by both the clinical community and consumers 2

Program features Unique service available as an enhancement to Health Advocate’s Second Opinion Program Second opinions available for a growing list of over 1,200 medical and surgical conditions in nearly every specialty Incorporates Health Advocate’s expertise in collecting medical records, imaging studies, laboratory reports and pathology specimens Timely turnaround of second opinion reports No installation fees or start-up costs Turnkey communications package 3

How it works Employer agrees to cover cost of MyConsult second opinions Health Advocate will include the program as an option presented to members with complex, serious and life-threatening conditions who contact us for assistance Employees can call us directly to participate in the program 4

How it works Employees access the program using the link to the specially-designed Health Advocate/Cleveland Clinic website on their Health Advocate member website Client is charged only for completed consults No additional charge for Health Advocate’s assistance Comprehensive electronic second opinion report are returned 10-14 business days after cases are assigned to a specialist 5

Comprehensive review Cases assigned to the most appropriate Cleveland Clinic physician specialist expert Thorough evaluation of all medical records and test results May agree with current treatment plan or suggest changes/additional tests Gives employees reassurance that an additional expert clinician is participating in their care 6

MyConsult outcomes Diagnosis Treatment recommendations Agree: 75% With changes: 15% (additional diagnoses; further study to make best decisions about interventions) Disagree: 10% Treatment recommendations No changes: 38% Minor changes: 22% Moderate changes: 24% Major changes: 16% Significant healthcare implications 7

Support from a Personal Health Advocate Exclusive feature available to Health Advocate members Personal Health Advocates: Assist with the online MyConsult request process Contact providers to coordinate the transmission of medical records, imaging studies, laboratory results and pathology specimens to Cleveland Clinic Answer questions and follow up as needed 8

What does it cost? Employers agree to cover the cost of the MyConsult second opinion $565 per case $745 if pathology review needed (e.g., most cancer diagnoses) MyConsult costs are passed on to client with no mark-up Health Advocate bills the client when the case is completed Health Advocate’s support included at no additional charge 9

Key benefits Increased peace of mind for employees with serious diagnoses Improved health outcomes Reduced medical costs Increased engagement and more informed decision-making Increased employee satisfaction and retention 10

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