Services Provider to Manage (J Code) Specialty Drugs Charged to the Medical Benefit Plan not to the PBM HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR  Innovation   Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: tference@hrmdco.com Website: www.hrmdco.com

Medical Benefit ( J Code) Drug Management Services Provider About 50% of the employer’s specialty drug spend is billed through the medical benefits plan not the PBM Therein, the operational, clinical and financial conflicts of medical carriers and /or PBM’s can interfere with producing optimal and cost-effective patient outcomes. Often, plan sponsors think the necessary management tools are in place to address “J ” billing code usage or other selection criteria when in fact, they are not. Thus, this services provider has developed an integrated process that streamlines workflows with all necessary and involved parties to optimize clinical and financial outcomes for self-funded plan sponsors.

Medical Benefit ( J Code) Drug Management Services Provider The process involves a pro-active and balanced coordination between a patient’s physician, an employer’s health plan administrator and a credentialed clinical team The clinical team renders evidenced-based coverage recommendations with an opportunity for peer level clinical consultations. The outcome for self-insured employers is greater visibility and transparency to actions that address increasingly complex high cost drug treatments in a cost-effective manner.

Medical Benefit ( J Code) Drug Management Services Provider Expected ROI varies with a range of 1:1 to 8:1 depending on a variety of factors such as employer member demographics, disease mix and severity; and benefit design effect(s) on site of service and/or sourcing of drugs. Medical Benefit ( J Code) Drug Management Services Provider

High Level Process Overview Patient Credentialed Clinical Assessment Team Receive TPA -validated drug plan Render coverage recommendation Optional peer clinical consultation Treatment Plan Notify Physician Notify Health Plan TPA Health Plan Administrator

Example - Drug Costs Imbedded Within Medical Sample Active Population (Non-Medicare) Medical Costs Incremental to PBM Costs 2% of members are expected to account for significant share of drug costs ~200 members per year Unabated, 2018 is likely to be ~$4.0M without affirmation of clinical benefit Continued growth of utilization and price increases can be expected to exceed PBM trends Covered lives 10,000 Number of utilizers 200* Expected drug spend (2% utilizers) $3,267,840* PMPM cost $27.23* *Service provider proprietary analytics modeling

Medical Benefit Drug Trend Management With and Without J Code Management With Management Faster access to real world clinical and financial visibility Pro-active management that validates optimal clinical and financial outcomes Opportunity of 1-8 times ROI 201x 201y

Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com Thank you for your potential interest in this fresh thinking