Join other like-minded employers for a day of education and innovation Join other like-minded employers for a day of education and innovation! Employers’ Health Coalition will introduce strategies and cost saving programs that will cure your health insurance BLUES!

Advocating Value and Innovation in Healthcare by way of these Key Actions: Representing Employers in Negotiations for the Highest Quality Healthcare at the Lowest Possible Cost Promoting Transparency in Healthcare Costs and Quality Providing Educational Opportunities Across all Levels of Coalition Membership Providing a Vehicle for Employers to Exchange Ideas & Information about Healthcare The Mission of Employers' Health Coalition is to arrange and promote programs and activities designed to benefit employer/employee provided health care; to promote access to and information about quality healthcare thereby enhancing the general health of the community. 

What’s frustrating to the “C Suite” about their health insurance program? No Control Lack of Transparency Unjustified Rate Increases Little (or no) Claims Info Stuck in a Bad Pool You’re too small to be self-funded Challenges in Implementing Wellness Forced to react - Not Strategic

Health Benefits Cooperative “Swimming in a HEALTHIER pool!”

What is a group cooperative? Captive Insurance Company Company “…a self-insured health fund with individual stop-loss contracts and funded to the maximum liability that gives members the ability to control their claim costs, learn and apply best practice strategies, flexible payment options AND advantage a “healthier pool!” Plus, when you become a member you also become a stakeholder with like-minded business owners partnering together to spread the risk of insurance and reap the rewards of a well-managed fund.”

COOPERATIVE STRUCTURE (member groups total 2,500 – 5,000 employee lives) Paid Monthly to Stop Loss Carrier Stop Loss $300,000+ Member “Shared” Cooperative Layer Shock Absorber $25,000+ - $300,000 A 25k B C 35k D 40k E 50k F 75k G H I J $300,000+ Paid Into Coop Shared Layer from Stop Loss Premium $25,000+ $300,000 Claims Paid by Employer “UP TO” the SIR Employer “owns” and greatest savings opportunity $25,000+ Individual Self Insured Retention Layer (SIR)

Sample Company vs. Fully Insured $1M Annual Premium $750,000 Total Claims (not a “great” claims year) $500,000 claims less than $25,000 (SIR claims) $250,000 claims paid from shared layer Specific and agg stop loss, admin, broker fees, risk mgmt., coop mgmt. fee $200,000 Expenses Cooperative Portion $200,000 Cooperative Loss Funds $0 - $25,000/claimant $500,000 Total Claims $100,000 Total Savings $900,000 Total Pay In Carrier renewal estimate = 13% - 18% Cooperative renewal estimate = 7% - 12%

SAMPLE CAPTIVE A B C D E F G H I J 10 Members $2,000,000 Loss Funds 80% LF Loss Ratio = $400,000 Remaining 10% pro-rata portion = $40,000 -

SAMPLE COMPANY $140,000 Total Savings $750,000 Total Claims $500,000 claims less than $25,000 $250,000 captive layer Specific and agg stop loss, admin, broker fees, risk mgmt., coop mgmt. fee $200,000 Expenses Captive Portion $200,000 Captive Loss Funds $0-$25,000/claimant $500,000 Total Claims $100,000 Total Savings $900,000 Total Pay In Captive Layer Profits $40,000 Distribution $140,000 Total Savings $860,000 Net Cost

Health Benefits Cooperative “Swim in a Healthier Pool!” Risk Management and Wellness Program Coordination Population health and trend forecasting data analytics Multiple plan designs and emphasis on PCP benefits ECRx pharmacy BENEFIT program Patient portal with health education tools Value Based Benefits and Risk Saving Programs High value provider networks* Patient concierge services $0 co-pay telemedicine Free diabetic testing supplies for patients and health coaching Bundled surgery payments for certain procedures Interventional orthopedics Well-being, employee engagement and employee assistance programs * Where networks are available

Health Benefits Cooperative Quarterly Calls/Annual Business Meeting Members “Own” the Solutions Member Commitment to Risk Control Focus on retention as a growth strategy Shared Best Practices – Peer to Peer Common Bond of Employer Members

“Delivering value for EACH member!”