CompuSourceHCC.com Proprietary and Confidential Connecting Great People PROBLEM: DATA ERRORS RESULT IN PARTIAL CMS PAYMENTS SOLUTION: COVERED CALIFORNIA RECONCILIATION RESULT: RECOVER MILLIONS IN UNPAID SUBSIDIES ARE YOU MISSING MILLIONS IN SUBSIDY PAYMENTS?

CompuSourceHCC.com Proprietary and Confidential Connecting Great People TODAY’S PROCESS FOR PLAN TO GET SUBSIDY PAYMENTS FROM CMS Enrollment File Effectuation File CMS Pay File CMS Payments

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CURRENT ISSUE #1 – DATA ERRORS WITH ENROLLMENT Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE Initial enrollment and maintenance data do not load correctly

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CURRENT ISSUE #2 – DATA ERRORS WITH EFFECTUATION Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE Incorrect effectuation / termination data sent to Exchange (dates, members, etc)

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CURRENT ISSUE #3 – DATA ERRORS WITH MISSED MEMBERS Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE High volume of pended members not sent to CMS due to data issues

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CURRENT ISSUE #4 – LOWER SUBSIDY AMOUNTS PAID ON SUBSCRIBERS Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE Lower subsidy amounts paid on subscribers Avg $500/per sub/per month e.g. 10,000 subs * 2 months = $10M

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CURRENT ISSUE #5 – LIMITED TIME TO ADJUST ERRORS Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE CMS must close out 2014 by 1Q15 Time is limited for Risk Adjustment

CompuSourceHCC.com Proprietary and Confidential Connecting Great People ALL CURRENT ISSUES WITH DATA RESULT IN LOWER SUBSIDY AMOUNTS Enrollment File Effectuation File CMS Pay File CMS Payments ISSUE Initial enrollment and maintenance data do not load correctly ISSUE Incorrect effectuation / termination data sent to Exchange (dates, members, etc) ISSUE Lower subsidy amounts paid on subscribers Avg $500/per sub/per month e.g. 10,000 subs * 2 months = $10M ISSUE High volume of pended members not sent to CMS due to data issues ISSUE CMS must close out 2014 by 1Q15 Time is limited for Risk Adjustment

CompuSourceHCC.com Proprietary and Confidential Connecting Great People CMS Pay File CMS Payments SOLUTION – DATA RECONCILIATION Eligibility Extract Weekly CC Recon File Payer Recon File Enrollment File Effectuation File

CompuSourceHCC.com Proprietary and Confidential Connecting Great People  2-3 weeks – Free assessment, establish contracts and access to data  2-3 weeks – Start Project - Obtain plan data and confirm validity and format  1 week – Use existing programs to analyze CC recon data  2 weeks – Reconcile Data  2 weeks – Develop plan to fix data in carrier system or at CC.  2 weeks – Implement changes  9 weeks total project time. PROVEN TIMELINE & PLAN

CompuSourceHCC.com Proprietary and Confidential Connecting Great People Large Blues Plan – Implement on the California Exchange Client Goals Engagement Highlights Areas Supported Benefits Realized Implement on the California Exchange  Healthcare Reform Requirements  Additional Covered Membership Objectives  Implement 834 inbound enrollments from the exchange  834 Maintenance transactions from the exchange  Effectuation processes back to the exchange for CMS payments  Data reconciliation of Membership Eligibility and Billing  CMS payment reconciliation for APTC/CSR  2015 Renewal of existing business through the exchange Financial  Found and recovered over $50M in CMS missed payments  Corrected 100k subscribers data issue affecting billed premium Technical  Establish Data Mart Recon process for the Plan going forward. Business:  Established over 95% accuracy for the 450k new membership from Healthcare Reform  Trained business teams how to troubleshoot issues with Enrollment, Billing and Claims  Renewals processed accurately within 95%  Reduced return mail volume by 50% Project Management Environment Management Data Reconciliation People  Establish Technical Leadership to consult teams through implementation and issues  Data Recon and configuration experts Process Technology Testing Defect Management & Fix Renewal  Establish new data recon teams and process to keep data in synch  Establish 834 troubleshooting process  Establish Billing troubleshooting processes  Testing processes  Extensive Testing and data recon using Oracle, SQL, and SAS Release Management CHOOSE OUR PROVEN APPROACH

CompuSourceHCC.com Proprietary and Confidential Connecting Great People 23 years Steve Bradley – CEO CompuSource HCC – Technical Program Exec Mr. Bradley has 23 years of healthcare and information technology experience including 2 years of Covered California Recon experience. He is an accomplished and delivery-focused executive skilled at delivering large technical integration projects and is a very strong communicator. He served as a Technical Lead HCR at Blue Shield of California and led teams to implement on the exchange and drive reconciliation of data with the exchange. Mr. Bradley personally uncovered over $50M in CMS payments due to Blue Shield of CA and helped reconcile over 100k other data discrepancies. He has consulted to many large healthcare payers including Cambia, United Dental, EyeMed, Anthem Blue Cross – Colorado and Blue Shield of Michigan. Cory Dekker – Architect & Data Expert Mr. Dekker has 25 years of IT experience as an Enterprise and Application Architect, Systems Engineer and Data Developer. He has 17 years of Health Insurance experience. He currently serves as Chief Architect and Facets Environments Manager for a BCBS plan in Iowa. Cory has a very keen understanding of data analysis and data warehousing and is a very strong data architect. Dan Kinser – COO CompuSource HCC – Program Executive Mr. Kinser has over 23 years of IT and client management experience including 10 years of experience at TriZetto where he served as an Engagement and Hosting Services Executive. He was responsible for large client implementations and ran application management services for over 50 customers in TriZetto’s hosting center. He managed over 100 applications, 3000 SQL, Oracle, and Sybase databases, and 1800 Windows servers, as well as coordinated Release Management for 20,000 changes annually. Dan has worked on executive teams for QCA, GEHA, WellPoint, BCBSNC, BlueKC, and EyeMed. 23 years 25 years WHO ARE WE?

CompuSourceHCC.com Proprietary and Confidential Connecting Great People  Steve Bradley   CONTACT