UNDERSTANDING THE GLOBAL PERSPECTIVE: It is the world is flat or the world is curved? Presented by Allen Koski, CEBS Cigna Global

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna INTRODUCTION Global Benefits are in flux: –Host of issues that complicate benefits, health care management, compliance for employers, expatriates and local national employees –Benefit programs need to reflect the wider range of countries in which expatriates are sent and local nationals reside –The US is not the only country in the midst of National Healthcare and/or Health Insurance Reformation –Emerging Markets (BRICS and CIVETS) vs. Previous Leading Destinations vs. Hardship Locations 2

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna 3 GLOBAL PEOPLE STRATEGY Formation Start-up Growth Maturity Expats Locally Hired Foreigners Locals S-T Assignees & External

1 Gap in communication of benefits and programs: Employers providing services, but expats not very aware of these services 2 One size does not fit all: Customization by country of assignment is necessary 3 Human resources: Expats demand more support of HR – need more understanding & support of their challenges abroad 4 Medical preparedness and care: Preparedness viewed as very important factor; all ages accessing care during assignment 5 BRICS: Really the most difficult countries of assignment? (Assignments in the U.S. need attention too) NFTC/Cigna Global EXPATRIATE TRENDS STUDY 2013: KEY FINDINGS

Why Wellness: “Working Well: A Global Survey of Health Promotion, Workplace Wellness and Productivity Strategies, July 2014 Buck Survey Sponsored by Cigna 6 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna Canada: Reducing employee absences due to sickness and disability U.S.: Reducing health care or insurance premium costs Europe/L.A./Australia: Improving workforce morale/engagement Asia: Improving workplace safety Going Global: 56% have a global health promotion strategy, up from 34% (2008) Wellness design: flexible work schedules, PTO, EAP, Regular Communications, Immunizations, Biometrics, Ergonomics, HRA, Coaching, Health Challenges, On-Site Occ Top excuses: Differing cultures, laws and practices; no global oversight; lack of vendors

Allen Koski, CEBS Cigna Global Health Benefits