1. Turn key management solutions

2. Challenges and Solutions The challenges of a well run marine program include a need for quality, consistency, and efficiency. The Cyrca solution includes: Accessible, cost-effective, medically appropriate health care Reduced medical costs Reduced injury or illness recovery time Reduced overall claims costs Meaningful data analysis and reporting Skilled program management Internet access to all data 24 / 7 / 365

3. Key Program Elements Network of health care providers / referral Early medical management intervention Incentives for use Program education and implementation Real-time communication and feedback Comprehensive bill review, repricing and processing Program management and auditing Data collection, database management and reporting

4. Products Available Specialty Medical Programs (when typical insurance coverage and programs do not meet the needs such as volunteers, aid-workers, Medicaid populations, international medical group programs) Managed Transplant Programs (sophisticated managed transplant programs which cover the entire episode of transplantation) Excess of Loss Protection (designed to bring reduced catastrophic costs and budget protection in a turnkey program) Marine Medical Management (24/7 risk management protection and US flagship vessel protection worldwide)

5. Technology Utilized All programs are enhanced by data accessibility of key trading partners: Access to medical management records, claims and notes are provided via a secure Internet connection for ease of management Forms and program documents are available for downloading or entry into the system Internet application is designed for program education and implementation Online reporting and data analysis queries ensure all parties have in- depth and accurate knowledge of program standing All appropriate PHI is protected and released as required by HIPAA

6. Cost Containment Network education and collateral materials Member – Administrator brochure / booklet Procedure manual 24 hour information available for easy network access / referral to appropriate provider type Geographically convenient locations to quality providers of health care Creating higher network utilization is key to cost containment. Our process includes:

7. Cost Containment Provider fees discounted and negotiated in advance Match to client’s geographic needs Access to specialty providers Availability of long-term care alternatives Other differentiators of our network cost containment approach include:

8. Cost Containment Early intervention provided by a registered nurse Physician oversight Supervision of Cyrca medical director Proven reduction in medical costs Potential to curb litigation costs In addition to network cost savings, our customized medical management services greatly benefit our programs through:

9. Cyrca Advantages Fully dedicated to program cost containment initiatives Experience with specialized injuries and illnesses Quality program management expertise Program customization (not an “out of the box” approach)