1. Creating Our Culture of Health at American Express April 7 2010

2. Overview A leading global payments, network and travel company established in 1850 Operate in over 130 countries around the globe Approximately 50,000 employees worldwide A Fortune 100 company Recognized as an “Employer of Choice” by several publications worldwide Self insured, high deductible health plans for all employees

3. Industries World’s largest card issuer Premier Travel and Expense Management World Leader in Travelers Checks and Prepaid Products International Bank

4. Healthy Living is about making better health a way of life at American Express. Through a shared commitment to wellness, together we can become a stronger and healthier community. Program Goals To promote health awareness, influence positive behavior change, improve productivity, enhance employee engagement and reduce health care expenditures. Mission and Goals

5.  Optimize utilization of existing programs and resources  Focus on prevention and intervene earlier to avoid more serious illnesses  Increase vendor awareness of other benefits to maximize inter- vendor referrals  Proactively refer individuals to higher quality providers and facilities  Identify and address underlying mental health or substance abuse issues that complicate medical treatment  Better engage employees (and family members) through an employee-centric operations flow  Measure through implementation of metrics for ongoing performance monitoring and improvement Objectives

6.  Senior Leadership – Chairman Ken Chenault  People Leaders  Human Resources  Health Advocacy Board (business Leaders)  Wellness Committees – across all large locations and many mid- size  Dedicated full-time Wellness staff  Healthy Living Wellness Centers  Healthy Living Activity Centers  Healthy Living Cafés  Vendor Partners Support Across Our Organization

7. Program re-branded and launched in 2009 Comprehensive, integrated model 1.Health Screenings 2.Health Assessment 3.Telephonic Health Coaching 4.Condition Management 5.Wellness Centers (Occupational health) 6.Activity Centers (Health Coaches, Registered Dieticians, fitness staff) Wellness Program

8. Employee Healthy Rewards = up to $150 EligibleActionHealthy Reward Covered/non- covered employees Complete your Health Assessment within specified timeframe $100 into HSA or Health Care Reimbursement Account if they don’t have an HSA Enroll in a Health Coaching or Condition Management program, or complete four online Selfhelpworks program (ongoing) $50 into HSA or Health Care Reimbursement Account if they don’t have an HSA

9. Spouse/Partner Healthy Rewards = up to $100 EligibleActionHealthy Reward Covered spouses/partners Complete your Health Assessment within specified timeframe $50 into HSA or Health Care Reimbursement Account if they don’t have an HSA Enroll in a Health Coaching or Condition Management program, or complete four online Selfhelpworks program (ongoing) $50 into HSA or Health Care Reimbursement Account if they don’t have an HSA

10. Free Preventive Prescription Drugs and Vitamins EligibleActionHealthy Reward Covered employees and covered spouses/partners 2009 – enroll in American Express medical plan Automatically receive certain prescriptions for free through Medco through Dec. 31, 2009 2010 – enroll in American Express medical plan, enroll in Health Coaching, Condition Management or four sessions of Selfhelpworks and use Medco’s mail-order service Continue/start receiving certain prescriptions for free through Medco through Dec. 31, 2010

11. Communications  Simplify and sustain messaging  Keep the momentum  Leverage marketing approach  Utilize various methods of media  Engage employees and their families  Feature real healthy stories and goals from employees  Tie to blue box values  Encourage the sharing of stories  Create competition  Report results