1. CBIA Health Connections an example of a successful exchange for 15+ years January 8, 2010

2. Presentation Overview l CBIA Health Connections Who we are Why we are successful l Rating rules in Connecticut l What we do l Lessons learned and opportunities

3. CBIA Health Connections l Introduced Jan. 1, 1995 l Employee choice model l 4 Health Plan choices l 5000+ companies l 75,000+ members

4. CBIA Health Connections l Standardized Benefits across Health Plans l Employer Chooses CBIA Health Connections l Employee Chooses the Insurer Price Network Formularies Satisfaction

5. Why CBIA has been Successful l Deliver value to: Market, Employer, Employees, Insurers l Engaged with and understand our customers l Stay true to core mission – small employers l Private sector status allows for: Innovation and adaptation to market changes Efficient operations l Avoid selection issues

6. Rating Rules in CT l Small Case Reform Laws – under 50 full time employees Adjusted Community Rating – no rate bands for claim experience Guarantee issue Guaranteed renewability Rating factors allowed: Age, family tier, gender, area, case size, SIC, plan design Reinsurance pool (CSEHRP)

7. Exchange & Administration CBIA Health Connections administered like one large plan to the insurers but there are a lot of details……

8. Lessons Learned in the Market l Potential Pitfalls Rates based on claims & health status Adverse selection Looking to save administrative costs only Operating outside of regular market practices Broker compensation variances

9. Things to Think About l Unintended consequences of rating changes l Coordination of multiple funding sources Subsidies Part-time employees l Risk adjustment (premium redistribution) l Minimal focus on wellness and behavior change

10. Opportunities l Bring culture of wellness to the small business market Has worked in large company market Currently no financial incentive Plan design with incentives / disincentives for wellness, prevention and care of chronic illness Decision support tools to help employees / patients make informed decisions about their health More transparency of quality and costs from providers l Promote competition, innovation and quality – subsidy should follow the customer

11. CBIA Health Connections an example of a successful exchange for 15+ years January 8, 2010