1. September 17, 2015

2.  7,000+ employees including Police, Fire, Public Works, Library, Health Department and other administrative support departments  Approximately 100 work locations scattered throughout the City  Many employees work out in the “field” during workday  Employees work a variety of hours and shifts depending upon the department  City provides Health Insurance coverage to both active employees and retirees (22,000 membership)  Healthcare costs had been increasing around 8-9% each year ◦ Expenditures approximately $139M in 2011 2

3.  2009 ◦ Negotiated labor contracts that included Wellness Program because employees and labor groups wanted to control health care costs ◦ Joint Labor-Management Committee (9 individuals from Labor and 3 from Management) forms and meets regularly to design Wellness Program  2010 ◦ Wellness and Promotion Labor Management Committee develops 3-step wellness program, completes RFP process, and selects Workforce Health to be partner for the Wellness Your Choice Milwaukee program ◦ City Wellness Program begins  Includes tobacco cessation classes for those who use tobacco, and a variety of worksite programs and activities led by Workforce Health 3

4.  2010 ◦ All employees and spouses offered 3-Step Wellness Health Appraisal process including lab work, on-line questionnaire and coaching session ◦ Over 80% participation has remained constant since program inception ◦ Members choosing not to participate pay monthly health assessment fee  2012 ◦ Implement benefit design changes to health plan including 12% employee premium payment, deductibles, co-insurance and out of pocket maximum ◦ Switch from insured HMO to self-funded EPO ◦ Continue to partner with UHC and with Workforce Health (WFH) on health and wellness initiatives  2013 ◦ Continue Wellness program and added onsite Wellness Center so WFH coaches and program leaders have a City worksite ◦ WFH also provides services outside of City Hall complex  2014 ◦ Expand 3-Step wellness initiative and add Healthy Rewards Program  Outcomes based program to keep people engaged year round in wellness activities and programs  Employees earn points through biometrics and activities to qualify for Health Reimbursement Account (HRA) award 4

5.  2015 ◦ Grow the Healthy Rewards program by adding additional point opportunities and increasing participation award ◦ Add onsite Workplace Clinic for employees and spouses ◦ Make health care benefit design changes including  Link co-insurance to UHC premium providers  Increase deductibles slightly but offset with increased HRA award for Healthy Rewards  Change 3 Tier drug co-pay to 20% co-insurance  2016 ◦ No Benefit Design Changes Anticipated ◦ Healthcare premiums for active employees are flat for the fifth year in a row. Reasons include  Benefit design changes that encourage more thoughtful and appropriate utilization  Switch to self-funding  Wellness program and Workplace Clinic 5

6. 6 Number of Participants 83%87% 85% 82% 86%

7. 7

8. 8

9. 9

10. 10

11. 11

12. 12