1. 2013 NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko / Ft. Wayne area March 11, 2014

2. © 2014 Mercer (US) Inc. 1 October 17, 2015 Oldest Marking 29 years of measuring health plan trends Largest 2,842 employers participated in 2013 Statistically valid Based on a probability sample -- only Mercer and Kaiser survey this way Covers employers of all sizes, all industries, all regions Results project to all US employers with 10 or more employees Most comprehensive Extensive questionnaire covers a full range of health benefit issues and strategies About Mercer’s National Survey of Employer-Sponsored Health Plans Employer size groups in presentation Small: 10-499 employees / Large: 500+ employees / Very large: 5,000+ employees

3. © 2014 Mercer (US) Inc. Who’s in the audience? Employers (HR, benefits, CFO, etc.) Recruiters / Employment Healthcare Providers / Health Delivery Organizations Vendors / Carriers Brokers / Consultants Other category? Small 10 - 500 Large 500 – 4,999 Very Large 5,000+ 2

4. © 2014 Mercer (US) Inc. 3 October 17, 2015 Health benefit cost grew 2.1% in 2013 – a 16-year low Employers warned of a rebound in 2014 Most employers say health reform will increase their spending in 2014 Many take action to counter ACA cost challenges CDHP enrollment continues to grow, matching enrollment in HMOs Employers use CDHPs to meet cost, choice and compliance goals Health management programs stress innovation and engagement Most employers that measure ROI see lower trends Widespread interest in private exchanges as a way to add choice While controlling cost and simplifying administration Employers remain committed to sponsoring health benefits Sustainable health programs will require workforce planning, proven strategies HIGHLIGHTS…………

5. © 2014 Mercer (US) Inc. *Projected Source: Mercer’s National Survey of Employer-Sponsored Health Plans; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April) 1990-2013; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April) 1990-2013. Cost growth slowed again in 2013, higher increases expected 2014 Average total health benefit cost per employee rose just 2.1% in 2013 Cost 2014 rebound? 4

6. © 2014 Mercer (US) Inc. 5 Cost rose faster among larger employers, but mid-sized employers experienced the highest cost per employee Employers with 5,000 or more employees All employers + 2.1% + 0.8% + 1.5% + 3.7% Employers with 10-499 employees Employers with 500-4,999 employees Cost

7. © 2014 Mercer (US) Inc. 6 Underlying cost trend still high at 8%, but employers plan to hold the average increase in per-employee cost to about 5% Estimated cost increase to renew plans with no changes vs. actual increase after plan changes * Projected Cost

8. © 2014 Mercer (US) Inc. 7 Cost shifting has been considerable Average PPO deductible for individual, in-network coverage Cost

9. © 2014 Mercer (US) Inc. 8 Median cost sharing* amounts for: Example 60% planPPOHMO HSA-eligible CDHP Deductible$2,000$500 $1,500 Hospital coinsurance/copay50%20%$250-- Out-of-pocket maximum$6,000$2,250--$3,000 8 The typical employer plan still meets the ACA’s plan value requirement of 60% of covered expenses – with room for further cost shifting Large employers * Cost sharing for individual, in-network coverage Cost Do you know your plan’s actuarial relative value?

10. © 2014 Mercer (US) Inc. 9 Don’t know Increase of less than 3% Increase of more than 10% No increase in health spending Expected impact due to higher enrollment and fees in 2014 Wholesale/ Retail Services Manufacturing Government Transportation/ Communic./Utility Health care Finance Expect increase of 3% or more due to higher enrollment and fees, by industry Most large employers say reform will boost health spending in 2014 – beyond normal cost increases – due to higher enrollment and fees Increase of 5-10% Increase of 3-4% Cost Last year’s

11. © 2014 Mercer (US) Inc. 10 Employers’ success in bringing cost growth under control will be challenged by health reform Employer actions holding cost down ACA impacts pushing costs up Individual mandate Expanded eligibility Mandated coverages Conservative pricing by carriers Resetting benefit value consumer-directed health plans greater employee cost- sharing New focus on employee choice More sophisticated health management programs Market innovations creating more efficient health care delivery

12. © 2014 Mercer (US) Inc. Managing growth in enrollment by changing contribution strategies Large employers Raise employee contribution percentage for dependent coverage Raise employee contribution percentage for employee-only coverage Other change 11 ACA

13. © 2014 Mercer (US) Inc. Employers taking bolder action to steer spouses to other coverage Special provisions concerning spouses with other coverage available Large employersVery large employers Spouses with other coverage are not eligible Spouses with other coverage must pay surcharge ACA I f y o u a d o p t t h i s a p p r o a c h, b e c e r t a i n n o t t o i n a d v e r t e n t l y d i s c r i m i n a t e ! [ H C E s, C i v i l R i g h t s, S t a t u t o r y … … ] 12

14. © 2014 Mercer (US) Inc. 13 But the shared responsibility requirements are just the beginning Majority of large employers in danger of getting hit with excise tax by 2022 …but almost a third said avoiding the tax influenced health plan decisions for 2014 Percent of employers that would be subject to the excise tax if they made no changes to their current plan… Avoiding the excise tax influenced health plan decisions for 2014 Excise tax did not influence 2014 decisions Source: 2011 National Survey of Employer-Sponsored Health Plans ACA

15. © 2014 Mercer (US) Inc. Taking steps now to avoid the excise tax in 2018 Large employers For nearly a third of employers – 31% – concerns over the 2018 excise tax influenced decisions for 2104 Introduced a CDHP or took steps to increase enrollment in an existing CDHP 19% Added or expanded health management programs12% Dropped a higher-cost health plan11% Unbundled dental and medical plans4% Other change(s)12% ACA 14

16. © 2014 Mercer (US) Inc. 15 Consumer-Directed Health Plans have become mainstream! CDHPs seen as central to meeting the challenges of health reform Provide a low-cost plan to newly eligible employees Encourage employees to use the health care system wisely Avoid the excise tax

17. © 2014 Mercer (US) Inc. Use of consumer-directed health plans is likely to accelerate over the next three years Large employers By 2016, 64% of large employers expect to offer a CDHP CDHP 16

18. © 2014 Mercer (US) Inc. 17 CDHPs typically pass the 60% “test” and cost about 17%-20% less than PPO and HMO coverage Medical plan cost per employee per year HSA-eligible CDHP (Includes employer contributions to HSA accounts) PPOHMO CDHP

19. © 2014 Mercer (US) Inc. 18 Employers working to build enrollment in CDHPs Large employers HSA-based CDHP enrollment rises over time % choosing CDHP when offered w/other medical plans Employer HSA funding drives enrollment... % choosing HSA when offered with other medical plans Expect to offer a CDHP as full replacement 3 years from now... but extensive communication is also important % choosing HSA when offered with other medical plans Employer HSA contribution of $800+ Employer does not have contribution to HSA CDHP

20. © 2014 Mercer (US) Inc. 19 Reducing cost by adding choice – a win-win approach Under health reform all individuals must have health insurance, so employers face rising enrollment and more diverse needs Choice promotes efficiency by allowing employees to buy only what they need Private exchanges add choice without adding administrative burden Eases transition to sustainable program

21. © 2014 Mercer (US) Inc. PUBLIC VS PRIVATE EXCHANGES Medical, prescription Dental, vision, life, voluntary, plus more Government sponsored Broker, insurer, TPA technology firm Actives, retirees PUBLICPRIVATE Open Closed Single or multiple carrier IndividualsGroup plans Insured or self-funded 20

22. © 2014 Mercer (US) Inc. 21 Private health care exchanges poised for rapid growth Considering for active employees Considering for pre-Medicare- eligible retirees Considering for Medicare-eligible retirees Considering private exchanges for either actives or retirees One-fourth of employers are considering switching to a private exchange within two years, and 45% would consider switching within five years Choice

23. © 2014 Mercer (US) Inc. Mercer Marketplace Efficient solutions for employers Funding DC or DB Standard Plan Designs Choice among multiple, pre- screened plans Employee Communications and Education Online Call Center Print and email Enrollment Administration Eligibility determination Data-driven events Election Management Contribution calculation Election Data Deductions Reporting and Premium Data Carriers Payroll HR Profes- sionals 22

24. © 2014 Mercer (US) Inc. Early results from Mercer Marketplace Employers’ top three reasons for moving to Mercer Marketplace Simplified administration and compliance Ability to better manage future costs, defined contribution facilitation Achieve immediate cost savings 63% 47% 41% Note: Reflects % of early adopters ranking reason as a significant factor in their decision to move to Mercer Marketplace; for most clients, more than one reason played a significant role. Choice 23

25. © 2014 Mercer (US) Inc. Right-sizing: Reduced number of over-insured 75% Typical range of value in current medical plans: 85% to 61% Mercer Marketplace range of value: 92% to 2% Impact of right-sizing on total cost (estimated): 5% to in year 1, and growing over time Choice 24

26. © 2014 Mercer (US) Inc. Early results from Mercer Marketplace Medical right-sizing in first year Average value of medical plans pre-Marketplace 80.4% 71.9% Average value of medical plans post-Marketplace $800 Per employee cost reduction from right-sizing Choice 25

27. © 2014 Mercer (US) Inc. Early results from Mercer Marketplace Most employers providing at least three plan options Choice 26

28. © 2014 Mercer (US) Inc. 27 More employers using voluntary benefits to maintain employee benefit options as core benefit plans change Large employers Give employees opportunity to fill gaps in employer-paid benefits Help employees take advantage of group purchasing power Accommodate employee requests Offer additional benefits at no cost to the employer To maintain employee benefit options as core benefit plans change Why employers offer a voluntary benefits program Profile of a successful voluntary program Employee-valued products User-friendly platform Multi-faceted enrollment solutions Robust education and communication program Program coordination Choice

29. © 2014 Mercer (US) Inc. 28 Voluntary BenefitsWork / Life Benefits* Disability Vision 83% 77% Fitness center or discounts64% Accident Whole / universal life Cancer / critical illness 59% 49% 43% Legal consult / referral Financial consult / referral Dep. care resource / referral Elder care resource / referral 41% 38% 32% 31% Long-term care Auto / Homeowners Hospital indemnity Pet 28% 19% 17% 9% Telecommuting / Work from home Adoption assistance On-site / near-site dep. care 25% 22% 11% 28 Percent of large employers offering the benefit 90% 60% 30% 0% Expanding employees’ view of the whole benefit package Meeting diverse needs without driving up employer costs * Data on work/life benefits (with the exception of fitness centers) is from Mercer’s 2012 survey Choice

30. © 2014 Mercer (US) Inc. 29 Integrating voluntary + core benefits improves employee up-take Percent of large employers reporting increase in up-take in last 2 years Voluntary benefits sponsors with integrated platforms reporting growth in take-up Voluntary benefits sponsors without integrated platforms reporting growth in take-up Choice

31. © 2014 Mercer (US) Inc. 30 Taking health management to a new level Employers are banking on health management to control long-term costs. In 2013, employers took steps to: Promote engagement as well as participation Create a supportive work environment Measure results

32. © 2014 Mercer (US) Inc. 31 Fewer employers are willing to offer only their health plan’s standard services Large employers More employers are contracting with specialty vendors and purchasing optional services from their health plans Through health plan – standard services only Through health plan – some optional services Contract with one or more specialty vendors Health

33. © 2014 Mercer (US) Inc. 32 Health management now the norm, addressing a full range of needs Percent of employers offering program Case management Disease management Nurse advice line Health advocate Health assessment Lifestyle management End-of-life case management Health REACTIVE PROACTIVE Addressing the continuum of health needs

34. © 2014 Mercer (US) Inc. 33 Financial incentives are becoming the norm in health management programs, and participation rates are rising as a result More employers are driving engagement through financial incentives, most often cash or contribution reductions Large employers using incentives report higher participation rates *Average % of identified persons actively engaged in program Large employersVery large employers Health assessment completion rate Lifestyle management program participation rate* Validated biometric screening rate Health

35. © 2014 Mercer (US) Inc. 34 Engaging employees to improve health habits Group activities and technology-based tools offered Large employers Worksite biometric screening event53% Business unit / location group challenges45% Onsite weight loss programs (such as Weight Watchers)40% Web-based portal with activity / incentive tracking40% Onsite exercise or yoga classes39% Personal challenges33% Peer-to-peer support21% Mobile apps for activity tracking / peer interactions15% None of these22% Health

36. © 2014 Mercer (US) Inc. 35 Continued growth in use of outcomes-based incentives More large employers linking incentives to what employees do about their health Offer lower premium contributions to non-tobacco users Provide incentives for achieving or maintaining targets for BP, BMI, cholesterol Health

37. © 2014 Mercer (US) Inc. 36 Measuring health management ROI can be challenging, but results are encouraging Very large employers 38% have formally measured ROI … Yes No Substantial positive impact on medical cost trend Small positive impact on medical trend No improvement in medical trend was found so far …with 79% reporting a positive impact on medical plan trend Health

38. © 2014 Mercer (US) Inc. 37 The largest employers lead the way with innovations that reward high-quality, efficient providers Value-based design Surgical centers of excellence Collective purchasing of medical benefits High-performance networks Telemedicine Reference-based pricing Medical homes Health

39. © 2014 Mercer (US) Inc. 38 Health reform has employers re-thinking workforce strategies Building a sustainable health program in the post-reform world means looking at workforce issues as well as benefit plan design Should we use more part- timers to limit the number of eligible employees? Does a segmentation strategy make sense? Stay in the game – or exit?

40. © 2014 Mercer (US) Inc. Requirement to extend coverage to all employees working 30 or more hours per week will hit some industries harder than others Percent of large employers that currently do not offer coverage in a qualified plan to all employees working an average of 30 or more hours per week Retail / wholesale ManufacturingTransportation / Communication / Utility GovernmentServicesHealth careFinancial services Takes effect 1-1-15! 39

41. © 2014 Mercer (US) Inc. Likely response to ACA’s requirement that all employees working 30 or more hours per week be eligible for coverage Based on large employers that do not currently offer coverage to all employees working 30 or more hours per week 40 Make all employees eligible for the full-time employee plans(s) Add a new lower-cost option for all employees Use segmentation strategy: Offer a lower-cost plan to newly eligible employees Pay shared responsibility penalty as necessary and…..

42. © 2014 Mercer (US) Inc. 41 About one in ten large employers will reduce some workers’ hours to limit the number of newly eligible employees Will have fewer employees working 30 hours or more per week Will make some other change in workforce strategy Will make no adjustments Already in compliance (no change needed)

43. © 2014 Mercer (US) Inc. Large employers remain committed to offering health coverage Percent of employers that say they are “very likely” or “likely” to terminate plans within the next five years Employers with fewer than 50 employees Employers with 50-199 employees Employers with 500 or more employees 42

44. Employer profile

45. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS About the Survey Employers Number of participants Kosciusko - Ft. Wayne14 Indiana 500+42 50-499 Employees720 500-4,999 Employees1,172 The employer groups shown in this presentation are: The map below shows which states fall into each of the four major geographic regions: 44

46. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Demographics Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Average employee age43444142 % of female employees45% 48%52% % of union employees13%11%6%16% Generally, every 1 year of age = +3% increase in cost And women incur more cost than men, until around age 50…. the the reverse is true. Unions tend to negotiate for richer (more expensive) plans. 45

47. Medical plan prevalence

48. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Type of medical plan offered Percent of employers offering each type of medical plan 47

49. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. Wayne Indiana 500+ 50-499 Employees 500-4,999 Employees Employee enrollment Percent of all covered employees enrolled in each type of medical plan 48

50. Total health benefit cost

51. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS *Total health cost includes medical, dental, Rx and specialty benefits Average total health benefit cost* per employee 50

52. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average total health benefit cost as a percentage of payroll for 2012 51

53. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Expected average increase in total health benefit cost per employee for 2014 *Changes to plan design or health plan vendor Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Before making any changes* 7.1%7.5%8.9%7.5% After making changes*3.2%4.4%5.4%5.0% 52

54. Employee contributions

55. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Employee contribution for individual coverage Average monthly contribution ($) Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees PPO / POS$100$117$130$122 HMO$111ID$146$119 HSA-eligible CDHP$59$66$73$74 HRA-based CDHP$116ID$112$97 Dental$16$14$23$16 54

56. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Employee contribution for individual coverage Average contribution as a % of premium Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees PPO / POS18%22%25%23% HMO19%ID31%23% HSA-eligible CDHP16%15%22%18% HRA-based CDHP19%ID26%22% Dental36%47%64%50% 55

57. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Employee contribution for family coverage* Average monthly contribution ($) *Family coverage is defined as coverage for employee, spouse and two children Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees PPO / POS$292$334$550$419 HMO$322ID$553$404 HSA-eligible CDHP$210$195$324$270 HRA-based CDHP$336ID$471$358 Dental$43$48$67$52 56

58. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Employee contribution for family coverage* Average contribution as a % of premium *Family coverage is defined as coverage for employee, spouse and two children Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees PPO / POS18%22%50%31% HMO20%ID47%31% HSA-eligible CDHP20%16%35%25% HRA-based CDHP26%ID38%30% Dental36%51%70%55% 57

59. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Salary-based contributions Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Contribution is same percentage of salary for all employees 0% 2% Use salary bands7% 1%11% Median number of salary bands 3ID 3 58

60. Coverage eligibility, election

61. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Average % of employees waiving own coverage 22%19%20%18% % of employers offering incentive to waive coverage 14%15%11%17% Coverage waivers 60

62. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % of employees electing dependent coverage 55%60%47%58% Make spouses ineligible for coverage if other coverage is available 29%21%8%7% Surcharge applies for spouses with other coverage available 21% 2%8% Offer same-sex domestic partner coverage 0%33%51%50% Dependent coverage 61

63. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Offer coverage to part-time employees* 46%64%43%64% Average number of hours / week required for coverage 23 2724 Part-time and full-time employees are offered different health plans 50%19%7% Part-time employees *Among employers that have part-time employees 62

64. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Offer mini-med or limited health plan Eliminated 2014 Next up: Skinny Med! Covers only 100% preventive care; qualifies as MEC and meets individual mandate 63

65. Strategic planning

66. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Expect to offer an account-based CDHP in next three years 65

67. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Offer on-site or near-site medical services* *Based on employers with 500 or more employees 66

68. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Accountable care organizations 9%12%ID9% Collective purchasing of medical benefits 0%16%ID13% Data warehouse45%35%ID18% High-performance networks27%21%ID14% Medical homes0%8%ID5% Reference-based pricing0%8%ID10% Surgical centers of excellence 36%29%ID21% Telemedicine0%8%ID10% Value-based plan design27%32%ID26% Advanced strategies used* *Based on employers with 500 or more employees 67

69. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Raise employer contribution by a set amount each year, employees absorb the rest of the increase 0%7%18%12% Provide same dollar contribution for all plans, employees pay more for more expensive coverage 31%24%43%29% Provide employees with subsidy to purchase coverage on their own 0% 10%5% Some other defined contribution approach 15%10%11% Not currently using or considering defined contributions 54%64%44%58% Considering (or currently using) a "defined contribution" approach to funding health coverage 68

70. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees For active employees25%26%39%27% For pre-Medicare-eligible retirees 0%20%24%16% For Medicare-eligible retirees 8%20%17%13% Would not consider a private health exchange within five years 67%60%57%64% Would consider providing a private health exchange within five years 69

71. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Health Care Reform

72. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Provide coverage to employees working an average of 30+ hours per week 71

73. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Make all employees eligible for current full-time employee plan(s) 100%92%82%71% Use a "segmentation strategy" 0% 8%9% Add a lower-cost plan and offer it to all employees 25%8%28%34% Make no changes to eligibility and pay the shared responsibility penalty 0%8%7%9% Likely actions to extend coverage to employees working 30+ hours per week* *Based on employers not currently covering employees working 30+ hours per week 72

74. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Likelihood of terminating medical plan(s) within the next five years 73

75. Preferred Provider Organization (PPO) / Point-of-Service Plans (POS)

76. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average PPO / POS* cost per employee, for active employees *Includes traditional indemnity plans 75

77. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS In-network Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Deductible required (% of employers) 100% 93%90% Median individual deductible amount $500$475$1,000$500 Median family deductible amount $1,200$1,000$2,600$1,000 PPO / POS deductibles Out-of-network Deductible required (% of employers) 86%94% 95% Median individual deductible amount $1,275$1,000$2,000$1,000 Median family deductible amount $2,850$2,000$4,000$2,000 76

78. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay86%78%86%83% % requiring coinsurance43%28%13%22% No cost-sharing is required 0%6% 1% Median copay amount$25 PPO / POS in-network primary care physician (PCP) visit cost- sharing 77

79. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring higher copay for specialist 43%47%46%47% Median copay amount, when higher than PCP $35 $50$40 PPO / POS in-network specialist visit cost-sharing 78

80. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay29%23%31%14% % requiring coinsurance100%84%70%87% No cost-sharing is required0% 5%3% Median coinsurance amount40% PPO / POS out-of-network physician visit cost-sharing 79

81. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring deductible / per- admission copay 0%9%13%21% % requiring coinsurance100%94%67%76% No cost-sharing is required0%3%20%10% Median deductible amountID $250 Median coinsurance amount20% PPO / POS in-network hospital stay cost-sharing 80

82. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring deductible / per- admission copay 0%3%11%13% % requiring coinsurance100% 85%92% No cost-sharing is required0% 7%2% Median deductible amountID $500$400 Median coinsurance amount40% PPO / POS out-of-network hospital stay cost-sharing = 80% in / 60% out 81

83. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay43%78%73%79% % requiring coinsurance57%47%36%34% Subject to plan's overall deductible 14%16%7% No cost-sharing for emergency room visit 0% 3%0% Median emergency room copay amount $150$100$125$100 PPO / POS emergency room visit cost-sharing 82

84. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual OOP maximum Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for in-network services $2,000 $3,000$2,250 Median for out-of-network services $4,000$4,250$5,250$4,000 PPO / POS out-of-pocket (OOP) maximums* Family OOP maximum Median for in-network services $4,000$4,100$6,000$5,000 Median for out-of-network services $9,000 $11,000$9,000 *Includes deductible 83

85. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. Wayne Indiana 500+ 50-499 Employees 500-4,999 Employees PPO / POS funding method 84

86. HSA-eligible Consumer-Directed Health Plans (CDHP)

87. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average HSA-eligible CDHP cost per employee*, for active employees *Includes employer account contribution, if any 86

88. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual deductible Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for in-network services $1,500 $2,500$1,500 Median for out-of-network services $4,450$3,000$4,000$3,000 HSA-eligible CDHP deductibles Family deductible Median for in-network services $3,500$3,000$5,000$3,000 Median for out-of-network services $8,450$6,000$8,000$6,000 87

89. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay0% 8%3% % requiring coinsurance75%88%49%66% No cost-sharing is required 25%12%43%31% Median coinsurance amount 20% HSA-eligible CDHP in-network physician visit cost-sharing 88

90. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay0% 4%3% % requiring coinsurance100% 74%85% No cost-sharing is required 0% 22%13% Median coinsurance amount 35%40% HSA-eligible CDHP out-of-network physician visit cost-sharing 89

91. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual OOP maximum Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for in-network services $3,950$3,300$4,000$3,000 Median for out-of-network services $9,750$7,250$6,500$6,000 HSA-eligible CDHP out-of-pocket (OOP) maximums* Family OOP maximum Median for in-network services $7,150$6,500$7,500$6,000 Median for out-of-network services $19,500$16,000$13,000$12,000 *Includes deductible 90

92. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Preventive Rx covered at separate, higher benefit level Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Not subject to deductible 0%8%4%23% 100% coverage for at least some Rx categories 25%42%3%15% Lower cost-sharing, but not 100% 0%4%3%6% Non-preventive prescription drugs subject to same coinsurance as any other medical expense 100%77%73%67% HSA-eligible CDHP prescription drug coverage *Includes deductible 91

93. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average % of eligible employees enrolled in HSA-eligible CDHP when offered as an option 92

94. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Fee paid by: Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Employer 38%58%34%60% Employee 25%19%21%15% No vendor fee 38%19%27%17% Not applicable – Employees independently select HSA trustee 0%4%19%8% HSA-eligible CDHP health savings account core / monthly maintenance fee 93

95. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Percent of employers making an HSA account contribution 94

96. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Employer contribution to account Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for employee-only coverage $735$750$800$500 Median for family coverage $1,350$1,500 $1,000 HSA-eligible CDHP employer contributions Among employers contributing to the account Type of employer account contribution Matching contributions 29%5% 8% Incentive-based contributions 0%5%2%20% Fixed, non-conditional contributions 71%90%95%82% 95

97. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. Wayne Indiana 500+ 50-499 Employees 500-4,999 Employees HSA-eligible CDHP funding schedule for employer account contributions 96

98. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Offer a limited-purpose Caution: Can be confusing! True or False? FSA in conjunction with HSA 97

99. HRA-based Consumer-Directed Health Plans (CDHP)

100. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average HRA-based CDHP cost per employee*, for active employees *Includes employer account contribution 99

101. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual deductible Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for in-network services $3,750ID$3,000$1,500 Median for out-of-network services $3,750ID$5,000$2,500 HRA-based CDHP deductibles Family deductible Median for in-network services $5,000ID$6,000$3,125 Median for out-of-network services $5,000ID$10,000$5,000 100

102. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay0%ID43%16% % requiring coinsurance0%ID28%69% No cost-sharing is required 100%ID29%18% Median coinsurance amount ID 20% HRA-based CDHP in-network physician visit cost-sharing 101

103. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring copay0%ID14%4% % requiring coinsurance50%ID76%96% No cost-sharing is required 50%ID9%0% Median coinsurance amount 30%ID30%40% HRA-based CDHP out-of-network physician visit cost-sharing 102

104. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual OOP maximum Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for in-network services $2,500ID$5,000$3,000 Median for out-of-network services $5,000ID$6,000$5,000 HRA-based CDHP out-of-pocket (OOP) maximums* Family OOP maximum Median for in-network services $3,800ID$10,000$6,000 Median for out-of-network services $10,000ID$18,000$10,000 *Includes deductible 103

105. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median for employee-only coverage $1,575ID$1,250$750 Median for family coverage $1,950ID$2,000$1,500 HRA-based CDHP employer contribution to account 104

106. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Place maximum on amount that can accumulate in account 105

107. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average % of eligible employees enrolled in HRA-based CDHP when offered as an option 106

108. Prescription drug benefits

109. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Annual change in cost per employee for prescription drug benefits 108

110. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Retail Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Same level for all drugs 14%12%6%5% 2 levels: generic, brand 0% 13%7% 3 levels: generic, formulary, non-formulary 29%56% 71% 4 or more levels 50%27%21%15% Use coinsurance for 1 or more drug categories 58%55%23%26% Employee cost-sharing requirements for prescription drug plans Mail-order Same level for all drugs 8%12%7%6% 2 levels: generic, brand 0% 9%8% 3 levels: generic, formulary, non-formulary 46%63%60%73% 4 or more levels 38%15%16%10% Use coinsurance for 1 or more drug categories 45% 22%21% 109

111. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Retail Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Generic $13$10$12$11 Brand-name formulary $25$28$32$31 Brand-name non-formulary $45$47$55$50 Copayments in prescription drug plans Average copayment among employers with three payment levels Mail-order (for 90-day supply) Generic $21 $22$21 Brand-name formulary $46$55$66$62 Brand-name non-formulary $92$100$114$105 110

112. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS How drug benefits are provided 111

113. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Mandatory generics (with or without physician override) 18%26%ID32% Step therapy (generics / preferred brands required before non-preferred brands) 55%69%ID49% Mandatory mail-order (maintenance drugs must be filled by mail after 2-4 fills at a retail pharmacy) 18%12%ID11% Retail penalty program (maintenance drugs are subject to higher cost sharing after 2-4 fills at a retail pharmacy) 9%7%ID7% Drug plan features among employers with 500+ employees 112

114. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Offer lower cost-sharing when filled at specialty pharmacy 10%12%ID9% Exclude some or all specialty medications from coverage under the retail pharmacy benefit or medical benefit 40%39%ID18% Other method20%12%ID12% Do not steer members to specialty pharmacy 30%37%ID62% Encourage use of specialty pharmacy Among employers with 500 or more employees 113

115. Health management programs

116. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Health assessment (HA)77%90%51%78% Any disease management (DM) program 79%93%53%79% Lifestyle management / behavior modification 69%74%47%65% Nurse advice line79%87%59%79% Health advocate services46%62%38%51% Case management77%90%48%81% End-of-life case management 17%26%28%46% Onsite fitness facility / subsidized or discounted 57%76%42%63% Type of health management programs offered 115

117. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Face-to-face individual coaching 44%52%21%37% Telephonic coaching78%81%78%80% Web-based individual coaching (email, texting) 78%64% 69% Online coaching modules56% 67%71% Type of coaching in lifestyle management program* *Among employers that offer lifestyle management programs 116

118. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Spouses eligible for key elements of health management program 117

119. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS How disease / health management programs are offered 118

120. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Business unit / location group challenges 29%45%24%44% Personal challenges43% 17%32% Worksite biometric screening event 64% 22%52% Onsite exercise or yoga classes 21%43%16%37% Onsite weight loss programs 29%40%11%38% Web-based portal with activity or incentive tracking 29%33%20%39% Mobile apps for activity tracking or peer interaction 7%17%8%14% Peer-to-peer support21%24%16%21% None of the above21%12%51%23% Other wellness activities offered 119

121. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Program participation rates 120

122. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Financial rewards45%53%23%44% Financial penalties27%24%8%15% Make charitable contributions on behalf of members 0% 3%2% Non-financial rewards0%6%4% Do not use any incentives27%26%70%45% Use incentives in connection with health management program 121

123. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Use incentives or penalties to encourage participation in: Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Health assessment, when offered 57%46%20%43% Validated biometric screening 40%41%9%30% Lifestyle management program, when offered 29%40%13%28% Health management incentives / penalties 122

124. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Require multiple actions to earn incentive (or use point system)* 0%25% 46% Use outcomes-based incentives for achieving, maintaining or progressing toward specific health status targets 27% 15%20% Maximum annual value of outcomes-based incentives an employee can earn (median) $860ID$200$350 Health management incentives / penalties continued * Among employers offering incentives 123

125. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Cash / gift cards25%42%45%40% Financial contribution to HRA, HSA, FSA 25% 16%17% Lower premium contributions 50%42%46%39% Lower deductible, copay or other cost sharing 0% 11%5% Median incentive*$85$197$200$120 Type of incentives used for health assessment Among employers offering HA incentive *Among employers that offer incentives in the form of cash, lower premium contribution or financial contribution to employee account 124

126. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Cash / gift cards25%38%35%33% Financial contribution to HRA, HSA, FSA 25%23%20%16% Lower premium contributions 75%54%44%42% Lower deductible, copay or other cost sharing 25%8%12%5% Type of incentives used for validated biometric screening Among employers offering biometric screening incentive * Among employers offering biometric screening incentive 125

127. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Cash / gift cards0%30%42%50% Financial contribution to HRA, HSA, FSA 0%20%15%11% Lower premium contributions 50% 27%25% Lower deductible, copay or other cost sharing 0% 14%3% Type of incentives used for lifestyle management Among employers offering lifestyle management incentive * Among employers offering lifestyle management incentive 126

128. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Lower premium contribution14%24%5%16% Other incentive0%19%2%7% Provide incentive for non-use of tobacco 127

129. Dental benefits

130. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Average cost of dental coverage, per employee 129

131. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Active PPO23%48%50%51% Passive PPO69%52%26%42% Dental HMO15%5%8%13% No provider network8%10%20%7% Type of dental plan offered 130

132. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Sealants85%79%76%78% Implants62%61%53%54% Treatment of TMJ23%21%32%23% Posterior composites54%32%47%41% Dental services covered 131

133. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Median coinsurance amount paid by plan for: Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Preventive services (Type A) 100% Basic restorative services (Type B) 80% Major restorative services (Type C) 50% Dental plan coinsurance 132

134. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Individual deductible Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % requiring deductible 77%67% 77% Median deductible $50 Dental plan deductibles for restorative services Family deductible % requiring deductible 77%67%64%76% Median deductible $150 Preventive care is subject to deductible 8%10%15%7% 133

135. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Median maximum annual benefit $1,000$1,500 Median lifetime maximum orthodontic benefit $1,000$1,500$1,000$1,500 Dental plan maximums 134

136. Other benefits

137. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Accident64%55% 59% Cancer / critical illness36%38%48%44% Disability79%81%76%84% Whole / universal life57%43%60%50% Vision71%83%67%77% Hospital indemnity21%12%29%17% Long-term care21%24%26%28% Auto / homeowners21%31%3%18% Pet0%7%2%9% Voluntary insurance benefits offered 136

138. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Health care FSA Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees % offering health care FSA 71%90%48%84% Average employee participation 26%19%27%22% Average annual voluntary contribution $1,571$1,440$1,238$1,354 Average % of contribution dollars forfeited in 2012 9%10%3%5% Flexible spending accounts (FSA) Dependent care FSA % offering dependent care FSA 71%90%46%83% Average employee participation 3% 8%6% Average annual voluntary contribution $3,282$3,086$2,987$3,257 Average % of contribution dollars forfeited in 2012 2% 1%2% 137

139. Retiree health care

140. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Offer retiree coverage* *To most retirees, on an ongoing basis (new hires will be eligible) 139

141. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Pre-Medicare-eligible retirees Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Private exchange or connector 0% 1% Premium reimbursement plan, health reimbursement account, or other subsidy 0%2%1%4% Provide a subsidy or other assistance to retirees purchasing health coverage independently Medicare-eligible retirees Private exchange or connector and a financial contribution 7% 0%1% Private exchange or connector, but not a contribution 7%2%1% Premium reimbursement plan, health reimbursement account, or other subsidy 7%2%0%4% 140

142. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Receive 28% subsidy for all / most covered retirees ID 34% Offer a plan that wraps around a PDP ID 24% Contract with vendor to offer PDP, EGWP or MA- PD plan ID 5% Continue to provide drug coverage through standard plan and do not receive subsidy ID 27% Some other approachID 3% Current approach to coordinating with Medicare Part D prescription drug benefit* * Based on employers with 500 or more employees 141

143. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. Wayne Indiana 500+ 50-499 Employees 500-4,999 Employees Contribution requirements for retiree-only coverage* Pre-Medicare-eligible retirees * Based on employers with 500 or more employees 142

144. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. Wayne Indiana 500+ 50-499 Employees 500-4,999 Employees Contribution requirements for retiree-only coverage* Medicare-eligible retirees * Based on employers with 500 or more employees 143

145. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Kosciusko - Ft. WayneIndiana 500+ 50-499 Employees 500-4,999 Employees Pre-Medicare-eligible retirees 65%ID 32% Medicare-eligible retireesID 34% Average retiree contribution* as a percent of premium, when cost is shared *For retiree-only coverage. Based on employers with 500 or more employees. 144

146. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Expect to continue offering retiree health coverage to new hires for the next five years* *Among employers that currently offer retiree health benefits to new hires and have 500 or more employees. 145

147. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Please participate in our next national survey! (and you’ll get your own customized report!) Barbie.Sparr@mercer.com or 317-261-9586 146

148. Definitions

149. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Definitions A consumer-directed health plan eligible for a Health Savings Account is a high-deductible health plan with an employee-controlled account. Employer contributions are optional. Account funds roll over at year end and are portable. A consumer-directed health plan with a Health Reimbursement Account is a health plan with an employer-funded spending account. Account funds may roll over at year end, but are not portable. Total health benefit cost is the total gross cost for all medical, dental, prescription drug, MH / SA, vision and hearing benefits for all covered active employees and their dependents divided by the number of enrolled employees. Total gross annual cost includes employer contributions to a Health Savings Account. Employee contributions are also included but not employee out-of- pocket expenses. Medical plan cost is the total gross cost for medical plans divided by the number of enrolled employees. Prescription drug, mental health, vision and hearing benefits for all active employees and their covered dependents are included if part of the plan. Dental benefits, even if a part of the plan, are not included in these costs. CDHP cost includes any employer account contribution. Nationally projectable PPO/POS and HMO medical plan costs for 2013 have been restated to include all prescription drug benefit costs (formerly, cost for carve-out prescription drug plans was not included in the medical plan cost, but will be going forward).

150. © 2014 Mercer (US) Inc. MERCER NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS Definitions, continued A mini-med or limited plan is a health insurance plan that provides far lower benefits than the typical comprehensive major medical plan. The annual maximum amount payable typically ranges from $1,000 to $50,000. Unless otherwise noted, employers with multiple plans of the same type were asked to respond for the largest plan of each type (i.e., the one with the largest enrollment). Family coverage is the coverage level for an employee, spouse and two children. A private exchange is a marketplace for insurance run by a private company or non-profit corporation that offers a choice of health plans and possibly voluntary products and services. Employers often provide a set contribution for each employee to spend on insurance. The exchange also typically provides an enrollment and administration platform with decision-support tools for employees to help them select appropriate coverage.