1. CIA Annual Meeting LOOKING BACK…focused on the future

2. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Moderator: Ron Hoskins Speakers: Teresa Negrich Brian Kassner Louis Bernatchez Moderator: Ron Hoskins Speakers: Teresa Negrich Brian Kassner Louis Bernatchez

3. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Agenda Trends in Critical Illness (CI) The health and wellness challenge Health spending accounts for small groups

4. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Trends in CI Biggest demand from large financial services companies and smaller companies in the west Voluntary product with an expectation of some evidence free coverage Selection risk can be mitigated by fairly standard pre-x Currently, there is no significant price pressure due to the use of common reinsurers

5. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Critical illness trends 6 primary players Players are looking for ways to differentiate the product through alternative benefit schedules – Will this mislead plan members? Support for the coverage varies significantly between advisors

6. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future The health and wellness challenge Plan sponsors are looking for ways to improve the health of their members, increase productivity and reduce benefit costs Insurers are responding with web based self- help wellness tools and the delivery of proprietary and/or third party health and wellness programs Many of these are promoted as product differentiators at no additional cost

7. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future The health and wellness challenge In promoting and delivering these products most insurers are stepping outside their core areas of expertise If third parties are delivering the core service, what value do the insurers bring? How do we measure the success of the programs? Will demand support the real economic cost of delivering these programs?

8. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future The health and wellness challenge How do you select the right providers? Will the actions of health and wellness suppliers create liabilities for the insurers?

9. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Health spending accounts for small groups We are seeing a growing demand for HSAs from small groups with less than 50 employees HSAs are seen as a means of providing “flexible” benefits and cost control Flexibility is achieved by providing the member with a lot of control over how the HSA money is spent

10. CIA Annual Meeting Session 5207: Plan Design Issues LOOKING BACK…focused on the future Health spending accounts for small groups Cost control is achieved through the conversion of at least part of the benefit program from a defined benefit to a defined contribution program.