1. 1  Expert pharmacy benefit management (PBM) consulting team  In-house pharmacists, PBM and Medicare Part D experts  Former C-level PBM executives averaging 20+ years industry experience each  Manage 18 million+ pharmacy lives  Provide unbiased, impartial, expert advice  Recommend solutions rather than products  Acquired by Lockton in 2012  Specialize in working with self-funded employers, health plans, TPAs and other payers to:  Optimize PBM arrangements  Leverage improved vendor relationships  Identify additional opportunities for cost savings  Develop strategies in a dynamic marketplace  Provide full disclosure on all compensation The Excelsior Solutions Difference

2. 2 Excelsior Pharmacy Analytics  Independent annual auditing of contractual guarantees  Based on all information affecting employer cost (discounts, dispensing fees, rebates, admin fees, brand vs. generic classification, formulary lists, drug mix management)  Employers receive penalty check if guarantees were not met  Ensure members are not being overcharged INDEPENDENT AUDITS INDEPENDENT AUDITS  Objective approach with transparency and no carrier/PBM-specific incentives  Rigorous financial valuation of all proposals  Clinical program evaluation  Winning PBM must submit to certain contract provisions, guarantees, and annual independent audits PBM MARKETING AND RENEWALS CONTRACT REVIEWS CONTRACT REVIEWS  Establish clear contractual definitions  Structure dollar-for- dollar performance guarantees  Secure objective audit procedures  Define clear algorithms for guarantee and penalty calculations  Pricing benchmarks  Disease analysis  Drug mix analysis and interchange opportunities  Contract review  Project employer savings if PBMs were shopped today  Brand vs. generic classification  Narcotic abuse DIAGNOSTIC STUDIES DIAGNOSTIC STUDIES

3. 3 Full Service Pharmacy Consulting  Creating Better Economics  Full Market Evaluation  Assess current contract > Renegotiate – Moving into years 4 and 5 with Premera  RFP that includes top PBM’s > Leverage health plan pricing  Transparent contract > Insure terms and conditions drive most favorable results for client  Allow collectives to participate  Trend Management  RX Mart: Data Analytics  Excelsior’s proprietary data solution  Holds PBM accountable to contract  Provides in depth utilization review  Drill down capabilities for each client's specific needs  Clinical Oversight  Pharmacist review of data to determine most effective PBM programs, i.e. Step Therapy, QL, PA  Narrow network evaluation  Specialty Rx consulting  Execution  Ongoing Account Management  Implementation oversight  Quarterly review meetings  Plan design benchmarking and consulting  Insuring PBM delivers on operational and service commitments

4. 4 RxMart Reporting – Holding your PBM accountable How is your PBM performing?

5. 5 Pharmacy Analytics YOUR MOST HIGHLY UTILIZED HEALTHCARE BENEFIT: PRESCRIPTION DRUGS BILLIONS Are Wasted on drug choices Contract Reviews Diagnostic Studies PBM Procurement and Renewals Independent Pricing Audits Specialty Drug Strategy Detailed Claims AnalysisFormulary Management Financial GuaranteesSpecialty-Drug Management Contract OptimizationMedication Adherence Improvement Plan Design StrategiesNetwork and Channel Optimization

6. 6 1% of members = 25–30% of pharmacy spend The Financial Significance of Specialty Pharmacy 53% of specialty paid under medical benefit, managing cost requires site of care strategies 6  Hemophilia patient’s annual cost: $850K; effective patient care saves 62% of overall care cost 5  Biosimilar appropriateness; 26% savings on $11B drug category 4  Ensuring adherence monitoring, $200B annual US cost from drug misuse 2  Lab verification; 1 Rx to 1 of the only 96% of Cystic Fibrosis patients not qualified for drug costs $300,000/yr 3  Hemophilia patient’s annual cost: $850K; effective patient care saves 62% of overall care cost 5  Biosimilar appropriateness; 26% savings on $11B drug category 4  Ensuring adherence monitoring, $200B annual US cost from drug misuse 2  Lab verification; 1 Rx to 1 of the only 96% of Cystic Fibrosis patients not qualified for drug costs $300,000/yr 3 Why Integrate the Specialty Medical and Pharmacy Strategies? 1%

7. 7 What It Is:  Analyzes a client’s potential financial exposure to key specialty/high cost drug categories  Targets key drugs in the pipeline, recently released drugs, specialty drugs, high cost diseases, and expanded indications for existing therapies  The tool was developed with FDA guidelines and is piloted with the following disease states:  Hepatitis C  High cholesterol PCSK9  Multiple Sclerosis  Cystic Fibrosis  Idiopathic Pulmonary Fibrosis  Uses medical and Rx data from InfoLock along with population disease rates  Model will continue to be refined with new drugs, disease states, & clinical data  Model shows minimum costs not inclusive of physician drug administration fees What It Is Not:  Predictive tool for a client’s TOTAL specialty spend Specialty Drug Financial Impact Modeling Tool v1.0

8. 8 Potential Additional 2016 Rx Costs

9. 9 Savings Insight  Based upon the limited data available in the claims experience, it creates a challenge to provide a full assessment of the savings affiliated with the current arrangement  To project the estimated savings we’ve leveraged the average per script savings achieved over Lockton’s book of business in 2014  Total annualized savings opportunity: $200,000 to $350,000  Renogiate AWP discounts, Rebates, Dispensing Fees  Implement best-in-class contract language  Quarterly Audit provision with full reconciliation annually Lockton Companies, Proprietary and Confidential Potential Annualized savings: $200k - $350k

10. 10 Lockton Pharmacy Analytics Lockton’s Pharmacy Analytics practice supports plan sponsors in assessing the current and future cost drivers of their pharmacy benefit plan and deploying strategies to enhance value and mitigate spending. Our experienced consultants will provide plan sponsors guidance on how to address immediate needs and opportunities while also positioning the plan to successfully manage future challenges.