Covenant Care – 25 to 250 employeesCovenant Care – 25 to 250 employees

A Competitive Alternative for Fully Insured Clients A Competitive Alternative for Fully Insured Clients

Covenant Advantage 200 Plus EmployeesCovenant Advantage 200 Plus Employees

Total Maximum Plan Cost Guarantee in Years 2 and 3Total Maximum Plan Cost Guarantee in Years 2 and 3

A competitive alternative for your clients who are fully insured

Protect your fully insured business with an alternative Fully Funded program An employer is only required to fund

Administrative Fees, Aggregate Premiums and Aggregate Factors

Provides a unique strategy for managing the employee risk factors that drive employer costs

The Covenant Care Program IntroductionThe Covenant Care Program Introduction

Caps Employer’s Risk

Allows Profit Margins to remain with the Employer

Can lower maximum plan costs

No Lasers – at Issue or at Renewal- No Cash Calls

Potential for Reimbursement of unused claim $$$

CAST – Covenant Applied Savings Techniques- Risk Management Solutions

Covenant Care Program -OverviewCovenant Care Program -Overview

CovenantCare AdvantagesCovenantCare Advantages

Fully Insured CovenantCare Self-Funded

Capped Funding Yes Yes No

Lasers No No Yes

Access to Claim Experience

No (under 100 EE’s)

Yes Yes

Premiums Fixed Fixed Variable

Cash Calls None None Weekly funding of claims up to specific per member

Administration Higher Cost, Less Service

Lower Cost, Great Service

Lower Cost, Great Service

Potential for year end savings

No Yes Yes

Percent of Chronic Diseases That are Caused by Poor Lifestyle

71% 70%82%

91%

0%

20%

40%

60%

80%

100%

Cancers Stroke Heart Disease Diabetes

The Health Care DilemmaThe Health Care Dilemma

35%

At Risk

50% Healthy

15%Acute

Chronic

59% of this years low cost population will be in next years high cost population.

Low Cost Population

The IssueThe Issue

15% of all plan participants have acute or chronic health conditions

This group drives 80% of the claims

59% of next years acute chronic high risk population will come from this years low cost population

The Usual ApproachThe Usual Approach

Reinsurance Premium

Administrative Fees

Employers typically implement cost shifting strategies only to reduce healthcare costs Plan Design Changes Plan Contribution Changes

Positive impact of these changes are short lived.

Cost shifting will not provide a positive impact to the overall healthcare trend.

This strategy does not address the root cause of rising health care costs…lifestyle related conditions

Employer Healthcare Costs

2%

12%

86%

Administrative Costs Stoploss Premium Paid Medical Claims

The SolutionThe Solution Discover the root cause of escalating health care costs

Employer implements a strategy focusing on risk management not on cost shifting

This strategy motivates employees to take a more active role in managing their lifestyle and health care expenses

Risk Management StrategyRisk Management Strategy

Precept MinistriesClaims Cost Per Member

$406.50 $375.18

$252.94

$406.50$463.41

$528.29

$0.00$100.00$200.00$300.00$400.00$500.00$600.00

2006 2007 2008

Covenant Risk Mgt. Strategy No Strategy

Claim Savings

Case Study 1 – Case Study 1 – Precept MinistriesPrecept Ministries

A faith based ministry needed to control their rising health care costs

Implemented our strategy in 2006 and have experienced a reduction in actual claims costs by as much as 62%

The ministry has saved $811,576 over past two years

Risk Management StrategyRisk Management Strategy

Case Study 2 – Case Study 2 – Benton County, ARBenton County, AR 2006 Health plan $500K in

the red 2006 implemented The

Covenant Risk Strategy 2008 Results

Paid back $500K Plan $2.3M in the

black Success brought to the

attention of the national media

Benton County Board of CommissionersClaims Cost Per Member

$395.37

$283.12$210.20

$395.37$450.72

$513.82

$0.00$100.00$200.00$300.00$400.00$500.00$600.00

2006 2007 2008

Covenant Risk Mgt. Strategy No Strategy

Claim Savings

Covenant Applied Savings Techniques and Risk Covenant Applied Savings Techniques and Risk Management StrategiesManagement Strategies

Covenant Pharmacy Initiatives MEDInnovations TC3 MEDai Predictive Modeling TelaDoc MAP Program Lab Card Benefit Program BRAVO Wellness – Optional

Incentive Incentive and Results Based Wellness Initiativesand Results Based Wellness Initiatives

Employers achieve immediate cost savings by linking incentives and penalties to participation and results of biometric screenings : BMI, Smoking, Blood Pressure, Cholesterol and Glucose

Bravo coordinates the screening process, appeals and the HIPAA compliant wellness requirements

HRA and Biometric results are sent to the employees & employer receives aggregate report

Employer is able to implement cost savings strategies using payroll contributions , multiple health plan designs, and HRA deposit

Results drive design and implementation of targeted wellness solutions to improved employee health and achieve long tern savings

CovenantCare Plan Features

Immediate Advance Funding The plan allows for a fixed budget each month. If

claims exceed the cumulative monthly attachment point, then claims are immediately advanced by Pan American Life. The employer is only responsible for funding monthly factors and premiums on the first of each month

Terminal Liability Option Three months of paid run out costs 1.5 months of

premium and factors Six months of run out costs 2 months of premium and

factors Can be elected and paid for any time prior to the

contract end date Unlimited Aggregate Maximum

LTM - Lifetime Maximum per individuals apply, but unlimited for the group

Covenant Care Plan Design Comparison

Premier Plan Plus Plan Access Plan

Plan Maximum $5,000,000 $5,000,000 $250,000

Deductible $500 $1,500 $1,000

Coinsurance 80/20 to $12,500

100% after deductible

50/50 to $10,000

Office Visit $20 / $40 100% after deductible

$20 / $40

RX Benefit $10 / $25 / $50 100% after deductible

$10 (Generic Only)

Maximum OOP $3,000 $1,500 $6,000

Covenant Advantage – Multi Year Rate Cap

The Covenant Advantage Plan has a total maximum Plan Cost Guaranteed for years 2 and 3, but the program must include the following:

•Medical Advocacy Plan (MAP)

•BRAVO Wellness

•CareHere – Onsite Clinic with 200+ employees per

location