City of Los Angeles2019 Annual Review

JUNE 4, 2020

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Agenda Executive Summary

Utilization Review- Exam Utilization- Network Utilization

Working Together

Performance Guarantee Review

Questions

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Executive Summary

Key activities

• Attendance at City Wellness Festival • Participated in Service Provider Outreach/Engagement Summit • Delivered 4 weeks of Popup Clinics – 95% Member satisfaction• Active partner with City of Los Angeles during implementation of Morneau Shepell• Secured 24-month vision plan extension with added Diabetic benefits effective in 2020• Participating presenter in the Maternity Wellness Workshop

Vision plan assessment

• Overall eye exam utilization of 32%, which is consistent with 2018• EyeMed exam utilization increased by 5% as compared to 2018• EyeMed exam utilization increased by 18.2% during the contract period

January 2017 – December 2019• The positive increase in exam utilization trend indicates the City of Los Angeles

membership is adapting to a standalone vision program

SummaryFocus on vision health resulted in an increase in overall eye exams over prior year. EyeMed saved City of Los Angeles members $5.8 Million retail in 2019; this represents an 11.5% savings increase over the prior year. On average members saved 70% ($246) on routine vision services and materials.

Utilization Review

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Growth in Vision Exam UtilizationCity of Los Angeles Contract Period of January 2017 – December 2019

Focus on wellness contributes to increases in exam utilization

o Since EyeMed’s introduction as the City’s standalone vision program in 2017, eye exam utilization has consistently increased.

o The City and EyeMed’s promotion of annual eye exams has contributed to an increase of 975 eye exams between 2017 and 2019.

Calendar Year Members Exams(EyeMed + Kaiser)

Utilization

2017 57,239 17,605 30.8%2018 56,978 18,083 31.7%

2019 57,484 18,580 32.0%

2020* 59,413 18,700 32.2%

*Enrollment forecast based on average membership increase of 3.4% Q1 2020 vs Q1 2019; exam utilization forecast based on 2019 growth rate of 0.9%

Combined eye exam utilization grew by 3.9% since January

2017

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EyeMed providers accounted for over 75% of exams in 2019;

EyeMed 24.6%, Kaiser 7.4%

24.2% 26.2% 26.3% 25.1%

0%

20%

40%

2017 2018 2019 EyeMed*

30.8% 31.7% 32.0%

0%

20%

40%

2017 2018 2019 EyeMed*

28.0%

Utilization Rate

o Overall eye exams have increased by 3.9% since 2017

o Members electing to use EyeMed providers have increased by 18.2% since 2017

o Wellness initiatives like the Pop-up Clinics have contributed to the increase in EyeMed provider utilization

Exams

Based on your 2019 calendar year end data for in and out-of-network claims*EyeMed book of business data for non-voluntary/employer paid client accounts

Materials

o Wellness emphasis on EyeMed eye exams revealed 4.4% of EyeMed members have a high-risk condition

273 unique members identified/referred with markers for High Blood Pressure

177 members identified/referred with markers for Diabetes

15% response rate to high-risk mailers

Exceeds utilization of EyeMed book of

business for employer paid groups

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Based on your 2019 calendar year end data*No longer part of EyeMed network, effective February 2020

2%

2%

4%

8%

9%

21%

55%

Sears*

JCPenney*

OON

Other retail

Target

LensCrafters

Independent

EyeMed Insight Network Choices

A Network of Choice and Convenience

Where Your Employees are Going

Your In-network Utilization

Retail24%

Independent76%

EXAM & MATERIALS UTILIZATIONCOMPOSITION

96% Retail is a valuable component of network:38% of all eye exams performed and 44% of materials werepurchased in a retailsetting

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$209

$175 $167 $142 $152 $143

$121

$180

$0

$50

$100

$150

$200

$250

How Choice Connects with Savings

*Based on your 2019 calendar year end data; frame only, does not include lenses

Value of integrated system:

• $150 frame allowance

• 40% purchase frames within their allowance

• EyeMed providers are contracted to maintain and display a minimum of 100 frames which retail for $130 or less

• $150 allowance provides access to over 500 frames covered in full, on average, across the network

Your average frame price by location*

Maximizing Your Vision Experience

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Results from Your Pop-up Clinics

4 clinic weeks Figueroa Plaza Central Library Public Works City Hall East

239 exams performed 68% utilization of appointments 95% member satisfaction

5% of patients received first eye exam 30% of patients were overdue for an

eye exam prior to Pop-up Clinic₁

2020 clinics rescheduled in 2021 Figueroa Plaza Central Library Public Works City Hall East

1Based on survey results for 2019.

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Supporting City of Los Angeles Wellness Initiatives

• Continued participation with Service Provider summits

• Support of wellness workshop • Participation during wellness fairs• Working group with Summit on

Diabetic communication

• Covered with $10 copay• Maps inside of the eye in

detail, assists with early detection of high-risk conditions

• Received by 26% of City of Los Angeles members in 2019

• NEW! For 2020• Office visits and diagnostic

testing once every 6 months• Gonioscopy• Extended

ophthalmology• Fundus photography• Scanning laser

Engagement Retinal Imaging Diabetic Benefits

Less than 10% of the EyeMed book of business includes

coverage for Retinal Imaging

9% of EyeMed book of business and only one of the City’s peers offer Diabetic Benefits

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Delivering on Key Performance Metrics

100% of ID cards mailed in 10 days 100% of eligibility files updated in 2 days 100% claims financial accuracy 100% claims processing accuracy 100% of claims paid in 10 days 9 seconds average speed of answer 0.6% call abandonment 100% complaint acknowledgment in writing within 3 business days 100% complaint resolution within 30 days 97% member satisfaction

C ity of Los Angeles 2019 calendar year end results

Direct impact on member satisfaction

In Closing …• We appreciate your business• We invest in innovation to make the plan better for your members• How can we improve?

NOW LET’S JUST TALK