Welcome! The Seminar Series by The Partners Group

Welcome! The Seminar Series by The Partners Group Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 1

Agenda TPG Overview Take 20 s Wrap Up 2

TPG Overview Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 3

TPG Overview Financial & insurance consulting firm with services including: Helping your employees succeed in health, wealth and retirement planning Locally owned with national strength & buying power Experience, expertise & innovative solutions

TPG Overview Employee Benefits Consulting 500+ Clients Health & Wellness Reporting & Analytics Ongoing Customer Service TPG Client Legislation & Compliance Vendor Management & Negotiations Communication & Education Risk Management / Commercial Insurance Other Services Private Client Services 401k, Financial Planning, Life, Disability 5

Healthcare Reform Update Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 6

Health Care Reform Update What Did We Know March 1, 2013 7

What Did We Know July 4th, 2013? 8

Final Employer Mandate Rules Quick Reminder Sledgehammer penalty is the most significant penalty because it can be triggered by a single individual but is assessed against what is potentially a large population Tack hammer penalty is generally less worrisome because it is triggered and assessed on an individual basis

Delay for Mid-Size Employers Small employers continue to be excluded from the employer mandate (fewer than 50 FTEE) Additional one year delay for mid-size employers (50-99 FTEE) The employer mandate will not apply to mid-size employers until the beginning of the 2016 plan year The question is: Do you know if you are a small, mid-size or large employer?

Are You a Large, Mid Size or Small Employer? Summary of employer size calculation ABC Company Example

Risk of Sledgehammer Reduced for 2015 In the proposed interim rules, the sledgehammer was triggered if the employer did not make an offer of MEC to at least 95% of full time employees The final rules offer transition relief for one year only that reduces that minimum offer rate to 70% There is still a risk of tack hammer penalties for full time employees in the gap Significantly reduces the risk of triggering the sledgehammer penalty in 2015 Threshold increases to 95% in 2016

Sledgehammer Calculation Softened In the proposed interim rules, the annual non deductible sledgehammer penalty was calculated by multiplying the total number of full time employees - 30 X $2,000 The final rules increase the exemption from 30 to 80 full time employees for 2015 only

Transition Relief for Fiscal Plan Years The final rules make it clear that for non-calendar plan years, the employer mandate will not apply to an employer until the first plan year in 2015 or 2016 (for mid-size employers) This transition relief only applies to plans that had a non-calendar plan year as of December 2012 So for any employer that renewed early in 2013 to delay certain 2014 ACA provisions, the transition relief will not apply

Defining Full Time Employees The final rules provide clarification around the optional safe harbor rule that allows for employers to establish a wait and see measurement period for variable hour and seasonal employees The final rules establish an alternative monthly measurement period These rules are complex but they are important to understand now, to ensure you understand the impact of these rules on your organization

Reporting Rules Released Simplified Employer Reporting

Reporting Rules Released Simplified Employer Reporting 17

What Do We Need to Know? Things Change! 18

Why Wellness? The real elephant in the room Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 19

Why Wellness? Body Mass Index (BMI): 30+ BRFSS, 2010 no data <10 10 14% 15 19% 20 24% 25 29% 30%

Program Types Outcome Based More aggressive stance Carrot or Stick limited to 30% (HCR) Evolving programs Accommodations / ADA? The possible future? Participation Based Crawl, walk, run Awareness Accountability Measureable No HCR limits Plan design (accommodations) 22

What is TPG Engagement? Obtaining permission from employees leads to adherence Voluntary Participation 23

Measurable Results Pacific Northwest Hospital 24

Measurable Results 2,145 participated both years Total cholesterol (greater than 200) (8.3% improvement) High Blood Pressure 2,145 lives (both years) Baseline Year One Borderline 653 606 (-7%) High 217 158 (-27%) 25

Measurable Results 260 Life Employer Engagement Requirements o o o Health risk assessment (HRA) Biometric event = Know Your Numbers Health coaching (if identified) Outcomes / Measurement o o o 98% HRA & biometric participation 173 health coaching reaches 294 individual employee goals set over 2 quarters 248 partially achieved 36 fully achieved 26

TPG s Engaged Plan Fully insured plan (Underwritten by Lifewise) Multiple plan design options Integrated wellness solutions Three year strategy meant to engage employees in their personal health and well being 27

Program Goals Competitively priced with rate stability Simplified program Focus on improving health vs. next renewal 28

TPG s Engaged Plan Wellness Design Pricing & Rate Stability Next Steps 29

Health Plan Alternatives Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 30

Agenda Defined Contribution Plans Captive Risk Programs 31

Defined Contribution Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 32

Why DC Now? Affordable Care Act Technology Consumerism / Choice 33

What is DC? Cafeteria Plan Pros Cons 34

What s New? Choice of multiple carriers and/or plans for both medical and dental plans Private Exchange Voluntary Options (Traditional & New) Enrollment Platform Consolidated Billing Decision Support Tools / Education 35

Enrollment Platform 36

Enrollment Platform 37

Enrollment Platform 38

Enrollment Platform 39

TPG Response Private Exchange Option (7/1) Benefit Consulting Evolving Marketplace 40

Captive Discussion Property of The Partners Group, LTD. Reproduction and further distribution is prohibited. If found, return to The Partners Group immediately. 41

What Is Driving Demand? Escape the fully insured marketplace Health Care Reform Fees Carrier Margins / Administration Load Subsidizing Carrier Rating Pool Self Funding - Controlled Risk 42

How Does A Captive Work? Self Funded Bundled Plan 43

Captive Candidates? 75 300+ Employees Stable workforce Good Demographics Strategic, long term buyer Fully insured and frustrated with lack of control and lack of access to data Historically good, stable claims experience / rates Focused on risk management with wellness intent 44

What We Want To Achieve! Transparency Access Risk Share Rate Stability 45

Next Steps? Interest? Not A Captive Candidate? 46

Wrap Up Three Key Topics Overview Only Each Group Is Unique We Appreciate Your Time This Morning! 47