Welcome Todays presentation will begin shortly. In order

Welcome Todays presentation will begin shortly. In order

Welcome Todays presentation will begin shortly. In order to hear the audio for this presentation, please turn up your speakers or click on the Info tab above this presentation in the upper-left hand corner of your screen. The toll-free dial-in number and access code can be found under this tab. All lines have been placed on mute. If youd like to ask a question, please use the chat feature in the bottom right corner and send your question to all panelists. Legal Disclaimer: The appropriateness and legal permissibility of the wellness programs and strategies discussed in this presentation should be confirmed independently by groups before undertaking. Not all programs described are currently available for NY insured market. Wellness-based financial incentives may not be available. State law and regulations may apply. Federal rules relating to wellness programs offered by ASO and insured groups also may apply. All results described are for purposes of example only. Actual program results will depend on various factors and cannot be guaranteed. Proving Wellness is Important to your Business Strategy May 2012

Employer Webinar Services provided by Empire HealthChoice HMO, Inc. and Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Not for further distribution. Healthier employees, healthier companies Your employees are your most valuable asset. You want them to be healthy, but theres more to it than that. When your employees are healthy Productivity can increase Premiums or total medical spending may be reduced Wellness programs and a corporate culture of health can help employees change their lifestyle and improve their health Providing wellness solutions for employees is a sound business strategy and can help control costs According to the Bureau of Labor Statistics, the average person spends 53% of their waking hours at work. 1. U.S. Department of labor, Bureau of Labor Statistics website, American Time Use (June 2010), www.bls.gov

A case for 360 Health: Lifestyle behavior There is clear evidence that the major chronic conditions that account for so much of the morbidity and mortality in the U.S., and the enormous direct and indirect costs associated with them, in large part are preventable - and that to a considerable degree they stem from, and are exacerbated by, individual behaviors. In particular, overweight and obesity, lack of physical activity, and smoking greatly increase the risk of developing the most serious chronic disorders. By changing the way they live, individual Americans could change their personal health status and the health landscape of the Nation dramatically. Source: Prevention Makes Common Cents DHHS http://aspe.hhs.gov/health/prevention/ accessed 5.2.2012 The business value of wellness Helping employees improve their health is one of the best long-term strategies for reducing your health care costs. Based on a 2010 study, nine out of ten wellness program participants said they had success in losing weight and got regular checkups More than 80% said that they increased their level of exercise, improved

their diet and nutrition, or managed blood pressure, cholesterol levels, and stress More than half (57%) of employees who participated in their companies health & wellness programs said they were very effective at impacting their productivity The above information is based on results of 8th Annual Study of Employee Benefits Trends, Findings from the National Survey of Employers and Employees, MetLife 2010. Results do not relate to Empire-offered programs. Actual program results not guaranteed. Employees expect wellness 89% of employees expect their workplace culture to promote healthy lifestyle concepts1 91% of employees believe employers have a responsibility to maintain and improve the health and well-being of their employees2 Nearly two out of three individuals are interested in participating in wellness programs and 20% are even willing to pay extra for a wellness program3

1 2 3 Faircloth, Inc 2009 SOURCE: HMC Building a Culture of Health study. Q3 2008 (outcomes validated Q4 2008. Results do not relate to Empire members.) 2008 Survey of Health Care Consumers. Deloitte Center for Health Solutions. What is wellness? Typical Employer Definition of Wellness: An opportunity to change the lives of employees for the better, potentially resulting in a healthier business through increased productivity and reduced medical expenses Typical Member Definition of Wellness: Wellness is having the energy and vitality to be productive and feel and perform our best Definition of a Culture of Health: A Culture of Health is one in which your employees know that it is

important to the company that they make decisions and behave in such a way as to help them be as healthy as possible Concrete goals On-site health coaching Internally published metrics Formal Wellness Committee Tobacco free workplace 24/7 NurseLine Preventive health Services On-site wellness classes

What are the financial impacts of having a culture of health? Companies with a Culture of Health can have a greater impact on their medical trend over time From 2006 to 2008, average annual percent change in medical trend Large = 1,000+ Employees Source: HMC Building a Culture of Health study. Q3 2008 (outcomes validated Q4 2008). Based on 2009 telephone survey of 400 company decision makers to ask whether they were working to build a Culture of Health and, if so, what kind of outcomes they were having. Does not necessarily correspond to Empire groups. Note that results depend on various factors and cannot be guaranteed. What other benefits could my Company see with a culture of health? Companies with a Culture of Health may experience greater outcomes than their competitors Perceived positive outcomes compared to peer companies (mean agreement score) based on 2009 telephone survey of decision makers at 200 large employers

10-point scale: 1 = My company is much worse than peer group 10 = My company is much better than peer group Source: HMC Building a Culture of Health study. Q3 2008 (outcomes validated Q4 2008). Based on 2009 telephone survey of 400 company decision makers to ask whether they were working to build a Culture of Health and, if so, what kind of outcomes they were having. Does not necessarily correspond to Empire groups. Note that results depend on various factors and cannot be guaranteed. 360 Health: Your Total Health Solution 360Health Programs with Empire Management Comprehensive Medical Management: Utilization Management, Case Management, Complex Care, NICU, and Transplant

ConditionCare* Support Programs (vascular at-risk, oncology, low back pain, musculoskeletal) End Stage Renal Disease * MyHealth Coach Tools & Resources [email protected] Empire, such as: MyHealth Assessment MyHealth Record Care Comparison [email protected]

Guidance 24/7 NurseLineSM Future Moms Behavioral Health UM MyHealth Advantage* Pharmacy* Healthy Lifestyles Worksite Wellness EAP Staying Healthy Reminders Productivity Solutions

All 360 Health programs are not listed above. The programs listed in bold are optional and available for ASO Large group accounts at additional cost. The programs listed with an asterisk (*) are included for fully insured Large Groups accounts. Empire resources for you Wellness Promotion Resources: Time Well Spent Downstate - empireblue.com/ timewellspent Upstate - empireblue.com/bc/ timewellspent Wellness Calendar http://wellnesscalendar.empireblue.com MyHealth Assessment Promotional Toolkit on Time Well Spent Employer Guide to Wellness in the Workplace Wellness Topics Employee Survey Wellness at Work flier

Approach to health promotion & wellness Organizational commitment can maximize engagement and outcome Multi-year program helps build a culture Program Components of health and wellness awareness and participation Over time Enhances readiness of the population for

change Helps foster level of trust and confidence in programs Can increase levels of intervention and engagement Member Promotional Campaign Health Promotion & Wellness Topics My Health Advantage Step wise approach can build momentum based on success in prior phases Multiple modalities provide greater accessibility and drive participation Incentive based programs (rewards), when permitted, can provide additional encouragement to increase engagement and participation levels

Worksite Wellness Healthy Lifestyles Incentives Take it to the next level: Integrate wellness into your workplace Every company is different, so find out which wellness programs can mean the most to your employees! Take a look at your demographics Look for the best ways to communicate to your employees. And dont forget about family members and dependents at home because a positive impact with them can also lower medical costs. Evaluate HRA data to the extent appropriate Implement an employee survey Work with your Empire Account team to analyze your claims information to find trends, as appropriate Consider environmental changes (no smoking policy, bike racks)

The more information you have, the better your plan will be. Always follow confidentiality and privacy rules when analyzing data. Employer Guide: Promoting wellness in the workplace Helps you and senior leaders start putting a wellness plan into action step by step Build a wellness team Lay out a specific plan for your wellness campaign Set specific goals and objectives Develop a timeline Delegate roles and responsibilities Create a budget Promote health and wellness ideas Begin communicating directly to employees Set up a wellness fair Evaluate your results as appropriate

When You Have a Limited Budget: Best Practices Encourage healthy behaviors for your employees even if you dont have a robust wellness budget. Here are some best practices: Executive support Build a Wellness Team Understand what health issues matter most to your employees Provide Access to Discounts and Health Improvement programs Ongoing Communication Create Healthy Competition Measure Outcomes

Expand your wellness program: Sample - 3 Year Wellness Strategy CDH & PPO/Cost-efficient HMOs Wellness programs Introduction of Company paid wellness credits paid out as premium credits in the following year Company Wellness Credit: $400/associate; $400/spouse Company Wellness Credit: $200/associate

Awareness (Screening + Health Assessment) Year 1 Participation (Programs + TobaccoFree or Tobacco Cessation Program) Awareness (Screening + Health Assessment) Year 2 Increased Company Wellness Credit Propose: $tbd/associate: $tbd/spouse Results (Be in Healthy Range/Show

Improvement) Participation (Programs + TobaccoFree or Tobacco Cessation Program) Awareness (Screening + Health Assessment) Year 3 Measuring results When it comes time to size up your wellness program, youre going to want proof that your plan is working and how it may be affecting your companys bottom line. Track attendance of events and competition participation Conduct pre/post surveys to determine the value of the event and if people learned something new or plan to use the information Has your wellness plan improved attendance and reduced sick leave usage and employee turnover? Compare pre/post aggregate program results, biometric screening

results, or health assessment results If you are an ASO group, analyze claim costs and impacts from previous benefit changes. Communicate the results to participants, company leadership, and your Empire rep! ROI & the broader picture ROI can be difficult to measure, so its best to take a comprehensive look at programs to understand the full benefits Engagement/Participation Rates Employee Satisfaction & Retention

Improved Health Biometrics and Clinical Measures Enhanced Productivity Reduced Absenteeism Reduced Benefit expense (Workers Comp. & Disability included) ROI Success Stories Worksite wellness: Case study* Client: 5250 employees, Primary manufacturing -- specializing in marketing and publishing services Multiple locations, employees include off-site sales teams and seasonal workers Worksite Wellness Strategy: Offer Health Screenings: Total Cholesterol, HDL, LDL, Triglycerides, Blood Glucose, Blood Pressure, BMI Held 30 on-site events. Added physician fax back options to reach off-site employees

Employees received financial incentives for participation in addition to monthly premium contribution based on scoring results. Email, communications from on-site coordinators, letters to the home . *Based on actual client outside New York State. Example only. Wellness-based financial incentives may not be available for insured groups. Worksite wellness: Case study* Population Participation: 47.7% (=2504/5250) Screening Results & Satisfaction:** 37.2% of participants had an obese BMI*** (compared to 34.1% of American adults 2003 2006) 8.1% of participants had high total cholesterol*** (compared to 16.3% of American adults 2003 - 2006) 8.1% of participants had high blood pressure*** (compared to the 2003 - 2006 U.S. average of 17.9%)

98% of the attendees found the health screening useful 86% of the attendees learned something new about their health 90% said they would share the information they learned with their doctor 89% said health screening motivated them to make at least one healthy behavior change *Based on actual client outside New York State. Example only. In all cases, results depend on various factors and cannot be guaranteed. Wellness-based financial incentives may not be available for insured groups. **2,325 satisfaction surveys were returned (return rate of 93.8%). Percentages include the number of members who agreed or strongly agreed with the statements. *** Compare to the most recent 2003-2006 U.S. estimates by the Centers for Disease Control and Prevention (CDC). Lifestyle management: Case study* Client: 3,922 employees, financial institution-locally owned, multiple locations across two states

65% female, average age 41 Lifestyle Management Strategy: Launched Healthy Lifestyles Online & Telephonic in January 2008 Encouraged participation by adding incentives Results 22% of enrollees participated in lifestyle campaigns, which is the highest among benchmark $900K = total estimated savings for health care and productivity in 2010 Estimated $2.8 million saving from 2008 2010 *Based on actual client outside New York State. Example only. In all cases, results depend on various factors and cannot be guaranteed. Wellness-based financial incentives may not be available for insured groups. Lifestyle management: Case study* Telephonic Coaching Risk Reduction 2010 program year: enrollees reported a total of 994 health risks

and indicated they improved or eliminated 36% of those risks. 2009 program year: 1,119 health risks were reported and enrollees reported they improved or eliminated 33% of those risks. 2008 program year: 2,541 health risks were reported and participants reported they improved or eliminated 29% of those risks. *Based on actual client outside New York State. Example only. In all cases, results depend on various factors and cannot be guaranteed. Wellness-based financial incentives may not be available for insured groups. It doesnt take that much to move the needle Once you have wellness programs for your employees, you can have a greater impact on future health care costs For people with pre-diabetes, lifestyle changes, including a 5%7% weight loss and at least 150 minutes of physical activity per week, can reduce the rate of onset of type 2 diabetes by 58%1 A 1% reduction in health risks such as weight, blood pressure, glucose,

and cholesterol risk factors estimated to save $83 to $103 annually in medical costs per person for a sample population2 For every gram of salt that Americans reduce in their diets daily, a quarter of a million fewer new heart disease cases and over 200,000 fewer deaths could potentially be prevented over a decade3 NOTE: In all cases, results depend on various factors and cannot be guaranteed. 1 National Diabetes Education Program Provider toolkit Your Game Plan for preventing type 2 diabetes 2003 2 Henke, R.M., Carls, G.S., Short, M.E., Pei, X., Wang, S., Moley, S., Sullivan, M., and Goetzel, R.Z. (2010) The Relationship between Health Risks and Health and Productivity Costs Among Employees at Pepsi Bottling Group. Journal of Occupational & Environmental Medicine, 52(5), 519527. 3 American Heart Associations 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention 2009 Sign up for other events & webinars in 2012 June 19th - Wellness on a Dime: Low or No cost Wellness tools to help you build your Wellness Strategy July 17th - Amp it Up: What you can do to get your employees engaged: Employer success stories and Open Enrollment opportunities August 14th - Walking the Walk: How to plan a health fair and other on-site wellness events

September 18th - Free Wellness Tools on empireblue.com: Online resources to help employees manage their health stop smoking and lose weight Sign up today! http://group.empireblue.com/360healthNY Q & A session If you would like to ask a question to our presenter, please type in the Q&A box to the right side of your screen and send to all panelists. Services provided by Empire HealthChoice HMO, Inc. and Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Not for further distribution. Thank You! If you have more questions, please contact your broker or Empire representative. Legal Disclaimer: The appropriateness and legal permissibility of the wellness programs and strategies discussed in this presentation should be confirmed independently by groups before undertaking. Not all programs described are currently

available for NY insured market. Wellness-based financial incentives may not be available. State law and regulations may apply. Federal rules relating to wellness programs offered by ASO and insured groups also may apply. All results described are for purposes of example only. Actual program results will depend on various factors and cannot be guaranteed.

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