Creating a Best-in-Class Insurance Solution for Physician Groups

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1 Lockton Creating a Best-in-Class Insurance Solution for Physician Groups Lockton St. Louis has Teamed with Stratum Med to Deliver Insurance Solutions for Specialty Physician Practices Dedicated Account Team c Insurance Experts Group Purchasing Rate Protection 30,000 Employees 6,000 Physicians $20 Million Total Premium L O C K T O N C O M P A N I E S

2 PHYSICIAN GROUPS EXPERIENCED, KNOWLEDGEABLE, CAPABLE Highlights More than $20 million total premium 22 members Over 6,000 physicians represented 30,000 employees Client Sampling Carle Clinic Dean Clinic Marshfield Clinic Mt. Kisco Medical Group Polyclinic The Iowa Clinic Who We Are Stratum has partnered with Lockton to provide physician groups access to insurance products at a low cost attained by group purchasing. Lockton s dedicated c Team supports implementation, administration, communication Stratum products assuring members quality execution ir programs. Toger we provide healthc organiations an edge in controlling cost absolute assurance programs aligned with needs an ever evolving healthc industry while delivering exceptional services. Advantages to Groups who Access Stratum Leverage Stratum s collective buying power when negotiating with insurance carriers Direct access to underwriting markets who underst healthc industry Increased stability during adverse insurant market cycles Complete transaction cost transpncy Create a second to none peer group where issues can be shd discussed Sh talents capitalie on wealth intellectual capital which exists amongst participating members Stabilie costs via risk sharing established through Stratico, Stratum Med s wholly owned captive Specialty Physician Group Specialied contracts for specialied needs a medical practice Specialied claims management a dedicated longterm disability (LTD) claims team Specialied marketing can help provide long term commitment stable pricing because Stratum s overall sie Specialied customer service a centralied team providing endto-end quality dedicated solely to physicians groups Specialied design customied specifically for each physician group to meet needs group covered physicians staff 2

3 ADVANCED SOLUTIONS What Sets Lockton Apart in c Industry? Administrative Support Product Program Administration Program Support Property Casualty Industry-focused expertise working with health systems, physician groups, managed c organiations, long-term c companies More than 700 healthc clients serviced by Lockton nationwide with all forms alternative risk program: captives, RRGs, trusts Excellent reputation with domestic international underwriters Unparalleled client services Financial Risk Solutions Actuarial/ Quantitative Analytics Resources to Evaluate Program Economics Design Reinsurance Captive GLOBAL SERVICE PRESENCE AROUND THE WORLD Exped Services Communication Experts Technology ERISA/ Compliance Attorneys Voluntary c Employee Benefits $1.1+ Billion annual benefit premium 1,838 average benefit client sie (by number FTEs) $18 B premium placed 64 Strategic Service Partners clients 35,000+ 4,950 $1B+ revenue client retention 95% Risk Control Services Loss Control Reduces frequency claims Injury Prevention Focused on at-risk behaviors Claims Improve organiational readiness for catastrophic events Complex claim resolution Conduct claims audits to improve outcomes compliance Claims Cost Control Focused on post-injury management Focused on reducing claims severity 3

4 STRATUM PHYSICIAN INCOME PROTECTION Strategies Efficient Program Design Align STD, LTD, FMLA to enhance claim management, 100% Catastrophic Benefit 1 Covers an additional $8,000 to $10,000/month to a maximum 100% TOTAL compensation Payable with ADL-loss, cognitive impairment, or presumptive disability (se traditional triggers for long term c insurance) Benefit Restoration for Highly Compensated manage leave more efficiently leverage cost Superior Products Service Best in class policy language claim support for physicians Close Gap in Program Design Utilie guaranteed issue voluntary benefit restorations for highly compensated employees % Income Replacement 60% Base Salary + Bonus 60% Base Salary only Voluntary Individual Insurance Insurable income is Base Salary + 75% to 100% Bonus Combined with LTD insures up to 60% TOTAL compensation to a cap $5,000 to $10,000/month Guaranteed Issue to no exams! Individual rates level cannot increase with age Individually-owned coverage; 100% portable Tax-free benefits Current Group Long Term 180 day elimination period 60% base salary Monthly maximum benefit amount = $5,000 Benefit Restoration for Highly Compensated Typical Program Design Group Purchasing Taxable benefits Significantly reduce price volatility driven by market fluctuation claim experience Knowledge Sharing Capitalie on member best practices 60% Base Salary only Short Term Elimination period 30 days (sick days must be exhausted) Coverage begins day 31 ends day 120 Benefit 60% basic weekly salary up to $1,500 Benefit Duration = Full Social Security Retirement Age (65-67) Typical Program Design 1 Catastrophic Benefits paid if employee loses ability to perform two or more Activities Daily Living (eating, bathing, dressing, transferring, toileting continence); becomes cognitively impaired; or presumptively disabled Stratum LTD Benchmark LTD Who Pays? Eligibility Waiting Period Elimination Period Benefit % Monthly Max Def Pre- Earnings 60% EE Paid/40% ER 40% 1st Month following hire date 59% wait 30, 60, or 90 days 62.5% 90 days 29% 180 days 8.5% 270 days 79% 60% ben 8% 50% ben 13% >60% Average $11,772 Median $15,000 54% use W-2 wages 46% use base monthly pay 4

5 ADVANCED SOLUTIONS Stard Enhanced Contract Provisions Residual Definition Own specialty including sub-specialty definition occupation for physicians Weekly benefits up to 60% employee s lost income Waiting periods for accident sickness ranging from 1-30 days maximum benefit duration coordinates with LTD program Contributory non-contributory s Vocational rehabilitation initiated on appropriate claims for earlier identification return-to-work opportunities Enhanced Contract Options Options which match desire to encourage claimants to return-towork replace most lost income in all claims situations. Three return-to-work incentive calculation options 1. 50% fset (stard) 2. Proportionate loss (good for high earners) % from all sources (only with Hartford LTD) Two salary continuation/sick pay coordination methods 1. Direct fset (stard) % From all sources (only with Hartford LTD SHORT-TERM DISABILITY INSURANCE FOR MEDICAL GROUPS 5

6 PHYSICIAN DESIGNED LTD CONTRACTS Examples AMBS Recognied Subspecialities Anessiology: pain medicine, pediatric anessiology, sleep medicine, critical c medicine Internal medicine: advanced heart failure transt cardiology, cardiovascular disease, gastroenterology, hematology, interventional cardiology Sub-Specialty Definition Lockton Stratum place physician groups with carriers whose contracts specifically define own occupation as specialty or sub-specialty a physician was performing at date disability. Over 145 sub-specialties recognied by AMBS No board certification required No limited period time No earnings loss required during elimination period No speciality-based income requirement Claim fice experienced in adjudicating provision Pediatrics: adolescent medicine, neonatal, perinatal medicine, pediatric cardiology, pediatric gastroenterology Diagnostic radiology: neuroradiology, nuclear radiology, pediatric radiology, vascular, interventional radiology Minimal Contract Limitations The Hartford s LTD Contract does NOT contain: Prudent person Self-reported conditions Musculoskeletal Reasonable accommodation Matory rehabilitation Maximum capacity during own occupation benefit period Limitations on living outside United States or Canada 6

7 ADVANCED SOLUTIONS SPECIALIZED CLAIM HANDLING FOR PHYSICIANS STAND-ALONE LTD CLAIM INITIATION LTD Application received. Reviewed by Team Leader for assignment to appropriate pathway. Ability Advocate Reasonable Predictable Resolution Ability Partner Ongoing Intervention Support Assigned LTD Claim Analyst, w ho reviews all to determine any missing action. Ability Advantage Multi- Faceted Life Event The triage encompasses multiple factors, such as medical complexity, occupational duties, financial considerations. Necessary Information received? Yes Stard Enhanced Contract Provisions Our stard LTD provisions special interest to Medical Groups: Own specialty including sub-specialty definition occupation for physicians Elimination period is satisfied with a loss just one essential duty income loss is not required Greater two return-towork benefit formulas Make claim determination if possible. Advantageous treatment salary continuation/sick leave/ PTO/STD No Is benefit effective date in future? No Yes Send a second request letter for additional. The Claim Analyst must follow up w ith claimant via phone (2 nd request for ), send 3 rd /final request letter. Second request enough to make decision? Yes No reduction to benefits for individual disability employer retirement benefits Conversion benefit, sabbatical leave continuation Workplace modification benefit Progressive illness benefit Approve claim. Deny as appropriate. Accidental dismemberment loss sight No Continue to follow -up in accordance with ERISA guidelines to gar needed to make a claim determination. Long-term Insurance for Medical Groups Stratum Hartford know business can adapt to unique needs. All Physician claims processed by our most experienced Ability Analysts: Over 22 years dedicated to industry; with more than 6 years tenure Single point contact for each claimant to develop a personalied experience Experience with unique issues every specialty, sub-specialty, impact a disability Understing different types income, receivables, ir impact on a disability claim Peer to peer review medical, both in-house third party Claimant Satisfaction LTD 98.5% STD 89% Average Turnaround Time LTD LTD with STD Over 90% within 30 days benefit effective date Over 96% within 20 days benefit effective date New LTD claims received Over 1200 Return-to-work Over 30% our claimants have worked while receiving a benefit 7

8 VOLUNTARY BENEFITS Individual Insurance* EMPLOYEE INCOME Scenario Disabled physician with predisability monthly income $42,000 $50,000 $40,000 Group LTD triggered a monthly benefit $15,000 $30,000 Earnings deficit by $27,000 monthly $324,000 annually $20,000 $10,000 Full Salary $16,200 $27,000 $0 Employee Income Group Benefit Benefit With Individual Protection Improve Percentage Replacement Income * Chart shows a significant increase in monthly disability income when group LTD is paired with a voluntary IDI 8

9 ADVANCED SOLUTIONS Practice Overview Executive Enrollment Technology Communication Resources Voluntary Worksite Benefits Comprehensive coordination with Group Long-Term Leverage Lockton s market opportunity to maximie design Employee enrollment platforms Benefit admin services Employee engagement education resources Increase EE Education Needs analysis Product evaluation Leverage resources services available in conjunction with a voluntary benefits fering Streamline benefit selection Voluntary Individual Insurance Pricing Illustration Employee Age Annual Income Group LTD Benefit (Monthly) IDI Benefit (Monthly) Total % Income Replaced CAT Rider (Monthly) Total % Income Replaced w/ CAT Rider Monthly Premium 50 $4,000 $15,000 $7,000 58% $9,484 83% $ $627,500 $15,000 $7,000 42% $10,000 61% $ $452,000 $15,000 $7,000 58% $9,410 83% $ $400,000 $15,000 $7,000 66% $8,333 91% $ * Price illustration based on a quote for selected employees a Stratum member hospital 9

10 TOTAL BUSINESS SOLUTIONS Stratum Lockton leverage member purchasing power to develop superior products lower costs over a wide range insurance products. Each program is designed specifically for specialty physician organiations supported by Lockton s dedicated team healthc pressionals. OBJECTIVES Deliver Unique Products Leverage Purchase Power Communication Technology Service Culture EXPERTISE c Voluntary Actuary Support SOLUTIONS Measure underst Assess alternatives Advocate Design Superior Service Global Market Access Claim Analytics Captive Consulting Monitor Results Listening Understing Strategy Performing Employee Benefits Group Life Short-Term Long-Term Voluntary Benefits Executive Benefits Risk Solutions Stop Loss PBM ACHA Stratum members have access to: Property Casualty Services Liability Workers Compensation Property Cyber Pressional or Errors Omissions Directors & Officers Liability Loss Prevention Claim Analysis Support Risk Management Solutions Captive Consulting Leave Management Data Analytics Actuarial Services Strategic Engagement Mergers Acquisitions Benchmarking 10

11 ADVANCED SOLUTIONS MEMBER C OMMU NIC AT ION TOO LS Stratum Live! What s Stratum L ve? Stratum L ve prov des a secure HIPAA comp ant method for co aborat on between Stratum/Lockton account teams Med ca Assoc ates C nton The porta keeps a c ent spec fic nformat on organ ed upto-date read y access b e Such nformat on nc udes Carr er vendor Lockton contact nformat on Pro ect track ng P an documents L nks to on ne too s he pfu resources Event ca endar And much more Lockton Communications Services Publications ON THE LOCKT unicati Employ ee Comm Pre post enro ment mater a s COMPANY 20XXENROLLMENT OPEN NAME s. any voluntary paid for you ongoing amounts benefits available This benefits not readily employer-sponsored in benefits costs dollars paid costs The annual used. The Where actual coverage in s. to to provide to participate has been made employer costs Every effort average premiums. (e.g., medical) is always actual claims However, re administration, in this. include data. 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The This employment error always Plan Documents. a contract constitute any by ficial does not if you have be governed as such. It Human Resources not be construed should benefit. Contact any particular or a guarantee Important Statement X-Ray/Radiology Inpatient Hospitaliation Hospital 30, ending June fiscal year For current is contributing 3.09% 20XX, CLIENT payroll to Ascension total our CLIENT s Plan on behalf Pension Associates. that pension benefit years amount on The actual is dependent earnings you earn annually highest average service, credited age. (HAE) provided pension samount total Personalied amount illustrate annually including have earned, calendar benefit you most recent during you earned pension s personalied end June. year. The by normally provided Pension questions. 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Et aut apel sunt arcius, commolorro Si volor restiunt sit litem num to exere molupta parum est, quam nonserion nis apero enimet omnimin aciassi tisquate restibus. ipsum faccus eum dolupta tusus quundis doloria esciis pere, senis ficiet onsequas imusam res pero berchici volum nis molupti niscidis quistrum eos eos et volesse consenis maximusam, odi necuptis dis natis simagname adit enihit omni et a doluptata que alis as parchit quo Incille sequos accatur verempedi apelibus tem none invelendam harciusda debit raepudant apic excerovid molest re nis estempo ernat. saepudae intibusdae non naturereiunt optibus, sin evercip is sit moluptam eatendi cusa natem enienisquo idellat Sincerely, Life is Sunday June T F S S M T W MAY Tuesday Wednesday Thursday Friday Saturday 4 All rights reserved. Flier.pdf Thinkstock. Images 2014 Newsletter\-14\14EG\14EG Templates\EB\OE text Insert here. text Insert here. Clark Kn Kaiser OPTIONAL. Growth is Monday Choose wisely. change. April T F S S M T W S:\ALDRIDGE\ISSDocs\ All rights reserved. Thinkstock. Images S:/filepath 25 1 XX to Month Month XX First Last President COO reserved. Postcard.pdf All rights 2014 Thinkstock. Images Newsletter\-14\14EG\14EG Templates\EB\OE S:\ALDRIDGE\ISSDocs\2011 its Forms Affidav custom Lockton can create s for you. forms affidavit VERIFICATI Form S:\EB\Shd in at least 80% Diabetes Academy Driven is Now in Session Diabetes Academy is a free class given by a Novo Nordisk Diabetes Educator to help you learn managing diabetes. about Plan? characteristics: following in Consumer have coverage kicks Plans is a or even hospitaliation, What risk illness, insurance loved Driven Out--Network virus to A flu vaccine reduces before choice 6 months Consumer you from spreading In-Network deductible Everyone, death can prevent get vaccinated. doctor You have family from flu: Diabetes Management works: you meet to ones. Protect to meet older, is to go until vaccine? 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Employee Signature 3 SPOUSAL/DEPE COVERAGE partner or spouses form to <company> company contact Working Spouse [Client] requires Via fax to: for all employees, health s must ir employer s fax number to elect that to keep costs down via to: medical, coverage through In an effort Scanned copy his/her employer applies to <company> about have access to comprehensive coverage through for health s. This asked questions employees who <company> who have medical s will pay secondary list commonly partners <company> to be eligible for coverage under <company> see below for a Spouses domestic in order will pay first coverage. Please ir employers partner s employer s elect coverage through spouse s or domestic programs. The this effort: following: dental vision partner meets partner s coverage. or my domestic spouse s or domestic legally married, Verification to whom I am employees spouse loses coverage? or vision coverage. my Status that my spouse, would be able to What ifwhich medical, dental Non-Tobacco Name s employees, I hereby certify spouse Select for Company program access to comprehensive apply) Employee good health a qualifying event or vision coverage. event without does not have tobacco cessation (Select all that overallcomplete medical, dentalto encourage is considered does not work in a recognied 30 days qualifying must alsothis comprehensive In an effort or domestic partner partner s employer employees enrolled within that does not fer My spouse tobacco Your spouse/domestic works for a company enroll in [Client] who do not use partner s employer. limitations. or domestic partner page. medical rates. period or pre-existing My spouse spouse s or domestic Form on next fered by a waiting can receive discounted you will be ineligible coverages not but gains Coverage Certification is June 20, 2011, his/her employer Partner Employer Vision indicated below Resources by Spouse/Domestic update have coverage through s coverages this form to Human Spouse/ does not currently Dental status. You must in[year] year? coverage for do not return also complete through you tobacco What if my spouse If partner s his/her employer s employer must medical Medical elected to take an employer-sponsored period for discount, regardless spouse/domestic through works has enrollment coverage open coverage. Your for non-tobacco would need or domestic partner annual eligibility for s as secondary My spouse spouse at each subsequent on next page. for <company> status a qualifying event tobacco discount. Date: through refore eligible Certification Form Effective non-tobacco This is considered Employer Coverage Group # & Coverage order to qualify for terminate coverage Domestic Partner Carrier Name, update our employer s Effective Date: Medical: List so that we can to join his/her Conditions immediately Group # & Coverage Tobacco Terms notify HR Carrier Name, an Approved Discount Dental: List Effective Date: [Client]. Please Completion Non-tobacco Group # & Coverage or domestic partner s Carrier Name, User under spouse s Tobacco Vision: List Cessation Program eligibility files accordingly. benefits begin Definition fulfill 80% indicate when least one tobacco who is able to waiting period, who uses atvision If any An employee s. or is in a benefits a tobacco An employee or chew) requirements medical, dental or domestic partner that pipe, cigtte, <company>(i.e., cigar, If spouse form you certify participation Coverage to, product By signing this Dependent use have coverage under will be subject for our medical partner will not claim payments. employer: or social tobacco cessation program eligible month spouse or domestic per week. Casual be subject to reimbursing Name s verify that dependents first dependent this form, outlined below. partner, you may discount by Company If you do not return In an effort to Conditions to certify thattoir non-tobacco spouse or domestic present constitutes tobacco Eligibility Terms an Affidavit for an ineligible employee s ability vision s. must complete claims paid <company> Dependent following domestic partner underst medical, dental, completion spouse oremployees definition. you have read to remain on who decls ir status. to Company Name from an employee or self-employment child(ren) eligible verification Terms Conditions documentation to prove non-working Documentation online. program. Dependent Eligibility right to request for tax records repayment an approved affidavit is available <company> has right to ask The Right to Request subject to immediate documentation: addition, we have for right to request this form will bename has Right to request Plan. In from employment on Company ir Employer s may be released an employee who Cessation Programs s intentionally falsifies is not eligible for An employee who Approved Tobacco under <company> documentation from a false : coverage terminated cessation programs a tobacco user Recourse for making s, may have Approved tobacco community paid by health decls him/herself cessation paperwork. upon available premium or claims approved tobacco employment-related may vary based enrolled in an tobacco users attended intentional falsification an alternative, employee resources. As to verify that Please return this Employee Name What to Do or people doctor doesn t Will not keep Just because or upper c doesn t mean from getting sick Colds many give you an antibioti s, as well as you or child respiratory infection Will not help you n t sick. s, caused by some ear infection feel better If antibiotics about viruses, not bacteria. y with doctor Talk things for ten Do used too for or What Not to best treatment colds or or antibiotics can t treat like better when dem feel not To Do can stop child s illness. says y not viral infections y has an upper when a doctor ly against bacteria you or child working effective : needed child really needs respiratory infection when you or c for n antibioti e whe an resistanc or pharmacist Do not take m. Antibiotic Ask doctor like a cold or no longer cure a viral infection antibiotics can about over--counter s has been a most sore throats that may help bacterial infection ed treatment options is consider s concern for years prescribes an reduce symptom most critical If doctor one world s infection: intake antibiotic for bacterial Increase fluid public health threats. rest cs doses when antibioti Get plenty Do not skip Get smart about vaporier or fight bacterial t any iate to cool-mis save a Use appropr Do not to relieve m for viral next time you saline nasal spray infections. Taking antibiotics for sore as a cold, most sick congestion infections, such or child gets is many throats, acute bronchit s: sinus or ear infection infection Will not cure 2014 ON FORM Coverage Verification Partner spouse/domestic employee you electing s. this form if dental or vision You must complete effective date. for medical, to benefit (15) days prior family coverage Via mail to: approximately fifteen Spouse/Domestic NDENT [Client] will Effective [Date], audits which implement dependent through ADP. will be conducted is process A dependent audit dependent/s verifying that in eligible to participate you example, [Client]. For show some type may be asked to spouse is a spouse pro that a or a child (ex. marriage certificate) birth certificate). is child (ex. have dependent All employees who through an audit. coverage will go I am a... gone through certify you have I hereby After will only be audited non-tobacco initial audit, you for to user eligible if you make a change Non-tobacco again a premium adding to medical that includes discount coverage approved dependent. user who is enrolled in an Tobacco July 1, program as tobacco cessation at least 80% or participate in I pledge to attend to education in order required classroom discount upon qualify for non-tobacco underst I will program. I completion pro Name to provide be asked by Company an approved completion enrollment program. enrolled in an who will not be Tobacco user as cessation program approved tobacco that I am not July 1, I acknowledge to non-tobacco discount eligible for medical premium. Your name (printed) date Your signature l s, Specia Fliers, Poster Newsle tters any nonlockton can format tion into a copyrighted informa poster or flyer. Images Thinkstock. All rights reserved. S\eb\barwe\eecom\flyers\Diabetes.pdf Text rights reserved. Thinkstock. All Images 2011 EB\SR\EE Communications\Fliers\2012\FluShot2012.pdf reserved. All rights 1.pdf Thinkstock. Images s\eb\shd\eecom\flyers\\cdhp ss Month ly Wellne Newsle tters creates three Every month ISS Benefits clients. newsletters for provided in These also client. Spanish for each LIVE EAT well BE well DOG CTO O Calories BITE BER Total fat Saturated fat Cholesterol BUTTONS PREVE NTION 013 OCTOBER 2 well PASTA STAYING AND BOWS ACTIVE DURING PREGNANCY OCTOBER g 1g 0 mg 127 mg chicken Sodium In a bowl, combine Physical 9g 5 minutes Mix well. Activity 5. is broth cornstarch. 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Thinkstock usted médico estao publicación informativos. o tratamiento. de Imágenes con fines médico diagnóstico en presional obtener u otro médica, y bienestar para consejo médico condición de salud en línea CDC (CDC). de de su de fuente alguna nformación es una Web icial importantes sobre hallar CDC.gov a temas y estadísticas, el sitio Puede índice y es directo datos en el acceso científicos,900 temas información proporciona artículos y más de CDC.govseguridad, y y recursos salud Thinkstock herramientas publicación CDC.gov A-Z de de esta Este boletín de beneficios del empleado es por su departamento presentad a usted de recursos humanos informativos. y es sólo con No tiene fines médico o tratamiento. el propósito de sustituir al consejo Siempre busque u otro presional el consejo de médico si tiene su médico preguntas sobre condición médica, alguna diagnóstico o tratamiento. 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CDC.gov A-Z 2014 Thinkstock publication Images in this 4 11

12 Our Mission To be worldwide value service leader in insurance brokerage, employee benefits, risk management Our Goal To be best place to do business to work Saint Louis Three CityPlace Drive, Suite 900 Saint Louis, Missouri (314) Memphis 1715 Aaron Brenner Drive, Suite 512 Memphis, Tennessee (901) Lockton, Inc. All rights reserved. Images 2014 Thinkstock. All rights reserved. [Rev 01/17/14] S\EB\CLIENTS\S-Z\STRME08\\Specialists.pdf

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