Accreditation Application CEO Cancer Gold Standard 2010

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Accreditation Application CEO Cancer Gold Standard 2010 Company:Massachusetts Mutual Life Insurance Company Number of US Employees:6,642 file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 1/12

Gold Standard Accreditation Application Pillar 1: Tobacco Use 1a: Establish and enforce tobacco-free worksite policies Our tobacco-free worksite policy is specifically worded to be tobacco-free rather than smoke-free. Our tobacco-free worksite policy is in place and applies to all U.S. based employees, including temporary workers, contractors and visitors, at all of our U.S. sites Indoors: Our policy prohibits the use of tobacco within all company facilities at all U.S. sites, whether our facilities are owned, leased or shared. Outdoors: Our policy prohibits the use of tobacco on company grounds or campus at all of our U.S. sites, whether the grounds are owned, leased, or shared. Our policy prohibits the use of tobacco in all employee vehicles on our company grounds. Our policy prohibits the use of tobacco in company-owned or company-leased vehicles regardless of their location. Our tobacco-free worksite policy includes procedures for enforcement. Our tobacco-free worksite policy is communicated to all employees, temporary workers, including contractors, and to visitors to our sites. 1b: Ensure that health benefit plans include coverage at no cost for evidence-based tobacco treatments (counseling and medications). All of our health benefit plans include coverage for tobacco-cessation assistance for enrolled employees and their covered dependents at no cost to the employee. We understand that the definition of health benefit plan may include reimbursement accounts or third party vendor arrangements whereby employees receive 100% reimbursement for all evidence-based tobaccocessation treatments including counseling, prescription medicines and over-the-counter medicines. We cover counseling for tobacco cessation at 100%, that is, our employees and covered dependents are not required to pay a deductible, a co-pay or co-insurance. We cover at least one tobacco-cessation prescription medicine (examples: Zyban, Chantix) at 100%, that is, our employees and covered dependents are not required to pay a deductible, a co-pay or co-insurance. We cover at least one tobacco-cessation over-the-counter (OTC) Nicotine Replacement Therapy (NRT) medicines (examples: gum, patch, lozenges) at 100%, that is, our employees and covered dependents are not required to pay a deductible, a co-pay or co-insurance. In a few bullets, describe your approach to covering Rx, OTC, and counseling at 100% for your employees and their eligible, covered dependents. Please note any caps you impose on the coverage. *All employees and spouses provided free on-line smoking cessation programs *All prescription smoking cessation medications are free to coverered employee and dependen ts in our health plans *6 free EAP visits / year to each household member regardless of health insurance coverage *Interested quitter's directed to 800 Quit-Now Smoking cessation program * Smoking cessation program available on company wellness portal at no charge * Up to two free NRT courses available to employees * In 2011 up to 2 free courses of NRT will be offered to all covered lives including dependents file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 3/12

. 1c: Establish workplace-based tobacco-cessation initiatives We have workplace-based initiatives in place, such as quit lines, smoking cessation seminars, onsite support groups, lunch n learns and other workplace-based programs to help our employees quit the use of tobacco. Please briefly describe your workplace-based initiatives in the area of tobacco cessation. In four or five bullets, list specific examples of what you are doing at your work site to promote tobacco cessation above and beyond the requirements of 1a and 1b. *Annual HRA to gather smoking metrics *Home Office onsite EAP counselors offering 6 free visits to each household member *Home Office free cessation counseling provided at on-site medical clinics *Smokers insurance rates in 2011 *Created a detailed corporate communication plan promoting smoking cessation options *Entire web page with tobacco cessation resources available on our intranet Self help print materials available in our Health Services Department file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 4/12

Pillar 2: Diet & Nutrition 2a: Sustain a culture that supports healthy food choices. We have programs or initiatives in place that promote and encourage healthy food choices, designed to make it easier for our employees to maintain healthy diets. We are confident that our employees are likely to describe our company culture as one that is supportive of healthy eating habits. 2b: Provide access to nutrition/weight control programs. We offer our employees a variety of nutrition and weight control programs Describe your workplace-based nutrition and weight control programs and how they contribute to a company culture that supports healthy food choices. In four or five bullets please list specific examples of what your organization has done in order to make it easier for employees to maintain a healthy diet. *Various incentive programs offered by the Wellness Activity Centers and Live Healthy, Live Well program, i.e., to boost fruit and vegetable consumption; one-on-one nutrition coaching b y Health/Fitness Professionals available to employees. *Robust interactive Live Healthy Live Well portal with dietary and nutritional information, tra ckers, and weight control programs *Healthy Eating Every Day (20-week behaviorally based nutrition and fitness coaching progra m) *Biggest Winner (6-week weight management program focusing on food and exercise logs) *Various nutrition-focused Lunch & Learn presentations delivered by dietetics professionals. * Subsidize healthy foods in our cafeteria * "Your Health Your Way" web portal dedicated to nutritional value information of our cafete ria foods, healthy eating, and healthy cooking * Live healthy cooking demonstrations in our cafeteria * Nutritional counseling offered under health benefit plans * Working on bringing a dietician on site for Q3 2010 file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 5/12

Pillar 3: Physical Activity 3a: Sustain a culture that promotes physical activity We have programs or initiatives in place that promote and encourage physical activity, in order to make it easier for employees to be physically active. We are confident that our employees are likely to describe our company culture as one that is supportive of physical activity. 3b: Demonstrate commitment to eliminating barriers to active lifestyles We offer programs that are intended to assist employees achieve an active lifestyle. Briefly describe your organization s commitment to physical activity and how your initiatives contribute to a culture that promotes physical activity. In four or five bullets please list specific examples of what your organization has done to encourage employees to be physically active. * Mutiple incentive driven physical activity challenges offered throughout the year * Green lines (1 and 1 1/2 miles) painted outside our 2 corporate offices and utilized to promot e walking * Fitness Centers (with showers) located on each campus and open on weekends * Bike racks provided for bicycle commuters * Quarter mile tunnel painted, music added, and distance marked to promote walking * Fit trail available with exercise stations file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 6/12

Pillar 4: Prevention, Screening & Early Detection 4a: Sustain a culture that promotes appropriate cancer-screening behaviors We offer programs, initiatives and/or we have ongoing employee communication in place in order to advise employees of age and gender-appropriate, recommended cancer-screenings and to promote a high level of participation in screenings We are confident that our employees are likely to describe our company culture as one that actively promotes and encourages age and gender-specific cancer screenings Describe the strategies you employ to educate your employees about when to be screened or vaccinated for which particular cancers based on their age and gender, as well as educating them about why it is important to be screened. In four or five bullets please list specific examples of ways in which you encourage employees to obtain the recommended screenings. * Lunch and learn on cancer screening and prevention presented by American Cancer Society (ACS) * Cancer screening recommendations located on our wellness portal * Screenings covered at 100% by health plans * Flex time available to allow access to screenings * Communication (5 separate video segments) for cancer prevention co-produced with ACS * Producing "cancer personal stories" videos for our intranet * Annual health fair with ACS presence * Personal Stories/Testimonials article on intranet allowing employees to share their story 4b: Ensure that health benefit plans include cancer-screening provisions that adhere to the American Cancer Society (ACS) Guidelines or the US Preventive Services Task Force (USPSTF) Guidelines. All of our health benefit plans, including self-insured or fully insured plans such as HMOs, provide coverage for cover cancer screenings for enrolled employees and their covered dependents. All of our health benefit plans provide coverage for vaccines that have been approved by the FDA, and recommended by the CDC, for the prevention of cancer. Currently we are covering Gardasil and/or Cervarix for the prevention of cervical cancer. All of our health benefit plans cover specific tests and cancer screenings as recommended by either the American Cancer Society (ACS) guidelines or the US Preventive Services Task Force (USPSTF) guidelines, or some combination of the two. Specifically, at a minimum, we certify that all of our health benefit plans meet the following screening requirements: Minimum Cancer Screening Requirements for Gold Standard Accreditation Breast Cancer: Screening mammography, with or without clinical breast exam (CBE), every 1-2 years for women aged 40 and older. Cervical Cancer: Pap test, beginning within 3 years of onset of sexual activity or age 21 (whichever comes first), at least every 3 years for women Colorectal Cancer: Fecal occult blood test (FOBT), every year for men and women aged 50 and older Although the US Preventive Services Task Force (USPSTF) modified their recommendation for file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 7/12

screening mammography as of November 2009, the minimum screening requirements for Gold Standard accreditation remain as stated above. That is, a Gold Standard employer must cover screening mammography, with or without clinical breast exam (CBE), every 1-2 years for women aged 40 or older. If you cover more than the minimum screenings required by the Gold Standard as noted in the bullets above, please tell us which cancer screenings (e.g. Colonoscopy, Flexible Sigmoidoscopy, PSA, etc.) you are covering. Coverage is in place for *Mammogram, pap smear, gyn exam, fecal occult blood test: every 12 months * Digital rectal exam and one PSA every 12 months for males 40 and older * Every 5 years for 50 years and older: sigmoidoscopy every (avg risk) or double contrast bari um enima (avg risk) or colonoscopy every 10 years (avg risk) * For family history of colon cancer colonoscopies are offered every 5 years * Meet requirements for the Women's Health and Cancer Rights Act of 1998 4c: Offer health benefit plans that eliminate cost as a barrier to accessing preventive/screening tests and exams, including all vaccines approved by the FDA, and recommended by the CDC, for the prevention of cancer. All of our health benefits plans cover cancer screening and FDA-approved and CDC-recommended cancer vaccines ( Gardasil and/or Cervarix) either at no cost to our employees or their covered dependents or at a cost-sharing level that does not present an impediment to being screened or obtaining an appropriate vaccination. Please indicate the level of coverage for cancer screenings and vaccines, specifically addressing why cost does not present a barrier for employees to receive the appropriate screenings or vaccinations. All screenings and cancer prevention vaccines are covered at full cost or covered with a low c o-pay and waived deductibles. file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 8/12

Pillar 5: Access to Quality Treatment & Clinical Trials 5a: Provide education and promotion of cancer clinical trials Our employees receive ongoing communication and education to raise awareness of the importance and value of cancer clinical trials. Our goal is to educate employees about cancer clinical trials so that individuals will be better equipped to make an informed decision should a cancer diagnosis become a reality. In a few bullets please describe your approaches to educating employees about the importance and value of cancer clinical trials. * Cancer Clinical Trials were addressed in four June lunch and learns provided by both our Ch ief Medical Officer and the medical director of our regional cancer center. * A link to the National Cancer Institute PDF "Taking Part in Cancer Treatment Research Stud ies" will be placed on our company intranet in 2010. 5b: Offer health benefit plans that eliminate cost as a barrier to accessing cancer clinical trials. All of our health benefit plans, including self-insured or fully insured plans such as HMOs, have confirmed that they do not specifically exclude coverage for cancer clinical trials, i.e. our health benefits plans do not specifically state that standard cancer treatment will not be covered under the usual terms of our health benefits plans just because an individual elects to participate in a clinical trial. We understand that investigational drugs or agents are typically paid for by the clinical trial sponsor and would not be the responsibility of our health benefits plan(s). If an employee or covered dependent elects to participate in a cancer clinical trial, they will not be financially penalized by our health benefits program, i.e. they would receive the same benefits coverage as employees who do not participate in a trial. All of our health benefit plans cover participation in a cancer clinical trial at a cost-sharing level that does not present a financial challenge to employees who choose to participate in a cancer clinical trial. 5c: Ensure that health benefit plans provide access to cancer care at Commission on Cancer-approved facilities and/or NCI-approved cancer centers. All of our health benefit plans, including self-insured or fully insured plans such as HMOs, provide access to cancer treatment for enrolled employees and their covered dependents at Commission on Cancer-approved facilities www.web.facs.org/cpm/cpmapprovedhospitals_result.cfm and/or cancer centers designated by the National Cancer Institute (NCI) http://cancercenters.cancer.gov/cancer_centers/cancer-centers-list.html Describe the access your employees have to quality cancer treatment. You must list a few examples of centers where your employees may receive cancer treatment. file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutual 9/12

*We offer 4 self funded benefit plan opions. Our 2 national carriers offer coverage at commis sion on cancer approved facilities. Our 2 local HMO's do not without prior approval. *In 2011 all benefit plan options will offer coverage at Commission on Cancer-approved facili ties. * In addition, the Dana-Faber Cancer Institute is covered under our 2 national carriers and with approval by our local HMO's. * Our CEO is a member of the ACS CEO's Against Cancer program file:///c:/users/therese/documents/ceo%20round%20table/gold%20standard/archive%20online/massachusettsmutualfinancialgroup/mass%20mutua 10/12