DMW Sample Report

Decision Master ® Warehouse Health Plan Management Report ABC Training Company Demo Project 1 /07/201 9 January 1, 201 8 - December 31, 201 8 Prepared by: EBS One Gateway Center Suite 650 Newton, MA 02458 (617) 244-3737 Project Id 351737 Propriety, Confidential and Subject to Confidentiality Agreement.

ABC Training Company Methodology and Enrollment Summary We analyzed your medical claims experience compared to that of your peers. This comparison will allow you to identify and address potential issues concerning health care utilization and costs. Be sure to review all exhibits for the full scope of this analysis. Make note of large differences between your actual experience and the norm, as this may indicate room for improvement. This report: • Displays claims paid from January 1, 2018 to December 31, 2018, but may not reflect all claims incurred over this period. • Is calculated using the propriety claims analysis system Decision Master® Warehouse. The following counts and assumptions are used to create this report for your company: Number of employees 831 Number of single contracts 688 Number of single + 1 contracts 0 Number of single + 2 contracts 0 Number of family contracts 143 Total enrolled 1,284 This document contains confidential and/or proprietary information, and may be used only by the person or entity to which it is addressed. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[2]

ABC Training Company Health Plan Cost Gauge how your total health plan expense per employee compares to that of other similarly sized employers in your region and industry. Keep in mind: • Prescription drug and fixed costs shown are based on values provided. • Claim amounts represent claims paid during the period; they may not reflect all claims incurred over this period. Region Midwest $10,000 Industry type Retail Points to consider: $8,000 • Do you employ the most appropriate funding method for your health plan? • Is there a need to review contribution $6,000 levels or implement a spousal carve-out? • What impact do catastrophic claims have $4,000 on your costs? • Is there a noticeable return on investment for managed care or other cost containment programs? $2,000 • Would potential cost savings be achieved if services, such as utilization review and disease management, were unbundled? $0 Actual Region Size Industry Total number of employees 831 Actual cost per employee $8,295.33 Total health plan cost $6,893,416.55 Norm cost per employee (region) $8,412.32 Norm total cost (region) $6,990,641.00 Norm cost per employee (employer size) $8,274.49 Norm total cost (employer size) $6,876,103.00 Norm cost per employee (industry type) $7,244.06 Norm total cost (industry type) $6,019,812.00 Norm source: "Employer Health Benefits 2014 Annual Survey", The Henry J. Kaiser Family Foundation and Health Research and Educational Trust, September 2014. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[3]

ABC Training Company Health Plan Cost Trend Examine the pattern of your claim charges and payments over the course of the reporting period to identify irregularities or opportunities. $1,400,000.00 $1,200,000.00 $1,000,000.00 $800,000.00 $600,000.00 $400,000.00 $200,000.00 $0.00 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Amount Charged Amount Paid Your Total Health Plan Cost Per Employee Total Net paid claims (less amount over specific) $5,352.97 $4,448,322 Prescription drug costs $1,569.03 $1,303,860 Administrative costs/premium $1,373.33 $1,141,235 Actual cost $8,295.33 $6,893,417 Region benchmark $8,412.32 $6,990,641 Employer size benchmark $8,274.49 $6,876,103 Industry type benchmark $7,244.06 $6,019,812 Norm source: "Employer Health Benefits 2014 Annual Survey", The Henry J. Kaiser Family Foundation and Health Research and Educational Trust, September 2014. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[4]

ABC Training Company Medical Claims Cost Compare your costs per member with the norm. Administrative and fixed costs are not included; prescription drug expense is included unless otherwise stated. Use this exhibit as your first indication as to whether your claims costs are in-line with your peers, based on benchmarking by location, industry and plan type. Points to consider: $5,000 • Are your costs in-line with that of your peers? • Is your plan design competitive? • Do any specific utilization and cost patterns $4,000 suggest areas of opportunity? • Are your high costs claims appropriately managed? $3,000 • Do you encourage preventive care for your plan participants? • Would a disease management program help $2,000 control costs? $1,000 $0 Actual Medical Claims Norm medical claims Actual medical claims/member $4,479.89 Norm medical claims/member $3,738.22 Percent over/under norm 19.84% Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[5]

ABC Training Company Employee vs. Dependent Claims Understand how your company's health care cost distribution by relationship compares to that of your peers, and determine whether that distribution reflects the goals of your health plan. Actual Paid Norm Paid 13% 24% 30% 11% 76% 46% Employee Spouse Dependent Employee Spouse Dependent Relationship Actual Norm Variance Employee $3,391,776 $1,319,372 157.08% Dependent $559,911 $1,075,604 -47.94% Spouse $496,634 $2,053,345 -75.81% Points to consider: • Are catastrophic claims skewing the distribution of claim dollars? • Do you have adequate cost containment strategies in place, and are they being communicated to the correct audiences? • Are you using contribution strategies and spousal carve-outs to reduce adverse selection against your plan? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[6]

ABC Training Company Inpatient and Outpatient Claims Assess how the distribution of your paid claims by inpatient versus outpatient setting compares to that of your peers. For this report, the data includes both facility fees (room and board, supplies, and ancillary services) and professional services fees (physician, surgeon, and anesthesiologist). Actual Paid Norm Paid 29% 34% 66% 71% Inpatient Outpatient Inpatient Outpatient Network Actual Paid Norm Paid Variance Inpatient $1,523,940.91 $1,271,005.57 19.90% Outpatient $2,924,380.64 $3,177,311.53 -7.96% Points to consider: • Is inpatient care appropriately managed? • Are effective disease management programs in place? • Does your network contain high-quality, fair-cost providers? • Can your costs be reduced by using pre-authorization mandates? • Have changing medical treatment patterns shifted medical care environments? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[7]

ABC Training Company Claims by Demographic Evaluate a breakdown of your claims by demographics to illuminate cost drivers. Claims by Age Claims by Gender 16% 21% 43% 57% 36% 27% 0-19 20-39 40-59 60+ Male Female Age Number of Average Paid per Total Paid Gender Number of Average Paid per Total Paid Range Claimants Claimant Claimants Claimant 0-19 226 $1,933.99 $437,081 Male 464 $4,663.30 $2,163,771 20-39 296 $3,616.54 $1,070,497 Female 627 $3,643.62 $2,284,550 40-59 393 $4,214.15 $1,656,161 60+ 176 $7,298.76 $1,284,582 Claims by Network Claims by Relationship 19% 24% 11% 64% 81% In Network Out Of Network Employee Spouse Dependent Network Number of Average Paid per Total Paid Relationship Number of Average Paid per Total Paid Claimants Claimant Claimants Claimant In Network 1,067 $3,965.35 $4,231,031 Employee 702 $4,831.59 $3,391,776 Out Of 245 $886.90 $217,290 Spouse 123 $4,037.68 $496,634 Network Dependent 266 $2,104.93 $559,911 Points to consider: • Is there a specific demographic with higher costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[8]

ABC Training Company Claims by Place of Service Gauge your plan’s costs by place of service compared to that of your peers. For this report, the data includes both facility fees (room and board, supplies, and ancillary services) and professional services fees (physician, surgeon, and anesthesiologist). The place of service categories used below are prescribed by the Centers for Medicare & Medicaid Services (CMS). Note: Some carriers may use different conventions and the settings in your analysis may vary. Total Paid by Place of Service Norm Total Paid Inpatient Hospital Actual Total Paid Outpatient Hospital $1,233,075 Office $693,910 $1,408,339 Emergency Room $415,511 $96,529 Home $218,601 $56,494 Other $63,960 $33,807 Surgery Center $33,234 $71,618 $0 $200,000 $400,000 $600,000 $800,000 $1,200,000 $1,600,000 Place of Service Actual Norm Variance Inpatient Hospital 34.26% 34.80% -1.56% Outpatient Hospital 33.70% 27.72% 21.58% Office 15.60% 31.66% -50.73% Emergency Room 9.34% 2.17% 330.45% Home 4.91% 1.27% 286.95% Other 1.44% 0.76% 89.19% Surgery Center 0.75% 1.61% -53.60% Points to consider: • Is there an appropriate mix of health care settings being used? Explore normative comparison in targeted areas: office visits, emergency room, inpatient hospital, etc. to discover specific opportunities. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[9]

ABC Training Company Claims by Place of Service and Age Evaluate a breakdown of your place of service utilization by age groups to illuminate cost drivers. Total Paid by Place of Service Inpatient Hospital Outpatient Hospital Office Emergency Room Home Other Surgery Center $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 $1,600,000 0-19 20-39 40-59 60+ Points to consider: • What could be driving higher than expected costs for a certain age group in a specific setting? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[10]

ABC Training Company Claims by Place of Service and Gender Evaluate a breakdown of your place of service utilization by gender to illuminate cost drivers. Total Paid by Place of Service Inpatient Hospital Outpatient Hospital Office Emergency Room Home Other Surgery Center $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 $1,600,000 Male Female Points to consider: • What could be driving higher than expected costs for either gender in a specific setting? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[11]

ABC Training Company Claims by Place of Service and Network Evaluate a breakdown of your place of service utilization by network to illuminate cost drivers. Total Paid by Place of Service Inpatient Hospital Outpatient Hospital Office Emergency Room Home Other Surgery Center $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 $1,600,000 In Network Out of Network Points to consider: • Does plan design effectively steer utilization to high quality, low-cost, in-network providers? • Are network providers assessable to all geographical concentrations of plan participants? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[12]

ABC Training Company Claims by Place of Service and Relationship Evaluate a breakdown of your place of service utilization by relationship to illuminate cost drivers. Total Paid by Place of Service Inpatient Hospital Outpatient Hospital Office Emergency Room Home Other Surgery Center $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 $1,600,000 Employee Spouse Dependent Points to consider: • What could be driving higher than expected costs for a certain relationship in a specific setting? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[13]

ABC Training Company High Cost Claimants Research the top 10 high cost claimants to observe and measure general health risks present in your population. The top 10 claimants are shown by total claimant paid amount and 23% most costly diagnosis. Examining high cost claimants provides your company insight into how a small number of participants can be responsible for a large percentage of total claims. Points to consider: • Could addressing certain conditions or comorbidities reduce your overall costs? • Are your managed care strategies effective? • Would setting stop loss contracts be appropriate? 77% High Cost Claims Other Claims Claimant ID Paid Diagnosis 93 $161,010 COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,708 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 679 $127,041 PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY 909 $113,021 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 166 $85,512 OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 407 $84,479 OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 949 $63,100 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $57,602 STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $56,604 ATRIOVENTRICULAR BLOCK COMPLETE $1,006,449 Total Paid $1,006,449 Liability Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[14]

ABC Training Company High Cost Claimants by Age Evaluate a breakdown of your top claimants by age group to illuminate cost drivers. 13% 16% 44% 27% 0-19 20-39 40-59 60+ Claimant ID Paid Age Diagnosis 93 $161,010 20-39 COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 60+ ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,708 40-59 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 679 $127,041 0-19 PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY 909 $113,021 60+ CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 166 $85,512 60+ OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 407 $84,479 40-59 OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 949 $63,100 60+ CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $57,602 40-59 STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $56,604 60+ ATRIOVENTRICULAR BLOCK COMPLETE $1,006,449 Total Paid Points to consider: • What factors contribute to higher costs among a certain age group? • Are there early detection or disease management strategies that could reduce costs related to specific diagnoses? • Would setting stop-loss contracts be appropriate? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[15]

ABC Training Company High Cost Claimants by Gender Evaluate a breakdown of your top claimants by gender to illuminate cost drivers. 30% 70% Male Female Claimant ID Paid Gender Diagnosis 93 $161,010 Male COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 Male ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,708 Male ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 679 $127,041 Female PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY 909 $113,021 Male CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 166 $85,512 Female OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 407 $84,479 Female OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 949 $63,100 Male CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $57,602 Male STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $56,604 Male ATRIOVENTRICULAR BLOCK COMPLETE $1,006,449 Total Paid Points to consider: • What factors contribute to higher costs among either gender? • Are there early detection or disease management strategies that could reduce costs related to specific diagnoses? • Would setting stop-loss contracts be appropriate? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[16]

ABC Training Company High Cost Claimants by Network Affiliation Evaluate a breakdown of your top claimants by network to illuminate cost drivers. 12% 88% High Cost In Network High Cost Out of Network Claimant In Out of Diagnosis ID Network Network 93 $161,010 $0 COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 $0 ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,556 $153 ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 909 $109,960 $3,061 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 407 $84,479 $0 OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 166 $79,619 $5,894 OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 949 $63,100 $0 CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $55,343 $2,260 STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $51,378 $5,226 ATRIOVENTRICULAR BLOCK COMPLETE 679 $22,357 $104,684 PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY $885,174 $121,278 Total Paid Points to consider: • What factors contribute to out of network utilization? • Is there an opportunity to negotiate discount arrangements with specific providers? • Does your network include high quality, low-cost providers, and centers of excellence? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[17]

ABC Training Company High Cost Claimants by Relationship Evaluate a breakdown of your top claimants by relationship to illuminate cost drivers. 13% 6% 82% Employee Spouse Dependent Claimant Paid Relationship Diagnosis ID 93 $161,010 Employee COMPLICATIONS OF TRANSPLANTED HEART 1067 $129,372 Employee ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY 345 $128,708 Employee ATHEROSCLEROSIS OF NATIVE ARTERIES OF THE EXTREMITIES UNSPECIFIED 679 $127,041 Dependent PARTIAL EPILEPSY WITH IMTRACTABLE EPILEPSY 909 $113,021 Employee CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 166 $85,512 Employee OTHER COMPLICATIONS DUE TO OTHER VASCULAR DEVICE IMPLANT AND GRAFT 407 $84,479 Employee OSTEOARTHROSIS LOCALIZED NOT SPECIFIED WHETHER PRIMARY OR SECONDARY INVOLVI 949 $63,100 Employee CORONARY ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY 995 $57,602 Employee STAPHYLOCOCCUS AUREUS SEPTICEMIA 533 $56,604 Spouse ATRIOVENTRICULAR BLOCK COMPLETE $1,006,449 Total Paid Points to consider: • What factors contribute to higher costs among a specific group? • Are there early detection or disease management strategies that could reduce costs related to specific diagnoses? • Would setting stop-loss contracts be appropriate? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[18]

ABC Training Company Paid Claims Distribution by Claimant Consider the distribution of your plan participants by paid amount categories when making decisions related to plan design and risk acceptance. 1,400 $0-$249 Points to consider: $250-$499 1,200 $500-$749 • Does your plan include appropriate $750-$999 deductible levels? 1,000 $1000-$2499 $2500-$4999 • What measures could be taken to reduce 800 $5000-$9999 costs in higher paid categories? $10,000-$24,999 600 $25,000-$49,999 $50,000-$99,999 400 $100,000-$149,999 $150,000-$499,999 200 $500,000-$999,999 $1,000,000+ 0 Actual Norm Actual Claimant Actual Percent Actual Norm Claimant Norm Percent of Norm Count of Total Cumulative Total Count Total Cumulative Total $0-$249 405 37.12% 37.12% 439.24 40.26% 40.26% $250-$499 103 9.44% 46.56% 190.27 17.44% 57.70% $500-$749 57 5.22% 51.79% 95.14 8.72% 66.42% $750-$999 61 5.59% 57.38% 40.26 3.69% 70.11% $1000-$2499 174 15.95% 73.33% 325.77 29.86% 99.97% $2500-$4999 103 9.44% 82.77% 115.43 10.58% 110.55% $5000-$9999 80 7.33% 90.10% 76.81 7.04% 117.59% $10,000-$24,999 59 5.41% 95.51% 57.50 5.27% 122.86% $25,000-$49,999 31 2.84% 98.35% 20.29 1.86% 124.72% $50,000-$99,999 8 0.73% 99.08% 9.06 0.83% 125.55% $100,000-$149,999 4 0.37% 99.45% 2.29 0.21% 125.76% $150,000-$499,999 1 0.09% 99.54% 2.07 0.19% 125.95% $500,000-$999,999 0 0.00% 99.54% 0.00 0.00% 125.95% $1,000,000+ 0 0.00% 99.54% 0.00 0.00% 125.95% Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[19]

ABC Training Company Paid Claims Distribution by Dollars Consider the distribution of your plan costs by paid amount categories when making decisions related to plan design and risk acceptance. Points to consider: $10,000,000 $0-$249 $250-$499 • Does your plan include appropriate $500-$749 deductible levels? $8,000,000 $750-$999 • What measures could be taken to reduce $1000-$2499 costs in higher paid categories? $2500-$4999 $5000-$9999 $6,000,000 $10,000-$24,999 $25,000-$49,999 $50,000-$99,999 $100,000-$149,999 $4,000,000 $150,000-$499,999 $500,000-$999,999 $1,000,000+ $2,000,000 $0 Actual Norm Actual Total Net Actual % of Actual Cumulative Norm Net Norm Percent of Norm Cumulative Paid Total Total Paid Total Total $0-$249 $25,652 0.58% 0.58% $253,554 5.70% 5.70% $250-$499 $36,078 0.81% 1.39% $447,946 10.07% 15.77% $500-$749 $36,867 0.83% 2.22% $377,662 8.49% 24.26% $750-$999 $53,031 1.19% 3.41% $209,071 4.70% 28.96% $1000-$2499 $281,156 6.32% 9.73% $3,159,198 71.02% 99.98% $2500-$4999 $365,093 8.21% 17.94% $405,687 9.12% 109.10% $5000-$9999 $563,747 12.67% 30.61% $536,912 12.07% 121.17% $10,000-$24,999 $825,541 18.56% 49.17% $877,654 19.73% 140.90% $25,000-$49,999 $1,094,047 24.59% 73.76% $701,500 15.77% 156.67% $50,000-$99,999 $508,553 11.43% 85.19% $623,655 14.02% 170.69% $100,000-$149,999 $498,142 11.20% 96.39% $279,799 6.29% 176.98% $150,000-$499,999 $161,010 3.62% 100.01% $494,653 11.12% 188.10% $500,000-$999,999 $0 0.00% 100.01% $20,017 0.45% 188.55% $1,000,000+ $0 0.00% 100.01% $16,904 0.38% 188.93% Norm Source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[20]

ABC Training Company Inpatient Analysis Gauge inpatient utilization, focusing on frequency and cost of admissions. For this report, the data includes: • Admissions to an inpatient facility for overnight stays. • Facility fees, such as hospital room and board, supplies, and ancillary services. • Professional services fees, such as physician, surgeon, and anesthesiologist. Admissions per 1000 Average Paid per Admission Total Paid 80 $20,000 $2,000,000 60 $15,000 $1,500,000 40 $10,000 $1,000,000 20 $5,000 $500,000 0 $0 $0 Actual Norm Actual Avg Norm Avg Actual Total Norm Total Actual admissions 0 Actual avg paid/admit Actual total paid $0 Norm admissions 86 Norm avg paid/admit $18,419.41 Norm total paid $1,578,791 Amount over/under norm -86 Amount over/under Amount over/under ($1,578,791) Percent over/under norm-100.00% norm norm Percent over/under Percent over/under -100.00% norm norm Points to consider: • What are common themes among admissions that could be addressed through education, wellness, or disease management? • Are catastrophic claimants or provider contracting impacting costs? • Is inpatient care appropriately managed? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[21]

ABC Training Company Inpatient Analysis by Demographic Evaluate a breakdown of your inpatient care by demographics to illuminate cost drivers. Inpatient Analysis by Age Inpatient Analysis by Gender No Data Available No Data Available Age Number of Average Paid per Total Gender Number of Average Paid per Total Range Admissions Admission Paid Admissions Admission Paid 0-19 0 $0.00 $0 Male 0 $0.00 $0 20-39 0 $0.00 $0 Female 0 $0.00 $0 40-59 0 $0.00 $0 60+ 0 $0.00 $0 Inpatient Analysis by Network Inpatient Analysis by Relationship No Data Available No Data Available Number of Average Paid per Total Relationship Number of Average Paid per Total Network Admissions Admission Paid Admissions Admission Paid In Network 0 $0.00 $0 Employee 0 $0.00 $0 Out Of 0 $0.00 $0 Spouse 0 $0.00 $0 Network Dependent 0 $0.00 $0 Points to consider: • Is there a specific demographic with higher utilization or costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[22]

ABC Training Company Inpatient Length of Stay Assess your inpatient claims, focusing on length of stay and cost per day. For this report, the data includes: • Admissions to an inpatient facility for overnight stays. • Facility services, such as hospital room and board, supplies, and ancillary fees. • Professional services, such as physician, surgeon, and anesthesiologist fees. Average Days per 1000 Average Paid per Day Average Length of Stay 300 $5,000 5 250 $4,000 4 200 $3,000 3 150 $2,000 2 100 50 $1,000 1 0 $0 0 Actual Norm Actual Paid Norm Paid Actual Avg Norm Avg Actual days 0.00 Actual paid/day Actual avg length of 0.00 Norm days 360.47 Norm paid/day $4,293.86 stay Amount over/under -360.47 Amount over/under Norm avg length of 4.28 norm norm stay Percent over/under -100.00% Percent over/under Amount over/under -4.28 norm norm norm Percent over/under -100.00% norm Points to consider: • How effective is your plan at steering participants to network providers? • Are effective disease prevention and management efforts in place? • Is there an opportunity to form relationships with centers of excellence to address certain needs? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[23]

ABC Training Company Inpatient Provider Usage Review the top 10 inpatient providers. For this report, the data includes: • Facility fees, such as hospital room and board, supplies, and ancillary services. • Professional services fees, such as physician, surgeon, and anesthesiologist (0 admissions will display). Inpatient Providers by Percentage Other No Data Available Points to consider: • How effective is your plan at steering participants to network providers? • What factors, if any, drive out-of-network utilization? • Is there an opportunity to negotiate better discounts from your top providers? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[24]

ABC Training Company Inpatient Surgery Review the top 10 inpatient surgical procedures. For this report, the data includes surgeon fees (anesthesia, assistant surgeon, facility/supply costs are excluded). Other No Data Available Points to consider: • Would pre-authorization mandates steer plan participants to a less costly, high quality outpatient setting for certain procedures? • Is an effective wellness program in place to prevent the need for surgical procedures for some lifestyle related conditions? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[25]

ABC Training Company Inpatient Maternity Gauge inpatient utilization for maternity care, focusing on frequency and cost of admissions. For this report, the data includes: • Admissions to an inpatient facility for overnight stays related to pregnancy or child birth. • Facility fees, such as hospital room and board, supplies, and ancillary services. • Professional services fees, such as physician, surgeon, and anesthesiologist. Admissions per 1000 Average Paid per Admission Total Paid 30 $5,000 $150,000 25 $4,000 20 $100,000 $3,000 15 $2,000 10 $50,000 5 $1,000 0 $0 $0 Actual Norm Actual Avg Norm Avg Actual Total Norm Total Actual admissions 0 Actual avg paid/admit $0 Actual total paid $0 Norm admissions 32 Norm avg paid/admit $4,402.00 Norm total paid $142,608 Amount over/under norm -32.40 Amount over/under ($4,402.00) Amount over/under ($142,608) Percent over/under norm-100.00% norm norm Percent over/under -100.00% Percent over/under -100.00% norm norm Points to consider: • Are you effectively promoting pre-conceptual and prenatal care? • Are the appropriate managed care programs in place? • Can you implement programs to improve work-life balance, increase productivity, and discourage absenteeism? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[26]

ABC Training Company Inpatient Maternity Length of Stay Assess your inpatient claims for maternity care, focusing on length of stay and cost per day. For this report, the data includes: • Admissions to an inpatient facility for overnight stays related to pregnancy or child birth. • Facility fees, such as hospital room and board, supplies, and ancillary services. • Professional services fees, such as physician, surgeon, and anesthesiologist. Average Days per 1000 Average Paid per Day Average Length of Stay 80 $2,000 3 2 60 $1,500 2 40 $1,000 2 1 20 $500 0 0 $0 0 Actual Norm Actual Paid Norm Paid Actual Avg Norm Avg Actual days 0.00 Actual paid/day Actual avg length of stay 0.00 Norm days 82.76 Norm paid/day $1,685.52 Norm avg length of stay 2.66 Amount over/under norm -82.76 Amount over/under Amount over/under norm -2.66 Percent over/under norm-100.00% norm Percent over/under norm-100.00% Percent over/under norm Points to consider: • Does your network include a selection of high-quality, low-cost providers? • Is there an opportunity to steer participants to providers with more advanced neonatal care facilities? • Would managed care recommendations be appropriate? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[27]

ABC Training Company Outpatient Surgery Evaluate your outpatient surgery costs compared to that of your peers. For this report, the data includes surgeon fees (anesthesia, assistant surgeon, facility/supply costs are excluded). Surgeries per 1000 Average Paid per Surgery Total Paid 1,400 $250 $300,000 1,200 $250,000 $200 1,000 $200,000 800 $150 $150,000 600 $100 $100,000 400 $50 $50,000 200 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual surgeries 947 Actual average paid $203.91 Actual total paid $193,101 Norm surgeries 1,768 Norm average paid $144.76 Norm total paid $255,938 Amount over/under norm -821 Amount over/under norm $59.15 Amount over/under ($62,838) Percent over/under norm -46.44% Percent over/under norm 40.86% norm Percent over/under norm -24.55% Points to consider: • How effective is your plan at steering participants to surgery centers over outpatient hospital settings? • Are there managed care options that can be considered? • Is an effective wellness program in place to prevent the need for surgical procedures for some lifestyle related conditions? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[28]

ABC Training Company Outpatient Surgery by Procedure Review the top 10 outpatient surgical procedures. For this report, the data includes surgeon fees (anesthesia, assistant surgeon, facility/supply costs are excluded). 5% 3% 4% 3% 6% LESION REMOVAL COLONOSCOPY KNEE ARTHROSCOPY/SURGERY SKIN SUB GRAFT FACE/NK/HF/G 3% DIAGNOSTIC COLONOSCOPY CATARACT SURG W/IOL, I STAGE INSERT TUNNELED CV CATH 4% SHOULDER ARTHROSCOPY/SURGERY UPPER GI ENDOSCOPY, BIOPSY 3% LESION REMOVE COLONOSCOPY 61% LAPAROSCOPIC CHOLECYSTECTOMY Other 6% 3% Procedure Claimants Total Paid Average Paid Percent of Total Paid CATARACT SURG W/IOL, I STAGE 9 $11,774 $1,308.19 6.10% LESION REMOVE COLONOSCOPY 18 $11,154 $619.65 5.78% LESION REMOVAL COLONOSCOPY 9 $9,609 $1,067.70 4.98% SHOULDER ARTHROSCOPY/SURGERY 5 $7,334 $1,466.87 3.80% SKIN SUB GRAFT FACE/NK/HF/G 1 $6,940 $6,939.73 3.59% LAPAROSCOPIC CHOLECYSTECTOMY 7 $6,685 $955.05 3.46% KNEE ARTHROSCOPY/SURGERY 6 $6,305 $1,050.84 3.27% DIAGNOSTIC COLONOSCOPY 12 $5,586 $465.49 2.89% INSERT TUNNELED CV CATH 3 $4,984 $1,661.41 2.58% UPPER GI ENDOSCOPY, BIOPSY 18 $4,974 $276.31 2.58% Points to consider: • Does plan design encourage appropriate use of chiropractic and physical therapy services? • Is an effective wellness program in place to prevent the need for surgical procedures for some lifestyle related conditions? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[29]

ABC Training Company Emergency Room Visits Gauge your plan’s emergency room utilization and costs compared to that of your peers. For this report, the data includes claims that took place in an emergency room setting or included emergency room procedure coding. Visits per 1000 Average Paid per Visit Total Paid 400 $1,000 $500,000 $800 $400,000 300 $600 $300,000 200 $400 $200,000 100 $200 $100,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 462 Actual average paid $900.39 Actual total paid $415,979 Norm visits 364 Norm average paid $345.55 Norm total paid $125,839 Amount over/under norm 98 Amount over/under norm $554.83 Amount over/under $290,140 Percent over/under norm 26.86% Percent over/under norm 160.56% norm Percent over/under norm 230.56% Points to consider: • Is your plan design competitive? • Do your plan designs and communications encourage the use of home care, nurse lines, urgent care centers, and primary care providers? • Are there ways to encourage use of non-emergency providers, such as workplace policies like, or making participants aware of nearby providers like urgent care centers? • Could hand sanitizing stations or communication of self-care tips aid in reducing emergency room utilization during cold and flu season? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[30]

ABC Training Company Emergency Room Visits by Demographic Evaluate a breakdown of your emergency room care by demographics to illuminate cost drivers. Emergency Room Visits by Age Emergency Room Visits by Gender 18% 16% 42% 58% 33% 32% 0-19 20-39 40-59 60+ Male Female Age Range Number of Visits Average Paid per Visit Total Paid Gender Number of Visits Average Paid per Visit Total Paid 0-19 76 $439.43 $33,396 Male 195 $870.55 $169,756 20-39 148 $841.16 $124,492 Female 267 $922.18 $246,222 40-59 154 $1,065.48 $164,083 60+ 84 $1,119.13 $94,007 Emergency Room Visits by Network Emergency Room Visits By Relationship 13% 20% 8% 73% 87% In Network Out Of Network Employee Spouse Dependent Network Number of Average Paid per Total Paid Relationship Number of Visits Average Paid per Visit Total Paid Visits Visit Employee 335 $997.68 $334,222 In Network 445 $927.53 $412,752 Spouse 35 $960.62 $33,622 Out Of 65 $49.63 $3,226 Dependent 92 $523.21 $48,135 Network Points to consider: • Is there a specific demographic with higher utilization or costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[31]

ABC Training Company Office Visits Gauge your plan’s office visit utilization and costs compared to that of your peers. For this report, the data includes claims that were coded as office visit procedures. Visits per 1000 Average Paid per Visit Total Paid 4,000 $120 $500,000 $100 $400,000 3,000 $80 $300,000 2,000 $60 $200,000 $40 1,000 $20 $100,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 2,757 Actual avg paid/visit $83.64 Actual total paid $230,591 Norm visits 4,332 Norm avg paid/visit $112.80 Norm total paid $488,663 Amount over/under norm -1,575 Amount over/under norm ($29.16) Amount over/under ($258,072) Percent over/under norm -36.36% Percent over/under norm -25.85% norm Percent over/under -52.81% norm Points to consider: • Do you provide self-care information for common illness such as colds, ear infections, and allergies at the appropriate seasonal intervals? • Is your plan design competitive? • Do you encourage regular visits and follow-ups with a primary care provider? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[32]

ABC Training Company Office Visits by Demographic Evaluate a breakdown of your office care by demographics to illuminate cost drivers. Office Visits by Age Office Visits by Gender 18% 15% 38% 30% 62% 36% 0-19 20-39 40-59 60+ Male Female Age Range Number of Visits Average Paid per Visit Total Paid Gender Number of Visits Average Paid per Visit Total Paid 0-19 421 $59.11 $24,887 Male 1,061 $79.66 $84,522 20-39 833 $79.10 $65,893 Female 1,696 $86.13 $146,069 40-59 998 $91.98 $91,793 60+ 505 $95.09 $48,018 Office Visits by Network Office Visits by Relationship 6% 19% 12% 69% 94% In Network Out Of Network Employee Spouse Dependent Network Name Number of Average Paid per Total Paid Relationship Number of Visits Average Paid per Visit Total Paid Visits Visit Employee 1,897 $86.52 $164,127 In Network 2,674 $85.03 $227,377 Spouse 344 $100.16 $34,456 Out Of 174 $18.48 $3,215 Dependent 516 $62.03 $32,008 Network Points to consider: • Is there a specific demographic with higher utilization or costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[33]

ABC Training Company Office/Clinic Provider Usage Review the top 10 office or clinic providers. Office/Clinic Usage by Percentage 18% 28% ESSENTIA HEALTH ST MARYS DETRO SANFORD CLINIC FARGO REGION ESSENTIA HEALTH SANFORD CLINIC NORTH 14% SANFORD CLINIC HALSTAD ESSENTIA HEALTH FOSSTON CLINIC SANFORD BEMIDJI MAIN 2% ESSENTIA HEALTH ST MARYS MAHNO 2% ESSENTIA HEALTH PARK RAPIDS CL WHITE EARTH MENTAL HEALTH 4% Other 4% 9% 5% 6% 8% Provider Name Network Number of Visits Total Paid Percent of All Paid ESSENTIA HEALTH ST MARYS DETRO Yes 559 $41,382 17.95% SANFORD CLINIC FARGO REGION Yes 272 $33,342 14.46% ESSENTIA HEALTH Yes 164 $21,516 9.33% SANFORD CLINIC NORTH Yes 242 $18,539 8.04% SANFORD CLINIC HALSTAD Yes 157 $13,020 5.65% ESSENTIA HEALTH FOSSTON CLINIC Yes 141 $10,873 4.72% SANFORD BEMIDJI MAIN Yes 77 $9,774 4.24% ESSENTIA HEALTH ST MARYS MAHNO Yes 128 $8,538 3.70% ESSENTIA HEALTH PARK RAPIDS CL Yes 77 $5,637 2.44% WHITE EARTH MENTAL HEALTH Yes 55 $3,814 1.65% Points to consider: • If urgent care centers appear in this list, have you considered a communication campaign to encourage participants to use primary care providers? • How effective is your plan at steering participants to network providers? • Are there specialists in this list? Have you considered adding higher copays for specialists to encourage primary care provider usage? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[34]

ABC Training Company Chiropractic Visits Gauge your plan’s chiropractic utilization and costs compared to that of your peers. Visits per 1000 Average Paid per Visit Total Paid 2,000 $30 $60,000 $25 $50,000 1,500 $20 $40,000 1,000 $15 $30,000 $10 $20,000 500 $5 $10,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 771 Actual avg paid/visit $14.37 Actual total paid $11,078 Norm visits 2,106 Norm avg paid/visit $26.40 Norm total paid $55,595 Amount over/under norm -1,335 Amount over/under norm ($12.03) Amount over/under norm ($44,517) Percent over/under norm -63.39% Percent over/under norm -45.58% Percent over/under norm -80.07% Points to consider: • Is your plan design competitive? • Do you provide your employees with self-care and preventive information, such as ergonomic information and proper lifting techniques? • Does your plan encourage preventive care? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[35]

ABC Training Company Physical Therapy Visits Gauge your plan’s physical therapy utilization and costs compared to that of your peers. Visits per 1000 Average Paid per Visit Total Paid 1,000 $30 $40,000 800 $25 $30,000 $20 600 $15 $20,000 400 $10 $10,000 200 $5 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 214 Actual avg paid/visit $7.83 Actual total paid $1,677 Norm visits 1,195 Norm avg paid/visit $27.60 Norm total paid $32,992 Amount over/under norm -981 Amount over/under norm ($19.77) Amount over/under norm($31,315) Percent over/under norm -82.10% Percent over/under norm -71.62% Percent over/under norm -94.92% Points to consider: • Is your plan design competitive? • Does your plan encourage preventive care? • Is an effective wellness program in place to prevent the need for care for some lifestyle related conditions? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[36]

ABC Training Company Radiology Services Gauge your plan’s utilization of radiology services and related costs compared to that of your peers. Visits per 1000 Average Paid per Visit Total Paid 1,200 $120 $100,000 1,000 $100 $80,000 800 $80 $60,000 600 $60 $40,000 400 $40 200 $20 $20,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 916 Actual avg paid/visit $101.22 Actual total paid $92,720 Norm visits 1,484 Norm avg paid/visit $5.88 Norm total paid $8,730 Amount over/under norm -568 Amount over/under $95.34 Amount over/under norm $83,990 Percent over/under norm -38.29% norm Percent over/under norm 962.09% Percent over/under 1,621.04% norm Points to consider: • Would it be more cost effective to encourage the use of stand-alone facilities as an alternative to diagnostics in a hospital setting? • Is your plan design competitive? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[37]

ABC Training Company Inpatient Behavioral Health Gauge inpatient utilization for behavioral health care, focusing on frequency and cost of admissions. For this report, the data includes: • Admissions to an inpatient facility for overnight stays related to substance abuse or mental health. • Facility fees, such as hospital room and board, supplies, and ancillary services. • Professional services fees, such as physician, surgeon, and anesthesiologist. Admissions per 1000 Average Paid per Admission Total Paid 10 $6,000 $80,000 8 $5,000 $60,000 $4,000 6 $3,000 $40,000 4 $2,000 $20,000 2 $1,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual admissions 0 Actual avg $0 Actual total paid $0 Norm admissions 12 paid/admission Norm total paid $69,933 Amount over/under norm -11.73 Norm avg $5,961.25 Amount over/under norm($69,933) Percent over/under norm-100.00% paid/admission Percent over/under norm-100.00% Amount over/under ($5,961.25) norm Percent over/under -100.00% norm Points to consider: • Is your plan design competitive? • Have you considered an employee assistance program (EAP)? • Does your network include high-quality, low-cost providers? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[38]

ABC Training Company Inpatient Behavioral Health by Demographic Evaluate a breakdown of your inpatient behavioral health care by demographics to illuminate cost drivers. Inpatient Behavioral Health by Age Inpatient Behavioral Health by Gender No Data Available No Data Available Age Number of Average Paid per Total Gender Number of Average Paid per Total Range Admissions Admission Paid Admissions Admission Paid 0-19 0 $0.00 $0 Male 0 $0.00 $0 20-39 0 $0.00 $0 Female 0 $0.00 $0 40-59 0 $0.00 $0 60+ 0 $0.00 $0 Inpatient Behavioral Health by Network Inpatient Behavioral Health by Relationship No Data Available No Data Available Network Number of Average Paid per Total Relationship Number of Average Paid per Total Admissions Admission Paid Admissions Admission Paid In Network 0 $0.00 $0 Employee 0 $0.00 $0 Out Of 0 $0.00 $0 Spouse 0 $0.00 $0 Network Dependent 0 $0.00 $0 Points to consider: • Is there a specific demographic with higher utilization or costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[39]

ABC Training Company Outpatient Behavioral Health Gauge your plan’s outpatient behavioral health utilization and costs compared to that of your peers. For this report, the data includes claims that occurred in an outpatient setting for substance abuse or mental health diagnoses. Visits per 1000 Average Paid per Visit Total Paid 1,200 $200 $250,000 1,000 $200,000 $150 800 $150,000 600 $100 $100,000 400 $50 200 $50,000 0 $0 $0 Actual Norm Actual Norm Actual Total Norm Total Actual visits 725 Actual avg paid/visit $92.26 Actual total paid $66,890 Norm visits 1,380 Norm avg paid/visit $156.21 Norm total paid $215,506 Amount over/under norm -655 Amount over/under norm ($63.95) Amount over/under ($148,616) Percent over/under norm -47.45% Percent over/under norm -40.94% norm Percent over/under -68.96% norm Points to consider: • Do you have an effective employee assistance program (EAP)? • Is word-of-mouth winning out over network communication? If so, is it driving network utilization toward out-of-network providers? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[40]

ABC Training Company Outpatient Behavioral Health by Demographic Evaluate a breakdown of your outpatient behavioral health care by demographics to illuminate cost drivers. Outpatient Behavioral Health by Age Outpatient Behavioral Health by Gender 3% 27% 46% 46% 54% 24% 0-19 20-39 40-59 60+ Male Female Age Range Number of Visits Average Paid per Visit Total Paid Gender Number of Visits Average Paid per Visit Total Paid 0-19 333 $71.40 $23,775 Male 335 $76.28 $25,553 20-39 177 $100.68 $17,821 Female 390 $105.99 $41,337 40-59 193 $120.61 $23,278 60+ 22 $91.64 $2,016 Outpatient Behavioral Health by Network Outpatient Behavioral Health by Relationship 6% 48% 48% 94% 5% In Network Out Of Network Employee Spouse Dependent Network Number of Average Paid per Total Relationship Number of Visits Average Paid per Visit Total Paid Visits Visit Paid Employee 345 $111.46 $38,453 In Network 695 $86.89 $60,389 Spouse 34 $103.32 $3,513 Out Of 44 $147.74 $6,501 Dependent 346 $72.04 $24,924 Network Points to consider: • Is there a specific demographic with higher utilization or costs? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[41]

ABC Training Company Analysis by Major Diagnostic Category Evaluate your costs for all possible diagnoses grouped as major diagnostic categories, as established by the American Medical Association. MDC Total Paid Actual % of Total Norm Total Paid Norm % of Total $ Over/(Under) Circulatory System $848,751 19.08% $355,866 8.00% $492,885 Musculoskeletal System $757,995 17.04% $622,765 14.00% $135,230 Injury, Poisoning and Toxic Effects of Drugs $134,670 3.03% $44,483 1.00% $90,187 Hepatobiliary System and Pancreas $172,824 3.89% $88,966 2.00% $83,858 Factors Influencing Health Status $483,797 10.88% $400,349 9.00% $83,448 Myeloproliferative & Poorly Diff. Neoplasms $70,847 1.59% $0 0.00% $70,847 Kidney and Urinary Tract $155,071 3.49% $88,966 2.00% $66,105 Eye $89,963 2.02% $44,483 1.00% $45,480 Nervous System $264,099 5.94% $222,416 5.00% $41,683 Digestive System $438,534 9.86% $400,349 9.00% $38,185 Male Reproductive System $19,653 0.44% $0 0.00% $19,653 Respiratory System $93,774 2.11% $88,966 2.00% $4,808 Burns $2,854 0.06% $0 0.00% $2,854 Multiple Significant Trauma $357 0.01% $0 0.00% $357 Skin, Subcutaneous Tissue and Breast $162,023 3.64% $177,933 4.00% ($15,910) Female Reproductive System $104,534 2.35% $133,450 3.00% ($28,915) Newborns and Other Neonates $12,303 0.28% $44,483 1.00% ($32,180) Other $0 0.00% $44,483 1.00% ($44,483) Endocrine, Nutritional and Metabolic $121,844 2.74% $177,933 4.00% ($56,089) Pregnancy, Childbirth and the Puerperium $94,417 2.12% $177,933 4.00% ($83,516) Alcohol/Drug Use $47,820 1.08% $133,450 3.00% ($85,630) Mental Diseases and Disorders $116,896 2.63% $222,416 5.00% ($105,520) Ear, Nose, Mouth and Throat $124,234 2.79% $311,383 7.00% ($187,149) Infectious and Parasitic Diseases $63,952 1.44% $311,383 7.00% ($247,430) Blood and Blood-forming Organs $67,110 1.51% $355,866 8.00% ($288,756) Points to consider: • Are there any specific categories that could be further examined to assess whether a disease management strategy would be effective? • How do catastrophic claims affect specific categories? Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[42]

ABC Training Company Analysis by Major Diagnostic Category and Age Evaluate a breakdown of your costs by major diagnostic categories by age group to illuminate cost drivers. Circulatory System Musculoskeletal System Factors Influencing Health Status Digestive System Nervous System Hepatobiliary System and Pancreas Skin, Subcutaneous Tissue and Breast Kidney and Urinary Tract Injury, Poisoning and Toxic Effects of Drugs Ear, Nose, Mouth and Throat Endocrine, Nutritional and Metabolic Mental Diseases and Disorders Female Reproductive System Pregnancy, Childbirth and the Puerperium Respiratory System Eye Myeloproliferative & Poorly Diff. Neoplasms Blood and Blood-forming Organs Infectious and Parasitic Diseases Alcohol/Drug Use Male Reproductive System Newborns and Other Neonates Burns Multiple Significant Trauma Other $0 $100,000 $300,000 $500,000 $700,000 $900,000 Age 0-19 Age 20-39 Age 40-59 Age 60+ Points to consider: • What could be driving higher than expected costs for a specific MDC for a certain age group? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[43]

ABC Training Company Analysis by Major Diagnostic Category and Gender Evaluate a breakdown of your costs by major diagnostic categories by gender to illuminate cost drivers. Circulatory System Musculoskeletal System Factors Influencing Health Status Digestive System Nervous System Hepatobiliary System and Pancreas Skin, Subcutaneous Tissue and Breast Kidney and Urinary Tract Injury, Poisoning and Toxic Effects of Drugs Ear, Nose, Mouth and Throat Endocrine, Nutritional and Metabolic Mental Diseases and Disorders Female Reproductive System Pregnancy, Childbirth and the Puerperium Respiratory System Eye Myeloproliferative & Poorly Diff. Neoplasms Blood and Blood-forming Organs Infectious and Parasitic Diseases Alcohol/Drug Use Male Reproductive System Newborns and Other Neonates Burns Multiple Significant Trauma Other $0 $100,000 $300,000 $500,000 $700,000 $900,000 Male Female Points to consider: • What could be driving higher than expected costs for a specific MDC for either gender? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[44]

ABC Training Company Analysis by Major Diagnostic Category and Network Evaluate a breakdown of your costs by major diagnostic categories by network to illuminate cost drivers. Circulatory System Musculoskeletal System Factors Influencing Health Status Digestive System Nervous System Hepatobiliary System and Pancreas Skin, Subcutaneous Tissue and Breast Kidney and Urinary Tract Injury, Poisoning and Toxic Effects of Drugs Ear, Nose, Mouth and Throat Endocrine, Nutritional and Metabolic Mental Diseases and Disorders Female Reproductive System Pregnancy, Childbirth and the Puerperium Respiratory System Eye Myeloproliferative & Poorly Diff. Neoplasms Blood and Blood-forming Organs Infectious and Parasitic Diseases Alcohol/Drug Use Male Reproductive System Newborns and Other Neonates Burns Multiple Significant Trauma Other $0 $100,000 $300,000 $500,000 $700,000 $900,000 In Network Out of Network Points to consider: • What factors contribute to out of network utilization? • Is there an opportunity to negotiate discount arrangements with specific providers? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[45]

ABC Training Company Analysis by Major Diagnostic Category and Relationship Evaluate a breakdown of your costs by major diagnostic categories by relationship to illuminate cost drivers. Circulatory System Musculoskeletal System Factors Influencing Health Status Digestive System Nervous System Hepatobiliary System and Pancreas Skin, Subcutaneous Tissue and Breast Kidney and Urinary Tract Injury, Poisoning and Toxic Effects of Drugs Ear, Nose, Mouth and Throat Endocrine, Nutritional and Metabolic Mental Diseases and Disorders Female Reproductive System Pregnancy, Childbirth and the Puerperium Respiratory System Eye Myeloproliferative & Poorly Diff. Neoplasms Blood and Blood-forming Organs Infectious and Parasitic Diseases Alcohol/Drug Use Male Reproductive System Newborns and Other Neonates Burns Multiple Significant Trauma Other $0 $100,000 $300,000 $500,000 $700,000 $900,000 Employee Spouse Dependent Points to consider: • What could be driving higher than expected costs for a specific MDC for a particular relationship? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[46]

ABC Training Company Lifestyle Evaluate your costs for lifestyle related claims, grouped by body system, as defined by and compared to Truven Health Analytics Inc. Patients per 1000 Average Paid per Patient Total Paid Body System Actual Norm Variance Actual Norm Variance Actual Norm Variance Breast 6 6 6.80% $2,382.93 $9,476.86 -74.86% $19,064 $70,990 -73.15% Cardiovascular 26 17 59.26% $7,622.27 $5,687.98 34.01% $259,157 $121,433 113.42% CNS 11 7 45.55% $2,471.53 $4,333.07 -42.96% $34,602 $41,677 -16.98% Dermatological 5 7 -26.22% $747.34 $1,395.86 -46.46% $5,232 $13,243 -60.50% Endocrine 110 150 -26.58% $489.65 $395.61 23.77% $69,041 $75,981 -9.13% ENT 12 3 311.64% $1,221.35 $3,193.45 -61.75% $18,320 $11,637 57.43% Gastrointestinal 16 16 1.91% $2,977.49 $2,620.35 13.63% $62,527 $53,997 15.80% Gynecological 3 2 76.30% $754.45 $7,156.76 -89.46% $3,018 $16,237 -81.41% Hepatobiliary 12 6 81.49% $10,237.55 $8,128.79 25.94% $153,563 $67,185 128.57% Immunologic 0 1 -100.00% $0.00 $1,526.96 -100.00% $0 $2,872 -100.00% Male Genital 1 3 -69.65% $119.67 $6,039.75 -98.02% $120 $19,899 -99.40% Miscellaneous 23 24 -0.91% $1,079.69 $982.19 9.93% $32,391 $29,737 8.92% Multisystem 73 141 -48.16% $246.12 $215.43 14.24% $23,135 $39,059 -40.77% Musculoskeletal 53 54 -1.42% $3,576.02 $2,399.40 49.04% $243,170 $165,511 46.92% Psychiatric 81 53 52.46% $635.43 $670.71 -5.26% $66,084 $45,753 44.44% Renal and UT 2 1 31.56% $20,508.43 $6,633.45 209.17% $41,017 $10,085 306.73% Respiratory 57 94 -39.67% $703.45 $625.65 12.43% $51,352 $75,705 -32.17% Vascular 10 9 14.47% $9,991.18 $2,706.95 269.09% $129,885 $30,743 322.49% Total 502 594 -15.55% $65,764.55 $64,189.22 2.45% $1,211,677 $891,746 35.88% Points to consider: • Are there any specific systems that could be further examined to assess whether a disease management or communication strategy would be effective? • How do catastrophic claims affect specific categories? Norm Source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[47]

ABC Training Company Lifestyle-Related Claims Assess your plan’s costs related to lifestyle-related categories. For this report, the data includes a sampling of categories that, in theory, could be reduced or eliminated given a change in behavior. 27% Points to consider: • Are there opportunities to address certain categories via communication and awareness? • Could a wellness program improve your lifestyle- related costs? 73% Lifestyle Non-Lifestyle Amount paid Heart $366,829 Accident $235,427 Cerebro $157,025 Disc $130,505 Respiratory $79,925 Kidney $73,552 Diabetes $62,360 Alcohol $49,217 Breast $19,064 High Blood Pressure $16,914 Hernia $11,443 Obesity $8,262 Skin $5,548 Uterine $3,018 Stress $370 $0 $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[48]

ABC Training Company Lifestyle-Related Claims by Age Evaluate a breakdown of your costs by lifestyle-related categories by age group to illuminate cost drivers. Amount Paid Heart Accident Cerebro Disc Respiratory Kidney Diabetes Alcohol Breast High Blood Pressure Hernia Obesity Skin Uterine Stress $0 $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 Age 0-19 Age 20-39 Age 40-59 Age 60+ Points to consider: • How can you structure communication and delivery strategies to impact appropriate audiences? • Could a wellness program improve your lifestyle-related costs? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[49]

ABC Training Company Lifestyle-Related Claims by Gender Evaluate a breakdown of your costs by lifestyle-related categories by gender to illuminate cost drivers. Amount Paid Heart Accident Cerebro Disc Respiratory Kidney Diabetes Alcohol Breast High Blood Pressure Hernia Obesity Skin Uterine Stress $0 $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 Male Female Points to consider: • How can you structure communication and delivery strategies to impact appropriate audiences? • Could a wellness program improve your lifestyle-related costs? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[50]

ABC Training Company Lifestyle-Related Claims by Network Affiliation Evaluate a breakdown of your costs by lifestyle-related categories by network to illuminate cost drivers. Amount Paid Heart Accident Cerebro Disc Respiratory Kidney Diabetes Alcohol Breast High Blood Pressure Hernia Obesity Skin Uterine Stress $0 $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 In Network Out of Network Points to consider: • What factors contribute to out of network utilization? • Could a wellness program improve your lifestyle-related costs? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[51]

ABC Training Company Lifestyle-Related Claims by Relationship Evaluate a breakdown of your costs by lifestyle-related categories by relationship to illuminate cost drivers. Amount Paid Heart Accident Cerebro Disc Respiratory Kidney Diabetes Alcohol Breast High Blood Pressure Hernia Obesity Skin Uterine Stress $0 $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 Employee Spouse Dependent Points to consider: • How can you structure communication and delivery strategies to impact appropriate audiences? • Could a wellness program improve your lifestyle-related costs? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[52]

ABC Training Company Preventive Care Evaluate utilization and costs associated with preventive care, as defined by and compared to Truven Health Analytics Inc. Actual Paid per member per year Norm Visits per 1000 Services per 1000 Avg paid per visit Avg paid per service Total paid Preventive Care Actual Norm Amount Over/Under Norm Percent Over/Under Norm Paid per member per year $38.17 $62.61 ($24.45) -39.04% Visits per 1000 188 457 -269 -58.93% Services per 1000 232 449 -217 -48.26% Avg paid per visit $203.36 $137.01 $66.35 48.42% Avg paid per service $164.46 $139.58 $24.89 17.83% Total paid $49,010 $80,397 ($31,387) -39.04% Points to consider: • Are plan participants encouraged to use preventive care services? • Are effective wellness initiatives in place to address needs relevant to your plan participants? Norm Source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[53]

ABC Training Company Preventive Care by Demographic Evaluate a breakdown of your preventive care claims by demographics to illuminate opportunities. This exhibit incorporates preventive care as defined by Truven Health Analytics Inc. Preventive Care Visits by Age Preventive Care Visits by Gender 15% 40% 42% 27% 58% 18% 0-19 20-39 40-59 60+ Male Female Age Range Number of Visits Average Paid per Visit Total Paid Gender Number of Visits Average Paid per Visit Total Paid 0-19 97 $169.20 $16,412 Male 101 $185.79 $18,765 20-39 43 $217.58 $9,356 Female 140 $216.03 $30,245 40-59 66 $234.49 $15,476 60+ 35 $221.87 $7,765 Preventive Care by Network Affiliation Preventive Care by Relationship 8% 41% 49% 92% 10% In Network Out Of Network Employee Spouse Dependent Network Number of Average Paid per Total Relationship Number of Visits Average Paid per Visit Total Paid Visits Visit Paid Employee 118 $224.55 $26,497 In Network 232 $204.22 $47,378 Spouse 23 $232.89 $5,356 Out Of 20 $81.57 $1,631 Dependent 100 $171.57 $17,157 Network Points to consider: • Is there a specific demographic that is underutilizing preventive care services? • How can you structure communication and delivery strategies to impact appropriate audiences? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[54]

ABC Training Company Preventive Care Top 10 Services Evaluate your top preventive care services. This exhibit incorporates preventive care as defined by Truven Health Analytics Inc. 1% PREV VISIT, EST, AGE 40-64 1% PREV VISIT, EST, AGE 18-39 2% PREV VISIT, EST, AGE 1-4 2% PREV VISIT, EST, AGE 5-11 4% PREV VISIT, EST, INFANT 5% PREV VISIT, EST, AGE 12-17 6% PREV VISIT, NEW, AGE 40-64 PREV VISIT, NEW, AGE 18-39 41% PREV VISIT, NEW, AGE 5-11 PREV VISIT, NEW, AGE 12-17 8% Other 12% 18% Service Claims Total Paid Average Paid Percent of Total Paid PREV VISIT, EST, AGE 40-64 99 $20,324.31 $205.30 41.47% PREV VISIT, EST, AGE 18-39 45 $8,629.23 $191.76 17.61% PREV VISIT, EST, AGE 1-4 38 $6,115.20 $160.93 12.48% PREV VISIT, EST, AGE 5-11 21 $3,768.26 $179.44 7.69% PREV VISIT, EST, INFANT 38 $2,866.46 $75.43 5.85% PREV VISIT, EST, AGE 12-17 30 $2,376.36 $79.21 4.85% PREV VISIT, NEW, AGE 40-64 10 $2,106.82 $210.68 4.30% PREV VISIT, NEW, AGE 18-39 7 $980.02 $140.00 2.00% PREV VISIT, NEW, AGE 5-11 3 $743.32 $247.77 1.52% PREV VISIT, NEW, AGE 12-17 4 $542.70 $135.68 1.11% Points to consider: • Are the types of services consistent with your demographics? • Is there an opportunity to promote specific services through communication and education? Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[55]

ABC Training Company Wellness Visits Assess the number and percentage of plan participants who are participating in wellness initiatives as well as total paid claims categorized as wellness services. For this report, the data includes claims that were segmented by definitions of diagnoses and procedure codes set by the US Preventive Services Task Force (USPSTF) as preventive care. Points to consider: Paid • Are your plan participants encouraged to utilize preventive care services? 4% • Have you considered conducting health risk assessments? • Are effective wellness initiatives in place to address needs relevant to your plan participants? 96% Wellness Other People Vision Screening (adult) 248 Preventive Care Checkups 217 Cholesterol Screening 167 Immunizations 139 Breast Cancer Screening 93 Cervical Cancer Screening 69 Healthy Pregnancy - Prenatal Diagnosis 58 Diabetes Screening 55 Healthy Pregnancy - Rh(D) Incompatibility 35 Prostate Cancer Screening 26 Sexually Transmitted Infection Screenings 26 Vision screening (child) 21 Abdominal Aortic 20 Colorectal Cancer Screening 16 Healthy Pregnancy - Rubella 11 Contraceptive Use - Prevention Intervention 6 Smoking cessation treatment 6 Blood Pressure Screening 2 Childhood Health Promotion 2 0 20 40 60 80 100 120 140 160 180 200 220 240 260 Wellness participants 603 Percentage of wellness participants 46.96% Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[56]

ABC Training Company Arthritis Assess the impact of arthritis on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of arthritis. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 60 $10,000 $250,000 50 $8,000 $200,000 40 $6,000 $150,000 30 $4,000 $100,000 20 10 $2,000 $50,000 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 72 Average paid/claimant $3,391.93 Actual total paid $244,219 Norm patients 24 Norm paid/claimant $8,367.54 Norm total paid $199,916 Amount over/under norm 48 Amount over/under ($4,975.61) Amount over/under $44,302 Percent over/under norm 201.36% norm norm Percent over/under -59.46% Percent over/under norm 22.16% norm Points to consider: • Is there an opportunity to better manage costs related to arthritis? • Have you considered starting the conversation with a communication campaign? For general health information on arthritis, refer to: • Arthritis Foundation, www.arthritis.org. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[57]

ABC Training Company Asthma/Chronic Obstructive Pulmonary Disease Assess the impact of asthma and chronic obstructive pulmonary disease (COPD) on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of asthma or COPD. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 20 $800 $20,000 15 $600 $15,000 10 $400 $10,000 5 $200 $5,000 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 24 Average paid/claimant $726.96 Actual total paid $17,447 Norm patients 22 Norm paid/claimant $534.77 Norm total paid $11,499 Amount over/under norm 2 Amount over/under norm $192.20 Amount over/under norm $5,948 Percent over/under norm 11.61% Percent over/under norm 35.94% Percent over/under norm 51.73% Points to consider: • Is there an opportunity to better manage costs related to asthma and COPD? • Have you considered starting the conversation with a communication campaign? For general health information on asthma and chronic obstructive pulmonary disease, refer to: • American Lung Association, www.lungusa.org. • Asthma and Allergy Foundation of America, www.aafa.org. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[58]

ABC Training Company Cancer Assess the impact of cancer on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of cancer. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 25 $10,000 $150,000 20 $8,000 $100,000 15 $6,000 10 $4,000 $50,000 5 $2,000 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 30 Average paid/claimant $4,736.63 Actual total paid $142,099 Norm patients 17 Norm paid/claimant $8,238.49 Norm total paid $137,782 Amount over/under norm 13 Amount over/under ($3,501.85) Amount over/under $4,317 Percent over/under norm 79.38% norm norm Percent over/under -42.51% Percent over/under norm 3.13% norm Points to consider: • Is there an opportunity to better manage costs related to cancer? • Have you considered starting the conversation with a communication campaign? For general health information on cancer, refer to: • American Cancer Society, www.cancer.org Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[59]

ABC Training Company Depression Assess the impact of depression on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of depression. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 60 $1,000 $80,000 50 $800 $60,000 40 $600 30 $40,000 $400 20 $20,000 10 $200 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 69 Average paid/claimant $657.80 Actual total paid $45,389 Norm patients 72 Norm paid/claimant $985.67 Norm total paid $70,648 Amount over/under norm -3 Amount over/under norm ($327.86) Amount over/under norm ($25,260) Percent over/under norm -3.73% Percent over/under norm -33.26% Percent over/under norm -35.75% Points to consider: • Is there an opportunity to better manage costs related to depression? • Have you considered starting the conversation with a communication campaign? For general health information on depression, refer to: • National Mental Health Association, www.nmha.org. • National Institute for Mental Health, www.nimh.nih.gov. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[60]

ABC Training Company Diabetes Assess the impact of diabetes on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of diabetes. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 80 $800 $80,000 60 $600 $60,000 40 $400 $40,000 20 $200 $20,000 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 92 Average paid/claimant $693.52 Actual total paid $63,804 Norm patients 88 Norm paid/claimant $422.84 Norm total paid $37,379 Amount over/under norm 4 Amount over/under norm $270.68 Amount over/under norm $26,425 Percent over/under norm 4.07% Percent over/under norm 64.01% Percent over/under norm 70.69% Points to consider: • Is there an opportunity to better manage costs related to diabetes? • Have you considered starting the conversation with a communication campaign? For general health information on diabetes, refer to: • Centers for Disease Control Prevention, www.cdc.gov/diabetes. • American Diabetes Association, www.diabetes.org. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[61]

ABC Training Company Heart Disease Assess the impact of heart disease on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of heart disease. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 200 $250 $40,000 $200 150 $30,000 $150 100 $20,000 $100 50 $10,000 $50 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 123 Average Paid/Claimant $227.19 Actual total paid $27,945 Norm patients 196 Norm Paid/Claimant $201.72 Norm total paid $39,519 Amount over/under norm -73 Amount over/under norm $25.48 Amount over/under norm ($11,574) Percent over/under norm -37.22% Percent over/under norm 12.63% Percent over/under norm -29.29% Points to consider: • Is there an opportunity to better manage costs related to heart disease? • Have you considered starting the conversation with a communication campaign? For general health information on heart disease, refer to: • American Heart Association, www.heart.org. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[62]

ABC Training Company Low Back Pain Assess the impact of low back pain on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of low back pain. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 140 $1,000 $100,000 120 $800 $80,000 100 80 $600 $60,000 60 $400 $40,000 40 $200 $20,000 20 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 102 Average paid/claimant $818.54 Actual total paid $83,492 Norm patients 177 Norm paid/claimant $382.13 Norm total paid $67,561 Amount over/under norm -75 Amount over/under norm $436.41 Amount over/under norm $15,930 Percent over/under norm -42.31% Percent over/under norm 114.20% Percent over/under norm 23.58% Points to consider: • Is there an opportunity to better manage costs related to low back pain? • Have you considered starting the conversation with a communication campaign? For general health information on low back pain, refer to: • American Academy of Orthopaedic Surgeons, www.orthoinfo.aaos.org. • American Chiropractic Association, www.acatoday.org. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[63]

ABC Training Company Obesity Assess the impact of obesity on your participants and plan compared to that of your peers. For this report, the data includes only costs associated with the primary diagnosis of obesity. The total cost of care for an affected patient is not considered in this exhibit. Patients per 1000 Average Paid per Claimant Total Paid 20 $2,500 $40,000 $2,000 15 $30,000 $1,500 10 $20,000 $1,000 5 $10,000 $500 0 $0 $0 Actual Norm Average Norm Actual Total Norm Total Actual patients 23 Average paid/claimant $362.41 Actual total paid $8,335 Norm patients 18 Norm paid/claimant $2,215.75 Norm total paid $39,341 Amount over/under norm 5 Amount over/under ($1,853.34) Amount over/under norm($31,006) Percent over/under norm 29.54% norm Percent over/under norm -78.81% Percent over/under -83.64% norm Points to consider: • Is there an opportunity to better manage costs related to obesity? • Have you considered starting the conversation with a communication campaign? For general health information on obesity, refer to: • Centers for Disease Control Prevention, www.cdc.gov/obesity. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[64]

ABC Training Company At - A - Glance General Information Total Employees 831 Total Covered Lives 1,284 Total Claim Charges $11,081,670.86 Total Claim Payments $4,448,321.55 Area Actual Norm Difference Experience Health Plan Costs $8,295 $8,412 -1.39% Favorable Medical Claims Costs $4,480 $3,738 19.84% Unfavorable Inpatient Analysis - Admissions/1000 0 67 N/A Not Available Inpatient Analysis - Average Paid/Admission $0 $18,419 N/A Not Available Maternity Admissions/1000 0 25 N/A Not Available Maternity Average Paid/Admission $0 $4,402 N/A Not Available Outpatient Surgery/1000 738 1,377 -46.44% Favorable Outpatient Surgery Average Paid $204 $145 40.86% Unfavorable Emergency Room Visits/1000 360 284 26.86% Unfavorable Emergency Room Average Paid $900 $346 160.56% Unfavorable Office Visits Visits/1000 2,147 3,374 -36.36% Favorable Office Visits Average Paid $84 $113 -25.85% Favorable Chiropractic Visits/1000 600 1,640 -63.39% Favorable Chiropractic Average Paid/Visit $14 $26 -45.58% Favorable Physical Therapy Visits/1000 167 931 -82.10% Favorable Physical Therapy Paid/Visit $8 $28 -71.62% Favorable Radiology Visits/1000 713 1,156 -38.32% Favorable Radiology Paid/Visit $101 $6 1,621.04% Unfavorable IPMH Admissions/1000 0 9 N/A Not Available IPMH Average Paid/Admission $0 $5,961 N/A Not Available Outpatient Mental Health Visits/1000 565 1,074 -47.45% Favorable Outpatient Mental Health Average Paid/Visit $92 $156 -40.94% Favorable Norm source: "Employer Health Benefits 2014 Annual Survey", The Henry J. Kaiser Family Foundation and Health Research and Educational Trust, September 2014. Norm source: Copyright ©2018 Truven Health Analytics Inc. MarketScan® Research Databases. All rights reserved. Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[65]

ABC Training Company Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[66]

ABC Training Company Copyright @ 2017 Zywave, Inc. 351737 - January 1, 2018 - December 31, 2018[67]