St Louis Public Schools 2010 Benefits Renewals MEDICAL = 9.7%

1. St Louis Public Schools 2010 Benefits Renewals MEDICAL = 9.7% Effective 1/1/2010 November 5, 2009

2. AGENDA • 2009 Historical Renewal Summary • Medical - 2010 Renewal Summary and Joint Benefit Committee Recommendation • RX - 2010 Renewal Summary and Joint Benefit Committee Recommendation • Dental - 2010 Renewal Summary and Joint Benefit Committee Recommendation • Life, STD, LTD, Vision - 2010 Renewal Summary and Joint Benefit Committee Recommendation • Cost Containment Strategies for 2011 2

3. 2009 Historical Renewal Summary • Holmes Murphy managed the RFP Process and 66 Insurance Companies and TPA’s were asked to quote. 62 Proposals were received. • Joint Benefit Committee participated in finalist presentations by UHC, Anthem, Caremark, Medco, Express Scripts, MetLife, Guardian, and BJC. • Pharmacy vendor change from CareMark to Medco. • Dental carrier change from Guardian and St. Louis Dental Care to UnitedHealthcare. • Life insurance carrier change from Reliance Standard Life to UnitedHealthcare. Increased benefit from $30,000 Life to $40,000 Life and AD&D. 3

4. 2009 Historical Renewal Summary 4

5. 2010 Renewal Summary – Medical • MEDICAL RENEWAL SUMMARY: • 14% Initial premium increase from UnitedHealthcare as expected from 2009; however, revised to 9.7% increase after medical marketing. • This reduced the annual estimated District responsibility for the Active population from $21,012,731 to $20,203,147. • 88% Loss Ratio – Paid Premium versus Paid Claims 6/08-5/09 • Renewal includes continuation of the Wellness Plan • Wellness eligible incentive dollars totals $556,675 which is funded by UnitedHealthcare • Modest plan design changes were reviewed; however, no significant premium savings available without drastically reducing employee/retiree benefits • Joint Benefit Committee Recommendation: • Renew with current plan designs at 14% rate increase. However, now increase is 9.7% 5

6. 2010 Renewal Summary - Rx • Rx RENEWAL SUMMARY: • 8.3% Premium increase recommended • Premium increase determined by claims utilization from 6/08-5/09 plus 9% annualized trend • Joint Benefit Committee Recommendation: • Maintain current benefit levels at recommended 8.3% premium increase 6

7. 2010 Renewal Summary - Dental • DENTAL RENEWAL SUMMARY: • 6% Premium increase from UnitedHealthcare • 71.5% Loss Ratio – Paid Premiums versus Paid Claims 1/09 – 5/09 • Joint Benefit Committee Recommendation: • Maintain current benefit levels at 6% rate increase 7

8. 2010 Renewal Summary – Life, STD, LTD, Vision LIFE, STD, LTD, VISION RENEWAL SUMMARY: • All under rate guarantee for 2010 (no increase from 2009) • Life and Dental Packaged Savings Discount still applies to the Medical Premium throughout 2010 Joint Benefit Committee Recommendation: Maintain current benefit levels at current rates 8

9. 2011 Cost Containment Strategies The District is considering several options to help control future costs: • Dependent audit • More emphasis on premium statement reviews/audits • Continued Wellness efforts • More Wellness and Disease Management claim analysis • Aggressive dialogue with JBC regarding additional strategies 9