Employee Benefit Workshop 2009

2. Employee Benefit Workshop 2009 • National Trends • IBBP Information • Analysis of the Plan • Wellness

3. National Health Care Trends • Over the past five years, the percentage of U.S population covered by health insurance has been constant – hovering around 84%

5. Coverage by Type of Health Insurance • The most recent data shows nationally, 72% of individuals have a traditional plan design, 20% HMO coverage and 8% HDHP HSA qualified

6. Employer Contributions • Nationally, the average annual employer premium contribution for family health coverage is 73.5%

7. Healthcare in Iowa • The number of Iowans without health insurance is 9.9%, compared to the national average of 15.3%

9. Employee Benefit Workshop 2009 • National Trends • IBBP Information • Analysis of the Plan • Wellness

11. Iowa Bankers Benefit Plan insures 28,501 people for health coverage.

12. IBBP Trust Reserve August 2009 $18,090,059 December 2008 $17,133,978 2008 Actuarial Certification Amount $8,050,445 December 2007 $16,996,278 2007 Actuarial Certification Amount $6,835,781 December 2006 $12,426,176 2006 Actuarial Certification Amount $7,419,510 December 2005 $5,539,728 2005 Actuarial Certification Amount $6,809,749 December 2004 $9,301,531 2004 Actuarial Certification Amount $$7,589,751 December 2003 $9,910,486 2003 Actuarial Certification Amount $6,038,208

13. 2008 Administrative Expense Ratio • 2008 Total Premiums $86,822,871 • Wellmark Administrative Fees -$4,627,118 • Plus IBIS Administrative Expense -$4,253,371 • Other Expense - Audit Expense -$23,983, Legal Expense - $30,591,Misc $642 • Total Administrative Expense $8,935,705 or • 10.3% Administrative Expense Ratio

14. Employee Benefit Workshop 2009 • National Trends • IBBP Information • Analysis of the Plan • Wellness

15. IBBP Total Claims Paid

16. Average Cost per Member • Over the past 12 months, the Plan paid $3,049 per member, increase of 15% over the past 4 years

18. Health and Pharmacy claims paid per member increased 9% mainly due to inpatient services Provider Savings totaled $44,547,715 or 36% of covered charges Members were liable for $12,557,980 or 20% of covered charges, down 1% from the previous year Medicare coordination and other COB savings totaled $2,122,639 143 members had claims in excess of $50,000 accounting for 22% of claims paid One claim hit stop loss-the total dollar amount is in excess of - $1,600,000 Major Trend Drivers

19. Nearly 29% of facility claims are paid outside the state of Iowa

20. The Plan paid out over $11 million in prescription drug claims in 2008—a cost increase of more than 11% from the year prior. • 63.6% of Plan members purchased a generic drug, which is 3.5% less compared to other health plans. • The three most costly drug classes paid for under the Plan are: • Therapeutic drugs (prescribed for cancer treatment or organ transplants) (10%) • Antidepressants (9%) • Anti-cholesterol drugs (8%)

21. Drug Claims 2004 to Current Date

22. Pharmacy