received a net increase of 23% which is an average of 3% annually. The group has maintained the same carrier and same union negotiated benefits for 7 of the 8-years. In addition, as part of the level-funded agreement where the group shares in any surplus, they have received administrative credits in 5 of the 8 years totaling $175,000+. This past year’s surplus ($70,000) equated to a 12% premium equivalent, so they have performed far superior to their 23% net increase over 8 years when surplus amounts are factored in. In 2013, we took the dental program self-funded and in the first year saved $35,000 in total cost. The dental program has significantly outperformed the fully insured equivalent rate for the last 7 years saving the group thousands of dollars annually. Example 4 – Innovative Strategic Solution – PEO Solution 100 employee hardware store chain with 17 locations. We consulted with the group 3 months prior to their 11/1/19 renewal where they were receiving a 9% increase to their benefit costs. We submitted the group to one of our preferred PEO partners who offered a -30% decrease under the benefit renewal cost (21% under current costs). This allowed the group to reconfigure their plans and contributions for the better, and still manage to obtain a -5% renewal under current costs. In addition, prior to the PEO taking over, the group needed to recruit a new controller and with our assistance and that of the PEO’s recruiting department we were able to provide two controller candidates. They were so happy with the candidates, that they ended up hiring both. Example 5 – Innovative Strategic Solution – Rx Carve Out 900 employee not-for-profit organization. While this employer is significantly larger than Iroquois, as you continue to grow and self-funding your medical program perhaps becomes a reality you may consider an Rx carve out program. An Rx carve out program is when a group partners directly with a pharmacy benefit manager, instead of through the carrier. In this example the client was working with two national brokerage firms who failed to advise them to explore this option. Therefore, they accepted our offer to review their Rx programs through OptumRx. Through our analysis we discovered that if they partnered directly with OptumRx instead of through their carrier they could obtain more favorable contract provisions; lower dispensing fees, lower ingredient costs, greater rebate shares etc. The guaranteed minimum savings over a 3-year period was 2.4million with no change to the PBM (they still use OptumRx), the plan designs or the drug formulary. All the savings were driven solely by renegotiating the terms and provisions of the pharmacy contract. We believe that these ‘think outside the box’ strategies are what differentiates our firm from other brokerage agencies as we have extensive experience with a wide variety of cost containment programs, vendors and products. Performance Monitoring F. Performance Monitoring 1. Describe how the firm evaluates/monitors a benefit provider’s performance. 2. Describe how the firm monitors claims and offers suggestions for plan designs to meet the needs of participants. 22