H.O.P.S Program 2024

H.O.P.S. Program Healthcare Optimization & Profit Strategy

Healthcare solutions built for the craft beer community

We don’t see healthcare for what it is.

We see it for what it can be.

Whether promoting local beer or advocating for favorable laws and lower excise tax rates, we believe the collective voice of the craft beer industry speaks louder than that of individual brewers alone.

This aligns with Sterling Seacrest Pritchard’s core philosophy that we are StrongerTogether. Our purpose is to serve the craft beer industry by solving the challenges in the current healthcare landscape.

Our unique approach to managing risk, provides breweries with the ability to build culture, foster collaboration & inclusion, while reducing one of the top costs on their P&L. H.O.P.S. (Healthcare Optimization & Profit Strategy) is the result of years of discipline, research, collaboration and learning and has allowed us to tailor solutions to meet the specific needs of the craft beer industry.

Stronger Together

CRAFT BEER INDUSTRY

BY THE NUMBERS…

+ Demographics & Risk Profile 70% male population

45% of population are in their 20s 35% of population are in their 30s < 2% of population are 50 yrs +

_ Average size of craft brewery

(< 50) employees (small group market)

_ Average number enrolled in health insurance (20) employees or less

_ Number of major medical carriers

(4) traditional carrier / networks (3 if < 20 enrolled)

_ Types of group insurance plans

(2) Fully-insured or Level-Funded (most competitive)

_ Available cost-containment programs (0) (Carriers retain 100% control & profits)

H.O.P.S. Program

Medical Plans with cost containment Designed to reduce costs while enriching coverage and boosting employee satisfaction

The Difference Is In The Details Traditional means of reducing medical premiums require more cost shifting to employees, resulting in higher deductibles and out-of-pocket costs. We believe this is an ineffective strategy. H.O.P.S. challenges this mindset with medical plans engineered to address the top cost drivers and cap employee and employer claims liability.

Our proven cost containment programs flatten the healthcare trend and provide participating breweries with multiple streams of redirected profits. The combination managing claims and re-directing carrier profits, allows employers to maintain flatter and more predictable costs – allowing for richer plans at the same cost.

Plan Administration & Employee Steerage o Better plan oversight reduces paid claims, delivering plan savings of 15%-20% o Our TPA partner optimizes the program behind the scenes, leveraging multiple cost saving programs o Fully transparent costs and real-time data & analytics eliminate surprises at renewal o Customized data & analytics provide the roadmap for future enhancements to our H.O.P.S. program

Integrated Pharmacy Savings Program o Our Rx program allows employees to obtain high-cost brand & specialty medications for $0 copays o Reduced pharmacy costs create a healthier claims experience, reducing the need for cost increases o Pharmacy rebates traditionally paid to insurance carriers, are paid directly to your brewery instead

Shared Risk Pool & Block Renewals o Craft Breweries pool together their exceptional risk profile in a fully-credible pool o Block renewals provide the most predictable and balanced year-to-year costs o On average, groups save enough in their first 4 years, to fully fund their 5th year

Understanding the healthcare landscape Understanding the pros & cons of health insurance funding options

Fully-insured

Level-funding

Fixed Premium Invoice

Fixed Premium & Administration Invoice

o Risk exposure tied to individual employer

o Risk exposure tied to individual employer

o Insurance carrier covers claims liability

o Insurance carrier covers claims liability

o Insurance company retains 100% of claims surplus

o Limited share of claims surplus from carrier

o Monthly insurance premiums cover everything

o Monthly insurance premiums cover everything

o No access to claims / population health data

o Limited access to claims / population health data

o No cost containment opportunities

o No cost containment opportunities

o Medical renewal based off employer’s experience

o Medical renewal based off employer’s experience

Self-funding

HOPS. . . .

Healthcare Optimization & Profit Strategy

Fixed Premium & Administration Invoice

Fixed Premium & Administration

o Risk exposure tied to individual employer

o Risk exposure is shared across 200 + employers

o Employer/Stop Loss covers claims liability

o Employer/Shared Risk/SL covers variable (claims)

o Employer retains 100% of unused claims

o Employers retain 100% of unused claims funding

o Multiple invoices for TPA, admin fees, stop loss

o Monthly premium equivalent covers everything

premiums, network access fees, broker fees, and

o $0 Virtual care + $0 Mental & Behavioral Health

claims below the up to the stop loss deductible

o Full claims / population health data & reporting

o Full claims / population health data & reporting

o Integrated cost-containment reduces claims/costs

o Multiple cost-containment programs available

o Pharmacy benefits reduce employer claims/costs

o Specialty Rx carve outs reduce claims and costs

o Employer receives 100% of pharmacy rebates

o Employers receive 100% of pharmacy rebates

o Block renewals based off experience of the pool

o Medical renewal based off employer’s experience

o Accelerated underwriting – without apps! o Path to isolate brewery risk pool (SIC 2082)

THE POWER OF CREDIBILITY, COUPLED WITH SHARED RISK. NOT YOUR TRADITIONAL

ASSOCIATION PROGRAM

H.O.P.S. provides a better alternative for breweries who feel trapped by the rising cost of health insurance.

By pooling together, the exceptional risk profile of craft beer industry and pairing that with our innovative cost containment programs, we address loss leaders in healthcare, and re-direct traditional carrier profits back to your brewery’s bottom line.

This combination of claims management and redirected revenue streams, allows our clients to maintain and/or enhance the value of employee benefits, without driving up the cost of healthcare.

From underwriting, to claims management and administration, H.O.P.S.’ holistic approach keeps it simple. Breweries have the benefit and protection of risk sharing, which all but eliminates shock renewals.

Our end-to-end support provides the flexibility and information you need to make fact-based decisions for happier, healthier employees, at the lowest cost.

2024 PROGRAM

UPDATES We can offer groups short or long contract periods, to bring them into alignment with H.O.P.S.’ July 1st block renewals forward.

o o o o o

Cost efficiency offers 80-85% variable spend Best pooled risk/ROI model available Block renewals provide year-to-year stability Thorough, regular, and transparent reporting Turnkey solution enhances employee experience

50 310 STATES

200+

CITIES

EMPLOYERS

IN CURRENT

RISK POOL

37,140+

NUMBER OF LIVES COVERED AVERAGE PROFIT DISTRIBUTIONS TO H.O.P.S. MEMBERS

10%

$5.49M

PREMIUMS RETURNED TO COLLECTIVE PARTICIPANTS IN 2021

$1,000,000,000+

MANAGED

HEALTHCARE SPEND

Healthcare Navigation Paving the way to lower costs and happier employees

Helping Members Navigate the Complicated Healthcare Maze Our healthcare navigation solution helps members makes better informed decisions about their healthcare.

Patient Care Coordinators help members find quality care at an affordable price in the easiest possible manner. Your coordinator can explain benefits, research the quality of health care providers, assist with scheduling procedures, and help members save on their prescription medications through our available pharmacy savings program.

Members are paired with an expert health guide, that has their plan information.

You have unlimited access to a healthcare expert who has your specific benefits information and will tailor their recommendations.

Access is available 24/7 through a simple, and easy to use app.

Use the app to connect with your health guide, view your benefits information, find a top doctor in your area, and much more.

View Insurance Coverage

See a breakdown of your benefits, including your co-pays. If you have questions about your coverage or about the price of a service, your health guide can answer them.

Get A Dedicated Care Plan

Your health guide can put together a plan with options for high-quality, in-network doctors. Select one and your health guide will schedule the appointment at a convenient time.

Review Or Dispute A Bill

Take a picture of your bill and send it to your health guide. They will answer your billing questions and explain your charges. If something looks wrong, they will dispute it on your behalf.

$0 Virtual Medical & Urgent Care Value added benefit for employees & members

$0 Virtual Care From The Palm Of Your Hand H.O.P.S.’ Virtual Care solution is your one-stop shop for all things healthcare. Services and consults are available to all family members in your household, even those not enrolled in the medical plan.

Virtual care saves you time, money and avoids unnecessary in person doctor visits for non-life-threatening illnesses. Doctors may prescribe medication, when necessary, and can call in the prescription to your local pharmacy for added convenience.

Given today’s competitive job market, many of our brewery clients have also chosen to offer the $0 Virtual Medical care + $0 Virtual Mental & Behavioral Health benefits to their part-time employees. The added value to your part time employees aids in recruiting and retention and positions you as an employer of choice.

General Medical Guidance Consult with a doctor 24/7 in all 50 states for minor illnesses (cold, flu, sinus infection, pink eye, UTI, allergies, etc.).

Physicians can call in prescriptions to members’ local pharmacy.

Telemedicine / Urgent Care Consult with a doctor 24/7 in all 50 states for minor illnesses (cold, flu, sinus infection, pink eye, UTI, allergies, etc.). Virtual appointments are completely free and can be scheduled M-F, 8am-11pmEST and 9am-5pmEST on weekends.

Follow-Up Care Coordinate any follow-up care with your health guide.

$0 Virtual Mental Health Value added benefit for employees & members

Mental & Behavioral Health Our solution provides you and your loved ones with access to online therapists, allowing them to get instant access to help from the comfort of your own home. Members have access to multiple means of care delivery including live (one-on-one) telephonic counseling, digital group therapy, text therapy, digital behavioral health, interactive toolkits and more.

Advantages o Real-time Scheduling - Schedule care directly with counselors and coaches o Nationwide footprint of counselors and coaches o Users have visibility to provider schedules o Telebehavioral (video) appointments available in as little as 24 hours o Powered by preference: participants can choose a provider with whom they feel comfortable o Powered by data: Counselors and other coaches have visitbility to clinically validated survey responses prior to care delivery

Verified for MHSA match

Immediate support

Verified availability

Personalized assessment and navigation

Referrals made to EAP clinicians who are also in-network with the member’s health plan

Prior to providing a referral, we verify the counselor’s willingness to accept new patients within the participant’s preferred time frame

Every call, around-the-clock, is answered directly by a licensed and experienced mental health clinician; no phone tree or attendant Care advocates, all licensed counselors, conduct a clinical assessment and provide guidance to the ideal discipline (counseling or coaching) and modality

Schedule the appointment

Choice of provider

Cultural competency

Diagnostic tools

In addition to verifying the MHSA match and availability, we offer to schedule the first appointment with the counselor Our clinical and organizational services are built on a foundation of competence to meet the diverse needs and preferences of every patient

In addition to clinical specialty, MHSA match and availability, referrals are also matched with a member’s geographic, demographic and cultural preferences We use a variety of diagnostic tools (SBIRT, WOS, SPS-6, PHQ-9, AUDIT) to guide the clinical care path and measure health and productivity impact

(PBM) Pharmacy Benefit Manager Solving the issue of high-cost and specialty medications

(PBM) Pharmacy Benefit Manager H.O.P.S. pharmacy program delivers Rx cost containment and member advocacy, along with a dedicated clinical pharmacist for every brewery. This proactive management reduces pharmacy claims and drugs costs, while providing employees with a personalized member experience. Breweries and employees will both benefit from the embedded cost containment programs, as well as the education and guidance on pharmacy trends.

Drug Formulary Management In-house formulary management provides greater flexibility and transparency of costs.

Our program’s customer service department is staffed by certified pharmacy technicians.

PBM Rebates H.O.P.S.’ pass-through PBM contract creates a revenue stream by re-directing carrier PBM rebates from the insurance carrier, back to your bottom line – reducing your healthcare spend.

Mail Service Delivery Access to a self-owned & operated mail order pharmacy is convenient and delivers huge savings to your employees. Members have 24/7 access to consult with a clinical pharmacist.

In-house Specialty Pharmacy Allows the sourcing of high-cost brand and specialty medications, reducing claims costs and saving your employees money. In most cases, the member receives their medication at a $0 copay.

Variable Copay Program Maximize specialty drug copay assistance programs and track member out-of-pocket costs with our specialty copay assistance & accumulator program. This proactively identifies available programs for your employees.

Diabetes Management Diabetes affects one in 10 Americans and is the leading non-specialty drug cost driver. H.O.P.S.’ comprehensive program was designed to improve member health education and outcomes.

Ancillary and Worksite Benefits H.O.P.S.’ Association Health Plan provides a National network with wholesale discounted offerings for your employees

Save money on ancillary & worksite benefits Our program delivers the most affordable and robust ancillary products available. Your employees will have access to a wide range of unique coverages, allowing them to take the best care of themselves and their loved ones. These wholesale discounted products were designed to meet the unique needs and demographics of the craft beer industry and eliminate the barriers to entry with no underwriting or participation requirements.

Dental

Vision

Life, AD&D

Accident

Short-Term Disability

Long-Term Disability

MULTI-YEAR RATE GUARANTEE

WITH NO UNDERWRITING

ELIGIBILITY GOES DOWN TO (1)

ENROLLED PER LINE OF COVERAGE Critical Illness

Hospital Indemnity

Employee Assistance Program

COVERAGES CAN BE ISSUED ON A

COMPANY PAID OR VOLUNTARY BASIS

Case studies from our H.O.P.S clients

ISSUE

EFFECT

REMEDY

Brewery with 64 enrolled

The impact of this $11k/month

H.O.P.S. PBM partner sourced

employees, received back

drug prevented the brewery

the medication outside of the

to back renewals of 24% +

from ever having a manageable

plan, which eliminated the

due to a high-cost medication

renewal and the employee was

claims impact while providing

accounting for 52% of their

hitting their out-of-pocket max

the member their prescription

monthly premium cost.

just to receive their medication.

at a $0 copay.

ISSUE

EFFECT

REMEDY

Brewery with 20 enrolled

Traditional carriers declined

The brewery moved into our

employees had two high

to quote due to such a high

H.O.P.S. program and was

cost “shock” claims with a

renewal, so the brewery had to

able to move back to a much

traditional carrier leading to

scale back the benefit plan to a

richer plan, due to a significant

a 65% increase at renewal.

high-deductible (HSA) plan.

cost reduction to the brewery.

Most clients see such a significant reduction in the first 4 years of the program, the 5th year is fully-funded from those savings.

Healthcare Trend vs. H.O.P.S. trend

*H.O.P.S. trend above excludes rebates, claims surplus distributions or underwriting profits.

When factored, employer’s costs are even less than what’s represented above.

HOW DO WE GET STARTED?

1) Provide a census for all benefit eligible employees: click here to download the H.O.P.S. census template Once completed, click here to securely upload your census

2) Underwriting Review / Quoting Process Once submitted, the standard turnaround time is 3-5 business days to receive a proposal. *Rates subject to change based on census changes and/or final enrollments.

3) Review available plans and make decisions Our team will illustrate available plans and review the employer and employee costs - based on your contribution strategy.

4) Book employee open enrollment meeting Our team will provide a customized Employee Benefits Guide, as well as an online enrollment system.

Employee open enrollment meetings will either be conducted online or in-person, depending on location.

We will review all available benefits in these meetings, so employees feel confident in their elections.

Implementation Timeframe & Process The average time from submission (all completed employer paperwork), to your go-live date is approximately 10-15 business days.

The delivery of employee ID cards averages 7-10 days after a complete employer submission (all documents & signatures) has been received. Temporary cards available within a week.

Sterling Seacrest Pritchard Brewery Practice Group Rodney Westbury, Jr. | Partner Brewery Practice Group Leader rwestbury@sspins.com 404-993-2188 Pamela Downs | Client Service Executive

Serve passionately.

Stay purposeful.

Be StrongerTogether.

Brewery Practice Group Service Lead pdowns@sspins.com 678-832-8651 Leslie Kirkland | Employee Claims & Support Senior Client Service Assistant & Training Specialist lkirkland@sspins.com 404-995-1792

Stronger Together

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