Iowa Bankers Benefit Plan

1. Iowa Bankers Benefit Plan April 2011 Update

2. Iowa Bankers Benefit Plan Update 2011 • IBBP Demographic Update • Financials and Year End Numbers • Analysis of the Plan

3. Iowa Bankers Benefit Plan Health and Dental Employee Numbers

4. IBBP Employee Demographics

7. IBBP Demographic Detail • Health membership has declined 4% - 26,004 (2007) to 24,947(2011) in the past 4 years. • The workforce is primarily female (67%). • Overall the gender is female (55%). • The greatest concentration of members is between the ages of 5 – 34(42%) and accounted for 24% of health claims paid. • Members over 45 account for 41% of membership and 60% of health claims paid.

8. Iowa Bankers Benefit Plan Update 2011 • IBBP Update • Financials and Year End Numbers • Analysis of the Plan

9. IBBP Health Cost Summary

10. 2010 Total Premiums: $99,382,931 Wellmark Administrative Fees: $5,054,467 IBIS Administrative Expense:$4,469,936 Other Expense: Audit Expense $25,000 Legal Expense $47,452 Misc. Expense $489 Total Administrative Expense :$9,597,344 9.6% Administrative Expense Ratio 2010 Administrative Expense Ratio

11. Iowa IBBP Comparison of Administrative Expense

12. Iowa Bankers Benefit Plan Trust Reserve August 2011 $27,794,822 December 2010 $20,629,731 2010 Actuarial Certification Amount $9,698,548 December 2009 $18,210,897 2009 Actuarial Certification Amount $8,739,928 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

13. Iowa Bankers Benefit Plan Update 2011 • IBBP Update • Financials and Year End Numbers • Analysis of the Plan

14. Total IBBP Claims by Month

15. Inpatient Services Summary

16. Outpatient Services Summary

17. Office Visit Services Summary

18. IBBP Drug Claims by Month

19. Prescription Drugs • Generic utilization increased 13%, but remained slightly below the Wellmark book of business. • Prescription claims paid per member decreased nearly a percent, well above expected trend. • A number of specialty medications including Humira, Copaxone, Avonex and Enbrel noted at left contributed to the pharmacy costs, but were off-set by decreased utilization and increased generic utilization. • Nearly 25% of members obtained no prescriptions and another 41% had claims paid of $100 or less. Just over 11% of members filled prescriptions in excess of $1,000, accounting for 42% of prescriptions and 81% of prescription dollars paid. • Biologic response modifiers accounted for the most claims paid (9.4%). These include several specialty meds used to treat multiple sclerosis. Antidepressants and disease modifying anti-heumatics (used to treat rheumatoid arthritis and other autoimmune conditions) followed, each with 6.2% of claims paid.

20. Generic Pipeline *Generic market entrance is estimated based on existing patent expiration dates. Patent litigation may alter these projections and actual savings may vary. Wellmark Blue Cross and Blue Shield

21. IBBP Total Health and Pharmacy Claims Paid Per Member The Average Increase over the Past Five Years was 5.1%

22. Most Costly Diagnosis Categories

23. Health Status Distribution

24. IBBP Over All • Including all members, enrollment has increased 1%. • Health claims paid per member increased less than 1% due to a 6% decrease in inpatient claims. Outpatient claims paid were 7% higher than last year. • Pharmacy claims paid per member decreased 1%,compared to 22% increase in 2010. • 165 members account for 23% of total claims paid. • Over all, health and pharmacy claims paid increased .06%, compared to 7.4% last year

25. IBBP Dental Highlights • 47.9% of paid claims are for check-ups • Average claim cost is $142.67 • 94.8% of members receive service in-network • Provider savings averages 12.5% of billed charge • 84.4% of covered members visited a dentist at least once in the past 12 months • 2% of our members met or exceeded the annual benefit maximum(all plan options combined)