Pitney Bowes – Developing a Culture of Health Investing in Employees: Creating a “Culture of Health”

1. Pitney Bowes– Developing a Culture of Health Investing in Employees: Creating a “Culture of Health” Andrew Gold Exec. Director, Global Benefits Planning March 4, 2008

2. About Pitney Bowes • 85-plus year legacy • Fortune 500 company • $6.0 billion leading mailstream technology solutions provider • Global team of more than 35,000 employees • Presence in more than 130 countries worldwide • More than 2 million customers

3. Healthy, Engaged, Productive Employees Personal Responsibility Corporate Role Healthy Work Environment Investing in a Culture Of Health Vs. Only Managing Health Care Costs.

4. Health Benefit Strategy— The 4 Key Actions • Negotiate employee services • Educate employees to improve their health status • Provide target delivery of Health Care Services • Engage employees financially

5. Health Care Strategy — Design • Support the strategic goal: Provide programs, tools and incentives that enable employees to maximize their health and permit them to actively engage in work. • Affordable for both corporation and participant • Employee cost must be considered in context of total compensation • Support individual responsibility • Identify key drivers of health / healthcare • Remove barriers to access. • Benchmark to internal metrics and external reference points

6. Health Care Strategy— Predictive Modeling Key predictors for Pitney Bowes of High Cost Claims • Illness burden and costs driven by lack of pharmaceutical compliance • 50% of population had a chronic medical conditions: diabetes, coronary artery disease, cardiovascular, asthma • Individuals with total health care costs less than $781 but greater than $0 in the base year will be low cost in the subsequent year. • Currently working with Univ. of Southern California on new predictive model.

7. Health Benefit— plan design • Routine Services • Copays (office visits, urgent care, ER) • 20% coinsurance (routine lab/x-ray) • Preventive Services • Low cost or no cost • Major Services • Choice of deductible and coinsurance maximums – capped exposure to catastrophic costs

8. Tier 1 Tier 1 Most generic drugs Most generic drugs and all brand name drugs for: 10% Coinsurance • Asthma • Diabetes • Hypertension Tier 2 • Most preferred brand name • drugs, including those for: 10% Coinsurance • Asthma • Diabetes • Hypertension Tier 2 Most preferred brand name drugs 30% Coinsurance 30% Coinsurance Tier 3 • Non-preferred brand name • drugs, including those for: Tier 3 Non-preferred brand name drugs • Asthma • Diabetes • Hypertension 50% Coinsurance 50% Coinsurance Health Benefit— pharmacy benefit “Traditional” Rx Benefit New Rx Access Benefit

9. Health Benefit— pharmacy benefit • Percentage of participants with sub-optimal adherence declined • Decreased Emergency Department and Hospitalization rates • Average patient co-pay for these conditions decreased (50%) • Average annual cost of care decreased for both conditions: • Diabetes (6%), Asthma (15%) • Average annual pharmacy costs also decreased: • Diabetes (7%), Asthma (19%) • Diabetes-related disability costs (75%) and duration (29%) decreased within 2 years

10. Health Benefit— pharmacy benefit 2008 • Targeted conditions • Asthma • Diabetes • Hypertension • Hormonal antineoplastic agents • Anti-convulsants • For patients with Diabetes and/or post-myocardial infarct: • Beta blockers • Statins • ACE inhibitors

11. Health Benefit— onsite medical clinics • Roughly 35,000 clinic encounters a year in 7 clinics • Services provided by Occupational Health Nurses, Nurse Practitioners, Physician Assistants, Physicians and Medical Assistants • Distribute entire course of therapy for common conditions • 73% of employees with access to a clinic utilized the clinics during the year • 96% of people who utilize the facility rank their experience as good to excellent • Accredited within local health plans and AAAHC

12. Health Benefit— EAP and behavioral health • EAP—two models (up to 8 sessions) • Face-to-face • On-site clinic • Private office • Telephonic • Managed Behavioral Health • Out-patient • In-patient • Integrated Medical / Disability Management for behavioral health conditions

13. Health Benefit— disability services • Absence Management / Behavioral Health Integration • 25% reduction in approved cases • Disability durations decreased 66% • 19% reduction in lost work days • Net cost averted $2.5 million/year • While, employee continues in mental health benefit

14. Health Care University • Part of the overall Pitney Bowes Benefits • Mission: To provide employees with the environment, the tools, and the motivation to enhance their health and well-being. • Pertinent health information • National and local programming • Resources and references • Interactive tools to improve knowledge, skills, and behaviors related to health improvement, disease management, and self-care

15. Health Care University • Count Your Way to Health • Healthy Food Service • Fitness Programming/Fitness Centers in larger sites • Employee Assistance Programs • On-line Health Care University Courses • Communication and Health Education • Health Screening programs • Free Flu Vaccination program • Prenatal Care – “Great Expectations”

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