Themes

Create convenient access

Incentivise the right behaviours

Integrate

1

2

3

Themes

Create convenient access

Incentivise the right behaviours

Integrate

1

THE VITALITYHEALTH INTEGRATED MODEL

THE VITALITYHEALTH INTEGRATED MODEL

THE VITALITYHEALTH INTEGRATED MODEL

GPS – GATEKEEPERS TO HEALTHCARE

GP’s are a trusted entry point for healthcare

Doctor

Family / friends

Online forums

Online experts

Online reviews

Health magazines

95%

35%

24%

16%

9%

8%

Sources of advice on health matters

Accessing GP services is getting harder

Patients waiting on average more than 1 week for a non-urgent GP appointment

2014 2015

56%

74%

Target guaranteeing a GP appointment within 48 hours removed in 2010

NHS Direct closed in March 2014

Sources: nVision Research 2013 and Pulse 2014

CONSUMER DEMAND MORE FROM GPS

Consumers desire more choice and access

coordinate with my doctor's office

communicate with my doctor's office

adhere to my doctor's treatment plan

track my health goals

75%

70%

65%

62%

Percentage who would sign up for an app or website that helped them :

Health insurance is all about access and choice

Key drivers of health insurance sales

Sources: nVision Research 2013, Vitality Health

INTRODUCING VITALITY GP

Expert advice on wellness and

illness

“Whether you want to find out what you should do to get healthier or want to discuss a health issue before making a claim, our Vitality GPs can help. You can speak to a Vitality GP face-to-face through video consultations or over the phone 24 hours a day”

! available from Q2 2015

MULTI-CHANNEL HEALTHCARE

24/7 access

advice on health matters

referral to physiotherapist & surgical consultant

Vitality lifestyle coaching GP HELPLINE(reassurance &

advice)

Service Attributes Outputs

GP

+flexible appointment

times(including weekends & evenings)

online booking system(ensuring appointment within 48 hrs)

choice of GP (gender, availability, special

interests, 10 years UK experience, CQC accredited)

medical underwriting (can authorise treatments)

secure upload of images (e.g. for mole check)

secure sharing of records

review & rate facility (member can review & rate

experience)

(diagnosis & referral )

prescribe Vitality

order minor diagnostic tests

order prescriptions

schedule follow-up appointment

authorise referral to physiotherapist

(via Priority Physio network)

authorise referral to CBT therapist

(via CBT network)

authorise referral to consultant

(Alliance Surgical, Oncologist & medical consultant)

referral to NHS GP & A&E

THE COST OF VITALITY GP

£25 (per

consultation)

Actual Cost

GP

FREE

Cost to Member

GP

EXAMPLE SCENARIOS

I am illCan a Vitality GP treat me ?Do I need to go to my NHS GP or A&E ?Do I need a referral ?

I am seeking medical advice for me or a family memberI have a mole / skin lesion I will be travelling Do I need a full medical screening ?My child has a high temperature do I need to take them to A&E ?

I have already been diagnosed – Now what ?What is your opinion ?Can I see my named consultant?Can you refer me for a second specialist opinion ?

I’ve a recurring problem – acute flare upCan you treat me ?Can you refer me ?

I have a chronic condition Can you monitor me ?Can you help me manage my condition ?

1

2

3

4

5

CASE STUDY 1

Reassurance is just a call away

It’s the weekend and Nikki’s son is sick. She doesn’t know what to do. How serious is it? The GP’s surgery isn’t open and Nikki doesn’t know if she should take him to hospitalNikki phones the Vitality GP who advise her on the best course of action for her son and whether or not they need to go A&E.

The Vitality GP consultation

CASE STUDY 2

The Vitality GP consultation

Liz’s arm has come up in a nasty rash. It came on quite quickly and it’s itchy and sore. She wants to see a doctor quickly so they can tell her what it is, but she can’t take time off work at short notice.

With Vitality GP Liz is able to book a video consultation with a GP at a time that works for her. The GP can see the extent of Liz’s rash by video and through additional photos Liz sends him, the GP can assess the rash in more detail. The GP then advises Liz on the best course of treatment and whether or not she should see a dermatologist.

CASE STUDY 3

The Vitality GP referral

Mark has sprained his ankle and needs to see a GP. This is tricky because when he phones his GP’s surgery to book an appointment, the only available ones that week are in the middle of the day. Mark’s busy at work then and doesn’t have time to go during the middle of the day

With Vitality GP Mark is able to book a video consultation with a GP within 48hrs and at a time which suits him. The GP recommends a course of physiotherapy and is able to book Mark’s first session for the next day at a clinic near his work.

PRESCRIPTIONS AND TESTS

prescribes medication

prescription fulfilled by

LloydsPharmacy

pick up from local

LloydsPharmacy or

home delivery

recommends minor tests

full blood count, urea and electrolytes, urine for culture and sensitivity, ultrasound scans or plain X-rays

£100 (per year)

PRIMARY CARE

BENEFIT

Part of Core Cover No impact on No-Claims Discount Not subject to excess deduction

Tests and scans

Tests / scans Average cost

Full blood count £78

Liver function profile £98

Urea and electrolytes

£78

X-ray £109

Chest X-ray £101

Private prescriptions

Prescription Average cost

Amoxicillin £8.15

CASE STUDY 4

The Vitality GP prescription

It’s 8am and Tom has just had a video consultation with the Vitality GP before going to work. The GP has written him a prescription. Normally Tom would take his prescription into a pharmacy in his lunch break and wait while they put together the prescription – this normally takes a while as the pharmacy is always busy at lunchtime

Through its partnership with LloydsPharmacy, Vitality GP sends Tom’s prescription straight to LloydsPharmacy who prepare Tom’s prescription for him to pick up during his lunch break

KEY MESSAGES Clients

Convenience24/7 access to primary care, including payment for minor diagnostics and private prescriptions

Coordinated Carea single point of referral and navigation for your treatment to ensure the best member experience and most appropriate clinical pathway

Prescribe Wellnessa unique ability to combine clinical pathways with wellness interventions to achieve the best health outcomes

Employers

Reduce employee time off work due to time needed to see GP, and minor illness

Rewardemployees with a truly unique, relevant and highly valued new benefit

Remind employees of your commitment to helping them manage and improve their health and wellbeing

TREATMENT

1.Limited clinical and claims information

2.Limited consultant & provider information

3.Size disadvantage for negotiation

Customer

NHS GP

Consultant

Health Insurer

1.Access to clinical and claims information 2.Access to consultant and provider information 3.Size advantage for negotiation

1.Increasingly hard to contact 2.Little or no knowledge of consultant quality and

charging patterns 3.Little or no knowledge of networks and services

available through health insurers Who is best to advise ?

Information asymmetry in the independent healthcare system means that healthcare consumers have little or no informed choice

Real time access to consultants’ & therapists’ profiles

Real time access to consultant and therapists’ diaries

Members able to choose GP according to their selection

criteria

Members able to rate GP according to overall

experience

Continuous feedback loop between insurers and

providers ensuring quality of referrals and outcomes

Quality assured medical access for member

WITH SERVICE INTEGRATION COMES VALUE FOR ALL

GP panel delivers clinically appropriate primary care & wellness services and enabled to authorise onward referral for treatment

Consultants empowered to make treatment recommendations

according to clinical appropriateness and not member’s chosen hospital list

Insurer is able to deliver greater customer and partner value while still achieving cost efficiencies

Member has immediate access to an integrated

healthcare system

GP

feedback loop

direct referral to consultants

consultant refers member

to most appropriate facility for

treating the presenting condition

GP SELECT

Member books video consultation with Vitality GP

Vitality GP can authorise

further treatment

and referrals

prescriptions

minor tests

physiotherapy

cognitive behavioural

therapy

GPA&E

GP

PRICING

BASE

COUNTRYWIDELOCAL

-10%

-15%

GP SELECT

33%( up to)

COUNTRYWIDE PLUS

! available from Q2 2015Pricing is indicative only, and correct as at November 2014

KEY MESSAGES

Empowers GP to make decisions together with the patient without the influence of the insurance company and without the restriction of a defined hospital list

Facilitates access to clinicians with expertise relevant to your condition at the earliest opportunity

Removes unnecessary utilisation in the system by eliminating repeat consultations and diagnostics

Allowsus to pass on efficiency savings to the member, consistent with our shared-value insurance model

OUT-PATIENT COVER

Out-patient Cover

MRI/CT/PET Scans no impact on out-patient limit In-network physiotherapy

Consultations up to chosen out-

patient limits with option to

fully cover consultant referred

diagnostic tests

Diagnostic tests

Out of network physiotherapy

£35 per

session

Core cover

MRI/CT/PET Scans

New Out-patient cover

MRI/CT/PET Scans are only covered when an out-patient option has been selected

1. Including high cost scans in Core Cover inflates the cost of Core

2. Requirement for consultant referral for scans means its counter intuitive to offer this cover without accompanying Out-patient Cover

3. 93% of new business clients opt for Out-patient Cover

Old approach to covering high cost scans

new benefits

Vitality Health continues to offer the most out-patient options in the market

Priority Physio claims DO NOT count towards the overall out-patient limit

Priority Physio Network provides access to over 1,400 physiotherapy clinics nationwide

! available from Q2 2015

WHAT DRIVES HOSPITAL CHOICE?

Location most likely to influence hospital choice

Gegraphic location

Previous experience

Waiting times for appointments

Comfort and quality of accommodation

Whether insurance covers cost

Consultant rec-ommendation

48%

36%

36%

33%

32%

32%

Most important reasons for choosing private hospital

Sources: Competition Commission / GFK 2012)

On average patients are willing to travel for 30 minsWillingness to travel to private hospital (average travel time in minutes)

Average London Urban Rural

32 31

25

35

Hospital of St John and St Elizabeth added to Countrywide Hospital List at no additional cost

HOSPITAL LISTS

National

Central London

main independent acute hospitals

main independent acute hospital beds

Countrywide

95%

88%

BASE PREMIUM

Countrywide Plus

100%

100%

33%(up to)

Local

70%+

67%+

-10%

Premier Hospital List renamed as Countrywide Plus

Sources: Laing & Buisson 2014

! available from Q2 2015

‘

over fifty percent of consultants with

admitting rights to Countrywide Plus

hospitals also have admitting rights to Countrywide List

hospitals

Average number of hospital specialists have admitting rights to

London Out of London

3 2

LONDON HOSPITALSMyth busting

67% of SME and corporate customers on the Countrywide Plus coverage live within 2 miles of a Countrywide List hospital

In 71% of cases, the nearest Countrywide List hospital is also the nearest Countrywide Plus Hospital

London consultants tend to only work out of 1 hospital

You have to have Countrywide Plus coverage to get ‘Premier’ consultants’

You have to have Countrywide Plus to get the best care and service

Aspe

n

Other

(no

n – Lo

ndon

)

Nuffiel

d

Spire

BM

I

Other

(Lon

don)

Ram

say

HCA

NHS

9.22

8.11

Vitality Health customer satisfaction scores with hospital

Sources: Competition Commission / GFK 2012) & VitalityHealth data 2014

ABILITY TO MEET CUSTOMER NEEDS

Malignant neoplasm, breast

Low back pain, site unspecified

Malignant neoplasm, colon,

Malignant neoplasm of ovary

Malignant neoplasm of prostate

Malignant neoplasm, bronchus or lung, unspecific

- Other and unspecified abdominal pain

Senile cataract, unspecified

impacted teeth

Pain in joint, lower leg

Unilateral or unspecified inguinal hernia

Intervertebral disc disorder

Injury to multiple structures of knee

Haemorrhage of anus and rectum

Atrial fibrillation and flutter

Sources: Vitality Health data 2014

Looking at the top 15 conditions we most commonly pay for in London, between them all 3 Central London Countrywide hospitals treat these conditions

KEY MESSAGES

Outside Central LondonWhere Central London hospital coverage is not required we believe that in the majority of cases the  Local Hospital List offers sufficient coverage with access to high quality facilities and consultants

Central LondonWhere Central London hospital coverage is required we believe that in the majority of cases the  Countrywide List offers sufficient coverage with access to high quality facilities and consultants

CANCER

Typical cancer benefits

Quick diagnosis

Rapid referral

Prompt hospital treatment

Radiotherapy

Chemotherapy

Drugs/treatments not covered by NHS

Latest technology e.g. Cyber Knife

Treatment at home

Health insurance offers reassurance in terms of cover

Concerns about NHS cancer provision prevail

HIDDEN COSTS OF CANCER Full Cancer module

renamed Enhanced Cancer Cover module but remains default module for quotes

New benefits added to Enhanced Cancer Cover module

Additional services Monthly

Cost Annualise

d Cost New cancer

benefits

Wigs hairpieces and head coverings £23 £276 £300

Fabric supports e.g. Mastectomy bras £14 £168 £200

Scalp cold capping £50 £200 Covered

Additional services Average Duration

Speech therapy 6 sessions 6 sessions 6 sessions

End of life home nursing care 12 – 14 days 14 days 14 days

available on new Enhanced Cancer

Cover module

Sources: Macmillan – Cancer’s Hidden Price Tag. Public Health England - What We Know 2013

Cancer Cover Enhanced

Cancer Cover

Diagnostics

Consultations

Investigations

Surgery

Surgery

Reconstructive surgery

Stem / bone marrow transplants

Oncology

Radiotherapy

Chemotherapy

Chemotherapy at home / work

Biological therapies 12 months

Bisphosphonates full cover if combined with chemotherapy & up to 3

months if used on their own

Hormone therapies

Support

Cash benefits

Dedicated nursing support

Assistance at home

Follow-up consultations 5 years no time limit

End of life care (pain relief)

Hospice donation

End of life home nursing care 2 weeks

Wigs hairpieces and head coverings

£300

Fabric supports e.g. Mastectomy bras

£200

Scalp cold capping

Speech therapy 6 sessions

OUR CANCER OPTIONS

! available from Q2 2015

Themes

Create convenient access

Incentivise the right behaviours

Integrate

2

BROAD RECOGNITION OF NEED TO INVEST IN HEALTHY BEHAVIOUR

‘ There would be merit in extending incentives for employers in England who provide effective NICE recommended workplace health programmes for employees ‘ - NHS – Five Year Forward View ‘

‘If the nation fails to get serious about prevention then recent progress in healthy life expectancies will stall, health inequalities will widen and our ability to fund beneficial new treatments will be crowded-out by the need to spend billions of pounds on wholly avoidable illness’

NHS – Five Year Forward View

2012 2013 2014

INCENTIVES HAVE SUCCESSFULLY ENCOURAGED GREATER AWARENESS OF HEALTH

2011 2012 2013 Q1 2014

Q2 2014

Q3 2014

non-smoker’s cashback

Removed HealthCheck

fee

Average Vitality Age completions per quarter

Average Vitality HealthChecks per quarter

Removal of Healthcheck fee applied to VitalityHealth members only

x3

x10Weekly movies

UNDERSTANDING HEALTH GETS EASIER AND CHEAPER Entry level Vitality Prevention Plus £50

Lifestyle Health Assessment

£122 BMI Essential £84

Mid-range

Vitality Active £64Female Health Assessment

£154 BMI Select £162

Vitality Core £85

Comprehensive

Vitality Executive £125360 Health Assessment

£257 BMI Advanced £246

360+ Health Assessment

£341 BMI Advanced Plus £329

Bluecrest offers health

screening services out of 1,732

locations nationwide

Discount of 50% applied to all

health screenings

Prices include 50% Vitality Discount and are rounded up to the nearest £1 for illustrative purposes

GREATER INSIGHT INTO THE RISK PROFILES AND NEEDS OF OUR MEMBERS

<=0 1 2 3 4 5 6 7 8 >=9

15% 15% 16%13%

11%9%

6%5%

3%

7%

Distribution of Vitality Age Gap

VITALITY AGE – ACTUAL AGE

Vitality Age and HealthCheck data gives us a unique ability to segment our membersand tailor interventions based on individual need

Based on analysis by Vitality

% o

f m

em

bers

<=0 1 2 3 4 5 6 7 8 >=9

15% 15% 16%13%

11%9%

6%5%

3%

7%

Distribution of Vitality Age Gap

VITALITY AGE – ACTUAL AGE

HIGH-RISK MEMBERS NEED TO GET CONTROL OF THEIR RISKS AND CONDITIONSThe least healthy 15% of members have an average of 3.1 risk factors compared to an overall average of 1.8

Based on analysis by Vitality

% o

f m

em

bers

<=0 1 2 3 4 5 6 7 8 >=9

15% 15% 16%13%

11%9%

6%5%

3%

7%

Distribution of Vitality Age Gap

VITALITY AGE – ACTUAL AGE

AT-RISK MEMBERS REQUIRE A REGULAR ROUTINE OF ACTIVITY AND WELLNESS

66% of these members are out of range for each of physical activity and nutrition

Based on analysis by Vitality

% o

f m

em

bers

Walking

Running

Compared with inactive people, those who run/walk for 15 minutes a day have a 14% lower mortality risk, and a 3 year

longer life expectancy

Source: “Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study”, Chi Pang Wen, Jackson Pui Man Wai, et al

SUSTAINED DAILY ACTIVITY CAN DRAMATICALLY IMPROVE LONG-TERM HEALTH

Relatively simple exercise behaviours (e.g. walking, cycling) may more easily

become habitual than behaviours that are rather complex (e.g. attending an

organized fitness program)...

Source: “Physical exercise habit: on the conceptualization and formation of habitual health behaviours”, Henk Aarts, Theo Paulussen and Herman Schaalma

EMBEDDING DAILY ROUTINES WITH REGULAR, MODERATE ACTIVITY IS KEY TO INCREASING OVERALL PHYSICAL ACTIVITY

Gym

Onl

ine

activ

ity

Scre

enin

g an

d pr

ev...

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Membership Month

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Ongoing pedometer usage (Cohort: Members registered

between Oct 2012 and Mar 2013)

44% usage af-ter 6 months

24% usage af-ter 6 months

Engagement in healthy activities by movie goers relative to non

movie goers:

Vitality members

Non-Vitality members

8.2x

14.1x16.8x

INCENTIVES CAN HELP CREATE NEW ROUTINES, BUT WE NEED TO MAKE IT SUSTAINABLE

Based on analysis by Vitality

Our experience with the cinema benefits have shown the effectiveness of rewards in increasing healthy behaviours

Based on new business 2013

More than one million wearables are expected to be sold this Christmas

Analysts are heralding 2014 as the year the wearable finally fully breaks into

mainstream consciousness

WEARABLE DEVICES TOGETHER WITH INCENTIVES GIVE US A UNIQUE ABILITY TO DRIVE SUSTAINED ENGAGEMENT

MAKING IT EASIER TO TRACK ACTIVITY AND GET ACTIVE Moves:

Free App for iPhone & AndroidNow you can link more activity devices and earn Vitality points with free mobile app Moves

MAKING IT CHEAPER TO TRACK ACTIVITY

50%

50% off selected Garmin activity tracking devices

Includes Garmin Swim, so now swimmers can be rewarded too

One of the largest producers of activity trackers in the market

Each adult member can earn 50% off either a Garmin or Polar device during the lifetime of their plan

REWARDING ACTIVITY THROUGH A NEW REWARDS CATEGORY

We have been inspired by the success of the cinema benefit in increasing Vitality Age completion; can we now use it to motivate regular physical activity?

9 points unlock a weekly reward

WEEKLY REWARDS

1 movie AND 1 drink per week

40 points unlock a monthly reward

MONTHLY REWARDS

Minimum of 1 song per month

Active Rewards

How it works:

INTRODUCING FREE PASS FOR VITALITY GOLD AND PLATINUM MEMBERS

To recognise the efforts of our Vitality Gold and Platinum members, we are giving these members immediate and ongoing access to Active Rewards, regardless of their weekly

and monthly points earning

<=0 1 2 3 4 5 6 7 8 >=9

15% 15% 16%13%

11%9%

6%5%

3%

7%

Distribution of Vitality Age Gap

VITALITY AGE – ACTUAL AGE

REGULAR ENGAGERS NEED SUPPORT TO SUSTAIN ENGAGEMENT

The challenge is to keep these members engaged in their health on an on-going basis %

of

mem

bers

Bronze Silver GoldPlatinu

m

10% 20% 40% 50%

£250 £300 £400 £500

£50 £75 £100 £125

25% 30% 35% 40%

50%

Rewarding ongoing engagement for the attainment of health goals

STATUS REWARDS

25%

Maximum cashback:

Maximum cashback:

Subject to terms and conditions

0

1,200

2,400

3,600

0

1,600

3,200

4,800

0

2,400

4,800

7,200

Reduced Status Requirements

0

800

1,600

2,400

Single

Unchanged

Couple Couple and family

Family1

1 - Couple with 18+ Dependant , 2 – Available from Q2 2015 for new business and renewal

CHANGING THE VITALITY POINTS STRUCTURE TO ALLOW EASIER PROGRESSION FOR FAMILIES

CASE STUDY - COUPLE WHO BOTH WALK 7,000 STEPS A DAY

It took 267 days for them to reach Silver:

Before: Silver status = 1,600pts

Now: Silver status = 1,200pts

It takes 200 days for them to reach Silver:

They get to Silver over 2 months earlier

Making moderate engagement more achievable for couples and families

Time taken to reach Silver:

CASE STUDY – RECOGNISING AND DRIVING MORE ENGAGEMENT

Wife goes to gym 3 times a week, but husband is un-engaged:

Wife Husband0

200

400

600

800

1000

1200

1400

1600

1800

Wife Husband0

200

400

600

800

1000

1200

1400

1600

1800

Wife Husband0

200

400

600

800

1000

1200

1400

1600

1800

Bronze status Silver status Gold status

Before wife’s effort was not recognised:

Couples joint status:

Now her effort is appropriately recognised:

If husband walks 7,000 steps

a day they can get to Gold:

Our new approach is designed to help get less active partners engaged, so couples and families can enjoy more rewards

Old thresholds: New thresholds:

Domestic European

ANNOUNCING AN EXCITING NEW STATUS REWARD PARTNER

Up to 40% off return flights including taxes and charges, to more than 70 destinations within UK and Europe

Vitality StatusDiscount off total fare*

Number of return flights per life per

annum

Bronze 5% 1

Silver 20% 1

Gold 30% 2

Platinum 40% 2

Number of flights per annum applies to each life named on the planThe discount applies to return economy flights and is subject to a minimum stay depending on the day of departure.2 nights stay needed for Sun to Thurs departures, and 1 night overnight stay needed for Fri and Sat departures.

WORKINGS OF THE BRITISH AIRWAYS BENEFIT

SUMMARY OF PARTNER CHANGES

Our new partners Withdrawals

We are removing some of our less used partners to make way for even more partners

Our new partners will become available for new business from end of January 2015

New business: These partners will no longer be available for new business from 1 January 2015:

Existing business: Bookings for Mark Warner and Merlin are available up to renewal after 1 Feb 2015.

Ticketmaster and buymobile.net are available for new contracts and activations up to 1 Feb 2015. Existing phone contracts will be honoured until the end of their term..

Themes

Create convenient access

Incentivise the right behaviours

Integrate 3

STATUS LINKED EXCESS ADDITION

A non-discriminate way of sharing cost with employees and driving engagement

Vitality STATUS

£250 Max

£150 Max

£250 £150

£100 £100

£0 £50

£0 £0

Reduced excess for low status

employees

ENHANCED PERSONAL HEALTH FUND

Vitality STATUS

Annual Contributio

n

£75

£125

£175

£225

Service

average cost of a private sight test

£78

average cost of a private dental check-up

£30-£60

Bluecrest Vitality Executive Screening

£125*

Annual cost of a chronic prescription card

£104

Garmen Vívofit£44.50

*

Omron Elite Blood Pressure Monitor

£102.95

Betterlife Digital Tens Unit £25

50% towards indicator measurement devices/products, including blood pressure cuffs, cholesterol and blood glucose testing kits etc.

50% towards medical aids, including hearing aids, tens machines, first aid kits, dressings and medication

+

* Includes Vitality discount

INTELLIGENT INCENTIVES CAN CUT COSTS AND DELIVER GREATER VALUE TO EMPLOYEES

Status Linked Excess

£75

£125

£175

£225

Personal Health Fund

£60

£90

£120

£150

Non-smoker’s Cashback

£150

£100

£50

IN SUMMARY GP embedded in our product

Launch of new product

Introduction of Active Rewards

Powering our Status Rewards

INTRODUCING VITALITY INSIGHTS

visit vitalityinsights.co.uk

Reports & articles

Case studies

Regular insights, research and case studies showing the value of Vitality’s shared value approach