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1 LEAN Presentation Title Presentation Title Landmark Enrollment Application Navigator Second Line Joe Treichel Optum IT Sponsor Carolina Rayar Author Title Optum IT Delivery Manager Trent Olson UnitedHealthcare Owner 2016 Pegasystems Inc.

2 Who is Optum? Named one of world s Most Admired Companies in Insurance and Managed Care by Fortune in Health Benefits Ranked 14th of the Fortune 500 Health Services $157.1B FY15 revenue Helping people live healthier lives Helping to make the health system work better for everyone $67.6B+ FY15 revenue 100,000+ employees Our business landscape: OptumHealth OptumInsight OptumRx 2

3 Optum Success with Pega Projects generating over 60% auto processing of work Projects exceeding 9x operational improvement Projects above $275 million in net benefit Projects with 50% rate of return 32 applications in production and more in the pipeline 25 average number of active projects 120+ projects completed in 4 years 10 average opportunity pipeline k best practices, standards, and how-to s internal users 100k+ external users expert services reusable assets Pega Registered Business Partner 3

4 Why LEAN? Why build a Sales Agent-facing enrollment tool? Last year during the Medicare Annual Enrollment Period, over half of the applications submitted were by paper. Electronic applications are faster, provide better data, and are less expensive to process. UnitedHealthcare needed a mobile enrollment tool that enables their sales agents to meet consumers in a variety of locations; homes, restaurants, retail locations, community meetings, etc. Fewer application errors Reduced expense Increased sales 4

5 What is LEAN? Landmark Electronic Application Navigator (LEAN) New electronic enrollment application for UnitedHealthcare, built on a Pega platform Accessed from a mobile app (using a tablet device) or a computer Faster All Medicare Advantage/ Part D plans available One-stop shop Easier Streamlined application No more signature pads! Better Built-in safeguards Ability to view applications 5

6 LEAN: Support and Compatibility Devices Browsers PC Laptop 6

7 UnitedHealthcare Sales and Distribution Challenges Challenges Previous application was cumbersome for field agents to use, especially the signature pad and device compatibility Implications / Impacts Poor usability Negatively influences agents choice of which carrier to offer Four separate code bases implement the rules for online, offline, emodel, and telesales code to present applicable questions and answers for the selected plan Inconsistency to agents and enrollee Maintenance burden Cost of ownership Previous application did not support all products, which leaves paper applications as the only option Data capture validation quality is poor Results in manual entry and enrollment into multiple enrollment systems, negatively impacting quality and cost Enrollment is the origination of input and poor quality reduces claim auto adjudication rates among other data quality impacts Leads to downstream member dissatisfaction and negative impact on Star Ratings 7

8 Success Factors Sales agent ride along Operational walkthrough with agents Consumers Pilot (proof of concept) Optum / UnitedHealthcare collaboration Senior leader engagement UnitedHealth Group culture (integrity, compassion, relationships, innovation, performance) Iterative agile methodology Playbacks 8

9 Optum Technology Solution Consolidate enrollment rules for all products, all contained in one source Pega technology advantages One application design executes on multiple platforms All leading browsers (i.e., Chrome, Firefox, IE, Safari) ios and Android Responsive UI Insulates developer from complexity of HTML5/CSS3 to support transition between landscape and portrait display Strength in integrating rules with the overall application design including navigation, presentation, and processing Manages offline complexity with little or no developer involvement 9

10 Optum Technology Delivery Challenges New to mobile development Optum catching up in this space App store submittals High involvement with IRM and mobile security More DMZ environments needed in lower levels (Dev, QA) Can t get a true test of an external-facing app within firewall Cell signals in office building poor (Coffee Shop Testing) Bleeding edge of vendor software (Pega PRPC 7.1.8) 7,000 concurrent users - performance testing 10

11 LEAN Adoption Statistics 35% Decrease in agent time to complete an application Over 80,000 applications taken since implementation Over 10,000 unique selling agents No major outages during AEP Significant training and marketing execution Positive feedback from sales agents that LEAN is intuitive and easy-to-use 11

12 Promotional Video 12

13 DEMO

14 UnitedHealthcare : 2016 Pega Business Impact Award Winner Differentiated value Award given to companies who have deployed a Pega application AND achieved staggering results via quantifiable business returns in the area of Customer Service, Sales and Onboarding, Marketing, Operations or Pega 7 Platform Solution New electronic enrollment application for UnitedHealthcare, built on Pega platform Accessed from mobile app via tablet or computer Optum and Pega partner to roll out mobile Sales Agent Enrollment app for UnitedHealthcare clients Landmark Electronic Application Navigator (LEAN) Results Tool focused on individual Medicare and Retirement plans and has over 7,000 agents trained on using the tool, processing more than 1,000 applications per day on agents mobile tablets Time to value demonstrating a best in class user experience June 5, 2016, PegaWORLD 14

15 Q&A