As Seen In Quartz Magazine: What If Obamacare's Exchanges Were Spun Off as a Private, Venture-Funded Company?

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Because Your Health Is Everything

What Is OCARE?

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Affordable, easy-to-access health insurance for everyone. Because being

covered should be a right, not a privilege.

A smarter, simpler way to search for and manage your health insurance. One site.

One form. Because preserving your health shouldn’t give you a headache.

A solution to the single biggest obstacle to a freer, healthier and more productive

America: Guaranteed healthcare coverage, both to enhance your wellness when

you’re healthy, and to treat you in case of illness or accident.

What Is OCARE?

OCARE is a public-private partnership — jointly owned by the U.S.

government, who provided initial seed funding for its launch, and institutional,

venture and individual investors. It is being run as a for-profit social enterprise,

with half of its profits being distributed as rebates or invested in direct benefits for

OCARE members and users.

It operates under a 30-year contract with the government to develop and

manage the Affordable Care Act’s federal health insurance exchange, and to

provide a range of services designed to fulfill the ACA’s mandates and

requirements. While it is not a monopoly, its federal franchise gives it a scale that

allows OCARE to offer more competitive prices and a more comprehensive

set of offerings than state-run and private marketplaces.

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URS.

The Problem

The health insurance industry is broken.

Unavailable: 49 million Americans do not have any insurance.

Another 129 million are “trapped” due to potential uninsurability if

they lose their current policies.

Expensive: For those who do have coverage, the average cost

is $4565 a year and rising at an annual rate of about 6% — four

times the rate of inflation.

Inefficient: In the individual insurance market — over 14 million

persons — 29% of fees spent on health insurance go to

administrative costs. In the group market, up to 27% of fees from

SMBs (under 10 employees) goes to administrative costs.

Consumers feel that healthcare is out of their control — and out of control, in general.

• Costs are a concern: 62% of low income adults, 54% of middle income adults, and 44% of high income adults say

they are worried about the “the cost of healthcare” (The Futures Company, 2013 HEALTH & WELLNESS MONITOR)

• So are preexisting conditions: Nearly one in two adults has a chronic condition. The number is projected at 157

million by 2020. (LANCET, “TACKLING THE BURDEN OF CHRONIC DISEASES IN THE USA” JANUARY 2009)

• There is a real need for better and more transparent information: One in two consumers says that they “make

better decisions about health” when clear information is available. This is especially the case for Millennials, who are

disproporationately likely to be uninsured. (The Futures Company, 2013 HEALTH & WELLNESS MONITOR)

64%

67%

65%

62%

62%

36%$

33%$

35%$

37%$

38%$

0% 25% 50% 75% 100%

2013 US MONITOR: Do you feel you have control over your health?

YES$ NO$

MILLENNIALS

GEN XERS

BOOMERS

MATURES

TOTAL

The Opportunity

The Opportunity$40.4

$19.3$17.5 $16.3

$11.4

$0.0

$5.0

$10.0

$15.0

$20.0

$25.0

$30.0

$35.0

$40.0

$45.0

UnitedHealth Group Inc.

Humana Inc. Aflac Inc. Aetna Inc. Cigna Corp.

Dir

ect

Pre

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ms W

ritt

en

, B

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23% of

market

11% of

market

9.8% of

market

9.1% of

market

6.4% of

market

Though there are over 1,000 health insurance companies in

the U.S., the top five providers control 59% of the market.

32.730.6

16.3

12.29.9

8.5 8.56.2 5.2 5.0

0.0

5.0

10.0

15.0

20.0

25.0

30.0

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UnitedHealth Group

WellPoint Aetna Health Care Service

Corporation

CIGNA HealthCare

Kaiser Permanente

Humana Health Net Highmark Blue Cross Blue Shield of

Michigan

Nu

mb

er

of

En

roll

ees (

mil

lio

ns

)

The top 10 health insurance companies

have over 135 million paying enrollees.

Businesses see a huge and as-yet-untapped opportunity in the uninsured. • The “Big Five” control almost 60% of the market. Smaller players are challenged to compete with the massive

marketing budgets and sales infrastructures of these giants.

• But because the big insurers control so much of the existing market, they’re hitting the reality that the

future of their business is fundamentally about expanding the coverage universe. Future growth is going to

come from targeting the uninsured, not the currently covered.

Health Coverage Today

!

1. Consumer wants insurance

2. …faces complicated alternatives3. …and incomprehensible options

4. …relies on broker/agent advice

5. …after filling out many forms

6. …ends up with expensive or

insufficient healthcare

coverage, or getting denied

coverage completely.

21 3

456

Health Coverage—Reinvented

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456

1. Consumer wants insurance

2. …goes online to a single site3. …completes one data form

4. …browses simple, standardized

policy options with transparent

pricing from an array of

competing providers

5. …saves money on premiums

and preventative care

6. …receives cash rebates based

on medical loss ratio and cash

subsidies based on need

Our Solution: Changing the

Industry1. Aggregate 3. Negotiate2. Disintermediate

Efficient online

marketplace

Major insurers

Small & Individual Group Members

14 million covered by

individual

plans

5 million covered by

small group

plans

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We bring together a large pool of

insurance consumers, including those

from the 36 states that have opted out

of running their own exchanges, and

consumers who choose to use the

federal exchange rather than their state-

run option.

We give them secure access to an

efficient online marketplace, where

they can provide their personal

information a single time and search

and compare dozens of different

health insurance options.

Using the negotiating power of

our millions of members and our

federal franchise, we negotiate

the best rates and most complete

coverage options from insurers of

all sizes that qualify for inclusion

in our exchange.

Our Solution: Changing the Experience

1. Manage 3. Pay2. Track

We are a single, easy entry point for

managing their healthcare — from

private storage of your own basic

health information, to finding providers

and interacting with insurance

companies.

We offer a simple, real-time dash-

board for tracking your health — from

fitness, health stats and diet to doctor

and wellness appointments to

prescriptions. And it’s all available

both online and in a handy mobile app

— for real-time reminders and on-the-

go activity tracking..

Our secure payment infrastructure

allows you to pay insurance and

copay costs, as well as drug

expenses, using your OCARE

membership card — which also

offers discounts and special offers

from participating partners.

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Why Our Solution WorksWe offer a win-win-win scenario.

Consumers: Get cheaper healthcare, guaranteed coverage and

a simple, streamlined and secure way of managing and tracking

your healthcare relationship.

Providers: Access to millions of uninsured individuals in one

place, with minimal marketing investment; a level playing field for

providers to compete based on price, features and reputation;

direct insight into consumer health preferences and priorities.

Society: The ACA will provide access to quality healthcare to an

additional 25 million Americans — about half of the total

uninsured population, by 2020 — reducing the social cost of

illness and emergency care, while giving workers more freedom

than ever to switch jobs or launch entrepreneurial ventures

without fear of losing vital health coverage. About 13.5 million

Americans are expected to use the OCARE exchange to obtain

their insurance in the first seven years of its operation.

Revenue ModelWe generate revenues three ways.

Consumers: Targeted, clearly labeled advertising and vetted

special offers are provided to consumers on an opt-in basis.

Consumers are also able to subscribe to premium offerings, like

our enhanced dashboards and mobile app, online education and

telemedicine programs and our OCARE PLUS discount

club, which offers discounts on a wide range of healthy products

and activities, like fruits and vegetables, fitness and wellness

programs

Providers: OCARE charges a small percentage of provider

premiums for access to the marketplace. Providers may also pay

for priority listings and enhanced profiles, as well as access to

aggregated data (with full consumer privacy protection).

Institutions: OCARE operates under a 30-year renewable

contract with the federal government, as well as some states and

large individual businesses. A per-user management fee is

charged to offset the cost of secure recordkeeping and data

maintenance.

2013 Launch Plans

$299/mo

$198/mo

$320/mo

$255/mo

$310/mo

COMPARE

AUGUST-

SEPTEMBER 2013 OCTOBER 2013 NOVEMBER 2013

CLOSED ALPHA TESTING:

Randomly selected consumers from

36 states given early access for

user feedback. Focus on

UX, bugs, process, third-party

integration.

PUBLIC BETA TESTING:

Open beta, with alternating day

access based on last-name (A-J

M/W/F, K-Z T/Th/Sa; Sundays

reserved for bugfixes). Focus on

bugs, usability, load testing.

LAUNCH:

Full access with optimized

UX, process; rigorously load-

tested back-end. Coverage

delivery to begin January 1, 2014.

FundingOCARE is currently seeking a

Series B round of $1 billion.

SEED $250 million: Initial funding for OCARE came from the

federal government, which will retain 70% of outstanding equity

after the Series B round.

SERIES A $500 million: OCARE raised its Series A round from

venture and institutional investors, who will represent 20% of

outstanding equity after the Series B round.

SERIES B $1 billion: OCARE is seeking a final pre-IPO round

of financing, whose participants will represent 10% of

outstanding equity after the Series B round.

PUBLIC OFFERING: OCARE expects to file to raise $20 billion

in an initial public offering within the next 12 months.

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Because Your Health Is Everything