EXHIBIT G

Standard Clinic Operations shyVenipuncture Only Used Screening EventshyVenipuncture (per phlebotomist per

TBO shy separate proposal upon

request

TBO shy separate proposal upon

request

NA

TBO shy separate proposal upon

request

TBO shy separate proposal upon

request

TBO shyseparate proposal

NA

Contract Exhibit

v Ancillary Wellness Services

Signature Title Date

Company Name__________________________________

Address________________________ novla C RpoundCLlNICS

Contract Exhibitdocx Page 7

Sumner Count - Clinic Operation Pro Forma

Pro forma Pro forma Impact of First Full Operating Period Year 2 Year 3

~ - ~--Overview ~ h-h- =[[31 ~~ 1-

-- shy lt - ~

~~~~~ ~Jl ~

Economic Values

Returns

Health Promotion and Medical Management Cost ofmedical provider services $ 831566 $ 558529 Scheduled occupational services 56269 $ 50642 Labs 135480 100222 Drugs I 273 624 205218

Transactional values 1296938 914611

Impact of behavioral coaching and health risk management ~ 258350 138000

Estimated net impact physical therapy services 74918

Estimated emergency room savings 19110

Estimated savings from directed referrals 220719

1870036 1052611 Annual Total Return on Investment based on Direct Savlnas ~

Additional return values

Estimated Value of Difference in Provider TIme per Visit

TIme away from work savings

Total net returns

Investment PEPM

Operating overhead of clinic weIness platfonn health promotion and coaching Core operating overhead and management fees $1595

Clinic accass fee expense (if applicable) WeIness portal charges $173

Predictive modeling data integration service $050 Amortization of facilities and equipment investment nol~~

Offset User access fee income (if applicable) nnraJCIiClIlIfIi

Total investments

Total Net Economic Value after Costs

Annual Total Return on Investment based on Economic Values Note FoIIowmg keys 1tr~fnt1c8 m ltIiII rthlaquoIuJe only - we lt~ forother key defirdQnS

_Net result from operations of the clinic wenness platform and portal with coaching engaged at dinic site

Retum is calculated as the net return in transactional values indicated above divided by the total fees and similar service costs and amortization of investment in facilities if any Depending on Plan design and specific usage financial benefit may accrue in part to Members and in part to Plan but this pro forma analysis considers only costs incurred by the Plan But correspondingly inclusion of Member out of pocket expenses within this analysis would increase overall return on investment

-Return is calculated as the net return in financial values indicated above divided by the total fees and similar service costs and amortization of investrnent in facilities if any

$ 273036 5627

35258 68406

382327

$ 311635 7596

41085 73878

434195

$ 357584 9799

57802 79789

504974

120350

74918

19110

220719

817425

22 to 1

325341

80911

20639

323777

1184863

32 to 1

426171

87384

22290

350818

1391 637

38 to 1

361913 390866 422135

154224

1333562

15lt1224

1729953

154224

1967997

325380

35292 10200

326380 -

35292 10200

325380

35292 10200

-

$

370872

962690 $

370872

1359081 $

370872

1 597125

36 to 1 47 to 1 53 to 1

Proprietary ConfidentJal Operations Analysis Page t

Sumner County - Clinic Operation Pro Forma

Pro forma Pro forma novlo First Full Operating Period Year 2 Year 3 liE

Overview Per Member per Month

Note within this summary member for first year is employee only

Economic Values

Returns

Health Promotion and Medical Management Medical provider costs Scheduled occupational services Labs Drugs

Transactional values

Impact of behavioral coaching and health risk management

Estimated Impact physical therapy services 152 164 178

Estimated emergency room savings 039 042 045

Directed referrals 713

1661 24 08 2829

Estimated Value of Difference in Provider Time per Visit 736 794 858

Time away from work savings

Total net returns 2711 3516 4000

Investment Operating overhead of clinic weIness platform health promotion and coaching

Core operating overhead and management fees 661 661 661 Clinic access fee expense (if applicable) WeIness portal charges 072 072 072 Predictive modeling data integration service 021 021 021 Concierge referral service cost

Amortization of facilities and equipment investment Offset User access fee income (if applicable)

Total investments

Total Net Economic Value after Costs Annual Total Return on Investment based on Economic Values

Note Following keys iNS lor refarance In this schedule only - see 8acneroont for other key defin Itions

Nole Some founding difr8f9nces 01 fJ few cents may occur Qf BCCumulatfJ in the above summery

Net result from operations of the clinic wenness platform and portal with coaching engaged at clinic site

-Return is calculated as the net return in financial values indicated above divided by the total fees incremental costs of coaching and similar service activities and amortization of investment in facilities if any

PMPM PMPM

152

039

2140

Sumner pro forma evaluation 520 1312 )(ls Operations Analysis Page

Upda1a IIII~UlQll

novlo I (

Pro Forma Clinic Operations -Initial Values (year one) and tIature Value5 (year five) Undertying unimpaCed inflatIon assumpl ~on for Plan costs

Values Herein are Shown per Clinic Sile

Eligible employees

Estimated Eligible Dependents

Targeted participation percentage EIgibe employees Estimated eligible dependents

Estimated annual plan costs per employee at assumed Inflation rOIl Percentage of costa related 10 pharmacy benefit

Estimated annual plan costs related adutt population - (clinic can a dd chlldnm) and which can be Impacted from clinic and health management p

Drug portion of Ihl total

Total vlsll$ (20 minute slota)

Approlmate provider hours Per week Per 100 employee lives per week

Clinic encounter cosl$ ProVider hours

Provider cosl

Support cost

Eslimaled lab and supply costs (based on 20 mmute time Sial) Lab Supply

OperaUonal overhead for core management services Core fees C1lnic access fee paid 10 clinic employer sponsor MEOai dala inlegrahon fees Volume discount (rom sharing partner

Total

Cost for provision of clinical services

Estimated lotal drug coata Estimated percentage of impaC on drugs bull per Novia model

Estimated cost of drugs dispensed

Estimated cost of scheduled occupational health services

On-site or visiting coaching resource and health platform cos Coachrng hours WetneBS POrtal charges

Total coat of clinic and health promotion operations

Estimated displacement of Costs

EsUmated primary encounler costs Professional Lab Service lines

Total per encounterfTotalencounler cost - Estimated

Estimated Emergency Room Impact Estimated Displacement of Selected Occupational Services Estimated Impact physical therapy Drug costa dIsplaced from dispensing In clinic Estlmaled cot of Increaed utilization

Net dlspiacement 01 COlts

Net Financial Value of Clinical Operations ecludlng employee beneflt

Estimated savlnas from health risk management

Estimated Impact of dlraced referral net of service cost

Eslfmated net Impact on Plan cosl$ - per year

Estimated Value of Difference In Provider Time per Visit

Amorti2atlon of Facility Investment

Estimated time away from work saving - office visit only Average employee hourly COSI Hours saved per visit Estunated percenl9ge attribulable 10 employee usage CredioWry faclor

TIme estlmale savings

Total Estimated Economic Value

Calculation Cost

QrValue

rograma

-~

Imiddot

$2100 20

5862 75 oo~o

ltL--- lu---

-

IRIiii

= ---

Pro Forma Year 1 Pro Form) Yeu 2

- - -

l -l r-

ES lfllltHj EStlll1llctl

AfTlQUl ls Amounts

1700 1700 2400 2400

800 800 400 400

S 9800 $ 10584

2053 2053

S 16660000 S 17992800

S 3420298 S 3693922

8352 8352

67 67 39 39

3480 3480

S 313194 S 328854

211 928 222524

100222 105233 33407 35D78

$ 658752 S 691689

S 325380 S 325380

10200 10200

$ 335580 S 335580

S 994n2 S 1027269

205218 221635

1

50642 53174

138000 144900 35292 35292

173292 180192

$ 1423483 $ 1482270

A -

- bull S 1137701 $ 1228717

S 19110 $ 20639 56269 60770 7491S 80911

273624 ( ~~~~)(170655)

$ 1390966 $ 1502244

S (32517) S 19973

258350 470241

220719 323777

S 8553 $ 81U9

361 913 J9096e

154224 154224

$ 962690 S 1359081

Pro Form3 YtlJr 1 Pro Forma Year 4 Pro FOnTIC) Yeu 5

- - - - -I -

o bullbullbull

~_

--- -- -I -Elillrnltcd Eslmllt(lll Estml lod AmOHIi AmouIl15 Amom li

1700 1700 1700 2400 2400 2400

800 800 800 40 0 400 400

S 11 431 S 12345 S 13l3J

2053 2053 2053

S 19432224 S 20986802 S 22665746

S 3989436 $ 4 J08~90 $ 4653278

8352 8352 8352

67 67 67 39 39 39

3480 3480 3480

S 345296 S 362561 S 380689

233551 245333 257600

100222 100222 100222 33407 33407 33407

$ 712577 S 741524 S 771919

$ 325380 S 325380 S 325380

10200 10200 10200

$ 335580 S 335580 S 335580

$ 1048 7 $ 1077104 $ 1107499

23936e 258515 279197

55833 58624 61555

152145 159752 187740 35292 35292 35292

187437 195044 203032

$ 1530792 $ 1589288 $ 1651283

bull

S 1327014 $ 14331 76 S 1547830

$ 22290 S 24073 S 25999 65632 70 882 76553 87384 94375 10t 925

319155 344687 372282 (199052) (214976) (232174 )

$ 1622423 $ 1752217 $ 1892394

S 91631 $ 182929 S 241 112 I

578316 701691 839474

350818 382244 416045

S 1020765 S 1246864 $ 48163

422135 455906 492379

154224 154224 154224

S 1597125 S 1856 99 S 2143234

Page I Sumner pro tOfJla ampltaluetion 520 13v2 ds

Standard Clinic Operations shyVenipuncture Only Used Screening EventshyVenipuncture (per phlebotomist per

TBO shy separate proposal upon

request

TBO shy separate proposal upon

request

NA

TBO shy separate proposal upon

request

TBO shy separate proposal upon

request

TBO shyseparate proposal

NA

Contract Exhibit

v Ancillary Wellness Services

Signature Title Date

Company Name__________________________________

Address________________________ novla C RpoundCLlNICS

Contract Exhibitdocx Page 7

Sumner Count - Clinic Operation Pro Forma

Pro forma Pro forma Impact of First Full Operating Period Year 2 Year 3

~ - ~--Overview ~ h-h- =[[31 ~~ 1-

-- shy lt - ~

~~~~~ ~Jl ~

Economic Values

Returns

Health Promotion and Medical Management Cost ofmedical provider services $ 831566 $ 558529 Scheduled occupational services 56269 $ 50642 Labs 135480 100222 Drugs I 273 624 205218

Transactional values 1296938 914611

Impact of behavioral coaching and health risk management ~ 258350 138000

Estimated net impact physical therapy services 74918

Estimated emergency room savings 19110

Estimated savings from directed referrals 220719

1870036 1052611 Annual Total Return on Investment based on Direct Savlnas ~

Additional return values

Estimated Value of Difference in Provider TIme per Visit

TIme away from work savings

Total net returns

Investment PEPM

Operating overhead of clinic weIness platfonn health promotion and coaching Core operating overhead and management fees $1595

Clinic accass fee expense (if applicable) WeIness portal charges $173

Predictive modeling data integration service $050 Amortization of facilities and equipment investment nol~~

Offset User access fee income (if applicable) nnraJCIiClIlIfIi

Total investments

Total Net Economic Value after Costs

Annual Total Return on Investment based on Economic Values Note FoIIowmg keys 1tr~fnt1c8 m ltIiII rthlaquoIuJe only - we lt~ forother key defirdQnS

_Net result from operations of the clinic wenness platform and portal with coaching engaged at dinic site

Retum is calculated as the net return in transactional values indicated above divided by the total fees and similar service costs and amortization of investment in facilities if any Depending on Plan design and specific usage financial benefit may accrue in part to Members and in part to Plan but this pro forma analysis considers only costs incurred by the Plan But correspondingly inclusion of Member out of pocket expenses within this analysis would increase overall return on investment

-Return is calculated as the net return in financial values indicated above divided by the total fees and similar service costs and amortization of investrnent in facilities if any

$ 273036 5627

35258 68406

382327

$ 311635 7596

41085 73878

434195

$ 357584 9799

57802 79789

504974

120350

74918

19110

220719

817425

22 to 1

325341

80911

20639

323777

1184863

32 to 1

426171

87384

22290

350818

1391 637

38 to 1

361913 390866 422135

154224

1333562

15lt1224

1729953

154224

1967997

325380

35292 10200

326380 -

35292 10200

325380

35292 10200

-

$

370872

962690 $

370872

1359081 $

370872

1 597125

36 to 1 47 to 1 53 to 1

Proprietary ConfidentJal Operations Analysis Page t

Sumner County - Clinic Operation Pro Forma

Pro forma Pro forma novlo First Full Operating Period Year 2 Year 3 liE

Overview Per Member per Month

Note within this summary member for first year is employee only

Economic Values

Returns

Health Promotion and Medical Management Medical provider costs Scheduled occupational services Labs Drugs

Transactional values

Impact of behavioral coaching and health risk management

Estimated Impact physical therapy services 152 164 178

Estimated emergency room savings 039 042 045

Directed referrals 713

1661 24 08 2829

Estimated Value of Difference in Provider Time per Visit 736 794 858

Time away from work savings

Total net returns 2711 3516 4000

Investment Operating overhead of clinic weIness platform health promotion and coaching

Core operating overhead and management fees 661 661 661 Clinic access fee expense (if applicable) WeIness portal charges 072 072 072 Predictive modeling data integration service 021 021 021 Concierge referral service cost

Amortization of facilities and equipment investment Offset User access fee income (if applicable)

Total investments

Total Net Economic Value after Costs Annual Total Return on Investment based on Economic Values

Note Following keys iNS lor refarance In this schedule only - see 8acneroont for other key defin Itions

Nole Some founding difr8f9nces 01 fJ few cents may occur Qf BCCumulatfJ in the above summery

Net result from operations of the clinic wenness platform and portal with coaching engaged at clinic site

-Return is calculated as the net return in financial values indicated above divided by the total fees incremental costs of coaching and similar service activities and amortization of investment in facilities if any

PMPM PMPM

152

039

2140

Sumner pro forma evaluation 520 1312 )(ls Operations Analysis Page

Upda1a IIII~UlQll

novlo I (

Pro Forma Clinic Operations -Initial Values (year one) and tIature Value5 (year five) Undertying unimpaCed inflatIon assumpl ~on for Plan costs

Values Herein are Shown per Clinic Sile

Eligible employees

Estimated Eligible Dependents

Targeted participation percentage EIgibe employees Estimated eligible dependents

Estimated annual plan costs per employee at assumed Inflation rOIl Percentage of costa related 10 pharmacy benefit

Estimated annual plan costs related adutt population - (clinic can a dd chlldnm) and which can be Impacted from clinic and health management p

Drug portion of Ihl total

Total vlsll$ (20 minute slota)

Approlmate provider hours Per week Per 100 employee lives per week

Clinic encounter cosl$ ProVider hours

Provider cosl

Support cost

Eslimaled lab and supply costs (based on 20 mmute time Sial) Lab Supply

OperaUonal overhead for core management services Core fees C1lnic access fee paid 10 clinic employer sponsor MEOai dala inlegrahon fees Volume discount (rom sharing partner

Total

Cost for provision of clinical services

Estimated lotal drug coata Estimated percentage of impaC on drugs bull per Novia model

Estimated cost of drugs dispensed

Estimated cost of scheduled occupational health services

On-site or visiting coaching resource and health platform cos Coachrng hours WetneBS POrtal charges

Total coat of clinic and health promotion operations

Estimated displacement of Costs

EsUmated primary encounler costs Professional Lab Service lines

Total per encounterfTotalencounler cost - Estimated

Estimated Emergency Room Impact Estimated Displacement of Selected Occupational Services Estimated Impact physical therapy Drug costa dIsplaced from dispensing In clinic Estlmaled cot of Increaed utilization

Net dlspiacement 01 COlts

Net Financial Value of Clinical Operations ecludlng employee beneflt

Estimated savlnas from health risk management

Estimated Impact of dlraced referral net of service cost

Eslfmated net Impact on Plan cosl$ - per year

Estimated Value of Difference In Provider Time per Visit

Amorti2atlon of Facility Investment

Estimated time away from work saving - office visit only Average employee hourly COSI Hours saved per visit Estunated percenl9ge attribulable 10 employee usage CredioWry faclor

TIme estlmale savings

Total Estimated Economic Value

Calculation Cost

QrValue

rograma

-~

Imiddot

$2100 20

5862 75 oo~o

ltL--- lu---

-

IRIiii

= ---

Pro Forma Year 1 Pro Form) Yeu 2

- - -

l -l r-

ES lfllltHj EStlll1llctl

AfTlQUl ls Amounts

1700 1700 2400 2400

800 800 400 400

S 9800 $ 10584

2053 2053

S 16660000 S 17992800

S 3420298 S 3693922

8352 8352

67 67 39 39

3480 3480

S 313194 S 328854

211 928 222524

100222 105233 33407 35D78

$ 658752 S 691689

S 325380 S 325380

10200 10200

$ 335580 S 335580

S 994n2 S 1027269

205218 221635

1

50642 53174

138000 144900 35292 35292

173292 180192

$ 1423483 $ 1482270

A -

- bull S 1137701 $ 1228717

S 19110 $ 20639 56269 60770 7491S 80911

273624 ( ~~~~)(170655)

$ 1390966 $ 1502244

S (32517) S 19973

258350 470241

220719 323777

S 8553 $ 81U9

361 913 J9096e

154224 154224

$ 962690 S 1359081

Pro Form3 YtlJr 1 Pro Forma Year 4 Pro FOnTIC) Yeu 5

- - - - -I -

o bullbullbull

~_

--- -- -I -Elillrnltcd Eslmllt(lll Estml lod AmOHIi AmouIl15 Amom li

1700 1700 1700 2400 2400 2400

800 800 800 40 0 400 400

S 11 431 S 12345 S 13l3J

2053 2053 2053

S 19432224 S 20986802 S 22665746

S 3989436 $ 4 J08~90 $ 4653278

8352 8352 8352

67 67 67 39 39 39

3480 3480 3480

S 345296 S 362561 S 380689

233551 245333 257600

100222 100222 100222 33407 33407 33407

$ 712577 S 741524 S 771919

$ 325380 S 325380 S 325380

10200 10200 10200

$ 335580 S 335580 S 335580

$ 1048 7 $ 1077104 $ 1107499

23936e 258515 279197

55833 58624 61555

152145 159752 187740 35292 35292 35292

187437 195044 203032

$ 1530792 $ 1589288 $ 1651283

bull

S 1327014 $ 14331 76 S 1547830

$ 22290 S 24073 S 25999 65632 70 882 76553 87384 94375 10t 925

319155 344687 372282 (199052) (214976) (232174 )

$ 1622423 $ 1752217 $ 1892394

S 91631 $ 182929 S 241 112 I

578316 701691 839474

350818 382244 416045

S 1020765 S 1246864 $ 48163

422135 455906 492379

154224 154224 154224

S 1597125 S 1856 99 S 2143234

Page I Sumner pro tOfJla ampltaluetion 520 13v2 ds

Sumner Count - Clinic Operation Pro Forma

Pro forma Pro forma Impact of First Full Operating Period Year 2 Year 3

~ - ~--Overview ~ h-h- =[[31 ~~ 1-

-- shy lt - ~

~~~~~ ~Jl ~

Economic Values

Returns

Health Promotion and Medical Management Cost ofmedical provider services $ 831566 $ 558529 Scheduled occupational services 56269 $ 50642 Labs 135480 100222 Drugs I 273 624 205218

Transactional values 1296938 914611

Impact of behavioral coaching and health risk management ~ 258350 138000

Estimated net impact physical therapy services 74918

Estimated emergency room savings 19110

Estimated savings from directed referrals 220719

1870036 1052611 Annual Total Return on Investment based on Direct Savlnas ~

Additional return values

Estimated Value of Difference in Provider TIme per Visit

TIme away from work savings

Total net returns

Investment PEPM

Operating overhead of clinic weIness platfonn health promotion and coaching Core operating overhead and management fees $1595

Clinic accass fee expense (if applicable) WeIness portal charges $173

Predictive modeling data integration service $050 Amortization of facilities and equipment investment nol~~

Offset User access fee income (if applicable) nnraJCIiClIlIfIi

Total investments

Total Net Economic Value after Costs

Annual Total Return on Investment based on Economic Values Note FoIIowmg keys 1tr~fnt1c8 m ltIiII rthlaquoIuJe only - we lt~ forother key defirdQnS

_Net result from operations of the clinic wenness platform and portal with coaching engaged at dinic site

Retum is calculated as the net return in transactional values indicated above divided by the total fees and similar service costs and amortization of investment in facilities if any Depending on Plan design and specific usage financial benefit may accrue in part to Members and in part to Plan but this pro forma analysis considers only costs incurred by the Plan But correspondingly inclusion of Member out of pocket expenses within this analysis would increase overall return on investment

-Return is calculated as the net return in financial values indicated above divided by the total fees and similar service costs and amortization of investrnent in facilities if any

$ 273036 5627

35258 68406

382327

$ 311635 7596

41085 73878

434195

$ 357584 9799

57802 79789

504974

120350

74918

19110

220719

817425

22 to 1

325341

80911

20639

323777

1184863

32 to 1

426171

87384

22290

350818

1391 637

38 to 1

361913 390866 422135

154224

1333562

15lt1224

1729953

154224

1967997

325380

35292 10200

326380 -

35292 10200

325380

35292 10200

-

$

370872

962690 $

370872

1359081 $

370872

1 597125

36 to 1 47 to 1 53 to 1

Proprietary ConfidentJal Operations Analysis Page t

Sumner County - Clinic Operation Pro Forma

Pro forma Pro forma novlo First Full Operating Period Year 2 Year 3 liE

Overview Per Member per Month

Note within this summary member for first year is employee only

Economic Values

Returns

Health Promotion and Medical Management Medical provider costs Scheduled occupational services Labs Drugs

Transactional values

Impact of behavioral coaching and health risk management

Estimated Impact physical therapy services 152 164 178

Estimated emergency room savings 039 042 045

Directed referrals 713

1661 24 08 2829

Estimated Value of Difference in Provider Time per Visit 736 794 858

Time away from work savings

Total net returns 2711 3516 4000

Investment Operating overhead of clinic weIness platform health promotion and coaching

Core operating overhead and management fees 661 661 661 Clinic access fee expense (if applicable) WeIness portal charges 072 072 072 Predictive modeling data integration service 021 021 021 Concierge referral service cost

Amortization of facilities and equipment investment Offset User access fee income (if applicable)

Total investments

Total Net Economic Value after Costs Annual Total Return on Investment based on Economic Values

Note Following keys iNS lor refarance In this schedule only - see 8acneroont for other key defin Itions

Nole Some founding difr8f9nces 01 fJ few cents may occur Qf BCCumulatfJ in the above summery

Net result from operations of the clinic wenness platform and portal with coaching engaged at clinic site

-Return is calculated as the net return in financial values indicated above divided by the total fees incremental costs of coaching and similar service activities and amortization of investment in facilities if any

PMPM PMPM

152

039

2140

Sumner pro forma evaluation 520 1312 )(ls Operations Analysis Page

Upda1a IIII~UlQll

novlo I (

Pro Forma Clinic Operations -Initial Values (year one) and tIature Value5 (year five) Undertying unimpaCed inflatIon assumpl ~on for Plan costs

Values Herein are Shown per Clinic Sile

Eligible employees

Estimated Eligible Dependents

Targeted participation percentage EIgibe employees Estimated eligible dependents

Estimated annual plan costs per employee at assumed Inflation rOIl Percentage of costa related 10 pharmacy benefit

Estimated annual plan costs related adutt population - (clinic can a dd chlldnm) and which can be Impacted from clinic and health management p

Drug portion of Ihl total

Total vlsll$ (20 minute slota)

Approlmate provider hours Per week Per 100 employee lives per week

Clinic encounter cosl$ ProVider hours

Provider cosl

Support cost

Eslimaled lab and supply costs (based on 20 mmute time Sial) Lab Supply

OperaUonal overhead for core management services Core fees C1lnic access fee paid 10 clinic employer sponsor MEOai dala inlegrahon fees Volume discount (rom sharing partner

Total

Cost for provision of clinical services

Estimated lotal drug coata Estimated percentage of impaC on drugs bull per Novia model

Estimated cost of drugs dispensed

Estimated cost of scheduled occupational health services

On-site or visiting coaching resource and health platform cos Coachrng hours WetneBS POrtal charges

Total coat of clinic and health promotion operations

Estimated displacement of Costs

EsUmated primary encounler costs Professional Lab Service lines

Total per encounterfTotalencounler cost - Estimated

Estimated Emergency Room Impact Estimated Displacement of Selected Occupational Services Estimated Impact physical therapy Drug costa dIsplaced from dispensing In clinic Estlmaled cot of Increaed utilization

Net dlspiacement 01 COlts

Net Financial Value of Clinical Operations ecludlng employee beneflt

Estimated savlnas from health risk management

Estimated Impact of dlraced referral net of service cost

Eslfmated net Impact on Plan cosl$ - per year

Estimated Value of Difference In Provider Time per Visit

Amorti2atlon of Facility Investment

Estimated time away from work saving - office visit only Average employee hourly COSI Hours saved per visit Estunated percenl9ge attribulable 10 employee usage CredioWry faclor

TIme estlmale savings

Total Estimated Economic Value

Calculation Cost

QrValue

rograma

-~

Imiddot

$2100 20

5862 75 oo~o

ltL--- lu---

-

IRIiii

= ---

Pro Forma Year 1 Pro Form) Yeu 2

- - -

l -l r-

ES lfllltHj EStlll1llctl

AfTlQUl ls Amounts

1700 1700 2400 2400

800 800 400 400

S 9800 $ 10584

2053 2053

S 16660000 S 17992800

S 3420298 S 3693922

8352 8352

67 67 39 39

3480 3480

S 313194 S 328854

211 928 222524

100222 105233 33407 35D78

$ 658752 S 691689

S 325380 S 325380

10200 10200

$ 335580 S 335580

S 994n2 S 1027269

205218 221635

1

50642 53174

138000 144900 35292 35292

173292 180192

$ 1423483 $ 1482270

A -

- bull S 1137701 $ 1228717

S 19110 $ 20639 56269 60770 7491S 80911

273624 ( ~~~~)(170655)

$ 1390966 $ 1502244

S (32517) S 19973

258350 470241

220719 323777

S 8553 $ 81U9

361 913 J9096e

154224 154224

$ 962690 S 1359081

Pro Form3 YtlJr 1 Pro Forma Year 4 Pro FOnTIC) Yeu 5

- - - - -I -

o bullbullbull

~_

--- -- -I -Elillrnltcd Eslmllt(lll Estml lod AmOHIi AmouIl15 Amom li

1700 1700 1700 2400 2400 2400

800 800 800 40 0 400 400

S 11 431 S 12345 S 13l3J

2053 2053 2053

S 19432224 S 20986802 S 22665746

S 3989436 $ 4 J08~90 $ 4653278

8352 8352 8352

67 67 67 39 39 39

3480 3480 3480

S 345296 S 362561 S 380689

233551 245333 257600

100222 100222 100222 33407 33407 33407

$ 712577 S 741524 S 771919

$ 325380 S 325380 S 325380

10200 10200 10200

$ 335580 S 335580 S 335580

$ 1048 7 $ 1077104 $ 1107499

23936e 258515 279197

55833 58624 61555

152145 159752 187740 35292 35292 35292

187437 195044 203032

$ 1530792 $ 1589288 $ 1651283

bull

S 1327014 $ 14331 76 S 1547830

$ 22290 S 24073 S 25999 65632 70 882 76553 87384 94375 10t 925

319155 344687 372282 (199052) (214976) (232174 )

$ 1622423 $ 1752217 $ 1892394

S 91631 $ 182929 S 241 112 I

578316 701691 839474

350818 382244 416045

S 1020765 S 1246864 $ 48163

422135 455906 492379

154224 154224 154224

S 1597125 S 1856 99 S 2143234

Page I Sumner pro tOfJla ampltaluetion 520 13v2 ds

Sumner County - Clinic Operation Pro Forma

Pro forma Pro forma novlo First Full Operating Period Year 2 Year 3 liE

Overview Per Member per Month

Note within this summary member for first year is employee only

Economic Values

Returns

Health Promotion and Medical Management Medical provider costs Scheduled occupational services Labs Drugs

Transactional values

Impact of behavioral coaching and health risk management

Estimated Impact physical therapy services 152 164 178

Estimated emergency room savings 039 042 045

Directed referrals 713

1661 24 08 2829

Estimated Value of Difference in Provider Time per Visit 736 794 858

Time away from work savings

Total net returns 2711 3516 4000

Investment Operating overhead of clinic weIness platform health promotion and coaching

Core operating overhead and management fees 661 661 661 Clinic access fee expense (if applicable) WeIness portal charges 072 072 072 Predictive modeling data integration service 021 021 021 Concierge referral service cost

Amortization of facilities and equipment investment Offset User access fee income (if applicable)

Total investments

Total Net Economic Value after Costs Annual Total Return on Investment based on Economic Values

Note Following keys iNS lor refarance In this schedule only - see 8acneroont for other key defin Itions

Nole Some founding difr8f9nces 01 fJ few cents may occur Qf BCCumulatfJ in the above summery

Net result from operations of the clinic wenness platform and portal with coaching engaged at clinic site

-Return is calculated as the net return in financial values indicated above divided by the total fees incremental costs of coaching and similar service activities and amortization of investment in facilities if any

PMPM PMPM

152

039

2140

Sumner pro forma evaluation 520 1312 )(ls Operations Analysis Page

Upda1a IIII~UlQll

novlo I (

Pro Forma Clinic Operations -Initial Values (year one) and tIature Value5 (year five) Undertying unimpaCed inflatIon assumpl ~on for Plan costs

Values Herein are Shown per Clinic Sile

Eligible employees

Estimated Eligible Dependents

Targeted participation percentage EIgibe employees Estimated eligible dependents

Estimated annual plan costs per employee at assumed Inflation rOIl Percentage of costa related 10 pharmacy benefit

Estimated annual plan costs related adutt population - (clinic can a dd chlldnm) and which can be Impacted from clinic and health management p

Drug portion of Ihl total

Total vlsll$ (20 minute slota)

Approlmate provider hours Per week Per 100 employee lives per week

Clinic encounter cosl$ ProVider hours

Provider cosl

Support cost

Eslimaled lab and supply costs (based on 20 mmute time Sial) Lab Supply

OperaUonal overhead for core management services Core fees C1lnic access fee paid 10 clinic employer sponsor MEOai dala inlegrahon fees Volume discount (rom sharing partner

Total

Cost for provision of clinical services

Estimated lotal drug coata Estimated percentage of impaC on drugs bull per Novia model

Estimated cost of drugs dispensed

Estimated cost of scheduled occupational health services

On-site or visiting coaching resource and health platform cos Coachrng hours WetneBS POrtal charges

Total coat of clinic and health promotion operations

Estimated displacement of Costs

EsUmated primary encounler costs Professional Lab Service lines

Total per encounterfTotalencounler cost - Estimated

Estimated Emergency Room Impact Estimated Displacement of Selected Occupational Services Estimated Impact physical therapy Drug costa dIsplaced from dispensing In clinic Estlmaled cot of Increaed utilization

Net dlspiacement 01 COlts

Net Financial Value of Clinical Operations ecludlng employee beneflt

Estimated savlnas from health risk management

Estimated Impact of dlraced referral net of service cost

Eslfmated net Impact on Plan cosl$ - per year

Estimated Value of Difference In Provider Time per Visit

Amorti2atlon of Facility Investment

Estimated time away from work saving - office visit only Average employee hourly COSI Hours saved per visit Estunated percenl9ge attribulable 10 employee usage CredioWry faclor

TIme estlmale savings

Total Estimated Economic Value

Calculation Cost

QrValue

rograma

-~

Imiddot

$2100 20

5862 75 oo~o

ltL--- lu---

-

IRIiii

= ---

Pro Forma Year 1 Pro Form) Yeu 2

- - -

l -l r-

ES lfllltHj EStlll1llctl

AfTlQUl ls Amounts

1700 1700 2400 2400

800 800 400 400

S 9800 $ 10584

2053 2053

S 16660000 S 17992800

S 3420298 S 3693922

8352 8352

67 67 39 39

3480 3480

S 313194 S 328854

211 928 222524

100222 105233 33407 35D78

$ 658752 S 691689

S 325380 S 325380

10200 10200

$ 335580 S 335580

S 994n2 S 1027269

205218 221635

1

50642 53174

138000 144900 35292 35292

173292 180192

$ 1423483 $ 1482270

A -

- bull S 1137701 $ 1228717

S 19110 $ 20639 56269 60770 7491S 80911

273624 ( ~~~~)(170655)

$ 1390966 $ 1502244

S (32517) S 19973

258350 470241

220719 323777

S 8553 $ 81U9

361 913 J9096e

154224 154224

$ 962690 S 1359081

Pro Form3 YtlJr 1 Pro Forma Year 4 Pro FOnTIC) Yeu 5

- - - - -I -

o bullbullbull

~_

--- -- -I -Elillrnltcd Eslmllt(lll Estml lod AmOHIi AmouIl15 Amom li

1700 1700 1700 2400 2400 2400

800 800 800 40 0 400 400

S 11 431 S 12345 S 13l3J

2053 2053 2053

S 19432224 S 20986802 S 22665746

S 3989436 $ 4 J08~90 $ 4653278

8352 8352 8352

67 67 67 39 39 39

3480 3480 3480

S 345296 S 362561 S 380689

233551 245333 257600

100222 100222 100222 33407 33407 33407

$ 712577 S 741524 S 771919

$ 325380 S 325380 S 325380

10200 10200 10200

$ 335580 S 335580 S 335580

$ 1048 7 $ 1077104 $ 1107499

23936e 258515 279197

55833 58624 61555

152145 159752 187740 35292 35292 35292

187437 195044 203032

$ 1530792 $ 1589288 $ 1651283

bull

S 1327014 $ 14331 76 S 1547830

$ 22290 S 24073 S 25999 65632 70 882 76553 87384 94375 10t 925

319155 344687 372282 (199052) (214976) (232174 )

$ 1622423 $ 1752217 $ 1892394

S 91631 $ 182929 S 241 112 I

578316 701691 839474

350818 382244 416045

S 1020765 S 1246864 $ 48163

422135 455906 492379

154224 154224 154224

S 1597125 S 1856 99 S 2143234

Page I Sumner pro tOfJla ampltaluetion 520 13v2 ds

Upda1a IIII~UlQll

novlo I (

Pro Forma Clinic Operations -Initial Values (year one) and tIature Value5 (year five) Undertying unimpaCed inflatIon assumpl ~on for Plan costs

Values Herein are Shown per Clinic Sile

Eligible employees

Estimated Eligible Dependents

Targeted participation percentage EIgibe employees Estimated eligible dependents

Estimated annual plan costs per employee at assumed Inflation rOIl Percentage of costa related 10 pharmacy benefit

Estimated annual plan costs related adutt population - (clinic can a dd chlldnm) and which can be Impacted from clinic and health management p

Drug portion of Ihl total

Total vlsll$ (20 minute slota)

Approlmate provider hours Per week Per 100 employee lives per week

Clinic encounter cosl$ ProVider hours

Provider cosl

Support cost

Eslimaled lab and supply costs (based on 20 mmute time Sial) Lab Supply

OperaUonal overhead for core management services Core fees C1lnic access fee paid 10 clinic employer sponsor MEOai dala inlegrahon fees Volume discount (rom sharing partner

Total

Cost for provision of clinical services

Estimated lotal drug coata Estimated percentage of impaC on drugs bull per Novia model

Estimated cost of drugs dispensed

Estimated cost of scheduled occupational health services

On-site or visiting coaching resource and health platform cos Coachrng hours WetneBS POrtal charges

Total coat of clinic and health promotion operations

Estimated displacement of Costs

EsUmated primary encounler costs Professional Lab Service lines

Total per encounterfTotalencounler cost - Estimated

Estimated Emergency Room Impact Estimated Displacement of Selected Occupational Services Estimated Impact physical therapy Drug costa dIsplaced from dispensing In clinic Estlmaled cot of Increaed utilization

Net dlspiacement 01 COlts

Net Financial Value of Clinical Operations ecludlng employee beneflt

Estimated savlnas from health risk management

Estimated Impact of dlraced referral net of service cost

Eslfmated net Impact on Plan cosl$ - per year

Estimated Value of Difference In Provider Time per Visit

Amorti2atlon of Facility Investment

Estimated time away from work saving - office visit only Average employee hourly COSI Hours saved per visit Estunated percenl9ge attribulable 10 employee usage CredioWry faclor

TIme estlmale savings

Total Estimated Economic Value

Calculation Cost

QrValue

rograma

-~

Imiddot

$2100 20

5862 75 oo~o

ltL--- lu---

-

IRIiii

= ---

Pro Forma Year 1 Pro Form) Yeu 2

- - -

l -l r-

ES lfllltHj EStlll1llctl

AfTlQUl ls Amounts

1700 1700 2400 2400

800 800 400 400

S 9800 $ 10584

2053 2053

S 16660000 S 17992800

S 3420298 S 3693922

8352 8352

67 67 39 39

3480 3480

S 313194 S 328854

211 928 222524

100222 105233 33407 35D78

$ 658752 S 691689

S 325380 S 325380

10200 10200

$ 335580 S 335580

S 994n2 S 1027269

205218 221635

1

50642 53174

138000 144900 35292 35292

173292 180192

$ 1423483 $ 1482270

A -

- bull S 1137701 $ 1228717

S 19110 $ 20639 56269 60770 7491S 80911

273624 ( ~~~~)(170655)

$ 1390966 $ 1502244

S (32517) S 19973

258350 470241

220719 323777

S 8553 $ 81U9

361 913 J9096e

154224 154224

$ 962690 S 1359081

Pro Form3 YtlJr 1 Pro Forma Year 4 Pro FOnTIC) Yeu 5

- - - - -I -

o bullbullbull

~_

--- -- -I -Elillrnltcd Eslmllt(lll Estml lod AmOHIi AmouIl15 Amom li

1700 1700 1700 2400 2400 2400

800 800 800 40 0 400 400

S 11 431 S 12345 S 13l3J

2053 2053 2053

S 19432224 S 20986802 S 22665746

S 3989436 $ 4 J08~90 $ 4653278

8352 8352 8352

67 67 67 39 39 39

3480 3480 3480

S 345296 S 362561 S 380689

233551 245333 257600

100222 100222 100222 33407 33407 33407

$ 712577 S 741524 S 771919

$ 325380 S 325380 S 325380

10200 10200 10200

$ 335580 S 335580 S 335580

$ 1048 7 $ 1077104 $ 1107499

23936e 258515 279197

55833 58624 61555

152145 159752 187740 35292 35292 35292

187437 195044 203032

$ 1530792 $ 1589288 $ 1651283

bull

S 1327014 $ 14331 76 S 1547830

$ 22290 S 24073 S 25999 65632 70 882 76553 87384 94375 10t 925

319155 344687 372282 (199052) (214976) (232174 )

$ 1622423 $ 1752217 $ 1892394

S 91631 $ 182929 S 241 112 I

578316 701691 839474

350818 382244 416045

S 1020765 S 1246864 $ 48163

422135 455906 492379

154224 154224 154224

S 1597125 S 1856 99 S 2143234

Page I Sumner pro tOfJla ampltaluetion 520 13v2 ds

novlc Sumner County - Clinic Operation Pro Forma

Pro forma effect on Annual Medical Expenditures from Managing Risk Profiles and Centralized Referral

Pro Forma Year Pro Forma Year Pro Forma Year Pro Forma Year Pro Forma Year 1 2 3 4 5

Annual expenditures at assumed Inflation $ 16660000 22859852 $ 24688641 26663732 $ 28796830

Reduction attributable to clinIc and health management Clinical operations 32 517 (19973) (91631) (162 929) (241 112)

Heallh promotion impact measured in this schedule 701691

Directed referral Impact NIA 27854027

416045

Net annual expenditure subject to health promotion Oblectlve for reduction In risk factors

16471798 $ 22257752 $ 23 715950 S 25540243 $ 27437982

Costs attributable to controllable risk factors

Smoking dlel rcse elc 2493 4 161444 5629 575 $ 601 4803 $ 6462476 $ 6944 009

Targeted cumulallve reducllon In high risk profile 600 750 900 1050 1200

Pro forma economic effect of reduction In rsk middot9shy 249687 $ 422218 S 541332 $ 678560 $ 833281

Estimated effect of stated change In

conditions

Alternative 1 See Information In Appendix A MmiddotiiiN

Move rom high risk 10 moderale risk prom 60 84 104 125 146 167

Over age 55 Persons Amoun t $ 4810

Age 4510 54 Persons Amount $ 4898

Below age 45 Persons Amount 3726

Annual flnanciallmpact per this analysis _ill_

Accumulallng Impact Alternative 2 See Information In Appendix A

55

S

46

9

29

$

$

11 238624

2 47184

7 11 5344

401152 401152

$

S

11 64428

2 12740

7 31 143

108311 509463

$

$

S

11 69583

2 13759

7 33634

116976 626439

$ 11

751 49 2

14860 7

36325

126334 752773

Improve to body mass index by one Isvvl reduce two risks for persons with four risks 84 104 125 146 167

BM I above 35

BMI 30 1035

BMI 2510 30

Persons Amount Persons Amoun t Persons Amount

6928

6516

6246

17

25

42 $

$

4 124981

6 176323

10 281694

$ 4

33745 6

47607 10

76057

$

4 36444

6 51416

10 82142

S

$

S

4 39360

6 55529

10 8871 3

Annual flnanciallmpact per this analysis

Weighted Impact

$ $ $

582998 582998

S S

157409 740407

$ S

170002 910410

$ S

183602 1094012

General reduction in risk factors Specific illustration - risk profile Specific iIIustral ion - BMI prof le

S 187265 $ 316664 50144 72875

405999 63 683 92551

508920 78305

113801

624 961 94097

136752

Objective for Reduction In Cost per above S 187265 S 439682 S 562233 $ 701026 $ 855809

Sumner pro forma evaluation 52013v2xls Health Promotion and Steerage Pag2