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Technology Enables Market Opportunities
Smart Technology SolutionsHealth Claims Processing ● Human Capital Management ● Business Process Automation
Smart Employee Benefits Inc.John McKimm 416-460-2817
June 2013
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Notice
CAUTIONARY STATEMENT This document is intended for information purposes only. Statements made in this document may contain “forward looking” information about the company’s future business prospects. These statements – while expressed in good faith and believed to have a reasonable basis – are subject to risk and uncertainties that could cause actual results to differ materially from those set forth or implied by such forward looking statements. Investors should consult a professional advisor before making any investment decision.
PROPRIETARY NOTICE All pages of this document contain information proprietary to Smart Employee Benefits Inc. (“SEB”). This document shall not be used, or otherwise disclosed to anyone other than the organization or specific individuals to which this document is delivered. This document shall not be duplicated, or transmitted in any form by any means, or otherwise to anyone other than the organization without prior written permission from SEB. This restriction is applicable to all pages of this document. SEB reserves the right to have the recipient return all copies of this document at any time.
REFERENCEAll data and statistics referenced in this document are sourced from various publications from the insurance industry and research organizations including Fraser Group.
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Technology Enables Market Opportunities
SEB at a Glance
Offices Employees & Contractors Stock Market Symbol
\
Canada: Mississauga, Markham, Ottawa Approx. 123 in Canada TSXV: SEB Dubai, UAE and Hyderabad, India 45 in India
Share Price Shares Outstanding Market Capitalization
Range: $0.30 to $0.40 Basic: 61.0 mm F/D: 86.2 mm Approx. $20.0 mm
Note: Dilution at the lowest exercise price brings over $12.5 million of new capital
Insiders
Public
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Technology Enables Market Opportunities
SEB IS A TECHNOLOGY COMPANY
SEB is a Technology
Company
providing leading edge
“Business Processes Software,
Solutions & Services”
with particular emphasis on
“Managing Employee
Group Benefit Solutions and
other Healthcare Claims
Processing Environments”
Health Claims Processing• Group Benefits• Other Health Claims
Software and Systems Integration Solutions
Human Capital Management Software, Solutions and Services
Revenue Distribution Targets (24 months)
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Technology Enables Market Opportunities
SEB’s GROWTH STRATEGY ACQUISITION DRIVEN
1) Employee Group Benefits:
Acquisitions: target Third Party Administrators (“TPAs”), Benefit Consultants and Insurance Broker organizations.
Objective: secure client relationships and transition many of the front and back office business processes to the SEB technology environment, effectively turning outsourcing cost centres to in-house profit centres.
Organic Growth: driven by transition to SEB’s technology platform.
2) Governments - Federal, Provincial, Municipal
Acquisitions: target Technology companies (primarily IT) that have vendor relationships, security clearances and project references.
Objective: secure the business credentials necessary to be eligible to bid competitively. All government contracts are competitive RFP (Request for Proposal) processes.
Organic Growth: driven by budget increases in government contracts won and by new successful bids. Success increases as critical mass increases.
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Technology Enables Market Opportunities
SEB Business Model - Software Enabled Services
Acquisitions Underpin Growth Strategy Across Both
Divisions
Vision: “Services” Driven By Unique Software Solutions and Systems Integration Expertise
Big Data Management Solutions &
Expertise
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Technology Enables Market Opportunities
Health Claims Processing is Immediate Focus
1) Employee Group Benefits (over $33.0 Billion in 2012)
Pooled Benefits (AD&D, Term, Disability etc.)
Health Benefits (Drugs, Wellness, etc.)
Dental Benefits
2) Other Health Claims (over $23.0 Billion in 2012)
WSIB (12 in Canada, over $10.0 billion of claims)
Travel Claims
Government Health Plans (Federal & Provincial)
Dental and Pharmaceutical Associations
Hospitals, Private and Public
Other (numerous other applications)
Immediate Focus: Employee Group Benefit Health Claims
Processing Complementary Focus: Software, Systems Integration and Human Capital Management Solutions
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Technology Enables Market Opportunities
SEB’s Health Claims Business Model:Acquisition and Transition
Current Industry ModelNo Fully Integrated Solution
The SEB Business ModelA Fully Integrated Total Outsourcing Solution
The SEB Business Model focuses on acquiring TPAs and investing in Brokers/Consultants to effect more control over the Outsourcing and Insurers decisions. Typically, TPAs or Insurers control the Outsourcing decision and Brokers/Consultants have significant influence on whether a Client goes directly to an Insurer or a TPA. Both TPAs and Brokers/Consultants influence the selection of and negotiations with Insurers. SEB’s Objective is for Brokers/Consultants to Recommend the SEB TPA Environment.
SEB’s TPA Business Model and Technology Platform is a Total Outsourcing Solution Allowing SEB More Influence over the Outsourcing and Insurer Decision and Increases SEB’s Outsourcing Revenue Participation by up to 700%
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Technology Enables Market Opportunities
SEB’s Fully Integrated Technology Solution...Adjudicating at the Individual Level is Game Changing FunctionalitySEB has a “Fully Integrated Health Claims Processing Technology Platform” Capable of Totally Automating Adjudication and Reporting at the Employee/Individual/Detailed Benefit Level in one Technology Environment.
Note: 1) Estimated that over 300,000,000 drug and dental claims get adjudicated annually. In Canada Drug Claims alone exceeded $33,000,000,000 in 2012. 2) The “Holy Grail” of Healthcare Claims Processing is the “Adjudication Technology”. 9
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...SEB’s Fully Integrated Technology Solution...All Health Claims Processing Functionality Occurs in
One Integrated Technology Environment.
Configuration Management
System SEB Super User
SEB System Administrator
SEBCSR
SEBFinance
SEBASR
GroupAdmin
Group Employee
Providers
Brokers
TPAs
SEB Administration Module
On-Board New Client
Maintenance
Billing
Reporting
Payment
AUTHENTICATION LAYER
I N T E G R A T I O N
L A Y E R
A U TH E N T I C A T I O N
L A Y E R
Adjudication Engine
(Accepted and
Rejected Claims)
Security Management
Geography, Tax
Management
Language Management
GroupManagement
Class Management
Employee Management
Dependants Management
Brokers, Commissions Management
Carriers, Benefits
Management
Sales Rep, Commission Management
Providers (Dentist/Phar
macy)
Member Plan Booklet
Drug Information
Management
Dental Procedures
Management
Plan Management
P1
Telus Health
Other
Dentist
Pharmacy
Adjudication(Claims Data)Query/
ReportingAdministration
Replicate Claims
Card PrinterMobile App Ad-Hoc
ReportsStandardReports
Charts andDrill Down
A HUGE COMPETITIVE ADVANTAGE
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...SEB’s Fully Integrated Technology Solution
Automated Rules Based Adjudication Platform Supports The Most Flexible and Automated Plan Designs in the
Industry SEB’s rules based platform allows trained administrators, not programmers to create and implement new rules without the rigors of typical software development.
Adjudication Plan Design Rules
Adju
dic
ati
on F
isca
l R
ule
s
Claims Adjudication Processing Engine (Adjudicates all Health & Dental Claims)
SEB’s Rules
Engine is
separate from
the Adjudication
Processing
Engine.
All other
Adjudication
Processing
Engines
incorporate
these rules
directly into the
Adjudication
Processing
Engine.
Adjudication Plan Design Rules
Claims Adjudication Processing Engine (Adjudicates all Health & Dental Claims)
If / ThenElse = Answer
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SEB’s Health Claims Value Proposition
SEB’s Technology Platform Provides the Most Flexible Automated Plan Designs in the Industry.
Adjudication of health benefit claims on a detailed individual level, unique in the health claims processing industry.
Rules Based Adjudication in one technology environment for all benefit types versus the industry norm of multiple environments.
A fully integrated technology environment that is the most automated in the industry and is able to implement and adjudicate the most detailed and flexible plans in the industry.
Administration software that is seamlessly integrated with adjudication, payment processing and reporting. Enhances efficiency for all users. Unique in the industry. Can be deployed as a module.
Reporting is the most detailed in the industry and the only platform with self service functionality including real time access to standard reports and data mining capability for customized reports.
Objective: To Put Control of Each Health Care Dollar Into the Hands of the Employer/Employee
“YOU CAN ONLY MANAGE WHAT YOU CAN REPORT ON”12
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Technology Enables Market Opportunities
Canadian Group Benefits IndustrySteady Growth and Recession-Resistant
Premiums by Benefit Category - Grew over 81% since 2001
Benefit 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
1. Pooled
Life/AD&D $2.2 $2.2 $2.3 $2.4 $2.5 $2.5 $2.6 $2.8 $2.8 $2.9 $3.3
ST Disability $1.1 $1.1 $1.1 $1.0 $1.1 $1.1 $1.3 $1.4 $1.4 $1.4 $1.5
LT Disability $3.1 $3.4 $3.7 $3.9 $4.2 $4.4 $4.7 $5.0 $5.2 $5.4 $5.5
Total $6.4 $6.7 $7.1 $7.3 $7.8 $8.0 $8.6 $9.2 $9.4 $9.7 $10.3
% of Premiums 35.6% 34.0% 33.8% 32.6% 32.9% 31.6% 31.6% 31.6% 31.1% 31.1% 31.5%
2. Dental $4.5 $4.8 $5.1 $5.4 $5.6 $6.0 $6.3 $6.7 $6.9 $7.0 $7.3
% of Premiums 25.0% 24.4% 24.3% 24.1% 23.6% 23.7% 23.2% 23.0% 22.8% 22.4% 22.3%
3. Health $7.2 $8.2 $8.8 $9.7 $10.3 $11.3 $12.3 $13.2 $13.9 $14.5 $15.1
% of Premiums 40.0% 41.6% 41.9% 43.3% 43.5% 44.7% 45.2% 45.4% 46.0% 46.5% 46.2%
4. Total Premiums $18.0 $19.7 $21.0 $22.4 $23.7 $25.3 $27.2 $29.1 $30.2 $31.2 $32.7
Note: Total Premiums in 2012 is estimated to exceed $34.0 billion
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Technology Enables Market Opportunities
...Canadian Group Benefits Industry…Dominated by a Few Insurers
Top 10 Insurers – Control over 95.5% of MarketTPAs - process approximately 13% of Premiums, and Growing
Outsourcing Services – an Industry Norm for Insurers and TPAs
Insurers 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Sun Life 13.1% 21.2% 22.3% 20.8% 21.2% 21.8% 21.8% 21.0% 21.9% 23.0% 22.3%
Great West Life 18.3% 18.4% 25.9% 23.3% 22.9% 22.5% 22.1% 22.3% 22.1% 22.9% 22.1%
Manulife Financial 11.5% 11.1% 11.8% 22.9% 22.7% 21.8% 21.5% 21.0% 21.0% 21.1% 20.0%
Blue Cross 9.8% 10.2% 10.9% 10.2% 9.6% 10.6% 10.6% 10.5% 10.6% 10.7% 10.4%
Dejardins Financial
3.9% 4.2% 5.0% 4.8% 4.9% 5.1% 5.6% 5.9% 5.8% 6.1% 6.1%
SSQ Financial 3.2% 3.5% 3.9% 3.8% 3.9% 3.9% 3.8% 3.9% 4.0% 4.2% 4.2%
Greenshields N/A N/A 3.3% 3.4% 3.4% 3.5% 3.4% 3.6% 2.9% 3.6% 3.7%
Industrial Alliance N/A 2.5% 2.8% 2.6% 2.6% 2.7% 2.7% 2.9% 3.6% 3.1% 3.1%
Standard Life N/A N/A 2.1% 2.0% 2.1% 2.1% 2.1% 2.2% 2.1% 2.2% 2.2%
La Capitale N/A N/A N/A N/A N/A N/A N/A N/A 1.2% 1.3% 1.3%
Clarica Life 8.8%Acquired by Great West Life
------------------------------------------------------------------------------------------------------
Maritime Life 8.3% 8.1% 12.0%Acquired by Manulife
-----------------------------------------------------------------------------------
Canada Life 6.4% 6.3%Acquired by Great West Life
--------------------------------------------------------------------------------------
Liberty Health 3.1% 3.1%Acquired by Maritime Life
-------------------------------------------------------------------------------------------
Cooperators N/A N/A N/A 1.4% 1.4% 1.3% 1.3% 1.2% N/A N/A N/A
Note: 8 of the top 10 Insurers outsource adjudication. Only Blue Cross and Greenshields have their own dedicated adjudication platforms. 14
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Technology Enables Market Opportunities
SEB’s Business Strategy/Business Model Summarized
Technology Ownership and Expertise
turns cost centres to profit centers reducing costs for clients and capturing more revenue and profitability for SEB.
allows highly customized solutions to be provided to clients efficiently and cost effectively.
Acquisition Growth Model
acquires existing client relationships which can be transitioned to the fully integrated SEB technology environment enhancing profitability.
creates the critical mass of business relationships, vendor arrangements, reference projects and security clearances to win competitive RFP business, both government and private sector.
reaches consolidated profitability faster.
SEB, through acquisition and organic growth initiatives, is creating a global infrastructure of business and technology expertise, supporting a highly customizable and scalable “Services” business model around proprietary software solutions driving annuity revenue streams, with a primary focus on managing big data, particularly in healthcare.
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Technology Enables Market Opportunities
80,000+ Users
170 Countries
30+ Hub Enterprises
3+ Billion Transactions/Annum
20,000+ Spoke Trading Partners
10 Supply Chain Products
16
Corporate Profile
SEB’s First AcquisitionQLogitekimagine where you could be
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Technology Enables Market Opportunities 17
The Strategic Fit Between SEB and the QLogitek Acquisition...Supply Chain Expertise
A Supply Chain is any business that connects and manages transactions between parties with the objective of providing end to end visibility with complete integration to all internal and external systems. Supply Chains permeate the Business Operations of every organization.
QLogitek is a leader in providing Supply Chain software and systems integration expertise to multiple industries including retail, manufacturing, financial services, etc.
SEB has unique Adjudication Technology, the “Holy Grail” of the Health Claims Processing Supply Chain, capable of adjudicating at the employee/individual level.
QLogitek surrounds the Adjudication environment with Supply Chain solutions and expertise in Administration, Payment Processing and Reporting to enhance SEB’s fully integrated Health Claims Processing solutions platform. QLogitek is a highly respected technology company which adds credibility to SEB as a technology provider.
Result – the most flexible and easily customized Health Claims Processing solutions in the industry, delivered from a highly credible supply chain technology customer base.
Health Claims Processing is a Specialized Supply Chain
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QLogitekimagine where you could be
30+ Hub Enterprises 20,000+ Spoke Trading Partners
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Select Clients - all potential health benefit clients
- all RFP Reference Clients
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QLogitekimagine where you could be
19
Software & Services – 12 Proven SolutionsHosted EDI System
Supplier Order Mgmt. System
Customer Order Mgmt. System
SKU Mgmt. System
Inbound Mgmt. System
Product Lifecycle Mgmt. System
Claims Mgmt. System
Repair Order Tracking System
Supply Chain Performance Dashboard
Payment System (L’ePAY)
Managed Services
Supply Chain Consulting Services
Note: Health Claims Processing is a specialized supply environment
Credibility: Billions of transactions are processed annually
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QLogitekimagine where you could be
Awarded By Award / Designation
Name Year
Retail Council of Canada (RCC)
Supply Chain Excellence Award
2007
Council of Supply Chain Management Professionals
(CSCMP)
Supply Chain Innovation Award
2007
Microsoft Corporation Small Business Specialist 2006
Voluntary Inter-industry Commerce Standards
(VICS) Global Award 2005
Retail Council of Canada (RCC)
Annual Excellence in Retailing Award
2004
Retail Council of Canada (RCC)
Supply Chain Excellence Award
2004
Microsoft Corporation“Go-To” PartnerSupply Chain Management
2002
IDC Innovation Award 2001
Microsoft Corporation Microsoft.NET Award 2001
Awarded By Award / Designation Name Year
Retail Council of Canada (RCC)
Supply Chain Excellence Award 2012
Microsoft CanadaIMPACT Award WINNER
Integration Application Partner 2011
Microsoft Corporation
Technology Adoption Program SQL Azure Reporting 2011
Microsoft Canada IMPACT Awards Finalist
Application Integration Category 2011
Microsoft Corporation
Worldwide Partner Awards Finalist
Application Integration Category2011
Microsoft Canada IMPACT Awards Finalist
Hosting Category 2010
Microsoft Corporation
Virtual TS Program 2010
Microsoft Corporation
Worldwide Partner Awards Finalist
Application Integration Category 2010
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Recognition & Awards: Credibility as a Technology Provider
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Technology Enables Market Opportunities 21
About SOMOS: Critical Mass of Business with Governments Ottawa-Based Management
and Technology Consulting company
Customers include: Federal Government Information Technology
Organizations Developers and
manufacturers of technology-based products
Aerospace and Defence. Project Management and IT
Specialists Consulting Professional Services Training Systems
PRINCE2® Training since 1997 First North American Accredited
Consulting Organization (ACO) PRINCE2®
MoP®
P3M3®
First North American Accredited Training Organization (ATO) PRINCE2®
MoP®
P3M3®
PMI REP®
Microsoft Silver Partner Project and Portfolio Management
Deltek Tools Partner
SEB’s Second Acquisition
SOMOSA Clear Path to Results
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SOMOSA Clear Path to Results
22
Service/Market Mix:- Adds to Technology Credibility- Provides Reference Clients
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SOMOSA Clear Path to Results
23
Services Offered: Complementary in Customizing and Supporting Health Care Solutions
Consulting Diagnostics Strategic Planning Procurement Communications
PM Professional Services Project Managers PM Analysts & Support Project & Program
Planning Project Systems
Planning & Implementation
IT Professional Services Business Analysts Java Programmers DBAs
Training PRINCE2 Project
Management Managing Successful
Programs Management of Portfolios Management of Benefits Management of Risk PMBOK Workshops On-Line Training (soon)
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Technology Enables Market Opportunities
InforicaInnovation for your Unique Situation
24
About Inforica: Adds to Critical Mass of Business and Technology Expertise in Data Management Solutions
India Outsourcing Office: Low Cost Development and Support Infrastructure. Dubai (free zone company): Huge Market Opportunities for Health Benefit Solutions. (Oman Insurance in Dubai is the biggest user of the SEB Adjudication Platform.) Software Vendor Partnerships: Technology Credibility. Extensive Client Relationships: Market Opportunities for Health Benefit Solutions. References for RFP submissions: Important in Winning Competitive Bid Contracts. Energy Management Software and Business Process Solutions: Adds to Technology
Credibility and increases critical mass of transaction support infrastructure. Expand QLogitek and SEB Capabilities: Adds to Technology Expertise.
Inforica Inc. Extensive Systems Integration and
Data Management Technologies Expertise
Inforica Energy Solutions Inc.Energy Software Solutions and Business Process Automation
Services.Canada India and Dubai UAE
SEB’s Third Acquisition
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Technology Enables Market Opportunities
Independent Directors
Ron Barbaro, Chairman of the BoardNancy Elliott (2)
Keith HarrisChristine Hrudka Stephen Peacock (3)
Internal Directors & Executive Management
Walter Simone, Vice Chairman/Director (1) Barry Walsh, Director John McKimm, CEO/Pres/CIO/Director (1)
Robert Prentice, COO/CFO (1)
Latiq Qureshi, President, QLogitek (1)
Ralston Senewiratne, EVP (1) Adam Jasek, EVP (1)
SEB’s Executive Management and Board of Directors
SEB’s Executive Management and the Board of Directors have over 300years of experience and credibility in building and managing companies, including technology and Insurance related businesses.
Notes: 1) Members of the Executive Committee.2) Chair of Corporate Governance Committee. 3) Chair of Audit, Acquisition and Special Committee.4) Chair of Human Resource and Compensation Committee to be
appointed. 25
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Investment Highlights
Insider Share Ownership over 70%
Insiders own over 70% of SEB’s issued and outstanding shares.
Experienced Management and Board
Have a proven track record of building and managing companies utilizing both acquisition and organic growth strategies. Over 300 years of experience with extensive relevant industry and business relationships.
Market Leading Technology Advantage
SEB companies have leading, unique, proven, proprietary technology with the potential to cause major structural changes in the healthcare claims processing industry and create a new market presence.
Predictable, Scalable, Cost Structure
Solutions and services are largely executed by technology. People component is low cost and easy to scale.
High Gross Margin Business Model
The gross margins in health claims processing, from a fully integrated platform, are over 60%.
Recession Resistant Annuity Revenue
Steady growth in health benefits over the past decade even in in a recession.
Minimal Working Capital Requirements
Minimal Capital Expenditures. Clients pay in advance for most services. Huge Cash Float.
Massive Industry - Health Benefits
Over $56.0 billion in Health Claims Processing in Canada with over $34.0 billion in Employee Group Benefits Premiums.
High Growth Business Model - Acquisition/Investment/Joint Venture
Many acquisition/investment/joint venture opportunities in a fragmented industry. Owners looking for succession. Client Referral growth model.
Greater Participation in Revenue - Referral and Transition
Organic growth driven by transition of clients to SEB Health Benefits Technology platform. Transition to SEB technology Captures up to 700% more revenue.
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TSX: MSIMarket Cap:
$673+ million
TSX & TSXV Companies Have Achieved High Valuations Due to Game Changing Technology Solutions
TSX: CCTMarket Cap:$10+ billion
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SOMOSA Clear Path to Results
QLogitek
Inforica Innovation for your Unique Situation
imagine where you could be
SEB is an Acquisition Driven
Business Opportunity with a
Technology Advantage in an
Industry Characterized by Old
and Fragmented Technology
Solutions.
Acquisitions to Date all
contribute
to consolidated profitability.
Annualized consolidated sales are
in excess of $14.0 million.
Game Changing Technology
Solutions
For Health Claims Processing