Transcript Your way forward - BEST Health QUOTE

Assurant Health
Charging Face of Health Care
• There have been many economic and political changes
in the last year
– Health Care Reform
– Increase in major medical insurance premiums
– Confusion in the marketplace
• Despite these changes, the basic consumer need
HAS NOT changed
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Affordable health care
Access to care
Network discounts
Great customer experience
Reputable “A” rated carrier
Broad portfolio to meet spectrum of needs
Access to
Health Care
• 1st Dollar Benefit
• Deductible
• Fixed Benefit
• Unlimited Benefit
• Wellness / Rx
• Wellness / Rx
• Lower Premium
• Higher Premium
Assurant Health AccessSM
Supplemental Coverage
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Asset
Protection
Major Medical Products
Supplemental Coverage
Health Savings Accounts
Assurant Health AccessSM
Having Access PaysSM
Assurant Health AccessSM
 Alternative to traditional medical insurance
 Assurant Health Access is suite of limited benefit plans
 Value Plan
 Fundamentals Plan
 Enhanced Plan
 Pays a fixed benefit for each service, regardless of
actual charges
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Assurant Health Access
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Value
Access to immediate medical care
Benefits for hospitalization
Benefits for surgery
Outpatient services
No deductible, co-pay or coinsurance
National network discounts
Consumer Value and Education
• Patient Care
– Independent health care advocacy for routine or
non-emergency care
– Recommends quality doctors/facility that cost you the least
• Network Discounts
• Medco Pharmacy
• Retail Clinics
– Negotiated fee of $65 at Walgreen’s Take Care Clinic
• Health Payment Advocates (HPA)
– Use professional negotiators at HPA to reduce any outstanding
bills or set up a payment plan
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Looking for affordability
• Don’t see value in traditional medical plans
– Meeting a high deductible is not an option
• Place highest value on access to basic health care
– They need to stay healthy to keep working
– If something really bad happens … they’ll deal with it
• Haven’t had coverage or cannot afford traditional plans
• Dropping an IM or Group plan
• Child-only major medical is unavailable
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Everyday needs
Plan Feature
Office visits
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Value
Fundamentals
Enhanced
$50 each for 2 visits
$50 each for 4 visits
$75 each for 4 visits
Discount plus:
Prescriptions
Rx Discount
$10 for generic / $25
for brand/ $750/CY
Discount plus:
$10 for generic /$35
for brand/$750/CY
Immunization
Allergy Shots
$10 per
immunization
$10 per allergy shot
$100/CY combined
$10 per
immunization
$10 per allergy shot
$100/CY combined
$10 per
immunization
$10 per allergy shot
$100/CY combined
ER, Hospitalization and Surgical Benefits
Plan Feature
Value
Fundamentals
Enhanced
Inpatient
hospitalization
$1,000/day for
sickness
$2,000/day for injury;
$200,000/CY
$2,000/day for
sickness
$4,000/day for injury
$500,000/CY
$3,000/day for
sickness
$6,000/day for injury
$1million/CY
Inpatient and
Outpatient Surgery
Plan pays 100% of the
2010 Medicare
physician surgical
schedule
Plan pays 100% of the
2010 Medicare
physician surgical
schedule
Plan pays 150% of the
2010 Medicare
physician surgical
schedule
$200 / 1 per year
$200 / 2 per year
$200 / 3 per year
$100/ground;
$1000/air
2 trips/yr
$100/ground;
$1000/air
2 trips/yr
$100/ground;
$1500/air
2 trips/yr
1 urgent care or
ER at $250/visit
1 urgent care at
$100/visit
and
1 ER at $400/visit
Anesthesia
Ground and Air
Ambulance
Emergency Room
/Urgent Care
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1 urgent care or
ER at $150/visit
Outpatient Events
Plan Feature
Value
Fundamentals
Enhanced
$100 Surgical
pathology lab
$15 All lab except
surgical pathology
$25 Other OP Svc
$100 Surgical pathology
lab
$15 All lab except
surgical pathology
$25 Other OP Svc
$100 Surgical
pathology lab
$15 All lab except
surgical pathology
$25 Other OP Svc
$25/session
$25/session
$25/session
Outpatient
radiology services
$50 x-ray or ultrasound
$130 mammogram
$250 PET scan
$300 CT scan
$450 MRI
$50 x-ray or ultrasound
$130 mammogram
$250 PET scan
$300 CT scan
$450 MRI
$50 x-ray or ultrasound
$130 mammogram
$250 PET scan
$300 CT scan
$450 MRI
Outpatient
Calendar Year Max
$1,000/year
$1,000/year
$3,000/year
Outpatient lab
& other
Outpatient
PT/OT/SP
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Product differentiators
• Heath Access product differentiators
– Higher level of inpatient hospital confinement than many competitors
– $1,000-$3,000 on sickness and $2,000-$6,000 for injury
– Doctor visits are not limited to wellness, can be used
for sickness
– Inpatient is not limited to one visit per year
– Lifetime maximum is large $1M-$3M
– Medco pharmacy discounts typically 14-40%
– Save up to 60% on outpatient laboratory services
– Network discounts apply even after calendar year maximum
is reached
– Discount card is included with discounts for vision care, chiropractic
care, alternative health and wellness, and more
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At the point of service
How it all works
• Providers
– No claim forms when client assigns benefits
– Providers paid directly when client assigns benefits
– Clients can find participating network doctors at
multiplan.com/assurant or by calling Patient Care
• Pharmacy
– All plans -- client pays discounted rate at pharmacy
– For Fundamentals and Enhanced
• Medco informs us of claim
• Client receives check 2-4 weeks later
• Benefit can more than cover out-of-pocket expense
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Circle of care
Consumer Needs
health coverage
Applies for Health Access
Can contact HPA if
balance over $500
Visits doctor using
insurance card
Customer
receives EOB
with balance
due, if any
Lab work using
discount network
Visits pharmacy
to receive
Rx Discount
Benefits are applied
Network discount applies
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Health Payment Advocate Capabilities
• External advocate that customer contacts directly
• Negotiations to reduce amount owed by policyholder
• Review final bill for accuracy of charges (including verifying PPO
discounts, questionable charges)
• Establish payment plan to ease financial burden
HPA Contact Number 877.277.0080
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Patient Care Can Help
• In welcome packet customer receives a Patient Care
HIPAA release which they return to Patient Care to begin
the process
• Customer calls Patient Care to:
– Find a doctor
– Find doctor/hospital for non-emergency medical services,
Common examples: Colonoscopies, MRI’s, Knee Surgery Provide
cost and quality information on doctors and hospitals
• Identify lower-cost drug options
• Explain and educate how to manage health care benefits
Patient Care does not provide clinical or legal advice.
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Support your sales
• Assurant Health helps support
your sale by offering
– Welcome Call to customer to go
over key value proposition
• Sends Customer a Benefits Guide
post sale
– Explains to the customer how to
maximize their benefit dollar
– Details of HPA and Patient Care
with Contact Information
– Information on Discount card
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Wellness benefits to help keep you healthy
Routine gynecological exam with labs
Medical costs:
$175
$90
$265
- $116
$149
Save money by asking
Patient Care to
recommend a highquality but lower cost
doctor and facility
Office visit
Lab test
Total visit
Network discount
After discount
Value
Fundamentals
Enhanced
Total related charges
$149
$149
$149
Fixed-benefit office visit
$50
$50
$75
Fixed-benefit lab
$15
$15
$15
Total fixed benefit paid
$65
$65
$90
Customer pays balance
$84
$84
$59
Customer must assign benefits to provider to get network discount
Discount amounts based on Assurant Health claims data. Results may vary.
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Sickness benefits to get you healthy again
Take Care Clinic for strep throat
Medical costs:
$65
$5
$70
Negotiated rate, including lab
Generic Amoxicillin
Total related charges
Value
Fundamentals
Enhanced
Total related charges
$70
$70
$70
Fixed-benefit office visit
$50
$50
$75
Fixed-benefit generic Rx
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$10
$10
Total fixed benefit paid
$50
$60
$85
Customer pays
(receives) balance
$20
$10
($15)
Customer must assign benefits to provider to get network discount
Discount amounts based on Assurant Health claims data. Results may vary.
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Visit walgreens.com for
store locator
Injury Benefits to keep you moving
Broken Arm (radius)
Medical costs:
$1,440
ER /Physician Charge
Total related
charges
Fundamentals
Enhanced
$1,790
$1,790
$1,790
$150
$250
$400
$300
Cast Application
$465
Follow-up office visits (4)
Benefits Paid
ER /Physician
Charge
$475
X-rays (5)
Cast Application
$85
$85
$127
Total Expenses
Follow-up office
visits (4)
$100
$200
$300
X-rays (5)
$250
$250
$250
Total fixed benefit
paid
$585
$785
$1077
Remaining Balance
$1205
$1005
$713
HPA @ 20%
$241
$201
$143
Customer Pays
$964
$804
$570
$2,684
$894
$1,790
Network discount
After discount
Customer must assign benefits to provider to get network discount
Discount amounts based on Assurant Health claims data. Results may vary.
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Value
Assurant Health Access
Affordably priced within reach
Sample monthly premiums
Primary policyholder
0-17
18-30
31-40
41-50
51-64
Value
$54
$67
$74
$94
$144
Fundamentals
$89
$109
$119
$159
$249
Enhanced
$139
$169
$189
$249
$386
+ One-time, non-refundable application $25 processing fee
Premiums and fees may vary by state.
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Easy selling process
• Only 3 medical questions asked
• Simplified rating
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Not gender rated
Not area rated
No height or weight restrictions
Not rated for risk class
No smoker status
Has very broad age bands
Based on age of primary applicant
• One-time, $25 processing fee
• Simplified underwriting process improves placement
• Effective date is either the 1st or 15th of the following month
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Demographic Trends
Demo
Value
Fundamentals
Enhanced
Age
Fam 31-40 (35%)
Ind 41-50 (28%)
Ind 41-50 (30%)
Ind 31-40 (29%)
Ind 31-40 (30%)
Ind 41-50 (18%)
Marital
Status
Not divorced or
widowed
Single
Single
Not married
Ind/Fam
Individual or Family
Individual
Individual
Income
$27-76K individual
$27-76K individual
$55-154K family of 4 $55-154K family of 4
Employment Full time
status
Full time
$43-76K
Full time
• Even split between men and women
• Also appealing to older age groups due to cost of traditional
medical insurance
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New EASE layout with all three plan levels
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Choosing words carefully
What Assurant Health Access is - and isn’t
What it is:
• Excepted-benefit, fixed-indemnity plan
• Known benefit amount for each type of care
• First-dollar benefits: no deductible, copay or coinsurance
What it isn’t:
• Medical expense coverage
• Major medical
• Covered charges
• Reimbursement
• Creditable coverage
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Key differences of Assurant Health Access
• Strong history of major medical knowledge
– Pass along network, lab, and pharmacy discounts
– Conducts research to know what consumers use/need
• Meaningful hospitalization and inpatient benefits
• Includes benefits for outpatient to meet changing market
• Consumer Focused Education
– Package of Patient Care and Health Payment Advocates
• Alternatives to traditional medicine
– Negotiated discounts to walk in clinics
• Dedicated service team
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Integrated Selling with Health Access
• Online process makes it easier to bundle Accident, CI
and Dental
• 72% of apps have at least 1 ASC product
• 41% of apps have 2 or more ASC products
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Assurant Health Access
State Availability May 2011
NH
WA
VT
MT
ME
ND
MA
OR
MN
ID
NY
WI
SD
RI
MI
WY
NE
IL
NV
UT
OH
IN
DE
VA
WV
CO
CA
KS
CT
NJ
PA
IA
MO
DC
KY
MD
NC
AZ
OK
NM
TN
SC
AR
MS
AL
GA
AK
LA
TX
New AHA Portfolio Available
(Value, Fundamentals & Enhanced Available)
FL
HI
Current Fundamentals
Product Available
Product Not Yet Available
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Rev. 3/17/11
Accident Insurance
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Accident Insurance
• An indemnity scheduled accident policy which pays a flat
benefit for each covered benefit under the plan
• Pays regardless of other coverage in place,
no coordination of benefits
• Premiums can not increase based on usage
• No co-pays or deductibles
• Visit any hospital or doctor
• Rates are designed to
remain stable
• Consumer can own this policy
for as long as they live!
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Accident Enrollment
• Two enrollment decisions
– Level 1 or Level 2 benefits
– 24-hour or off-the-job coverage
• Simplified issue — a few health questions
• Coverage is guaranteed renewable for life
• Coverage cannot be canceled based on the number of
claims filed
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Accident Key Benefits
Benefit Summary
Level 1
Level 2
$100 Adult/ $50 Child
$100 Adult / $50 Child
$1,000
$1,000
ICU Confinement
$500/day
$500/day
Accident Hospital Confinement
$250/day
$300/day
Up to $2000 (2nd degree) /
$20,000 (3rd degree)
Up to $2500 (2nd degree) /
$25,000 (3rd degree)
$15,000
$20,000
- Dislocation
Up to $1000/$4000
Up to $1250/$5000
- Fractures
Up to $3000/$4000
Up to $3750/$5000
$100-$800
$130-1000
Scheduled amounts up to $2000
Scheduled amounts up to $2500
$30,000
$50,000
Ambulance (ground/air)
$150/$1000
$200/$1500
Lodging
$100/night
$125/night
$200
$200
$100/day
$150/day
$25
$35
Accident Emergency Treatment
or doctor’s office)
Initial Accident Hospitalization (ICU)
(ER
Accident Specific–Sum Injury
- Burns
- Coma 7 days unconscious
- Lacerations
- Surgical Repair
Accidental-Death
Major Diagnostic Exams
Rehabilitation Unit
Accident Follow-up Treatment
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Accident Example
If insured was in an auto accident, he/she could receive the
following benefits, which are paid in addition to any coverage
provided by auto insurance or major medical.
Transportation to hospital
Hospitalization
Hospital stay
ER treatment
Fractured hand
Stitches
3 Physical Therapy treatments
Benefits paid directly to consumer
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Based on benefits of level 1 coverage
$
$
$
$
$
$
$
$
150
1,000
250
100
1,000
400
75
2,975
Eligibility for Accident Insurance
• Eligibility
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Adult issue ages: 18 through 64
All unmarried children through age 18 (through
age 22 if full-time student, may vary by state)
Height/Weight chart
Accident Policy can cover all family members
• Rates
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DO NOT vary by age or preferred/standard health class
Monthly Accident Premiums
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Individual
1 Parent Family
Primary/Spouse
2 Parent Family
$22.90
$31.10
$32.30
$39.80
Value of Access and Accident
• By laying Access and Accident the value to the
consumer is clear.
Example of consumer with a broken arm and how the plans would pay
Charged
Discounted
rate
Plan Pays
Accident
Pays
Customer
Pays
ER fee
1900
1805
250
0
1555
ER doc
200
115
0
100
15
Surgery / Application of cast
(broken arm)
300
150
150
1250
+1250
Office visit follow-ups (4)
465
300
200
140
+60
X-ray follow-ups (5)
475
240
125
0
115
$3340
$2610
$725
$1490
$375
Customer saves $1455 on this one incident by having Health Access vs. being uninsured
By adding an accident plan, the customer’s out of pocket would be reduced to only $375.
Accident is level 2, open reduction of broken arm. Actual amounts would vary, for
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Dental Insurance
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Dental Coverage
• Dental is an indemnity based scheduled benefit
• Describe product as a supplemental dental plan that
helps offset dental expenses
• Plan pays a fixed amount for a covered dental service,
regardless of the actual cost from the dentist
• This is not dental insurance tied to a PPO
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Dental Advantages
• Clients can keep their dentist or choose a new one —
no network restrictions
• Benefits available the next day for Preventive and
Basic services
• Three affordable and convenient plan designs to meet
client needs and budgets
• Great incentive to foster good oral care
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Sellable features
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•
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No ZIP code or industry for rating
Coverage is portable
Sold ages 0-64, 63 integrated
Guaranteed renewable to age 70
Can sell a stand alone dental policy to a child
No underwriting, only dental professionals are prohibited
Basic and Intermediate plan are not age banded
Dental Insurance
• If sold with Individual Medical or Assurant Health Access, only Basic
Plan and Plus Plan are available
• If sold stand alone, all three plans are available
• Preventative benefits do not count toward calendar year max
Basic Plan
(Level I)
Intermediate Plan
(Level II)
Plus Plan
(Level III)
$75 per visit
$100 per visit
$100 per visit
$25 - $200
$50 - $400
$50 - $400
based on procedure
based on procedure
based on procedure
Major
Services
None
None
Calendar Year
Max
$500
$1,000
Preventive
Separated by 150 days
Basic Services
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$20 - $1,000
based on procedure
$1,500
Covered Services
• Preventive Services, must be separated by 150 days:
• Basic Services:
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Includes cleanings, x-rays, fluoride and sealants
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Benefits are available immediately
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Pays $75 or $100 per visit (insured liable for balance)
• Intermediate Services:
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Includes fillings and tooth extractions
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Payments are 50% of the benefit for the first policy year
• Major Services (Plus Plan):
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Includes crowns, root canals, periodontics and oral surgery
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Only available on level-three plan
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180 days waiting period*, then 50% for the next 180 days
* Waiting period does not apply in all states
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Dental Waiting Period
• Applies to the Major Services of the Plus Plan ONLY!
• Applies if Stand Alone or Integrated Dental
• The two new Dental states (MD and CA) will include the 180 day
waiting period with first a effective date of 5/15/2011.
• The change to 180 waiting period will be implemented in an
additional 21 states (AL, AR, AZ, DE, GA, ID, IA, LA, ME, MI, MS,
MO, NE, NC, OK, SD, TN, TX, UT, WI and WY) with the May release,
and will have a first effective date of 7/1/2011.
• We will continue to sell old integrated dental in NH - it will be the
only remaining state for old dental.
• This waiting period will not apply to any inforce policies.
• Premium remains the same
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Preventive Services
• The customer will receive a flat benefit (Basic is $75
and Intermediate and Plus are $100) for each
preventive visit
• Customer is responsible for any additional costs
• A standard preventive visit example
Oral Exam
$ 65
Bitewing X-rays
$ 55
Dentist charges for preventive visit
$120
Plus Plan pays $100 preventive benefit
$100
Customer balance
$ 20
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Dental Rates
• Rates are age banded
• Discount when 2 or more people apply
• 40% discount is passed along to the consumer when
purchased at the same time as Health Access
Monthly Integrated Dental Premiums
Primary age 50
Individual
Primary/Spouse
2 Parent/2 Kids
Basic Plan
$9.30
$16.74
$32.58
Plus Plan
$30.65
$55.08
$89.04
Monthly Stand Alone Dental Premium
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Basic Plan
$15.50
$27.90
$54.30
Plus Plan
$51.00
$91.80
$148.40
Critical Illness Insurance
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Critical Illness Insurance
• Provides a one-time lump sum payment of up to $100,000
upon diagnosis of 15 life threatening conditions, such as
cancer, stroke and heart attacks
• Payment may be used to help fight the disease while
allowing the individual to focus on recovery
• Funds pay in addition to any coverage in place,
including major medical
• No deductibles or co-pays to meet
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Critical Illness (CI) Overview
• Policy term
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10 or 20 years
• Policy terminates at the earliest of:
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–
–
Policy term
Age 65, the CI benefits expire
The full life face amount is paid
• Add-ons:
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–
–
–
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Spouse coverage — same amount as policyholder
No dependent coverage
Waiver of Premium
Accidental Death Benefit
Critical Illness (CI) Overview
• Select the amount of CI
coverage first, ranging from
$5,000-$100,000 in $1,000
increments
• Select the life benefit amount
which will be presented as 50%,
100% or 200% of the CI amount
If an individual
selects $50,000
of CI insurance,
the term life
options will be:
50%
$25,000
100% $50,000
200% $100,000
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Critical Illness Plan Summary
• Covered Conditions 100% benefit:
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–
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•
Cancer (~invasive)
Heart Attack
Stroke
Kidney Failure
Major Organ Transplant
Burns
— Paralysis
— Coma
— Deafness
— Loss of Limbs
Covered Conditions 25% benefit
– Coronary Artery Bypass
– Advanced Alzheimer’s
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— Blindness
— Cancer (~in situ)
— Heart Valve Surgery
Overcoming objections
• If I have medical coverage, why do I need additional coverage?
– You will be responsible for any costs prior to deductible, plus copays and any other non medical costs associated with the disease
Will your family be impacted?
• If you have a life threatening disease which requires
prolonged treatment will it cause financial stress?
• Will you have to take an extended absence from
work that will reduce your wages?
• Will you be able to afford the best treatment
available?
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Where will I get the money?
• Drain savings account
– 61 percent of Americans could only live three months or less on
their savings, with 38 percent stating they don't have enough
saved to cover one month's expenses1
• Borrow on credit cards and pay high interest rates
– Credit card balances averages are $5,100 and projected to be
$6,500 at the end of the year2
• Borrow against 401k and pay fees
– Percent of people who have taken a loan on their 401k is 22%,
highest figure in a decade3
• File for bankruptcy
– 15 million Americans will file for bankruptcy up to 60% of
people are actually capsized by medical bills
Sources:
1.
http://www.ehow.com/facts_6777245_average-american-savings-account.html
2.
http://www.hoffmanbrinker.com/credit-card-debt-statistics.html
3.
http://beginnersinvest.about.com/b/2010/08/22/401k-loans-hit-10-year-high-and-average-401k-balances-up-15-over-last-year.htm
51 4.
http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH
Critical Illness Insurance
• Critical Illness/Life Insurance
$20,000
– Select coverage of $10,000, $20,000 or
in coverage for a
$30,000
40-year old male
– Benefits are paid in a one time lump sum
is less than
payment directly to you
$24 a month
– Allows consumer to focus on getting the best
treatment without worrying as much about
how to pay for treatment
– Coverage is available for spouse as well
– Term of coverage is 10 years
– Term Life benefit is part of the plan
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Make sure you touch on
• Customer will receive:
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–
–
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Separate policy and premium withdrawal per product
Coverage is portable
Supplemental benefits automatically renew
Supplemental rates are designed to be stable for the duration
• Make sure to fill out claim form for accident and assign
benefits for dental
• Customer will receive a welcome call for Health Access
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Assurant Supplemental Coverage
May 2011 Product Availability
Accident, Critical Illness & Dental
Accident & Critical Illness Only
Accident & Dental Only
Critical Illness & Dental Only
Accident Only
Critical Illness Only
Dental Only
No ASC Product Available
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*FL-Dental is available
integrated only
Individual Medical
Portfolio Update
Valued features included in every plan
•
•
•
•
•
•
Preventive Care
Choice of doctors and hospitals
Patient Care
Teladoc — 24-hour access to physicians by telephone*
HealthyDiscount*
Reduction of CSD’s
*Availability varies by state and plan design.
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CoreMed Plan Design Options
Deductible1
$2,000, $3,500, $5,000, $7,500, $10,000, $15,000, or $25,000
Coinsurance
100%, 80/20, 70/30, or 50/50 (Georgia: 60/40 vs. 50/50)
Coinsurance Out-of-Pocket
Maximum1
$0 to $7,500 depending on Coinsurance
Office Visit Copay
Option 1: Office visits subject to deductible and coinsurance; 3 Free
Teladoc visits included
Option 2: $35 – 4 visits per person, per year
Prescription Drug Coverage
Option 1: Subject to plan deductible and coinsurance
Option 2: Generic: $15 copay; Brand-name: $500 prescription
deductible1, then $25 copay with 50% coinsurance
Facility Fees
Option 1: $750 per day for the first three days as inpatient, $200 per
outpatient surgery
Option 2: $200 per day for the first three days as inpatient, $200 per
outpatient surgery
Option 3: No inpatient or outpatient facility fees
1 Family
deductible and coinsurance out-of-pocket maximums are two times the individual amounts listed and are
met collectively by two or more persons
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Teladoc® - Medical Care Option for Today
• Access 24 hours a day, 365 days a year — by telephone
• Affordable
– CoreMed — three for FREE
– OneDeductible — Consultations are only $38
• Physicians are licensed, board certified, U.S. based,
and experienced
• You call or go online anytime, from anywhere
– Home, work, or the road
– Let the doctor come to you
– A great option when you just don’t have time to sit in the
waiting room!
Availability varies by state and plan design.
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OneDeductible Plan Design Options
Deductible
•Family shares one deductible
•No separate deductibles
Individual plan options:
$1,200, $1,600, $2,100, $2,850, $3,750, $5,000
Family plan options:
$2,400, $3,200, $4,200, $5,700, $7,500, $10,000
Coinsurance
100%, 80/20, 50/50
Coinsurance
Out-of-Pocket Maximum
$0 to $2,500 — depending on coinsurance
Prescription Drugs
Applies to your plan deductible and coinsurance
One Decreasing Deductible:
Availability varies by state
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Reduce your deductible exposure - up to 70%
One Decreasing Deductible®
You may never pay your full deductible again!
• OneDeductible plans with:
– Plan deductible of $2,850 individual / $5,700 family or higher
– 100% coinsurance
• Earn 10% deductible credit
– January 1 and July 1
– Credits accumulate and roll over year to year
• Until One Decreasing Deductible is satisfied
• If satisfied, new credits begin the next January 1
• Decrease the amount you pay to:
– $1,500 for an individual / $3,000 for a family
• Eligibility requirements apply
Availability varies by state
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EASE Quoting Screen
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No Prior Coverage: 30 Day Effective Date
Delay
• The first effective date available for customers that do
not have prior coverage will be 30 days past the date
the application is submitted in the following additional
states:
– AK, AL, AR, AZ, FL, GA, MD, MI, MO, MT, NE, PA, SC, TN, TX, WI,
WY, IN, MN & OH
– States Previously implemented:
•
CO, ID, IA, LA, ND, NV, SD, UT, WV
– The spread between prior coverage and no prior coverage rates
will be reduced from approximately 26% to 15%
• Change will be for 6/1 Submission dates
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Rate Reductions (after trend)
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Coremed
Michigan
One
Deductible
8%
Missouri
6-26%
na
Florida
26-44%
1-25%
Georgia
1-21%
3%
Tennessee
6-11%
6-11%
na
Rate Reductions (after trend)
Coremed
Oklahoma
One
Deductible
6-26%
Virginia
6-26%
6%
Pennsylvania
6-21%
6-26%
South Carolina
11-21%
6%
Iowa
na
6-26%
6-26%
Rate reductions of 15-30% filed for North Carolina and West Virginia
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Underwriting Changes
• Easier to do business with: less ratings and CSD’s!
– Eliminating approximately 60% of ratings for customers with
prior coverage!
• Will be issued standard
• Will not apply to the following states: MI, CA, UT, ID, CT, MN, NH
– Eliminating CSD’s of $3000 and less for all business!
• Conditions that historically called for a $3000 or less CSD will now be
issued standard. Drug costs will be underwritten as they are today
• If applicant would otherwise qualify for preferred coverage, they will be
issued preferred!
• In states where CSD's are not allowed, alternative actions (ratings and
riders) will be removed for these same conditions
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Thank You!
Assurant Health is the brand name for products underwritten and issued by Time Insurance Company,
Milwaukee, WI.
J-78881