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Assurant Health News
July Implementation
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Assurant Health News
July Implementation
Product Training
May 2009
Agenda
• Assurant Affordable Health Access –
An easy solution now even easier to sell
•
•
•
•
•
•
•
3
New Sales Opportunities
HSA Tools Helps Clients Manage Funds
Good News in Kansas
CoreMed Drug Options
Patient Care Supports Retention
TelaDoc Helps Control Clients’ Costs
Health Access Electronic Submission
Assurant Affordable
Health Access
The affordable health insurance solution that covers the
everyday needs consumers value most
Assurant Affordable Health Access
• Launched in August 2008
– Paper application submission
• Seeing great sales success with
individual consumers
– Looking for affordable coverage
– Out of a job
– Employer doesn’t offer coverage
… and who are different than our traditional plan
buyers
5
• Placement rates 92+%
• Early retention results positive
Health Access Sales and % of Channel
700
14%
600
12%
500
10%
400
8%
300
6%
200
4%
100
2%
0
0%
MGA AHAA Apps
6
MGA % AHAA
% of Channel's Apps that are AHAA
16%
20
09
/A
pr
800
20
09
/M
ar
18%
20
09
/J
an
20
09
/F
eb
900
20
08
/D
ec
20%
20
08
/O
ct
20
08
/N
ov
1,000
20
08
/J
ul
20
08
/A
ug
20
08
/S
ep
AHAA App Counts
MGA: AHAA Apps
Expanding the IM Market
Individual
Market Today
18M
Americans
•New customer base –
incremental market space
•States endorsing Limited
Benefit plans to help solve
uninsured crisis
•NOT cannibalizing core
products, including Rightstart
7
Uninsured Americans
15M > 400%
Federal Poverty Level
7M 200-400%
Federal Poverty Level
2M Uninsurable
13M < 200%
Federal Poverty Level
9M Non-U.S. Citizens
46M Uninsured
Market Focus
Assurant Affordable Health Access
The right plans for the right time
• Affordability
Three modestly-priced plans
• Usefulness
Covers services for everyday needs
• Value
First-dollar benefits and discounts
• Accessibility
Easy to qualify
• Flexibility
Keep your doctor
8
Why it’s so popular
Consumers want an affordable plan with:
• First-dollar benefits on services for everyday
needs they value
–
–
–
–
Doctors’ office visits
Prescriptions
Preventive care
Immunizations
• Copays
• No high deductible
9
“Just Make it Simple”
Consumers dread shopping for health insurance
and are overwhelmed by the process.
10
What Consumers Say … Affordability is the #1
reason consumers purchase Health Access
• “I figured a little was better than nothing …
‘Peace of mind’ would be the three words that would
cover what I want to accomplish. I know that if I go
into the doctor, I know the office visit is covered. I
don’t have to worry about going to the doctor…It’s
peace of mind to have the office visit paid for”
(Noel/58).
• “It’s affordable…and it gives you what you need”
(Jolene/45).
• “For the small amount you spend, you get your value,
you get your money’s worth” (Robert/39)
11
What Consumers Say … The process of signing up
for Health Access was not difficult.
• “It was described as the good, better, best plans, and
you made a choice. I chose the middle one, the most
affordable for what I needed.” (Tracy/40)
• “He showed me the very basic to the middle of the
road and the Cadillac one. I chose the middle of the
road one, so I can be covered for doctor visits-like if I
get a cold, some kind of prescription plan that covers
at least something. Something that covers hospital
visits and basic procedures. This plan will pay up to a
certain amount. I can deal with that.” (Steven/37)
12
Who is the Health Access Customer
• 60% of HEALTH ACCESS applicants have high
school or technical school training as their
highest level of education
• 46% of HEALTH ACCESS applicants have family
incomes of less than $50,000
• 33% of HEALTH ACCESS applicants have family
incomes of less than $40,000
• 20% of HEALTH ACCESS applicants have a net
worth of less than $25,000
13
Assurant Affordable
Health Access
PLAN OVERVIEW
Assurant Affordable Health Access
Limited-Benefit Product
Three limited-benefit plans:
• Health Access Plan A
— No medical questions
• Health Access Plans B or C
— Limited medical questions
• An affordable option compared to major medical plans
• Coverage for certain services up to a set dollar amount
• Calendar year maximums
15
Health Access Product Overview
• Available in AL, AR, AZ, FL, IA, IL, IN, MI, MO,
MS, OH, OK, PA, SC, TN, TX, WI, WV and WY
• No benefit waiting periods
• Covers what is important to employees
— Doctors’ office visits and prescription drugs
— Preventive care and immunizations
• Network discounts
• Optional benefits such as Dental-Vision
Discount Plan, Dental Insurance and Cancer
Benefit
16
Coming for Mid August
• Suite Solutions
• Additional states:
– Certain- SD, AK, DE, MD, NE, NM, CO, GA
– Highly likely- LA, CA,
– Hopeful- NC, NV
17
Health Access Plan A Overview
• Easy to apply for:
— No underwriting (no medical questions)
— No pre-existing condition limitations
— No ratings
— No special exception riders
— No condition-specific deductibles
• Applicants through age 63 are eligible
• Covers services for everyday needs
— No modified benefit endorsements
• Health Advocates Alliance Membership (some
states)
18
Health Access Plan A
Doctor Office Visits
Client pays copay and the plan pays 100% of the
remaining cost of an eligible office visit including
wellness, examination, consultation, evaluation,
development of a treatment plan, immunizations
and allergy shots.
Prescription Drug
Client pays copay and plan pays 100% up
to a maximum of $750 per calendar year
19
•
•
•
•
•
$25 (Primary Care and Retail Health Clinic)
$35 (Specialist)
Limit 4 office visits
Plan pays $150 max per office visit
No deductible or coinsurance
• $10/$50 (Generic/Brand)
• Plan pays up to $750 max per calendar year
• No deductible or coinsurance
Outpatient Diagnostic Imaging and
Laboratory Services
• Plan pays up to $250 benefit for x-ray
and lab only
• No deductible or coinsurance
Surgical Services
• Must be performed during an office visit
• Plan pays $250 max per calendar year
• No deductible or coinsurance
Health Access Plans B and C Overview
• Only two medical questions
– Pregnancy/adoption
– Select few medical issues
• Applicants through age 63 are eligible
• Covers services for everyday needs plus inpatient, outpatient
and prescription drug benefits
• Easy to apply:
— Accept/Reject application
— No ratings
— No special exception riders
— No condition-specific deductibles
— No modified benefit endorsements
20
Health Access Plans B and C
PLAN B
Doctor Office Visits
$25 (Primary Care, Specialist & Retail Health Clinic)
Limit 4 office visits
Plan pays $150 max per office visit
No deductible or coinsurance
Client pays copay and the plan pays 100% of the
remaining cost of an eligible office visit including
wellness, examination, consultation, evaluation,
development of a treatment plan, immunizations
and allergy shots.
•
•
•
•
Prescription Drugs
• $10/$50/$75
Client pays copay and plan pays 100% up to a
maximum of $250 or $750 per calendar year
PLAN C
(Generic/Preferred Brand/
Non-Preferred Brand)
• $10/$50/$75
(Generic/Preferred Brand/
Non-Preferred Brand)
• Plan pays up to $250 in benefits
per calendar year
• No deductible or coinsurance
• Plan pays up to $750 in benefits
per calendar year
• No deductible or coinsurance
• $200 deductible
• 80%/20% coinsurance up to $500 in
benefits per calendar year
• $200 deductible
• 80%/20% coinsurance up to $1,000
in benefits per calendar year
Surgical Services
• Inpatient and Outpatient
• Up to scheduled benefit amount
• Up to $100,000 in benefits per
calendar year (based on schedule)
• No deductible or coinsurance
• Inpatient and Outpatient
• Up to scheduled benefit amount
• Up to $200,000 in benefits per
calendar year (based on schedule)
• No deductible or coinsurance
Assistant Surgeon
• Up to 20% of amount paid for surgery
Anesthesiologist
21
• Up to 20% of amount paid for surgery
Outpatient Medical Services
Includes outpatient hospital, surgical center or urgent
care facility and diagnostic imaging and laboratory
services, chemotherapy, and radiation performed
during an office visit or as outpatient.
Health Access Plans B and C
PLAN B
PLAN C
Ambulance (Ground/Air)
• Up to $100 ground/$1,000 air — per trip, up to two trips per calendar year
Emergency Room
• Up to $250 in benefits for each of two
visits per calendar year
• $100 emergency room fee
• Fee waived if admitted
• No deductible or coinsurance
• Up to $750 in benefits for each of two
visits per calendar year
• $100 emergency room fee
• Fee waived if admitted
• No deductible or coinsurance
Inpatient Benefit
Facility Charges
• Up to $750 in benefits per day
for sickness
• Up to $1,000 in benefits per day
for injury
• 80%/20% coinsurance up to $100,000 in
benefits per calendar year
• No deductible
• Up to $2,000 in benefits per day
for sickness
• Up to $4,000 in benefits per day
for injury
• 80%/20% coinsurance up to $200,000
in benefits per calendar year
• No deductible
Other Non-surgical/
Non-facility Inpatient
Services
• Considered under the inpatient per day maximum
• Coinsurance applies
• No deductible
Life Insurance
• Up to $10,000 benefit included for primary
Lifetime Maximum
• $ 1 Million
22
Discount Opportunities
• MultiPlan network discounts
• LabCard Select (LabOne) outpatient laboratory
services
• Medco participating pharmacies
• Patient Care Health Advocates
• Retail Health Clinics
• Health Payment Advocates
• Other diagnostic ancillary services
23
Rates
• Simplified rating
— Not gender or area rated
— Not rated for risk class
— No smoker status
— Has very broad age bands; based on primary
— Examples
— Plan A: 28-year-old woman w/ one child — Monthly rate = $74
— Plan B: 40-year-old husband and wife — Monthly
rate = $194
— Plan C: 30-year-old single man — Monthly rate = $104
24
Effective Date Rules
• Options are 1st or 15th of the month
• How to know which to choose:
— Enrollment Form signed date 1st-15th = 1st of next month
— Enrollment Form signed date 16th–31st = 15th of the next
month
— Example: Enrollment Form signed on 7/29 = first effective
date available of 8/15
25
Easier than ever to sell!
•Effective May 18 — Submit
Health Access business online
– www.assuranthealthsales.com
• Repositioned marketing materials
– Easier to reach broader market of individual
consumers
26
New Health Access Materials
• Reflect broader audience
• Identify everyday value for consumer
• Help consumer maximize value of limitedbenefit plans
– Consumer brochure
– Agent engagement pieces
– Health Insurance Reference Guide
27
Consumer Brochure
• Addresses need for affordable solution
• Highlights first-dollar benefits
• Details ease of qualifying for plans
28
Agent Engagement Pieces
• Portfolio overview brochure and highlight
pamphlet
• Position Health Access as solution to client
needs, especially in this economy
• Highlight what interests agents
– Pricing
– Eligibility questions
– Valued benefits
29
Health Insurance Reference Guide
• Reaffirms purchasing decision
• Provides realistic and achievable ways to stretch
value of limited-benefit plans
• Promotes consumer education and smart choices
• Provides post-sale education and additional ways
to maximize the benefits of the plan –
Limited benefit doesn’t mean limited value!
30
Materials List Highlights Other Options
• Materials available for each target customer
segment:
– Individual consumers
– Worksite
31
Agent Library Presentation
• Check out the Health Access point-of-sale
presentations in the Agent Library
• Email a presentation link to your clients
• New and revised Health Access presentations
will be available May 15.
Health Access – Individuals & Families
Health Access – Employers
Health Access – Employees
32
Health Access Sales Campaign –
Writing Agents (May 16-August 16, 2009)
• Sell one AAHA policy get an
Assurant mug
• Sell five AAHA policies get an
Assurant 24-can cooler
• Prizes distributed weekly
33
Health Access Sales Campaign –
General Agents (May 16-August 16, 2009)
• 1 st Tier Trip - Sell at least 25 policies
– Two-night stay at select properties in the continental U.S.
– Breakfast daily for two
– $100 worth of Marriott or Fairmont dollars
• 2nd Tier Trip - Sell at least 50 policies
– 3 night / 4 day trip
– 2 coach class airline tickets to Miami, Arizona, Napa Valley or
New York
– 3 nights at select Marriott, Renaissance or Fairmont properties
– $300 Marriott/Fairmont dollars
– Breakfast daily for two
• Maximum number of five trips per General Agent
34
New Sales Opportunities
• IL: Rates reduced with the Health Link Plans in the
northern suburbs of Chicago (zip codes 600-605),
offsetting trend
• CO: Rates in many zip codes lowered to better align
with Denver
• GA: Rates in Coventry network in Macon will decrease
5%; and have decreased in Atlanta to offset trend
• MI: New Physicians Care network is the lowest priced
network in Grand Rapids
• NC: Rates lower on all IM plans in Charlotte
– 11% on RightStart Elite, CoreMed Elite, MaxPlan Elite
– 9% for One Deductible Elite and SaveRight Elite
(continued)
35
New Sales Opportunities (continued)
• OK:
– Rates 5% lower on all IM plans in Tulsa
– Rates 9% lower on CoreMed Elite, Max Plan Elite and
RightStart Elite in Oklahoma City
• TN:
– In Chattanooga, rates on all IM plans reduced 5%
– Overall, with the Great-West network introduction,
rates in Chattanooga will be down 15 - 20%
• TX: Rates on CoreMed Elite, MaxPlan Elite and Right
Start Elite will be reduced in these markets:
– Austin - Reduced 4%
– Corpus Christi – Reduced 18%
– San Antonio - Reduced 5%
36
HSA Tools Helps Clients Manage Funds
• Comprehensive HSA administration service – no
monthly fee
• Services include:
– Efficient fund transactions and account tracking services
– Easy online claims payment including directly to providers
– Options such as a line of credit and mutual fund
investments
– Online access to helpful medical and prescription drug
information
– Easy access to HSA funds including a handy debit card
• For new and existing Assurant Health customers who
choose HSA Tools to administer their HSAs
37
Rate Guarantees
First time in Kansas!
• 24-month rate guarantee now available
• Stable rates help your clients plan ahead
• Optional with these plans
–
–
–
–
–
38
CoreMed Elite —$2,000 deductible and up
MaxPlan Elite —$2,500 deductible and up
OneDeductible Elite —$2,100 deductible and up
SaveRight Elite—all deductibles
RightStart Elite—$2,500 deductible and up
CoreMed Drug Options
• Prescriptions paid as any other covered charge
– No separate copay, deductible or coinsurance
– 100% coverage after deductible and coinsurance satisfied
– Here’s where you’ll see the larger discounts over the copay
option
–
–
–
–
Higher deductibles and/or lower coinsurances
Females vs. Males
Age 50+
Standard vs. Preferred
• Prescription copay option
– For clients seeking defined cost and who want copays
– Generic = $15 copay only; brand = $25 copay plus 50%
coinsurance after $500 deductible is met
39
Patient Care Supports Retention
• Launched in July 2008
• Keeps customers longer – positive impact
on retention
• Takes you out of the middle
• Available with all types of plans
– High deductibles—manage out-of-pocket
costs
– Health Access—maximize limited-benefit
plans
40
• See Agent Library and Find a Form for
details
TelaDoc Helps Control Clients’ Costs
• TelaDoc is another option for managing clients’ out-ofpocket costs
– Access to non-emergency healthcare by phone – 24/7
– Consultations by U.S. based, state-licensed, board-certified
physicians
– Services for registered plan members, age 10 and older
• Teladoc is included as a first dollar benefit on all
Coremed Elite and Maxplan Elite Non-Copay plans -3
free consultations per person each year
– Additional consultations are only $35 each and are subject
to deductible and coinsurance
• OneDeductible Elite plans and all Short Term Medical
plans (including HealthSaver®) include Teladoc
membership and policyholders have access to phone
consultations for $35 each, subject to deductible and
coinsurance
41
Health Access Electronic Solution
Health Access Quoting
• Health Access quoting will be available
via Create A Quote
• Only major change to quoting for Health
Access is on Quote Confirmation page:
– Begin Submission button allows for
electronic submission of Health Access
– “Click here” hyperlink is available for
Quote Linking of Health Access
43
Sales Home Page
Now, there are two ways to quote Health Access plans
44
Create A Quote path
Plan Information page
Health Access plans will
now appear on this page.
45
Quote Confirmation Page
46
Quote Confirmation Page
NEW FUNCTIONALITY for
Health Access applications:
Begins Quote Linking process
Begins Electronic Submission
47
Submission
Same, easy process as Individual Medical
• Personal Information
• Submit Options
– I am with client
– Online Verification
• Health Questions (only for Plans B/C)
– 2 or 3 instead of 17
• Payment
• Authorizations/Submit to Underwriting
• Confirmation
48
Health Questions
Health Access Questions all
on the same page.
Each question must be
answered for each applicant
in order to continue.
49
Underwriting Authorization
Underwriting Authorization for Health Access plans will match the
enrollment forms.
50
Questions?
51
Thank You!
52
You’re helping
change the landscape of
the uninsured market!
Thank you!
53