Transcript Document

Disability Products & Services
Life and Disability products are underwritten by Anthem Life Insurance Company. Independent licensee
of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered mark. The Blue Cross and
Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
The Anthem Life Disability Philosophy
• Create optimal disability outcomes for both the
employee and the employer while providing a
positive member experience.
• Customized care
• We evaluate a member’s functional ability based on
clinical and vocational information—not just statistics
and norms.
• The team intervenes early and stays with the case,
continuously working with the employee, provider
and employer to develop an action plan designed to
achieve the best possible outcome.
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Our Advantage
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Strength & Stability
Broad Product Offerings with Added Value
Benefit Features That Make The Difference
Flexible Reporting
Superior Customer Service
Our strength, innovation and dedication
makes us the right solution to your needs.
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Life & Disability’s
Strength and Stability
• A.M. Best: A (Excellent) agency rating
• Parent company ranked 38th on the Fortune 500
list
• Parent company named Most Admired Health
Insurance Company by Fortune Magazine
• Parent company ranked 2nd on 2006 Business
Week’s Top 50 Performing Companies
• More than 96,000 group customers and 5.8
million members*
• Large Case/National Accounts Expertise
• More than 50 years of experience*
Each affiliated life company is a separate, independent legal entity for financial purposes and is solely responsible for its own
contractual obligations and liabilities.
*Anthem Life internal data 2006
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Broad Product Offerings
Disability Product Portfolio
Voluntary STD
and LTD (Insured)
Short-Term
Disability (STD)
(Insured & ASO)
25% participation
required
Long-Term
Disability (LTD)
(Insured & ASO)
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Features That Make A Difference
Behavioral
Health
RN
Review
Review
Flexible
Reporting
Disability
Resources
Dedicated
Disability
Case Manager
Vocational
Rehabilitation
Social
Security
Advocacy
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Features That Make A Difference
• Short-Term Disability (STD)
• ASO case management models - Levels 1, 2, 3
• Flexible Advice to Pay services
• Behavioral Health Disability Program
• Resource Advisor Program
• Return to Work Assistance (Vocational
Rehabilitation)
• Social Security Advocacy
• Optional paperless claims intake process
• W-2 reporting and employer FICA matching
services available
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Features That Make A Difference
STD Case
Management Models
Level 1
Level 2
Level 3
Least intensive
management
More proactive
management
Most proactive
management
ASO Only
ASO Only
Fully Insured
& ASO
ASO = Administrative Service Only
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Features That Make A Difference
Short Term Disability Case Management Models
Level One (ASO only)
• Disability approval based on attending physician statement
• Payment continues until notification from client of return to work
• Desirable option when governed by management request,
labor restriction or company culture
Level Two (ASO only)
• Disability payments begin based on initial attending
physician statement
• Estimated time off work compared to optimal duration
guidelines for given diagnosis or procedure
• Disability leave beyond normal duration requires periodic medical
updates for continued benefits
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Features That Make A Difference
Short Term Disability Case Management Models
Level Three (Fully Insured or ASO)
• Objective medical documentation required to support disability
• Claimant’s job description evaluated to determine functional
impairment
• Clinical information and functional requirements assessed in
conjunction with duration guidelines
• Full vocational rehabilitation services included
• 100% review of all behavioral health claims by staff psychologist
• Registered Nurses assist in case management
• Independent Medical Examinations available for use when
appropriate
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Features That Make A Difference
Flexible Advice to Pay Services
• Full range of case management options available
• Reporting frequency based on client need to meet
payroll requirements
• Disability claim reporting can be tailored for
customer absence tracking
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Features That Make A Difference
Behavioral Health Program
• In-house Behavioral Health professionals
• All claims reviewed
• For appropriate diagnosis, treatment and disability
determination
• For early identification of depression in chronic and acute
medical conditions
• Ongoing behavioral health
training for disability
case managers
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Life & Disability Insurance Products
Innovative Supplemental Programs
Resource Advisor
• Included with group Disability plans at no additional cost
• Provides employees and family members with resources
that may help them achieve a healthier balance including:
• 24 hour toll-free telephone counseling
• Legal/Financial Counseling for employees
• Face to face counseling sessions for beneficiaries and
for employees who become disabled
• Access to Online Resources: resources and providers
for child care and elder care, legal and financial resource
center, excellent articles and links to a myriad of helpful
resources
• Online will preparation and identity theft information
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Features That Make A Difference
Return To Work Assistance
• Certified Vocational Rehabilitation Consultants on
staff
• Vocational rehabilitation assistance
• Return-to-work assistance (STD and LTD)
• In-house transferable skills analyses
• Internet access for rehabilitation opportunities
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Disability Products and Services
Social Security Advocacy
• In-house Social Security Consultants with years of
experience working for Social Security
Administration
• Immediate involvement in claims with catastrophic/terminal
conditions
• Award activity
• 67% within 12 months*
• 86% over 24 months*
• Saved an average of 15% in attorneys’ fees during
each of the past 5 years
• Highly successful overpayment recovery program
*Anthem Life internal data 2006
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Flexible Reporting
• Frequency based on client need
• Daily or weekly authorization reports available for Advice to Pay
customers or upon client request
• Quarterly and annual reporting on closed cases
• Financial data
• Gross and net benefit, withholdings, tax reporting, W-2 issuance
• Report elements
• Data for International Classification of Diseases (ICD),
Major Diagnostic Categories (MDC), age/gender, tenure
and alternate duty programs
• Trends
• Client data sorting
• Comparative reporting
• Claims costs
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Superior Customer Service
• Dedicated Service Center
• Over 98.1% financial accuracy in 2006*
• 93% of calls answered in <30 seconds in 2006*
Average speed to answer - 8 seconds
• Call abandonment rate - 1.5%*
• Busy Rate - 0%*
*Anthem Life internal data 2006
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Legal Disclaimer
Life and Disability products are underwritten by Anthem Life Insurance Company. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical
Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of
Maine, Inc. In most of Missouri: RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer
non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not
underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance
Company. In Virginia: Anthem Health Plans of Virginia, Inc. (serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.). In Wisconsin: Blue
Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or
administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ®
ANTHEM is a registered trademark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
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