FLEXguard Policy Features & Benefits

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Transcript FLEXguard Policy Features & Benefits

Agent Training

UAUHFX

United American Insurance Company

Proudly Serving Americans Since 1947

What United American Stands For…

*ratings as of 6/04, 8/04 respectively

Stability —

Meeting the life and health insurance needs of the public for over half a century

Financial Strength

• • A+ “Superior” financial strength rating from A.M. Best* AA “Very Strong” claims paying ability rating from Standard & Poor’s*

Quality Protection — protect you and your family now as well as in years to come

Insurance coverage to

Superior Service —

service for the life of your policy, backed by Home Office support staff

One-on-one personal

That’s our way… the United American way.

What are the headlines saying?

Healthcare costs still rising faster than the economy!

& More people uninsured!

Sources: Health Affairs, June 2003 AHIP, “2004 Elections: Medicare, the Uninsured, and Rising Costs Take Center Stage in Health Care Debate”, January/February 2004

Americans Face a Healthcare Crisis!

• • • Healthcare costs continue to advance much faster than the rest of the U.S. economy:

8.5%

increase in 2001

9.3%

increase in 2002

7.7%

increase in 2003

Costs are slowing but still far exceed the rate of general inflation!

Sources: Health Affairs, June 2004 National Coalition on Health Care, “Facts on Health Insurance Cost,” 2003 Centers for Medicare & Medicaid Services

The Cost of Health Care

Insurance premiums have risen at a rate even greater than the rate of health care inflation.

Factors Driving Rising Costs in Healthcare Rising Provider Expenses 22%

According to experts, “Consumers can expect to pay more for greater access to health care.”

Government Mandates & Regulations 18% Increased Consumer Demand 18%

Source: Health Insurance Association of America, Chartbook on Health Care Cost Trends, 2003.

Litigation & Risk Management 9% Other 6% Drugs, Medical Devices & Other Medical Advances 27%

Persons Without Health Insurance

Rising costs in healthcare are pushing up health insurance premiums and forcing Americans into the ranks of the uninsured.

1992 — 34.1 million 1996 — 40.9 million

2002 — 41.2 million

2003 — 43.6 million 2004 — 45 million

It becomes a problem if you are a member of the uninsured!

Source: United States Department of Commerce News, September 30, 2003

United American Insurance Card

In order to receive non-emergency or post-stabilization treatment, consumers must demonstrate an ability to pay …

This is when your United American health insurance card is most valuable!

Name: PAULA C. HOLDER Policy Number 57300876888 Policy Effective 01-25-03 The problem becomes finding affordable health insurance.

Where Do the Largest Medical Expenses Occur?

Hospital Confinement

Surgical Expenses

Emergency Room Charges

Source: Strunk, Bradley, and Ginsburg, Paul,

Tracking Health Care Costs: Spending Slowdown Stalls in First Half of 2004,

Dec. 2004

Hospital Confinement vs. Doctor’s Office Bills

• • Odds are 1 in 7 that you or a family member will have a hospital stay this year.

* Average hospital confinement includes room/board, surgical, miscellaneous and emergency expenses.

$3,972

was the average national daily hospital charge in 2003.

**

As compared to the larger medical expenses above, the average cost of a doctor office visit in 2003 was relatively low. It was only $83!

** Sources: * U.S. Department of Labor; **

Current Trends in Health Care and Dental Costs Utilization, 2004 Edition

;

Therefore, the most important areas to cover are:

Hospital Confinement

Surgical Expenses

Emergency Room Charges

Choosing a Healthcare Insurance Policy

• • • • • • • • •

Important things to consider!

Guaranteed renewable individual policies, not collectively renewable Issue age pricing, not attained age pricing No pre-authorization Excellent industry ratings & claims paying abilities No associations or association dues Use anywhere in the USA Local Home Office and Agent support No lifetime maximums Freedom to choose doctors and providers – no networks!

UA’s Freedom of Choice

With United American, you are in control of your health care — no gatekeepers, no primary care physicians, no pre-certification, no worries about using out-of-network providers which could run up huge co-payment obligations.

It’s YOUR health!

YOU choose your healthcare providers.

WHO? WHAT? WHEN? WHERE?

These are questions that YOU answer!

That’s our way… the United American way!

Are you looking for an Affordable Health Insurance Policy that makes good sense?

United American’s

FLEXguard Health Insurance Policy

FLEXguard Features

  Issue Ages: 0-63 Coverage for Individuals and Families  Guaranteed Renewable as long as premiums are paid on time    CHOICE OF BENEFIT AMOUNT – $100,000; $75,000; or $50,000 PORTABLE COVERAGE – individual policy goes where you do FLEXIBILITY – policy serves as basic or supplemental insurance  NO LIFETIME MAXIMUMS

DOWNLOAD SAMPLE BROCHURE

Policy Form GSP2. This policy has some limitations and exclusions. Plans and benefits vary by state.

FLEXguard Policy Features & Benefits

Maximum Benefit Per Injury or Sickness Daily Hospital Expense Benefit (after $500 deductible)*

For days 1-10 policy pays incurred expenses For the next 30 days policy pays incurred expenses

Daily Hospital Expense Benefit Hospital Admission Benefit If you or your insured family member is hospitalized, the policy will pay an admission benefit.

Outpatient (Non-Surgical) Benefit

outpatient hospital expenses diagnostic imaging such as x-rays, MRIs, etc.,radiation treatment such as for cancer. $100,000 Benefit Amount $75,000 $50,000

80% up to $4,000 per day 80% up to $2,000 per day 80% up to $3,000 per day 80% up to $1,500 per day 80% up to $2,000 per day 80% up to $1,000 per day Daily and Maximum Benefits are increased $1,000 each day for up to 10 days in the ICU $100 per hospital stay – benefit is not tied to incurred expenses – it can be used as you see fit.

80% up to $500 for any one injury or sickness 80% up to $400 for any one injury or sickness 80% up to $300 for any one injury or sickness

* For inpatient and outpatient surgeries Policy Form GSP2. This policy has some limitations and exclusions. Benefits are paid based on actual, incurred expenses.

FLEXguard Policy Features & Benefits

Surgical Expense Benefit Physician Charges INPATIENT: One doctor visit each day during an inpatient hospital stay.

Physician Charges OUTPATIENT: Doctor visits at a doctor’s office, clinic, or your home plus one physical exam each year. Benefit can be doubled.

Registered Nurse Benefit Ambulance Benefit Return of Premium Benefit

Benefit Amount

Up to $10,000 Up to $7,500 Up to $7,500 + up to 20% of surgical benefit for Assistant Surgeon + up to 25% of surgical benefit for Anesthesiologist 80% of the doctor’s fee, up to $50 per day Maximum of $2,000 for any one injury or sickness 80% up to $25 per visit 80% up to $50 for one physical exam per year $250 maximum per year NOTE: you may choose to double the benefit amount as shown below 80% up to $100 per 8-hour shift Up to three(3) shifts per day for no more than 90 days for any one injury or sickness 80% up to $200 for any one injury or sickness Double premiums refunded

Policy Form GSP2. This policy has some limitations and exclusions. Benefits are paid based on actual, incurred expenses.

FLEXguard Policy Features & Benefits

OPTIONAL BENEFITS* Additional Physician Charges Benefit Policy pays incurred expenses for ambulance service to or from a hospital.

Critical Illness Benefit Age 18-63 Rider Form R-CILS2 (including Cancer)

Applicants must qualify for this optional benefit rider See the Agent Manual for rules

Accident Benefit

Applicants must qualify for this optional benefit rider See the Agent Manual for rules

Choice of $10,000 or $20,000 benefit amount Age 18-63 Rider Form R-CILS2

Benefit Amount

80% up to $50 per visit 80% up to $100 for one physical exam per year $500 maximum per year One-time cash benefit of up to $50,000 for first diagnosis of critical illness including:

heart attackstrokeend stage renal failuremajor organ transplant complete paralysis of two or more limbsthird degree burns to 20% or more of the bodyloss of two limbstotal loss of eyesight. first diagnosis of cancerThe benefits for this rider will reduce by half at age 65.

Policy pays ONE of the following accident benefits:

accidental death benefit a lump sum amount for specified injuries a weekly hospital stay benefit (up to $500) for

up to 25 weeks

or a first aid medical care benefit (up to $80)

*Optional benefits will not continue if the policy terminates.

Policy Form GSP2. This policy has some limitations and exclusions. Benefits are paid based on actual, incurred expenses.

UA Partners

®

Program

Our optional health discount services program includes: • • • • • • • • Dental Vision Hearing Chiropractic Prescription Drug Vitamins & Nutritional Supplements 24-Hour Nurse HelpLine Travel Assist* UA Partners is not a health insurance policy. Members will receive discounts on medical services when they go to certain healthcare providers who are contracted with the plan. Members are solely responsible for payment of all healthcare services. No portion of any provider’s fee will be reimbursed or otherwise paid by the plan. This plan is administered by Best Benefits, Inc. 8420 Bryn Mawr, Suite 700, Chicago, IL 60631, www.FindBestBenefits.com.

* Availability may vary by state.

UA Partners

®

Program

Nationwide discount health services program with savings for: Chiropractic Dental Eye Care Hearing Aids Prescriptions Mail Order Pharmacy Up to 40% Up to 50% Up to 50% Up to 20% Up to 30% Save More $$ 0% 10% 20% 30% 40% 50%

Why United American?

• • • • • • • • • • • Providing quality health protection since 1947 Excellent ratings with A.M. Best and Standard & Poor’s Fast policy issue (4-6 weeks) Local office Personal support (always speak with a live person, either Home Office staff or Agent) Individual qualification (not a group plan) Guaranteed renewable policies, as long as premiums are paid on time Issue age pricing No associations or association dues Freedom of Choice UA Partners helps drive down the cost of health care services