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Assurant Health. Real Choices Introduction. Agent Outfitters. Overview New group insurance products and tools that will outfit you to sell small group medical insurance. Choice Real Choices I, II and III Real Choices HRAs and HSAs Efficiency Online tools for agents and employers
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Assurant Health Real ChoicesIntroduction
Agent Outfitters Overview New group insurance products and tools that will outfit you to sell small group medical insurance • Choice • Real Choices I, II and III • Real Choices HRAs and HSAs • Efficiency • Online tools for agents and employers • Underwriting • Responsiveness • Administration • Commissions and Agent incentives Assurant Health makes health insurance benefits available to working Americans
REAL CHOICESSMAssurant Health’s New Small Group Portfolio WA WA VT ME ME MT ND ND MN OR MN OR VT NH NH ID WI SD SD WI NY NY MA MI WY MI WY CT RI IA IA PA NE NJ CT NE NV OH IN OH IL IN MD IL DE UT UT WV CO CA CO WV MD CA VA KS KS MO KY DC NC NC TN TN AZ OK NM AR SC NM AR SC MS AL GA GA MS AL TX LA TX FL FL AK Real Choices - as of 5/1/2009 effective date For internal use only. Assurant Health is the brand name for products underwritten and issued by Time Insurance Company. J-60031 (4/2008)
Consumer Choice 80% of insureds have claims < $1,000 84% of insureds have claims < $2,000 87%of insureds have claims < $3,000 Assurant Health’s most popular plans typically include an office visit copay and prescription drug copay so there are less charges being applied to the deductible and coinsurance. Consequently, with a typical Assurant Health plan, fewer insureds reach a higher deductible. A provider discount was also factored in to these statistics.
Markets • Tampa • Orlando • Melbourne • Naples • Using Great West network
Real Choices Real Choices A virtual warehouse of product enables agents to meet the varied needs of small employer groups!
Real Choices Real Choices Products PROSPECTS
Real Choices I Real Choices I Premier Plan that Offers the Most Extensive Coverage • Preventive care including $750 first-dollar benefit • $500 first-dollar diagnostic imaging and lab benefit • Prescription drug coverage including $0 generic co-pay option • Physician office visit co-pay option that includes co-pays for ER and urgent care • Can increase lifetime maximum from $5 million to $10 million
Real Choices I Real Choices I – Most Extensive Coverage • On copay plans, $100 emergency room copay, then 100% thereafter • Unlimited ground and air ambulance after deductible and coinsurance • Affiliated provider benefit • Extensive transplant network • World-wide emergency coverage
Real Choices I Real Choices I – Most Extensive Coverage BENEFIT REAL CHOICES I Not all combinations of deductible, benefit percentage and out-of-pocket maximum are available.
Real Choices I Real Choices I – Most Extensive Coverage BENEFIT REAL CHOICES I
Real Choices I Real Choices I – Most Extensive Coverage BENEFIT REAL CHOICES I
Real Choices I Real Choices I – Most Extensive Coverage Features and Optional Benefits BENEFIT REAL CHOICES I
Real Choices I Real Choices I – Prescription Drugs Options: • $0/$25/$50 (generic/preferred brand name/ nonpreferred brand) • $15/$25/ $50 • $15/$45/$60 • $15/$50/$75 • Deductible and coinsurance plus Preferred Pricing Card • None - Preferred Pricing Card only Popular Features: • Save 10% on copays (copay is 2.7 times the selected copay amount) for any three-month drug supply by mail order • Birth control pills covered at retail pharmacy or mail order
Real Choices II Real Choices II Popular Plans that Offer the Most Choices • Many deductibles and benefit percentage choices • A variety of copay choices • Preventive care including $300 in first-dollar benefits with the option to increase to $800 • $2 million lifetime maximum with option to increase to $5 million • Priced 6% lower than Real Choices I
Real Choices II Real Choices II – Most Choices BENEFIT REAL CHOICES II Not all combinations of deductible, benefit percentage and out-of-pocket maximum are available.
Real Choices II Real Choices II – Most Choices BENEFIT REAL CHOICES II
Real Choices II Real Choices II – Most Choices Features and Optional Benefits BENEFIT REAL CHOICES II
Real Choices II Real Choices II – OutpatientPrescription Drugs • $0/$50/$75 with $500 brand name deductible* • $15/$25/$50 • $15/$25/$50 with a $250 brand name deductible • $15/$45/$60 • $20/$50/$75 • Subject to medical plan’s deductible and coinsurance • Preferred Pricing Card only Popular Features • Save 10% on copays for a three-month supply by mail order • Birth control pills are covered – retail and mail order * Deductible is for preferred and non-preferred brand name prescriptions
Real Choices III Real Choices III Streamlined Plans with the Most Affordable Coverage • Access point to health insurance market • Priced 15-20% below Real Choices II • Preventive care including $200 in first-dollar benefits • $2 million lifetime maximum
Real Choices III Real Choices III – Most Affordable Coverage BENEFIT REAL CHOICES III
Real Choices III Real Choices III – Most Affordable Coverage BENEFIT REAL CHOICES III
Real Choices III Real Choices III – Most Affordable Coverage BENEFIT REAL CHOICES III
Real Choices HRA and HSA Consumer-driven health care plans which will appeal to many Small Business Owners because they offer premium savings and tax savings
Health Reimbursement Arrangements HRAs are a creative means of financing insurance. Assurant Health’s HRA program offers many advantages: • More choices in designing a plan • Greater control over cash flow • More opportunities for tax deductions • Ability to retain ownership of funds • HRA admin services at no additional cost
Real Choices HRA I and II Real Choices HRA I and II – Payment Structures BENEFIT PERCENTAGE COINSURANCE PERCENTAGE CORRESPONDING DEDUCTIBLE CHOICES
Real Choices HRA I and II Real Choices HRA I and II – Payment Structures BENEFIT REAL CHOICES HRA I REAL CHOICES HRA II
Real Choices HRA I and II Real Choices HRA I and II – Payment Structures BENEFIT REAL CHOICES HRA I REAL CHOICES HRA II
Real Choices HSA I and HSA II Health insurance with tax-favored consumer choice options
HSA - Health Savings Accounts Choose an HSA if saving money is your priority. An HSA program combines major medical insurance with a tax-favored savings account. • With Assurant Health’s HSA Program, employers can • Save on premium with a high deductible health plan • Save on income taxes by making tax-free account contributions which can be used to pay for medical expense • Save for future needs by rolling over year-end balances • Save on separate account fees with HSA Tools
HSA Tools HSA Tools is Assurant Health’s comprehensive account services program. It is available at no additional cost and includes: • Efficient online claims payment and account tracking services • A VISA debit card for easy withdrawals • Tax-free interest on HSA funds • A line of credit option • An investment option • Online access to medical and prescription information
Real Choices HSA I and II Real Choices HSA I and II – Payment Structures BENEFIT REAL CHOICES HSA I AND HSA II HSA plans have a 24-month rate guarantee available! Not all combinations of deductible, benefit percentage and out-of-pocket maximum are available.
Real Choices HSA I and II Real Choices HSA I and II – Payment Structures BENEFIT REAL CHOICES HSA I REAL CHOICES HSA II
Real Choices HRA and HSA Account/Administration Services at No Additional Cost HSA Contact/Questions: 1-866-899-6200 Monday thru Friday From 8:00 a.m. – 5:00 p.m. Central Time HRA Contact/Questions: 1-866-HRA-7779 or www.ebcflex.com
Real Choices Premium Only Plans (POP) Premium Only Plans (POP) allow eligible insurance premiums to run through the employer’s payroll pre-tax Immediate tax savings for both the Employer and employee!
Real Choices Premium Only Plans (POP) Free!! • Administered through MHM Resources, Inc: • Dedicated Employer services toll-free number 800-280-5065, weekdays, 8 a.m. – 5 p.m., Central time or, email at assuranthelp@mhmbiz.com
Real Choices Out-of-Network Reimbursement Options Usual, Customary, and Reasonable (UCR) Scheduled Network (SCH) • Uses network fee schedule for out-of-network charges • Covered, negotiated charge will be lower than UCR fee • This option can lower premium 2% to 9% • Uses established, traditionalreimbursement schedule • Payment is typically at the 70th percentile
Real Choices Out-of-Network Claim ExampleTonsillectomywith no complications. Out-of-network charge: $2,000. Scheduled Network (SCH) Usual and Customary (UCR) • UCR charge is $1,400(70th percentile) • Insured’s responsibility is $600 • Negotiatednetwork rate is $1,200 • Insured’s responsibility is $800 If insured uses network services, responsibility is $0. Premium savings when selecting SCH is 2% to 9%. On a 10-person group, premium savings range from $640 to $2,880 per year. Two valuable sales tips: 1. Sell Scheduled Network option to make employer happy! 2. Tell employees to USE THE NETWORK PROVIDERS!
3-Year Benefit Packages • HSA Example: • Rate stays the same for 3 years • 5 Options available for Real Choices States • Additional form to fill out verify selection
Agent Outfitters Real Choices Efficiency Outfitting agents and employers with electronic, timesavingtools • Online Agent Self-Service • Online Employer Self-Service • Online Employee Self-Service
Agent Outfitters - Efficiency Online Agent Capabilities • Single sign-on through sales site: www.assuranthealthsales.com • MyAccount • www.answersbyassurant.com
Agent Outfitters - Efficiency Employer Self-Service Online tools at myaccount site on www.answersbyassurant.com • Employers can electronically: • Update contact information • Add or remove employees • Add or remove dependents • Order ID cards for employees • Access group insurance information 24/7 • Submit questions to Customer Service Department 24/7 • Compare HSAs with other plans using online calculator
Agent Outfitters - Underwriting Underwriting Committed to helping agents succeed
Agent Outfitters - Underwriting Underwriting • Attestation form instead of wage and tax information • 1-3 life groups require wage and tax • Group status available through EASE • Choice of waiting periods: 0, 30, 60, 90 and 180 days
Agent Outfitters - Underwriting Underwriting • Includes the following common medical conditions in base premium • Acne, Acid Reflux, Allergies, AD&D, High Cholesterol, High Blood Pressure and Mild Depression • Limited Questionaires • Simplified Employer Application
Underwriting • Employee choice (Plan choice) minimum of 3 employees with minimum of 2 in one plan (except employer HSA) • 15% differential only allowed • Network Choice • 1099 employees • Participation requirements - 3 lives and under 100% - 4+ lives 75%
New Business • Quoting is in the middle of the band +/-15% after underwriting • 1-2 Life groups quoted in Home Office only • prescreens@assurant.com • sgunderwriting@assurant.com • Underwriting Fax 414-299-1061 • Employer, Employee, Quote, last bill, check for submission
Your Success. OUR COMMITMENT. Responsive Agent Compensation Assurant Health is committed to promptly respond to the varied needs of employers and agents
Producing Agent Commission Schedule Allowed Tiers Tier 1-5 Tier 1-5 Tier 2-5 Tier 3-5 Tier 4-5