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Personal Cancer Indemnity

Personal Cancer Indemnity . Field Sales Guide . M-1071 Standard information only. Refer to state-specific introduction package for variations. Page numbers on slide match those in book. Page 9. Introduction. Cancer Facts. In the United States:

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Personal Cancer Indemnity

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  1. Personal Cancer Indemnity

  2. Field Sales Guide • M-1071 • Standard information only. • Refer to state-specific introduction package for variations. • Page numbers on slide match those in book. Page 9 Personal Cancer Indemnity

  3. Introduction

  4. Cancer Facts • In the United States: • Men: 1-in-2 lifetime risk of developing cancer. • Women: 1-in-3 risk. • Regular screening exams could increase survival rate. Page 15–16 Personal Cancer Indemnity

  5. Why AFLAC’s PCI? • Out-of-pocket costs (copayments and deductibles). • Additional expenses not necessarily covered by major medical. • Wellness Benefit promotes early detection! Page 16 Personal Cancer Indemnity

  6. Policy Provisions

  7. Important Provisions • 30-day waiting period. • Effective date. • Diagnosis date. Page Personal Cancer Indemnity

  8. Policy Benefits

  9. PCI Highlights • All benefits are indemnity. • Three distinct plan levels. • Simplified application process. Page 23 Personal Cancer Indemnity

  10. Mammogram Breast Ultrasound Pap Smear ThinPrep Biopsy Flexible Sigmoidoscopy Hemocult Stool Specimen CEA CA 125 PSA Thermography Colonoscopy Virtual Colonoscopy Chest X-ray Cancer Screening Wellness Benefit Payable once per person per calendar year Page 24 Personal Cancer Indemnity

  11. First-Occurrence Benefit • One-time payment made upon the diagnosis of internal cancer: • Insured/Spouse Child Level 1 $1,500 $2,250 Level 2 $2,000 $3,000 Level 3 $5,000 $7,500 • Internal cancer includes melanomas classified as Clark’s Level III and higher or a Breslow measurement (thickness) greater than 1.5 mm. Page 25 Personal Cancer Indemnity

  12. Hospital Confinement Medical Imaging Benefit Benefit • Level 1: $200 days 1–30 • $400 days 31+ • Levels 2 & 3: $300 days 1–30 $600 days 31+ • Pays for initial diagnosis or follow-up evaluation of internal cancer. • Level 1 $100 • Level 2 $150 • Level 3 $200 • Once per person per year Page 26 Personal Cancer Indemnity

  13. Radiation and Anti-Nausea Benefit Chemotherapy Benefit • Level 1 $100 • Level 2 $125 • Level 3 $150 • Level 1 $200/day • Levels 2 & 3 $300/day • Radiation Therapy • Must Be FDA or NCI Approved • Not Payable Same Day as Experimental Treatment Page 27 Personal Cancer Indemnity

  14. Experimental Treatment Immunotherapy Benefit Benefit • Level 1 $200/day • Levels 2 & 3 $300/day • Must be NCI approved • Not payable same day as Radiation and Chemotherapy • Level 1 $300 • Lifetime maximum $1,500 • Level 2 $400 • Lifetime maximum $2,000 • Level 3 $500 • Lifetime maximum $2,500 • Not payable for medications paid by R&C or Experimental Benefits Page 28 Personal Cancer Indemnity

  15. Nursing Services Benefit Surgical/Anesthesia Benefit • Benefits listed in Schedule of Operations • Procedures through same incision considered one • Additional 25% paid for anesthesia • Excludes skin cancer and reconstructive surgery • Level 1 $100 • Level 2 $125 • Level 3 $150 • Payable only for days when Hospital Confinement paid Pages 29–30 Personal Cancer Indemnity

  16. Outpatient Hospital Skin Cancer Surgery Surgical Benefit Benefit • All Levels: • Biopsy $100 • Excision of skin lesion $100 • Flap or graft $375 • Excision with flap or graft $600 • Level 1 $200 • Levels 2 & 3 $300 Pages 30–31 Personal Cancer Indemnity

  17. Prosthesis Benefit • Surgically implanted • Level 1 $2,500 • Level 2 $3,000 • Level 3 $3,000 • Non-surgically implanted • Level 1 $200 • Level 2 $225 • Level 3 $250 • Lifetime maximum of 2 each • Not payable for TRAM Flap procedure Page 31 Personal Cancer Indemnity

  18. Reconstructive Surgery Benefit • Facial Reconstruction • Level 1 $625 • Levels 2 & 3 $700 • Additional 25% paid for anesthesia • TRAM Flap • Level 1 $2,500 • Levels 2 & 3 $3,000 • Breast Reconstruction • Level 1 $625 • Levels 2 & 3 $700 • Breast Symmetry • Level 1 $325 • Levels 2 & 3 $350 Page 32 Personal Cancer Indemnity

  19. Inpatient During a covered confinement; benefit is multiplied by the number of days confined Level 1 $50 Level 2 $100 Level 3 $150 Outpatient During outpatient treatment in physician’s office, clinic, hospital, or ambulatory surgical center Level 1 $200 Levels 2 & 3 $250 Blood and Plasma Benefits Pages 32–33 Personal Cancer Indemnity

  20. Second Surgical Opinion NCI Evaluation/Consult Benefit Benefit • Level 1 $200 • Level 2 $250 • Level 3 $300 • Not payable same day as NCI Evaluation/ Consultation Benefit • $500 benefit • Additional $250 transportation/lodging costs • If more than 50 miles from home • Payable at Aflac Cancer Center • Not payable same day as Second Opinion Benefit Page 33 Personal Cancer Indemnity

  21. Ambulance Benefit Transportation Benefit • More than 50 miles from home • Level 1 $.40 per mile • Limit $1,200 • Levels 2 & 3 $.50 per mile • Limit $1,500 • Treatment for dependent child • 2 adults to accompany child • $200 ground • $1,000 air • Limit 2 trips per confinement Page 34 Personal Cancer Indemnity

  22. Lodging Benefit Transplantation Benefit • More than 50 miles from home • Level 1 $50 • Levels 2 & 3 $60 • Limit of 90 days per year • Payable once per person • Bone Marrow • $10,000 inpatient/outpatient • $1,000 for donor • Stem Cell • Peripheral stem cell • Level 1 $2,500 • Levels 2 & 3 $5,000 Pages 34–35 Personal Cancer Indemnity

  23. Extended-Care Facility Benefit • Within 30 days of hospital confinement • $100 per day for confinement • Limited to same number of days Hospital Confinement paid • Not payable on same day as Hospital Confinement • If extended-care stays separated by 30 days, second stay not covered unless again confined to hospital • Limit of 365 days per person Page 35 Personal Cancer Indemnity

  24. Hospice Benefit Home Health Care Benefit • First day • Level 1 $500 • Levels 2 & 3 $1,000 • Each day thereafter • All Levels $50 • Not payable same day as Home Health Care • Limit of $12,000 per person • $50 per visit • Within 7 days of hospital release • Authorized by physician • Licensed/certified person • Limit • 10 visits per hospitalization • 30 visits per year per person Page 36 Personal Cancer Indemnity

  25. Waiver of Premium Continuation of Benefit Coverage Benefit • Disability for at least 90 days • Inability to perform usual job • 2 or more ADLs if unemployed • Waived if receiving Hospice Benefits • Up to two months • Payroll deduction • 6 consecutive months • 30 days notification • Insured re-establishes premium payment Page 37 Personal Cancer Indemnity

  26. Optional Riders

  27. Building Benefit Rider Return of Premium Benefit Rider • Increases the FOB by $100 • per unit purchased • Builds until age 65 or internal cancer diagnosed • Issue ages: • 18–70 payroll • 18–64 nonpayroll • Cash value based on AP • Benefit is less any claims paid, including Wellness • Begins after 5 years; maximum refund at 20 years • Not eligible as pre-tax or employer-paid • Issue ages: 18–59 Page 67 Personal Cancer Indemnity

  28. Specified-Disease Benefit Rider • Benefits for hospital confinement due to listed diseases • 10 new diseases added • Issue ages: • 18–70 on payroll • 18–64 on non-payroll Page 67 Personal Cancer Indemnity

  29. Administrative Guidelines

  30. Administrative Guidelines • Payroll: 18–70 • Nonpayroll: 18–64 • Available to: • field force • government allotment • Dependent children to age 25 • Eligible for pre-tax • ROP Rider • Advanced Effective Date • Payment Modes • Domestic Partners • 1099 Workers Page 77 Personal Cancer Indemnity

  31. Completing the Application

  32. Applications and Forms • Payroll Application A-75001 • Nonpayroll Application A-75002 • Payroll Cancer History Form A-75030P • Nonpayroll Cancer History Form A-75030D • Conversion Application • Application to Remove Skin Cancer Exclusion Rider A-90030R Pages 94–111 Personal Cancer Indemnity

  33. Direct on SmartApp®

  34. Direct on SmartApp® Bank Draft Authorization • Bank draft and credit card only • Drafted immediately • Effective date • Draft date • Transit/ABA and account numbers • Separate BDA for each application Page 115 Personal Cancer Indemnity

  35. Sales Support Material

  36. Sales Support Materials • Brochures • A-75175 Level 1 – A-75275 Level 2 – A-75375 Level 3 • Insert Pages • A-75075 Building Benefit Rider • A-75076 Return of Premium Rider • A-75077 Specified-Disease Rider • A-59276 NCI-Designated Cancer Centers • Mailer • A-75080 Page 121 Personal Cancer Indemnity

  37. Leave With the Applicant

  38. Leave with the Applicant • Brochure/Insert Page(s) • Guide to Health Insurance for People with Medicare - if applicable • Replacement Notice, if required by state • A-8691, if applicable • Outline of Coverage, if required by state • Applicant must acknowledge receipt of outline on the application or business will be returned • A-75125 Level 1 A-75225 Level 2 A-75325 Level 3 Page 125 Personal Cancer Indemnity

  39. Premium Rates

  40. Types of Coverage Premiums • Individual • One-Parent Family • Under age 25, and qualified by IRS) • Two-Parent Family • named insured, spouse, dependent children • M-RS068 • Payroll, Direct, and Association rates • Premium Quote and SmartApp® • Premium Worksheet M-1061 Pages 129–133 Personal Cancer Indemnity

  41. Commissions

  42. Commissions • ROP rider has a separate commission package • PCI production eligible for: • stock bonus • nationally sponsored contests Page 137 Personal Cancer Indemnity

  43. Claims

  44. Claims • Cancer • S-2029 (see S-3087) • Pathology report required for first claim • Wellness • Automated letters sent annually after first claim • Specified-Disease • Use form S-2029 • Return of Premium • Submit written request to Claims • Waiver of Premium • Use form H-C0019 Page 145 Personal Cancer Indemnity

  45. Consultative Sales Process

  46. Marketing PCI

  47. Commitment Objective • What do you want to accomplish? • Set a clear commitment objective before the meeting. • Something that will move the sales process forward. Page 154 Personal Cancer Indemnity

  48. List of Forms for Selling PCI

  49. PCI Forms • Leave with applicant: • Brochure and NCI insert page • Rider Insert Pages • Outline of Coverage • Obtain from applicant: • Application • Cancer History Form • Replacement Notice • Statement of Understanding • if effective date advanced more than 60 days • Mailed with policy packet: • Welcome Letter • Policy • Selected Riders • Privacy Forms • Copy of Application • Replacement Notice, if applicable Page 170 Personal Cancer Indemnity

  50. PCI Forms • Additional forms • Mailer A-75080 • Field Sales Guide M-1071 • Guide to Health Insurance for People with Medicare A105712004 • Rate Booklet M-RS068 • Premium Worksheet M-1061 • Reinstatement Application A-75003 • Transmittal M-0018R • Payroll Account Acknowledgement Form M-0138 • Request for Change Form H-L0046 • Claims Instruction Sheet S-3087 • Claim Form S-2029 Page 170 Personal Cancer Indemnity

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