1 / 48

First Choice

First Choice. “ Guaranteed Issue ” Health Insurance Plans. Marketed by Licensed Representatives of GoHealth VMO.

loki
Download Presentation

First Choice

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. FirstChoice • “Guaranteed Issue” Health Insurance Plans • Marketed by Licensed Representatives of • GoHealth VMO

  2. Agents, please understand that any prospect who can afford and qualify for a Major Medical plan should be encouraged to purchase one. We do not endorse agents utilizing our plan if it is possible for the prospect to purchase coverage that is more comprehensive than our plan.

  3. With that said, also understand that we have two excellent plan designs, Traditional and Super Supp, that are specifically designed to reduce or eliminate the out of pocket costs left over by Major Medical for an average period of hospital confinement. This is one of the reasons that a high percentage of all FirstChoiceapplicants are in perfect or near perfect health, which also contributes to the success and longevity of our program.

  4. FirstChoiceProud of our Roots! Central United Life is a member of the Manhattan Insurance Group. Manhattan Life ( Est 1850 ) was the first insurance company to issue a life insurance policy on the life of a female. They also earned the nickname “Old Reliable” pay paying claims on the lives of deceased Confederate soldiers during the Civil War.

  5. Our Value Proposition • The Best Benefits • The Best Price • The Most Secure Policy • TheHighest Commissions • Fantastic Incentive Trips

  6. FirstChoicePlan Design FirstChoicePlans are true “Defined Benefit” plans. As such, the stipulated benefit is always paid in full, regardless of the billed amount. There is no “pays UP TO $$$” language in FirstChoicepolicies!

  7. FirstChoiceGuaranteed Issue Health Plans Who qualifies for “Guaranteed Issue” Consideration? Individuals (W-2 or 1099) age 18-65 whowork an average of 30+ hours per week, their spouse ( if 18-65 ) and their children.

  8. FirstChoicePlan Design By limiting eligibility to employees who work an average of 30+ hours/week,and avoiding marginal benefits subject to abuse, we are able to provide what we believe to be the strongest package of “Guaranteed Issue” benefits available in our industry today!

  9. FirstChoicePlan Design Remember that all FirstChoiceplans are GUARANTEED RENEWABLE POLICIES, not certificates of a Group Master policy or Association Plan. This provides much greater protection for the insured's!

  10. FirstChoiceGuaranteed Issue Health Plans If the policy holder is still actively at workon the policy anniversary date after age 65, and they desire to continue the coverage, they may keep the policy by maintaining employmentandrenewing at policy anniversary dates until age 70!

  11. FirstChoiceGuaranteed Issue Health Plans Are there any Ineligible Conditions or Ineligible Occupations with FirstChoice? NO! Individuals 18-65 working an average of 30+ hours per week may apply regardless of their Occupation or Pre-Existing Conditions!

  12. FirstChoiceGuaranteed Issue Health Plans How are Pre Existing Conditions treated? Conditions for which an insured sought or received medical treatment in the 12 months prior to application date, or which manifest symptoms that would have caused an ordinarily prudent person (a person of average intelligence) to have done so will not be covered for 12 months after the effective date, whether or not they are disclosed on the application.

  13. FirstChoiceGuaranteed Issue Health Plans There are THREEimportant areas that must be considered when selecting which Guaranteed Issue plans to market. We feel that the FirstChoicePlan Series is superior to the competition in all three!PLAN DESIGN, PREMIUM, and COMPENSATION

  14. FirstChoicePlan Design The FirstChoicePLATINUM Plan has 6 separate benefits, including the 4 most significant, that are equal to or superior to ANY GUARANTEED ISSUE PLANcurrently being sold!

  15. FirstChoiceGuaranteed Issue Health Plans Get a FirstChoiceBrochure& Note These Benefits: • Hospital Benefits, Up to $4500 perday! ($2500 day 1, & days 3 – 6, $1500 for day 2) $500 per day for days 7 – 365. Then, ICU pays an additional $2000 for up to 20 days/yr!) • Surgical Schedule of $10,000per occurrence + 25% to the • Anesthesiologist. • Accidental Injury scheduledbenefits up to $1800, plus $200 per injury, plus any applicable surgical/anesthesiology benefits. • Maternityas any other illness • Wellness($400 MAM, $100 PAP) • Doctor’s Office $100 x 4 (or $150 per visit if ER for Sickness) • ( SIR rider not available in NC & GA, HII not available in GA, Surgery • Rider is available in PA instead of Surgery + Rider. )

  16. FirstChoiceGuaranteed Issue Health Plans Most FirstChoiceplan designs include a unique combination of features that provide significant “front loaded” benefits when they are needed the most. There are three separate benefits designed to provide cash when hospital confined. The Daily Room Benefit The Indemnity Benefit The First Hospital Confinement Benefit

  17. FirstChoiceGuaranteed Issue Health Plans The Daily Room Benefit ispaid for up to 365 days per period of confinement, much longer than any competitor. ( Others are usually 30 or 31 days maximum )

  18. FirstChoiceGuaranteed Issue Health Plans TheIndemnity Benefit ispaid on the first day of hospital confinement in any calendar year.

  19. FirstChoiceGuaranteed Issue Health Plans The First Hospital Confinement Benefit is paid during the first period of hospital confinement of any calendar year. Depending on the plan selected, it can be as much as $10,000 over the first 6 days.

  20. FirstChoiceGuaranteed Issue Health Plans The First Hospital Confinement Benefit in both the GOLD and PLATINUMplan designs pays as follows: Day 1:$1,000 Day 2:$1,000 Day 3:$2,000 Day 4:$2,000 Day 5:$2,000 Day 6:$2,000 TOTAL: $10,000 If a period of confinement lasts less than 6 days, the balance of the benefit is available for a subsequent confinement for the same condition, provided it occurs within 90 days.

  21. FirstChoicePlan Design Unlike the competition, some of which have no benefit for Intensive Care, or pay it “in lieu” ( instead of! ) the DRB, FirstChoicepolicies pay all ICU benefits IN ADDITION TOany and all other benefits of the policy, including the DRB. This is a HUGE advantage to the policyholder!

  22. FirstChoicePlan Design Virtually ALL Guaranteed Issue Plans address SURGERY in one of two ways. Many pay a percentage, often 100%, of the Medicare reimbursement rate ( RBRVS, or Resource Based Relative Value Scale). What many agents and most clients do not realize is that this amount IS NOT based upon the total cost of the procedure, but simply on the amount charged by the PRIMARY SURGEON ONLY! This does not include the Operating Room, Suture Kits, dressings, etc.!

  23. FirstChoicePlan Design Some GI plans pay based upon the RBRVS, or Resource Based Relative Value Scale, also referred to as the Medicare Discount Rate. The rest address Surgery with an established Surgical Schedule, usually with a maximum benefit of $10,000.

  24. FirstChoicePlan Design Often, since the RBRVS is applied to the charges of the SURGEON ONLY, the benefit from a $10,000 Surgical Schedule will be more than for the identical procedure under a 100% RBRVS Medicare Reimbursement rate!

  25. FirstChoicePlan Design One drawback to many plans with Surgical Schedules is that they tend to limit coverage to one or two surgical procedures per year, maximum!

  26. FirstChoicePlan Design FirstChoiceincorporates the best of both, with a $10,000 Surgical Schedule that can be accessed an UNLIMITED number of times each year, for either inpatient or outpatient procedures!

  27. These are just a few examples of the FirstChoiceSurgical Benefits

  28. FirstChoicePlan Design The FirstChoice benefit for Anesthesiais the highest percentage paid, 25%of the amount paid for Surgery. Since our Surgical Schedule will often deliver more benefits and for more times than other plans, the Anesthesia Benefit is usually correspondingly higher as well!

  29. For example, with a Platinum Plan $10,000 Surgical Schedule, the following would be provided for Anesthesia ( 25% of Surgery Benefit provided for Anesthesia ) Surgical Event Surgical Schedule Dollar Amount Percentage for Anesthesia Heart Bypass 100% / $10,000 $2,500 Cholosystectomy30% / $3,000 $750 Hysterectomy, 50% / $5,000 $1,250 Radical Appendectomy 20% / 2,000 $500 A complete surgical schedule can be seen in the FirstChoiceProduct Guide on the FirstChoiceWebsite: www.FirstChoiceGI.com

  30. FirstChoicePlan Design Unlike the vast majority of competitors, FirstChoiceplansprovide benefits for MATERNITY, both Natural Delivery as well as Caesarian Section, effective 10 months after the policy effective date!!

  31. FirstChoicePlan Design FirstChoiceplans are among the few “Guaranteed Issue” plans currently known to include Private Duty Nursingbenefits.

  32. FirstChoicePlan Design The total paid for an Accidentwill come from several different plan benefits. They are: Accident Rider Specific Injury Rider( Not available in NCand GA ) Surgery Schedule Anesthesia

  33. FirstChoicePlan Design Accident Rider: Pays a (first dollar) benefit for each accident. Specific Injury Rider: Pays as much as $1,800 per accident from a (first dollar) schedule of procedures. Surgery Schedule:Pays a (first dollar) percentage of the Surgery Schedule, plus 25%+ for anesthesia!

  34. FirstChoicePlan Design There are benefits absent from FirstChoicethat appear with other Guaranteed Issue plans. They include Prescription Drugs, Outpatient Labs & X-Rays, Critical Illness, and “Association Junk”

  35. FirstChoicePlan Design Occasional Drugs are most commonlyAntibiotics,used infrequently, andPainMedication, usually very inexpensive. It is usually less costly over time for the client to ‘pay as you need’ these, as opposed to building in costs that drive up plan premiums.

  36. FirstChoicePlan Design X-RaysandLab tests are legitimate medical procedures, but have become abused as doctors increasingly practice ‘defensive medicine.’ We have chosen to avoid coverage for these elements in favor of additional coverage for expensive confinements/procedures. Yet, you’ll still have access to HUGE PPO discounts through Beechstreet Network.

  37. FirstChoicePlan Design Today, even though numerous “Guaranteed Issue” plans exist that feature solid Health Insurance benefits, most plans are still littered with movie tickets, rental cars, Disney discounts, and vitamins. With FirstChoice, you get quality INSURANCE BENEFITS, period.

  38. Beechstreet now offered with Platinum and Gold plans! Clients are provided access to a quality PPO repricing and Discount Medical benefits relationship through Beechstreet Network. This plan costs NOTHING to the policyholder! (This is a stand alone program, provided as a courtesy, and is not otherwise affiliated with CUL)

  39. FirstChoice Premiums Ranging from the “Super Supplement”to the “PLATINUM” plan design with the richest benefits we have seen in any Guaranteed Issuechassis, FirstChoiceplan designs are available in a variety of configurations, all of which are lower in price than competitor plans with fewer and smaller benefits!

  40. FirstChoiceCOMPENSATION Almost all “Guaranteed Issue” plans today pay a ‘levelized’ commission, and very few offer annualization. FirstChoiceplans provide ‘heaped’ first year commission with 6 months advanced commissionsavailable to agents that qualify!

  41. BMC Agency, Inc. and CULFirstChoice • STRONG BENEFITS! • ************************************************************************************************************ • Low Premiums! • *********************************************************************************************************** • High Compensation! • ************************************************************************************************************** • “The FirstChoice in • Guaranteed Issue Health Plans!”

  42. In our opinion, this is what makes FirstChoice the finest Guaranteed Issue program in America. But… How can we be of immense value to folks who qualify for and can afford Major Med?

  43. OurTraditional Supplement and Super Supplement may be even better values than our incredible Platinum and Gold plan designs!

  44. When used in conjunction with Major Medical plans for “an average period of hospital confinement”*, our Traditional Supp and Super Supp plans will often deliver sufficient funds to “reduce or eliminate the Out-of-Pocket charges associated with the confinement.” * According to the Statistical Abstract of the U.S. the average period of confinement in 2009 was 4.83 days.

  45. One way to use the FirstChoice supplements is simply purchase them in addition to existing Major Med plans to “fill the gaps.” EXAMPLE: For an ‘average’ confinement ( 5 days ) our Super Supp plan would pay, for a qualified stay, $5,000! $100 per day X 5 days = $500 $500 on day one = $500 5 days of FHC = $4,000 ------------------------------- Total = $5,000

  46. EXAMPLE: For an ‘average’ confinement ( 5 days ) our Traditional Supp plan would pay, for a qualified stay, $5,000 $100 per day X 5 days = $500 $500 on day one = $500 5 days of FHC = $4,000 ------------------------------- Total = $5,000 Plus, Up to $5,000 more for Surgery & $1,250 for Anesthesia!

  47. The Super Supp would deliver very similar benefits to the Traditional Supp plan, with the exception of Surgical and OP Sickness, for an even lower premium cost. In addition, the Super Supp complies with IRS section 223, and would not restrict an insured from making a tax free deposit into an HSA account if they so desired.

  48. Let’s take a 5 minute break, and then reconvene to discuss CUL’s excellent suite of Ancillary Cancer and Accident products that let you Stand out from the Worksite competition!

More Related