Presentation on theme: "PART 1: General Market Explanation PART 2: UA Coverage Solutions Form UASM-1 R05 2005 Agent Training Presentation Part 1 and Part 2 may be presented separately."— Presentation transcript:
PART 1: General Market Explanation PART 2: UA Coverage Solutions Form UASM-1 R05 2005 Agent Training Presentation Part 1 and Part 2 may be presented separately.
Part 1: General Market Explanation Medicare Review Medicare Supplement Long Term Care Life Insurance Insurer Selection
“When Medicare began in 1966 it had 19 million beneficiaries and a budget of $12 million. By 2010, the program is projected to serve 45 million Seniors, or one out of seven Americans, with a $300 million budget.” - Dr. Robert Field “What Should Medicare Look Like in 2010?” Medicare Symposium University of the Sciences, Philadelphia, PA May 14, 2003 Medicare Overview
Medicare consists of two parts — A & B: Medicare Today Medicare Part A Hospital Room & Board. Other Costs Associated with Confinement. Skilled Care in a Nursing Facility. Medicare Part B Medical insurance.
MEDICARE PART A — HOSPITAL MEDICARE PAYS: YOU PAY: Medicare Today 2005 Deductible:Most confinement $912 per costs after deductibleconfinement Days 61-90: All eligible $228 Daily remaining expenses Days 91-150:All eligible $456 Daily remaining expenses Days 151 on:Nothing All hospital costs
MEDICARE PART A — Skilled Nursing Facility MEDICARE PAYS: YOU PAY: Medicare Today Days 1-20: All eligible Nothing expenses after leaving the hospital — specific limitations Days 21-100:All eligible $114 Daily remaining expenses Days 101 on:Nothing All costs
MEDICARE PART B — MEDICAL Part B covers: Doctor & surgeon fees, most lab tests & X-rays performed outside the hospital and outpatient treatment. Medicare Today MEDICARE PAYS -- generally pays 80% of “approved”charges -- YOU PAY $110 annual deductible 20% of “approved” charges 100% of charges above Medicare “approved” amounts
PART A — HOSPITAL INSURANCE 1st DAY 61st-90th DAY60 DAY 21st-100th DAY YEAR BENEFIT INPATIENT HOSPITAL INPATIENT HOSPITALLIFETIME RESERVE SKILLED NURSING PERIOD BEGANDEDUCTIBLECOINSURANCECOINSURANCEFACILITY COINSURANCE PART B — MEDICAL INSURANCE ANNUAL DEDUCTIBLECOINSURANCE COVERED SERVICESCOVERED SERVICES 1966-1972$50.0020% of Approved Amount 1973-1981$60.0020% of Approved Amount 1982-1990$75.0020% of Approved Amount 1991-2004$100.0020% of Approved Amount NOW$110.0020% of Approved Amount 1966$ 40.00$ 10.00$ 20.00$ 5.00 197052.0013.0026.006.50 1980180.0045.0090.0022.50 1990592.00148.00296.0074.00 1995716.00179.00358.0089.50 1996736.00184.00368.0092.00 1997760.00190.00380.0095.00 1998764.00191.00382.0095.50 1999768.00192.00384.0096.00 2000776.00194.00388.0097.00 2001792.00198.00396.0099.00 2002$812.00$203.00$406.00$101.50 2003$840.00$210.00$420.00$105.00 2004$876.00$219.00$438.00$109.50 2005$912.00$228.00$456.00$114.00 per benefit period per day per day per day
PlansABCDEF*GHIJ* Core Benefits Skilled Nursing Home Part A Hospital Deductible Part B Deductible Excess Doctor Charges 100%80%100%100% Foreign Travel At-Home Recovery Prescription Drugs $1250$1250$3000 Preventive Care *Plans F & J also have high deductible plans. Standardized Med-Supp Plans
Hypothetical Example: Patient Liability after Medicare Need for Medicare Supplement PATIENT PLAN C PLAN FPLAN G LIABILITYPAYSPAYSPAYS PART A: Hospital Part A Deductible$ 912$ 912$ 912$ 912 30 Days @ $2286,8406,8406,8406,840 60 Days @ $45627,360 27,360 27,360 27,360 Additional Hospitalization20,000 20,000 20,000 20,000 3 units of blood @ $60180 180 180 180 SUBTOTAL:$55,292$55,292 $55,292$55,292 SNF: 80 Days @ $1149,1209,120 9,120 9,120 At-Home Recovery: 14 visits @ $40 560——560 PART A TOTAL:$64,972$64,412 $64,412$64,972 PART B: Outpatient Hospital Services & Medical PART B TOTAL:$12,599$8,333$12,599$11,636 TOTAL: $77,571 UNPAID $72,745 $77,011 $76,608 Plans F and G are not available in PA or VT; excess charges are prohibited in OH.
1.Can patients pick their primary-care physician? 2.What gets covered? Pre-existing conditions? Emergency-room visits? 3.How much will it really cost? Are there co-payments on prescriptions, routine doctor appointments and visits to specialists? 4.What if a patient wants to see someone not included in the plan? Managed Care ‘Freedom’? Questions Seniors should research in the case of HMOs:
5.How good are the HMO doctors? How many are board-certified? 6.Does the patient have access to any doctor in the HMO plan? 7.How convenient are the locations of HMO facilities and physicians? 8.What do current patients think of the HMO? Managed Care ‘Freedom’? Questions Seniors should research in the case of HMOs: (continued)
Initial Medicare Supplement policy selection is more critical than customers may realize. Only policies are standardized, companies are not. “First Year” Choices Choose a safe, strong, proven company — once. Research, understand and choose the best coverage for you — once. Qualify for coverage — once. Health status can change and qualifying for a different policy (an upgrade) may not be possible later.
On average, one year in a nursing home costs about $57,700. - Evans Research, May 2003 The average cost of a nursing home ranges from $98 – $457 per day, depending on location. - GE Financial, August 2003 Long Term Care Need
When a loved one dies many bills may remain and the family will need to find the money to pay them. Life insurance coverage bought now can help to cover these costs. Life Coverage Life insurance for final expense needs is generally for ages 50-80. Provides quick access to pay final expense costs. Protects loved ones from financial burden during a difficult time. Options can include varying face amounts, cash and loan values and living benefits.
Life insurance is purchased mainly to buy additional financial protection for families. Life Coverage Individual life policies offer 2 basic types of protection: covering a specified term or permanently covering one’s whole life. Ordinary life is the most widely used form of life insurance protection and it is broken into two types... whole life (permanent) and term insurance.
Most annuities are available for ages 0-80. Annuities are purchased for the purpose of producing periodic income at regular intervals for a specific time frame, such as 10, 20, 30 years or even life. Annuities Annuities help assure protection against the possibility of outliving one’s financial resources. Typically, annuities are intended to provide additional retirement income.
Choose the right company. Examine the company behind the product... financial stability, leadership experience, industry ratings and rankings. Life/Health Insurer Selection Match coverage needs to budget. The bottom line... what good is an insurer if you can’t depend on them when you need protection?
Medicare Supplement Long Term Care Critical Illness Cancer Life Coverages United American Review Part 2: UA Coverage Solutions
Source: AAIM, Oracle #1, January 2003, Alliance for Academic Internal Medicine Growth in the Medicare Supplement Market Millions Projected Number of People Age 65
Growth in the Medicare Supplement Market In 2003, the number of Medicare beneficiaries was over 40 million. It is estimated the number of Medicare beneficiaries will be over 66 million by 2050. - AAIM, Oracle #1, January 2003 Alliance for Academic Internal Medicine
Policy Forms MS A MS B* MS C MS D MS F MS G Core Benefits Skilled Nursing Home Part A Hospital Deductible Part B Deductible Excess Doctor Charges 100% 80% Foreign Travel At-Home Recovery There are ten standardized Medicare Supplement insurance plans; of these, United American offers six. *Plan B provides both senior and underage disability protection. Benefits are identical (separate app/brochures); senior rates are age-banded and Underage Disability rates remain one rate all ages. (Some states require designated Medicare Supplement plans be available to persons eligible for Medicare due to disability.) Excess charges are not applicable in PA and Ohio. Plans F and G not available in PA and VT. Plans and benefits may vary by state. United American Insurance Company is not associated with or endorsed by Medicare, Social Security or any other governmental agency. UA’s ProCare Med-Supp Portfolio
Groups of 50 or more retired employees are eligible — including eligible spouses. 100% participation is required. Coverage is guaranteed issue. Lower, community rates will be offered. The full UA ProCare portfolio is available. UA Group Medicare Supplements
United American delivers... UA Policyholder Services Personal one-on-one Agent attention. Fast policy issue for fast protection. Automatic Payment Plan (Bank Draft) for premium payment, thereby eliminating unintentional lapse and providing non-stop protection. Easy-to-understand product brochures with clearly defined benefit descriptions. Optional Customer Conveniences. UA Partners ® discount health services which includes “Automatic” Claims Filing ® for our Medicare Supplement customers (not available in KS).
Nationwide discount health services program with savings for: Chiropractic Dental Eye Care Hearing Prescriptions Mail Order Pharmacy UA Partners ® Up to 40% Up to 50% Up to 20% Up to 30% Save More $$
Virtually eliminates claims filing Direct provider payment Speeds claims processing Consolidated monthly claim statements Note: Federal law requires Medicare to file a small number of claims directly with insurers. UA Partners ® Our UA Partners program also includes our “Automatic” Claims Filing ® service for Medicare Supplement policyholders.
Insurance companies receive eligible Medicare Part B claims automatically from Medicare Part B administrators. Automatic filing virtually eliminates the need for customer claims filing. Not all Medicare Supplement insurers offer automatic filing. Companies offering automatic filing sometimes provide it only in limited areas. Federal law requires Medicare to file a small number of claims directly with insurers. “Automatic” Claims Filing ®
Dear Sirs, Thank you so much for the Partners membership card for the discount benefit program. I have used the card several times, and it is hard to believe how much I have saved on prescriptions. It is well worth the fee. I recommend the company (United American) to friends and relatives as often as I have the opportunity. Sincerely, E. Clark, Georgia Policyholder Praise
Dear Sir, I value very highly my insurance with you. You are indeed responsible for taking my worries about health care cost and giving me a sense of peace. Sincerely, J. Miller, MD Policyholder Praise
Mr. Mark McAndrew, I am thankful we had our insurance with your company. Your company can be proud of the way they handled all of our claims. Thank you! I can assure you that I will recommend your company to my friends or anyone for any type of insurance your company handles. Yours truly, L. Joehnek, MO
LTC Classic — Indemnity LTC Gold Series — Expense-Incurred Individual or Married Protection Issue Ages 40-84 Long Term Care * *Plans and benefits may vary by state. Not available in CA, CO, FL, ME, MD, MN, PA, RI, TX, VT or WI.
The Classic and Gold Series Plans offer these additional features: LTC Features Benefits for Alzheimer’s Disease — covers as any other sickness* Cognitive Impairment Lapse Protection Third Party Notification Guaranteed Renewable Protection Automatic Payment Plan Married couple rate *In most states, Alzheimer’s must be first diagnosed or treated after the policy is in force.
Features: Good Sense Plan Plans & benefits may vary by state. Policy Form GSP1 Issue ages 0-63 Miscellaneous Hospital Benefit amounts of $15,000 or $25,000 (less $500 deductible) Surgical Expense Benefit Radiotherapy Benefit Choice of Daily Hospital Room Benefit Daily Intensive Care Benefit – up to two times the daily room benefit
Why do people need Critical Illness insurance? HealthGuard Critical Illness Policy Form CILS Every 26 Seconds an American suffers a coronary event. On average, someone in the U.S. suffers a stroke every 45 seconds. Heart disease is the leading cause of premature, permanent disability in the U.S. labor force. Source: Heart Disease and Stroke Statistics – 2004 Update, American Heart Association
HealthGuard Critical Illness Available for ages 18 through 64. Select a lump sum benefit of $10,000, $20,000, $30,000, $40,000 or $50,000. A one-time, lump sum payment is made directly to the policyholder. As long as premiums are paid, the policy is guaranteed renewable to age 80. Pays in addition to any other coverages Individual and spouse coverage is available. Policy terminates upon payment of lump sum benefit. Benefit amounts are reduced by 50% at age 65. Policy Features:
HealthGuard Critical Illness Major Organ Transplant (heart, lung, liver, kidney, pancreas or bone marrow) Heart Attack Stroke Total & Permanent Loss of Eyesight in Both Eyes Total & Permanent Loss of Hearing in Both Ears End Stage Renal (Kidney) Failure What does HealthGuard Cover?
HealthGuard Critical Illness Suffering a critical illness can incur additional costs for things like lost income, out-of-network fees or travel expenses. Benefits paid by a critical illness policy can relieve worry and anxiety concerning the daily routine of living. When someone is critically ill, they don’t feel in control of their lives. Critical Illness insurance was conceived and developed by a physician. What is the value of Critical Illness insurance?
UA Cash Benefit Cancer Plan This is a supplemental cancer only insurance policy. Policy Form CANB Reasons To Buy UA’s Supplemental Cancer Coverage: Reason #1 Freedom To Choose How Money Is Spent No restrictions on the way the policyholder spends the benefit amount received... reconstructive surgery, choice of treatment plan or doctor, mortgage payments, travel expenses, income while not working, etc. It’s up to the policyholder to decide how best to spend the money.
UA Cash Benefit Cancer Plan Reasons To Buy UA’s Supplemental Cancer Coverage: Reason #2 Existing Coverage Doesn’t Matter Fact: The lump sum cash benefit amount is designed as a total cash payment. This frees the customer from having to forfeit any existing coverage. With UA’s Cash Benefit Cancer Plan there is no duplication of coverage. This is a supplemental cancer only insurance policy. Policy Form CANB
Reasons To Buy UA’s Supplemental Cancer Coverage: Reason #3 Liberal Qualification No physical exam is required to qualify — a few health questions will determine if you qualify for coverage. UA Cash Benefit Cancer Plan This is a supplemental cancer only insurance policy. Policy Form CANB
First diagnosis, cash benefit supplemental cancer policy. Pays one-time cash payment of up to $10,000, $20,000, $30,000, $40,000, $50,000. Benefit paid upon written satisfactory proof according to the policy of diagnosed internal cancer or malignant melanoma. Coverage for Individual, Single Parent and Family — issue ages 0-69. Policy pays in addition to any other existing coverage. No hospitalization or treatment required to collect the full benefit amount due. This is a supplemental cancer only insurance policy. Plan and benefits may vary by state. Policy Form CANB UA Cash Benefit Cancer Plan
Whole Life — Level or Increasing RT85 Renewable Term Life 21-Pay UA Life Plans* *Plans and benefits may vary by state
Ages 45-80 Level Benefit with 4 Payment Options - 10 Year Pay - 20 Year Pay - 15 Year Pay - Ordinary Life Graded Benefit— Offered where approved.* - Available on level and increasing benefit choices Increasing Benefit — Grows 5% each policy year for 20 years until it doubles. - Ordinary Life payment option only Living Benefit— Offered where approved. Whole Life 400 Series Life Plan Policy Forms SWL & SWLGD *Plan and benefits may vary by state
Ideal protection for families just starting out and for those who need additional insurance coverage. * Plan and benefits may vary by state. Policy Form RT10/GT10GD RT85 Renewable Term Life Insurance Policy* Available ages 18-85 Immediate coverage with policy issue Graded Benefit - offered where approved Cash Benefit paid directly to beneficiary Living Benefit (where approved) Deposit Fund Rider
UA Deposit Fund Rider The Deposit Fund Rider (DFR) is an interest bearing account and can be attached to new RT-85 Renewable Term Life insurance policies. 3% guaranteed minimum interest rate on deposits No charge or interest penalties for withdrawals Minimum deposit amount is $5.00. Additional funds may be deposited by check with a completed transaction form.
Life insurance for the “child rearing” years Plan and benefits may vary by state. Policy Form URL-CBP 21-Pay Life Insurance Policy Available ages 0-79 Coverage for individuals, families and seniors Face amount increases 5% per year Optional child and Accidental Death Benefit Riders (Additional premium applies.)
United American will provide a complimentary Memorial Guide to each current or prospective policyholder. The Memorial Guide documents important information that aids families in making final preparations: vital statistics, military record, immediate family and special requests. This Guide allows clients to assess their final expense needs and their level of preparation. Memorial Guide
Issue ages 0-80 Single Premium Tax-deferred growth Guaranteed interest rate at all times Optional maturity date 5 income options include monthly checks Plan may vary by state. Policy Form USPDA02 UA Lifestyle Annuity
1.Over 50 years of Life/Health insurance experience 2.Full range of Life and Health products —Medicare Supplement, Long Term Care, Cancer, Life (whole life, term, annuities) 3.One of the largest writers of individual Medicare Supplements (NAIC Final Med-Supp Experience Report 11/6/03) 4.Personal Agent service 5.Fast policy issue for fast protection 6.UA average Medicare turnaround times: claims processing — 3.56 days. 7. Timely policyholder communications 8.Freedom to choose physicians & facilities on all health coverage 9. Simple “Yes/No” applications 10.Optional customer conveniences including UA Partners ® discount health services 10 GREAT REASONS TO BUY UA COVERAGES United American Review
United American Insurance Company is not connected with or endorsed by the U.S. government or the federal Medicare program. Unless specified, these Medicare Supplement policies will not duplicate Medicare payments or pay expenses not Medicare eligible. These policies described herein have exclusions and limitations. This is a solicitation for insurance, and an agent representing United American Insurance Company may call you to provide costs and complete details. Pre-existing condition means an injury sustained or sickness manifesting itself prior to the policy effective date. Form UASM-1 R05 2005
UNITED AMERICAN SECURITY FOR TODAY AND TOMORROW United American Insurance Company Headquarters McKinney, Texas