Presentation on theme: "Welcome to Standard Life and Accident. Why sell Cancer Insurance? Who is the right client? What types of plans are available? What type of plan is best?"— Presentation transcript:
Why sell Cancer Insurance? Who is the right client? What types of plans are available? What type of plan is best? How does the Resolutions Cancer plan work?
A recent quote from the Associated Press “Costly illnesses trigger about half of all personal bankruptcies, and most of those who go bankrupt because of medical problems have health insurance, according to findings from a Harvard University study. The study said 38 percent had lost coverage at least temporarily by the time they filed for bankruptcy, with illness frequently leading to the loss of both a job and insurance”.* *Associated Press updated 2/2/2005
Study done in 2009 by Kaiser Foundation found the following: 1.High cost-sharing, caps on benefits and lifetime maximums leave cancer patients vulnerable to high out of pocket health care costs. 2.People who depend on their employer for health insurance may not be protected from catastrophically high health care costs if they become too sick to work. 3.Cancer patients and survivors are often unable to find adequate and affordable coverage in the individual market.
4.While high-risk pools are designed to help cancer patients and others who are uninsurable, they are not available to all cancer patients and some find the premiums difficult to afford. 5.Waiting periods, strict restrictions on eligibility, or delayed application for public programs can leave cancer patients who are too ill to work without an affordable insurance option.
For an affordable premium, many clients can have supplemental individual coverage to help pay for the expensive treatment of cancer.
Who is a typical prospect for supplemental Cancer Insurance? Everyone is at risk to some degree of being diagnosed with cancer during their lifetime. One in 2 men and one in 3 women will be diagnosed with cancer at some point in their lives. Although the risk to children is much less than adults, family plans make adding children’s coverage very affordable.
Who can qualify for supplemental Cancer Insurance? Anyone who has not already been diagnosed with Cancer or has been treatment free for over 5 years or has not been diagnosed with HIV or AIDS.
Two basic types of coverage are available: –Lump Sum –Expense reimbursement
Lump Sum coverage can be in the form of Critical Illness coverage covering more than just Cancer. It usually pays a specified amount ranging anywhere from $5,000 to $500,000 upon the first diagnosis of major critical illnesses like Cancer, Heart Attack and Stroke. It can also be in the form of Cancer only coverage.
Either way, once the lump sum benefit is paid out for cancer, the coverage for Cancer ends. The advantage to this type of coverage is that it is simple to understand and the client has a specified amount of money to use for any expenses they wish.
The disadvantage is that since Cancer can be a long term illness, once the lump sum is paid out, expenses may continue, leaving the insured without ongoing coverage. Another disadvantage is that it is unsuitable for Section 125 Cafeteria Plans as the benefits could be considered taxable to the insured.
Treatment for Cancer is constantly changing as new drugs and procedures are developed. Often, experimental and other treatments are not covered by traditional health insurance. This can leave holes in a patients coverage resulting in high out of pocket costs. The Resolutions Cancer Plan was developed to fill some of those holes.
Ambulance: actual charges are paid Anti-Nausea Medication Expense: $150 per month Attending Physician Expense: $40 per day Bone Marrow Donor Expense – Applies if the Daily Hospital Confinement Rider is also selected and covers the Daily Room Benefit for the donor (donor does not have to be included in the policy) Bone Marrow or Stem Cell Transplant: $15,000 lifetime Colony Stimulating Factor: $1,000 per month Convalescent Care Facility: $100 per day Hairpiece Expense: $150
Home Health Care: $75 per day $450 per year for medicine and supplies $300 for services of a nutritionist Hospice Care: $100 per day Inpatient Blood, plasma and platelets: $300 per day Inpatient Oxygen - $300 per confinement Inpatient Private Duty Nurse: $150 per day Lodging: $75 per day for adult companion to the patient
Medical Imaging, treatment planning: $1,000 per year Mental Health Consultation: $50 per session National Cancer Institute Evaluation: $750 –Also covered is transportation to the facility: $350 Outpatient blood, plasma and platelets: $300 per day Outpatient hospital or ambulatory surgical center: $350 per day Outpatient Private Duty Nursing: $150 per day Physical, speech and audio therapy: $1,000 per year
Positive Diagnosis Benefit: $300 for a test to confirm diagnosis Prosthesis Expense Benefit: –Surgically implanted: $3,000 per implant –Non-surgically implanted: $2,000 per device Medical Equipment Expense: $1500 per year Second and Third surgical opinion: actual charges Transportation Expense: actual charge for airfare for both the patient and donor
Tutorial Benefit: $20 per session for education tutoring for a child receiving treatment Waiver of Premium Wheelchair accessible home modifications: $1,000 lifetime benefit
First Occurrence: $500 - $10,000 First Occurrence Building Benefit: $100 - $600 per year Hospital Intensive Care: $100 - $1,000 per day Specified Disease: $1500 - $4500 Surgical Schedule: $500 - $10,000 Daily Hospital Confinement: $100 - $600 Initial Hospitalization: $1,500 - $4,500
Annual and Daily Radiation,Chemotherapy, Immunotherapy and Experimental Riders –Chemotherapy, Radiation, etc can be very expensive treatments. Experimental treatment may not be covered by primary health insurance –The insured can choose between Daily or Annual limits. The Daily limit may not cover the cost of the treatment versus a total annual expense with no limit on each treatment.
–On the other hand, the Insured may not feel the total annual benefit is sufficient for treatment costs and would prefer to have a benefit for each treatment. Annual Cancer Screening Benefit: $25 - $125 –Works well for younger applicants. Covers the new Human Papillomavirus Vaccine
Daily Hospital Confinement Rider –Important if the client is concerned about donor benefits –Benefit is doubled after 30 days in the hospital Hospital Intensive Care Rider –Pays benefits for confinement in an intensive care unit for any illness and double the benefit if the confinement is due to Cancer or a travel related injury. Good for clients that have limited primary health coverage.
First Occurrence Benefit –For clients who like the idea of a lump sum payment upon diagnosis First Occurrence Building Benefit –Can be added to the First Occurrence Benefit to protect against the rising costs of cancer treatment
Surgical Benefit Rider –For clients who have limited surgical coverage on their primary health insurance Specified Disease Rider –For clients who want additional protection against other types of less common critical illnesses such as Lyme Disease, Reye’s Syndrome, Nile Virus, etc.
Rates are easy to calculate: Individual One Parent Family Two Parent Family Based on the Primary Insured’s age No male/female or smoker/ non-smoker distinctions
35 year old with spouse and 2 children Base Plan: $121.90 Riders: $242.90 –$50 Annual Screening –$5,000 First Occurrence –$5,000 Surgical Schedule –$200 Daily Confinement –$200 Daily Chemotherapy Total monthly premium: $30.28
45 year old with 2 children Base Plan: $139.90 Riders: $184.40 –$50 Annual Screening –$5,000 First Occurrence –$200 Daily Hospital Confinement –$5000 Annual chemotherapy Total monthly premium: $26.92
55 year old Individual Base Plan: $210.40 Riders: $344.70 –$5,000 First Occurrence –$1,000 Surgical –$200 Daily Hospital Confinement –$500 Daily Chemotherapy Total monthly premium: $28.61
American Alliance for Personal Financial Independence (AAPFI) Applicants must be at least bronze members to apply Bronze: $1.00 monthly Vision, Vitamins, Car Rental Silver: $2.50 monthly Mail Order Drugs, Fitness Clubs, UPS and Office Depot Gold: $4.00 monthly Long distance and internet
10+ lives Issue Ages: 17 – 99 (Composite Rate) Producer works with Employer to design plan and rider options based on what the employees can afford List Billing