1. It’s time for a change…
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2. The company behind the change…
Philadelphia American Life Insurance Company (PALIC)
has a history dating back to 1904 and is now part of the
New Era Life family of insurance companies
Over $300,000,000 of annually premium income.
Over $120,000,000 of Health Premium annually
Philadelphia American Life Company is licensed in 47 ….states.
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3. The man behind the company
Dr. Bill Chen, our president, and CEO, earned his doctorate in theoretical statistics from Purdue University in 1970 and became a Fellow in the Society of Actuaries in He has spent nearly 30 years in the life and health.
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insurance industry. He has been honored by numerous organizations including Ernst and Young, Merrill Lynch Regional and was recognized as Entrepreneur of the Year in 1994 by Inc. Magazine.

4. It’s time for a change…
RETHINK the way you view healthcare
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5. Empowered healthcare is the Mission..
Think Prevention
Smart and healthy lifestyle choices
Think Control
Take control over personal healthcare decisions

6. For a growing number of American's, the days of $20 co-pays are coming to an end.
It’s a new world of Defined Benefit plans and supplemental benefits.
Now, WE are required to be more pro-active in controlling our medical expenses AND be equally pro-active in the management of our personal health.

7. The Key to Controlling Healthcare Costs is More Than Co-Pays and Deductibles
It’s about providing the “right” plan at the right time to help guide personal decisions.

8. Welcome to Health Saver Plus!
Your Guide to the Next Generation
of Affordable Health Insurance
In today’s market where health insurance is often unavailable or unaffordable, Health Savers Plus can help provide you and your family with peace of mind by proving health insurance benefits you can afford.
The idea is that affordable, quality healthcare is achievable if you the consumer, have the basic knowledge and willingness to make informed decisions by discussing your treatment plan and costs with the healthcare professional of your choice. 8

9. Welcome to Health Saver Plus!
Your Guide to the Next Generation
of Affordable Health Insurance

10. Key Features Include $5,000,000 Lifetime Maximum
Choose from three benefit options
.Pick your Base Plan Deductible
Number of Benefit Units to fit your needs
Calendar Year Benefit Maximum
Use any Doctor or Hospital you choose “Without Penalty”

11. Three Calendar Year Deductibles To Choose From
Three Calendar Year Deductibles To Choose From . Maximum of three Deductibles per policy
$ 1,000
$ 2,500
$ 5,000

12. Choose Your Maximum Benefit Level .
Maximum Covered Benefits Per Covered Person per Calendar Year
$100,000
$250,000
$1,000,000
Maximum Number of Days Per Covered Persons 30 60
180 12

13. Hospital Indemnity Benefits – Facility Fees .
Select The Number of Benefit Units To Fit Your Needs
1 Unit
2 Units
3 Units
Daily Indemnity Benefit For Hospital Confinement
$1,000
$2,000
$3,000
Confinement in a Hospital Intensive Care Unit (ICU)
(Up to 20 days per Calendar Year
$1,500
$4,500
Daily Indemnity Benefit For Hospital Confinement For Mental Illness, Alcohol and/or Substance Abuse
$ 500
Daily Indemnity Benefit For Hospital Confinement in a Rehabilitation Facility or Skilled Nursing Facility
Daily Indemnity Benefit For Outpatient Radiation or Chemotherapy
Inpatient Physician Hospital Visit per visit
$ 50
$ 100
$ 150
Daily Indemnity Benefit for Outpatient Hospital or Ambulatory Surgical Center services when surgery is performed
Emergency Ambulance for each trip due to a covered injury or Sickness that results in a hospital confinement.
$250
per trip 13

14. Professional Services .
1 Unit
2 Units
3 Units
Surgical Procedure:* The plan will pay this benefit if any Covered Person undergoes a surgical procedure when performed in a Hospital or in an Ambulatory Surgical Center due to a eligible Accident or Sickness.  
1 X the Policy fee schedule
2 X the Policy fee schedule
3 X the Policy fee schedule
Inpatient Pathologist / Radiologist:* The plan will pay this benefit if any Covered Person undergoes an Inpatient Pathologist / Radiologist procedure as a result of a Covered Accident or Sickness.
Assistant Surgical Services
We will pay 20% of the amount listed in the fee schedule
Anesthesia Benefit for covered services
We will pay 25% of the amount listed in the fee schedule
* The reimbursement schedule for 1 unit is similar to what is payable under Medicare’s Physician ..fee schedule for surgeries. You may acquire up to three units based on plan selected 14

15. Sample of Common Surgeries .
CPT
DESCRIPTION
19307
mastectomy, modified radical
27130
total hip arthroplasty
29881
knee arthroscopy/surgery
33533
coronary artery bypass, arterial, single
93510
left heart catheterization
45380
colonoscopy and biopsy
47562
laparoscopic cholecystectomy
50590
lithotripsy, fragmenting of kidney stone
58150
total hysterectomy
66984
cataract surg w/intraocular lens, 1 stage 15

16. Sample Fee Schedule Comparisonby State
Policy Fee Schedule (1 Unit)
100.00%
Alabama
87.00%
Arkansas
85.00%
Arizona
93.68%
Colorado
93.59%
Georgia - Atlanta
97.03%
Iowa
86.41%
Illinois - Chicago
105.66%
Illinois - Rest of the state
92.96%
Indiana
90.50%
Louisiana - New Orleans
97.82%
Michigan - Detroit
107.11%
Michigan - Rest of the state
94.80%
Missouri - St. Louis
94.78%
Mississippi
88.18%
Nebraska
85.49%
Ohio
95.76%
Oklahoma
86.99%
Pennsylvania - Philadelphia
106.03%
Pennsylvania - Rest of the state
94.60%
South Carolina
88.38%
Tennessee
89.06%
Wisconsin
89.36%
Sample Fee Schedule Comparisonby State 16

17. $ 50 per visit up to $150 per calendar year
Outpatient Benefits .
CALENDAR YEAR DEDUCTIBLE
$500 per insured
Calendar Year Maximum
$2,000
Units
1 Unit
2 Units
3 Units
Outpatient Office Visit $ $ $
Other Outpatient Services (per test)
MRI, CAT Scan or Nuclear testing
Other diagnostic testing or X-rays
Laboratory testing
Injections
$ 175 40 10 5
$ 350 80 20
$ 525
120 30 15
Generic Prescription (per prescription filled)
$ 5
$ 10
$ 15
Brand Name Prescription (per prescription filled)
$ 10
$ 20
$ 30
Well Care Maximum
$ 50 per visit up to $150 per calendar year 17

18. Receive Benefits From Three Pools .
Patient Protection and Affordable Care Act
Receive Benefits From Three Pools . 18

19. Medical Plan Comparison .
Hospital Indemnity
Pays based on Define Benefit Schedule
Deductible is Applied Against Eligible Benefits
Major Medical
Pays based on Expense Incurred
Deductible and Co-Payment is Applied Against Eligible Expenses

20. Diverticulitis 6 day stay $1,000 Deductible 3 Units
Health Saver Plus
Diverticulitis
6 day stay
$1,000 Deductible
3 Units
Inpatient Hospital
6 days
Eligible Benefit
Deductible
Payable
Out of Pocket
Hospital Bill
$25,469.71
$18,000.00
$1,000.00
$17,000.00
$8,469.71
Pathology Bills
81003
$9.00
$9.66
-$0.66
80053
$33.00
$45.42
-$12.42
85025
$33.42
-$24.42
84132
$11.25
$19.74
-$8.49
80074
$25.00
$204.63
-$179.63
82247
$10.00
$21.57
-$11.57
82248
85651
$8.00
$15.24
-$7.24
Radiology Bills
71020
$47.00
$26.91
$20.09
72193
$255.00
$141.36
$113.64
74160
$270.00
$154.26
$115.74
74020
$57.00
$32.91
$24.09
76705
$130.00
$70.98
$59.02
Hospital Visits
$286.00
$150.00
$136.00
$225.00
$75.00
$210.00
$60.00
$175.00
Totals
$27,770.21
$19,875.09
$18,875.09
$8,895.12

21. Rate does not include a one time $30.00 non-refundable application fee
Pricing
Our most economical plans (Male/Female age 40 with 2 children)
1) Family Rate 1 Unit / NTU $1,000 Deductible with a …..$100,000 Annual Maximum $
2) Family Rate 2 Units / NTU $2,500 Deductible with a …..$250,000 Annual Maximum $
Our most popular plan (Male/Female age 40 with 2 children)
3) Family Rate 2 Units / NTU $1,000 Deductible with a …..$250,000 Annual Maximum $
4) Family Rate 2 Units / NTU $1,000 Deductible with a …..$1,000,000 Annual Maximum $
Rate does not include a one time $30.00 non-refundable application fee

22. Enhanced 24 Hour Accident Expense Insurance Plan with
Accident Disability Income Benefit
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23. Enhanced Accident Expense Plan .
BENEFIT SUMMARY
1 Unit
2 Units
Accidental Injury Benefit 
$ 2,000.00
$ 4,000.00
Accidental Death Benefit
$ 50,000.00
$ 100,000.00
Ground or Air Ambulance
$ 5,000.00
$ 10,000.00
Hospital Income Benefit  $
$300.00
Dismemberment Benefits
Loss of Finger or Toe
Single Loss Benefit
Multiple Loss Benefit $
$ 1,000.00
Loss of Hand, Arm, Foot, Leg $
$ 20,000.00
Loss of Site
Single Loss Benefit (One Eye)
Multiple Loss Benefit (Both Eyes) 23

24. Two Benefit Period To Choose From Only Two Occupational Classes
Enhanced Accident Expense Plan .
Optional Accident Disability Income Benefit  
1 Unit
2 Units
Monthly Benefit
$ 1,000.00
$ 2,000.00
Two Benefit Period To Choose From
12 Months
24 Months
Only Two Occupational Classes
Type 1
Type 2 24

25. Monthly Bank Draft Rates Issue Ages for Accident Plan 0-75
Issue Ages for Accident Disability Rider
ACCIDENT PLAN
1 Unit
2 Units
Insured
$23.00
$31.05
Insured & Spouse
$44.28
$56.93
Insured & Children
$53.48
$69.00
Family
$74.75
$94.88
Child Only
$16.10
$20.13
ACCIDENT DISABILTY INCOME RIDER
1 Unit
2 Units
Type months
$10.35
$20.70
Type months
$13.23
$26.45
Type months
$19.55
$39.10
Type months
$52.90

26. Underwriting It’s time for a change… Simplified Issue Application
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27. Simplified Issue Application .27

28. Simplified Issue Application .28

29. Simplified Issue Application .29

30. Underwriting
“Made Easy”
It’s time for a change…
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31. It’s time for a change… Underwriting Tip -1
To help you ensure we are receiving accurate information from the applicant, you might let them know that a representative from the home office will call and review the application and their prescription history that you are about to review with them. You might tell them as your agent you are going to:
“Ask them a series of questions about their medical history and ask them what medications they have taken in the last 12 months. These will be the same questions that the Company will ask you on a recorded phone call when they process your application.”
Please be as thorough as possible to ensure consistency between their application and the recorded quality assurance call. This will help in getting their application processed in a timely manner.
It’s time for a change…
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32. Underwriting Tip - 2 What is a Pre-Existing Condition?
Explain to the applicant how we handle Pre-existing Conditions to ensure they understand how it works
What is a Pre-Existing Condition?
“A condition for which treatment was rendered or recommended by a Physician or for which drugs or medicine was prescribed within 12 months prior to a covered Person’s Effective Date.
Underwriting Tip - 2
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33. New Business Flow Chart
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34. It’s time for a change… Paper Fax E-APP Application Application
Reviewed For
Checked for
YES
Processing
Legibility No
Yes
It’s time for a change…
Ask For
All Forms
another Fax
Missing or
Forms
Original
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App To Be
Mailed
Manually Key
Into System
Contact
Agent
LSP
Policy System

35. Underwriter’s Desk IntelliScript Pre-Screen QAC APS or Other
Decline
Requirement
Review
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No Requirements or
After Review of new
Conditional NO
information
Offer
YES
+ Issue Policy
+ Draft Premium

36. IntelliScript
Prior
2007
2008
2009
2010
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37. Quality Assurance Call
The Quality Assurance Desks will be open from 8:00 am to 5:00 pm CST Monday thru Friday.
The purpose of this call is to allow the applicant to add any information that may have forgotten to disclose to the agent
A “Thank You ” is sent from the home office upon receipt of the application to let the applicant know that we will be calling them and if they have not heard from us we invite them to call the toll free number to complete the call.
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38. Let them know about the Quality Assurance Call and
How Do I Get Quick Issue
Let them know about the Quality Assurance Call and
how important it is.
Let them know that we will be ordering an RX history showing prescriptions they have had filled and the doctor’s name.
Make sure you charge the correct rate ups. If they are not on the application, you will find them located in the Underwriting Guide –This relates specifically to question 13!
Let your client know what underwriting will be expecting
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39. Stress The Importance of Question #13
How Do I Get Quick Issue
In the last 12 months, other than conditions listed on the application, has any applicant had any medical or surgical advice or treatment or including prescriptions or operations or been advised to have medical tests or surgery that has not yet been performed, or is awaiting medical tests?
If YES-you will need to refer to the Underwriting guide to determine if any action is necessary.
Stress The Importance of Question #13
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40. WHAT ABOUT CONDITIONS NOT ON THE APPLICATION?
The application ask about common conditions, but not all medical conditions! Please use the UW Manual if conditions are disclosed but not asked on the application. Question 13 ask about “Other” conditions.
ANEMIA Within 2 Years since recovery = 2 Points
Between 2-5 years since recovery = 1 Point
More than 5 years = STD
Otherwise = DEC
GASTRIC BYPASS SURGERY-
Within the last 12 months = 2 Points
1 Year-3 Years-full recovery = 1 Point
More than 3 years, full recovery = STD
With Complications = DEC
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41. Get complete information
How Do I Get Quick Issue
If the Rx history and the Quality Assurance Call are ...consistent with the information on the application-you ……..can expect QUICK turnaround
If information is developed through any of these ..…sources that is not consistent with the application, an ……..APS may be ordered which may delay issue several …….weeks.
Getting complete information, avoids underwriting … …requiring the agent to go back later which may cause …you to have to “Resale” the program
Get complete information
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42. Underwriting Made Easy
Get quick answers to your Underwriting Questions?
Tobacco Rate
My client stopped smoking five years ago. He smoked 2 packs a day but now only smokes an occasional cigar once or twice a week, can I quote him the non-tobacco rate?
Thanks
Successful Agent
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43. Underwriting Made Easy
In Summary-Explain to the client
How Pre-Existing Condition’s are applied
How the surgical schedule works with the based on the number of units they selected
The application process including the Quality Assurance Call
How important complete medical and prescription history
is in completing the application.
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Underwriting is always available to help at

44. Online Services

45. The following slides will provide you with the following information
How to register Online as a new agent
Access to Downloading the eApp
Check the status of your pending business
Download a copy of your application
Get a copy of your commission statement
See your latest commission check

46. Register Today At

50. Download
The eApp

51. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus

52. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus
Select either the Health Saver Plus or the
Enhanced 24 Hour Accident Expense Plan

53. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus

54. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus

56. Now You Can Login To Online Agent Service At

58. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus

60. Dave Collett

61. Download a copy of your completed Application

62. Manage Your Agent Profile
Sales
Forms
Online
Applications
Commission
Statement
Pending
Business
Online Applications
Medicare Supplement
Health Saver Plus

65. Use 60000Demo as your agent number while you are familiarizing yourself with the eApp otherwise it will assume a life application
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