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Health Access Plans The Right Plans for Difficult Times.

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Presentation on theme: "Health Access Plans The Right Plans for Difficult Times."— Presentation transcript:

1 Health Access Plans The Right Plans for Difficult Times

2 Assurant Affordable Health Access Health Access limited-benefit plans Solution for rising cost of health care Solutions for the uninsured Health Access limited-benefit plans Solution for rising cost of health care Solutions for the uninsured

3 Health Access Plans Based on consumer research, covers what is important to employees –Doctor office visits and prescription drugs –Preventive care and immunizations Network discounts Affordable Portable No benefit waiting periods Optional benefits such as Dental-Vision Discount Plan, Dental Insurance and Cancer Benefit Based on consumer research, covers what is important to employees –Doctor office visits and prescription drugs –Preventive care and immunizations Network discounts Affordable Portable No benefit waiting periods Optional benefits such as Dental-Vision Discount Plan, Dental Insurance and Cancer Benefit

4 Assurant Affordable Health Access Launched mid 2008, currently available in 17 states Use for gapping high deductibles Over 90% placement rate Retention high, consumers find value Launched mid 2008, currently available in 17 states Use for gapping high deductibles Over 90% placement rate Retention high, consumers find value

5 Plan C Plan B Plan A Health Access Plans – Early Results Sales to date:

6 Health Access Plans – Early Results

7 Sales Velocity Trend Overall Access sales represent 5% of total IM Access in FLA. 15% of total IM sales

8 Health Access Plans Available in –AL, AR, AZ, FL, IA, IL, IN, MI, MO, MS, OH, OK, PA, SC, TN, TX, WI, WV, WY Evaluating Risk –MIB Whats Coming: EASE automated submission – targeted May 16, 2009 Available in –AL, AR, AZ, FL, IA, IL, IN, MI, MO, MS, OH, OK, PA, SC, TN, TX, WI, WV, WY Evaluating Risk –MIB Whats Coming: EASE automated submission – targeted May 16, 2009

9 Limited-Benefit Product Overview Three limited-benefit plans: Health Access Plan A –No medical questions Health Access Plans B or C –Limited medical questions Limited-benefit plans provide: An affordable option compared to major medical plans Coverage for certain services up to a set dollar amount Calendar year maximums Three limited-benefit plans: Health Access Plan A –No medical questions Health Access Plans B or C –Limited medical questions Limited-benefit plans provide: An affordable option compared to major medical plans Coverage for certain services up to a set dollar amount Calendar year maximums

10 Health Access Plan A Overview No medical questions Eligibility rules apply Applicants through age 63 are eligible Not employer-sponsored Health Advocates Alliance Membership (some states) Benefits for every day needs Easy to apply for: No underwriting No pre-existing condition limitations No ratings No special exception riders No condition-specific deductibles No modified benefit endorsements No medical questions Eligibility rules apply Applicants through age 63 are eligible Not employer-sponsored Health Advocates Alliance Membership (some states) Benefits for every day needs Easy to apply for: No underwriting No pre-existing condition limitations No ratings No special exception riders No condition-specific deductibles No modified benefit endorsements

11 Health Access Plan A Doctor Office Visits Client pays copay and the plan pays 100% of the remaining cost of an eligible office visit including wellness, examination, consultation, evaluation, development of a treatment plan, immunizations and allergy shots. $25 (Primary Care and Retail Health Clinic) $35 (Specialist) Limit 4 office visits Plan pays $150 max per office visit No deductible or coinsurance Prescription Drug Client pays copay and plan pays 100% up to a maximum of $750 per calendar year $10/$50 (Generic/Brand) Plan pays up to $750 max per calendar year No deductible or coinsurance Outpatient Diagnostic Imaging and Laboratory Services Plan pays up to $250 benefit for x-ray and lab only No deductible or coinsurance Surgical Services Must be performed during an office visit Plan pays $250 max per calendar year No deductible or coinsurance

12 Health Access Plans B or C Product Overview Limited medical questions Applicants through age 63 are eligible Inpatient, outpatient and prescription drug benefits Easy to apply for: Accept/Reject application No ratings No special exception riders No condition-specific deductibles No modified benefit endorsements Limited medical questions Applicants through age 63 are eligible Inpatient, outpatient and prescription drug benefits Easy to apply for: Accept/Reject application No ratings No special exception riders No condition-specific deductibles No modified benefit endorsements

13 Health Access Plans B or C Plan BPlan C Doctor Office Visits Client pays copay and the plan pays 100% of the remaining cost of an eligible office visit including wellness, examination, consultation, evaluation, development of a treatment plan, immunizations and allergy shots. $25 (Primary Care, Specialist, and Retail Health Clinic) Limit 4 office visits Plan pays $150 max per office visit No deductible or coinsurance Prescription Drugs Client pays copay and plan pays 100% up to a maximum of $250 or $750 per calendar year $10/$50/$75 (Generic/Preferred Brand/Non-Preferred Brand) Plan pays up to $250 in benefits per calendar year No deductible or coinsurance $10/$50/$75 (Generic/Preferred Brand/Non-Preferred Brand) Plan pays up to $750 in benefits per calendar year No deductible or coinsurance Outpatient Medical Services Includes outpatient hospital, surgical center or urgent care facility and diagnostic imaging and laboratory services, chemotherapy, and radiation performed during an office visit or as outpatient. $200 deductible 80%/ 20% coinsurance up to $500 in benefits per calendar year $200 deductible 80%/20% coinsurance up to $1,000 in benefits per calendar year

14 Health Access Plans B or C Plan BPlan C Surgical Services Inpatient and Outpatient Up to scheduled benefit amount Up to $100,000 in benefits per calendar year (based on schedule) No deductible or coinsurance Inpatient and Outpatient Up to scheduled benefit amount Up to $200,000 in benefits per calendar year (based on schedule) No deductible or coinsurance Assistant SurgeonUp to 20% of amount paid for surgery AnesthesiologistUp to 20% of amount paid for surgery Ambulance (Ground/Air) Up to $100 ground/$1,000 air – per trip, up to two trips per calendar year Emergency Room Up to $250 in benefits for each of two visits per calendar year $100 emergency room fee Fee waived if admitted No deductible or coinsurance Up to $750 in benefits for each of two visits per calendar year $100 emergency room fee Fee waived if admitted No deductible or coinsurance

15 Health Access Plans B or C Plan BPlan C Inpatient Benefit Facility Charges Up to $750 in benefits per day for sickness Up to $1,000 in benefits per day for injury 80%/20% coinsurance up to $100,000 in benefits per calendar year No deductible Up to $2,000 in benefits per day for sickness Up to $4,000 in benefits per day for injury 80%/20% coinsurance up to $200,000 in benefits per calendar year No deductible Other Non- surgical/Non-facility Inpatient Services Considered under the inpatient per day maximum Coinsurance applies No deductible Life InsuranceUp to $10,000 benefit included for primary

16 Network and Discounts The Health Access plans are not PPO plans Passive discounts through MultiPlan –www.MultiPlan.com/assurant Choice of doctors and hospitals No out-of-network fees LabCard Select (LabOne) offers discounts on covered outpatient laboratory services –www.LabCardSelect.com Additional Discount Opportunities –www.assuranthealth.com/corp/ah/ customers/findancillary provider The Health Access plans are not PPO plans Passive discounts through MultiPlan –www.MultiPlan.com/assurant Choice of doctors and hospitals No out-of-network fees LabCard Select (LabOne) offers discounts on covered outpatient laboratory services –www.LabCardSelect.com Additional Discount Opportunities –www.assuranthealth.com/corp/ah/ customers/findancillary provider

17 Rates Simplified rating –Not gender rated –Not area rated –Not rated for risk class –No smoker status –Has 5 very broad age bands –Based on age of primary applicant Examples of Monthly Rates –Plan A: 28-year-old woman w/ one child – $74 –Plan B: 40-year-old husband and wife – $194 –Plan C: 30-year-old single man – $104 Simplified rating –Not gender rated –Not area rated –Not rated for risk class –No smoker status –Has 5 very broad age bands –Based on age of primary applicant Examples of Monthly Rates –Plan A: 28-year-old woman w/ one child – $74 –Plan B: 40-year-old husband and wife – $194 –Plan C: 30-year-old single man – $104

18 Assurant Affordable Health Access Get engaged Be aware of opportunities Use to recruit Get engaged Be aware of opportunities Use to recruit


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