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MMGAP_GA-PPT UAI0567 R0108 www.unitedamerican.com/foundation This is a solicitation for insurance. You may be contacted by an Agent representing United.

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Presentation on theme: "MMGAP_GA-PPT UAI0567 R0108 www.unitedamerican.com/foundation This is a solicitation for insurance. You may be contacted by an Agent representing United."— Presentation transcript:

1 MMGAP_GA-PPT UAI0567 R0108 This is a solicitation for insurance. You may be contacted by an Agent representing United American Insurance Company. Policy and Rider Forms: MMGAP, SWL, RT10, R-MMGAP-HO, ABR1, DFR, U4272. Limited Benefit Hospital Expense Policy

2 MMGAP_GA-PPT UAI0567 R0108 The Foundation Signature Series was designed to help pay hospital inpatient deductibles, copayments, and coinsurance for individuals with current or pending major medical health coverage or comprehensive health insurance as their Primary Medical Policy.

3 MMGAP_GA-PPT UAI0567 R0108 Calendar-Year Maximum Benefit Levels Policy Form: MMGAP

4 MMGAP_GA-PPT UAI0567 R0108 Choose your Calendar-Year Maximum Benefit. $2,000 $5,000 $2,500 $6,000 $3,000 $7,500 $4,000 $10,000 The calendar year-maximum benefit you select does not have to be the same as your major medical deductible. The calendar-year maximum benefit starts Jan. 1 and ends Dec. 31. Your benefit amount starts over on Jan. 1. Policy Form: MMGAP

5 MMGAP_GA-PPT UAI0567 R0108 Foundation Signature Series Limited Benefit Hospital Expense Policy UA will pay up to 100% of your out-of-pocket deductibles, copayments, or coinsurance required by your major medical policy for hospital inpatient treatment, up to the calendar-year maximum benefit*. Ages Policy Form: MMGAP *Limitations and Exclusions apply. Preexisting Condition Limitation applies.

6 MMGAP_GA-PPT UAI0567 R0108 Policy Benefits There is no limit to the number of hospital inpatient confinements policyholders can have during one year – the policy pays for deductibles, copayments, and coinsurance until the policyholder reaches their calendar-year maximum annual benefit, as long as the expense is covered by the policyholders Primary Medical Policy* as a Hospital Inpatient Expense. Policyholders can choose to have benefits paid directly to them or assigned to a health service provider. If the policyholder dies due to an accidental bodily injury while covered under this policy, all premiums will be refunded**. Policy Form: MMGAP *Limitations and Exclusions apply. Preexisting Condition Limitation applies. **Death must occur while this policy is in force and with 180 days of injury.

7 MMGAP_GA-PPT UAI0567 R0108 How Does A Policyholder File A Claim? Claims are submitted to United American Insurance Company. The policyholder must submit a copy of the major medical providers Explanation of Benefits (EOB) along with a standard hospital billing form (UB-04). Policy Form: MMGAP *Limitations and exclusions apply. Preexisting Condition Limitation applies.

8 MMGAP_GA-PPT UAI0567 R0108 Optional Hospital Outpatient Benefit Rider Policy and Rider Form: MMGAP and R-MMGAP-HO

9 MMGAP_GA-PPT UAI0567 R0108 Optional Hospital Outpatient Benefit Rider Available at an additional cost UA will pay 50% of your out-of-pocket deductible, copayment, or coinsurance required by your major medical policy for hospital outpatient treatment, up to the calendar-year maximum benefit*. Note: The total deductibles, copayments, and coinsurance covered under the Hospital Inpatient Benefit and the Hospital Outpatient Benefit combined are limited to the maximum annual benefit per calendar year. Policy and Rider Forms: MMGAP and R-MMGAP-HO *Limitations and Exclusions apply. Preexisting Condition Limitation applies.

10 MMGAP_GA-PPT UAI0567 R0108 Number of Outpatient Hospital Visits/Procedures Covered There is no limit to the number of outpatient hospital visits/procedures you can have during one calendar year – we pay your out-of-pocket deductibles, copayments and coinsurance until you reach your calendar-year maximum benefit, as long as the expense is covered by your major medical policy*. Note: The total deductibles, copayments, and coinsurance covered under the Hospital Inpatient Benefit and the Hospital Outpatient Benefit combined are limited to the maximum annual benefit per calendar year. Policy and Rider Forms: MMGAP and R-MMGAP-HO *Limitations and Exclusions apply. Preexisting Condition Limitation applies.

11 MMGAP_GA-PPT UAI0567 R0108 Examples of How the MMGAP Policy Works The following examples demonstrate how the MMGAP Policy works, what is covers, and what it doesnt cover. With the examples where MMGAP policyholders increase their Primary Policy deductible, it should be mentioned that policyholders can apply their premium savings toward potential out-of-pocket expenses for which the they are now responsible.

12 MMGAP_GA-PPT UAI0567 R0108 Kates Story Examples for illustrative purposes only. Rates vary by state. Charges vary by hospital and major medical provider.

13 MMGAP_GA-PPT UAI0567 R0108 Kates Story Kate is a 45-year-old teacher. She has major medical coverage through her employer. She selected a $5,000 deductible policy for the lower premiums. Kates major medical policy also requires a copayment and 20% coinsurance. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

14 MMGAP_GA-PPT UAI0567 R0108 Kates Story Kate purchased an MMGAP Hospital Inpatient Expense Policy with a $7,500 calendar-year maximum benefit to help cover her hospital inpatient deductible, copayment, and coinsurance. Lets take a look at a year in Kates life and what expenses MMGAP Policy will and will not cover. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

15 MMGAP_GA-PPT UAI0567 R0108 Kates Story In January, Kate begins having sinus congestion and sinus headaches. She visits her general practitioner and is diagnosed with a sinus infection. Kate incurs these charges: $200 for the doctors visit 1, including a $15 copay $4 in charges for a prescription drug (Penicillin 2 ) from the retail pharmacy 3 The MMGAP Policy does not pay for doctors visit copayments, charges, or lab work, or prescription drugs. Remaining MMGAP Policy calendar-year maximum benefit: $7,500 1 The Washington Post, Oct. 22, Most Patients Get Antibiotic for Sinus Infection, American Society of Health-System Pharmacists, March 19, Wal-Mart $4 Prescription Program, Oct. 23, 2007 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

16 MMGAP_GA-PPT UAI0567 R0108 Kates Story Occurrence: General Practitioner Doctors Visit Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible. ExpenseBilled ChargesMajor Medical PaidMMGAP PaidKate Paid Doctors Visit$200$185$0$15 Prescription Drugs$4$0 $4 Total$204$185$0$19 Remaining MMGAP Policy calendar-year maximum benefit: $7,500

17 MMGAP_GA-PPT UAI0567 R0108 Kates Story In March, Kate developed pneumonia and spent two nights in the hospital. Fortunately, she purchased a $7,500 Foundation Signature Series to help cover her deductible, copayment, and coinsurance. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

18 MMGAP_GA-PPT UAI0567 R0108 Kates Story Total Hospital Expenses Billed to Major Medical Policy for Inpatient Hospital Charges:$15,100 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

19 MMGAP_GA-PPT UAI0567 R0108 Kates Story Kates Major Medical Explanation of Benefits MMGAP PaidDeductible$5,000 MMGAP PaidHospital Admission Copayment$ 100 MMGAP Paid20% Coinsurance$2,000 Total Kate Owed$7,100 Foundation Paid $7,100 Amount Kate Paid$0 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

20 MMGAP_GA-PPT UAI0567 R0108 Annual Foundation Premium $759* – vs.– Potential Hospital Expenses $7,100 Kate has $400 remaining in her calendar-year maximum benefit. *Kate was also responsible for $19 in out-of-pocket expenses associated with her General Practitioner Doctors visit. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

21 MMGAP_GA-PPT UAI0567 R0108 Roberts Story Examples for illustrative purposes only. Rates vary by state. Charges vary by hospital and major medical provider.

22 MMGAP_GA-PPT UAI0567 R0108 Roberts Story Robert is a 33-year-old single father. He has a major medical policy with a $2,500 deductible. Roberts policy requires a copayment and 20% coinsurance with a $5,000 stop loss. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

23 MMGAP_GA-PPT UAI0567 R0108 Roberts Story He purchased an MMGAP Hospital Inpatient Expense Policy with a $4,000 calendar-year maximum benefit to help cover his hospital inpatient deductible, copayment, and coinsurance. Lets take a look at a year in Roberts life and what expenses the MMGAP Policy will and will not cover. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

24 MMGAP_GA-PPT UAI0567 R0108 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible. Roberts Story In February, Robert begins coughing. When the coughing persists for more than two weeks, he visits his general practitioner. The doctor has a radiologist perform an X-ray of Roberts chest during the office visit. Robert incurs multiple charges: $200 for the doctors visit 1, including a $10 copay $86 for chest X-ray 2 $63.60 in charges for a prescription drug (Ipratropium Bromide 3 ) from the retail pharmacy 4 The MMGAP Policy does not pay for doctors visit copayments, charges, or lab work, or prescription drugs. Remaining MMGAP Policy calendar-year maximum benefit: $4,000 1 The Washington Post, Oct. 22, March 27, Chronic cough, Mayo Clinic, May 8, MedStore International, March 27, 2008

25 MMGAP_GA-PPT UAI0567 R0108 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible. Roberts Story Occurrence: General Practitioner Doctors Visit ExpenseBilled ChargesMajor Medical PaidMMGAP PaidRobert Paid Doctors Visit$200$190$0$10 Doctors Lab Work$86$0 $86* Prescription Drugs$63.60$0 $63.60 Total$349.60$190$0$ *Applied to major medical annual deductible. Remaining MMGAP Policy calendar-year maximum benefit: $4,000

26 MMGAP_GA-PPT UAI0567 R0108 Roberts Story In November, Robert had a motorcycle accident that resulted in a one-night hospital stay. Total Hospital Expenses Billed to Major Medical Policy for Inpatient Hospital Charges:$10,800 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

27 MMGAP_GA-PPT UAI0567 R0108 Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible. Roberts Story Roberts Major Medical Explanation of Benefits MMGAP PaidDeductible$2,416 MMGAP PaidHospital Inpatient Copayment$ 100 MMGAP Paid20% Coinsurance$1,000 Total Robert Owed$3,516 MMGAP Paid $3,516 Amount Robert Paid $0

28 MMGAP_GA-PPT UAI0567 R0108 Annual Foundation Premium $176* – vs.– Potential Hospital Expenses $3,516 Robert has $484 remaining in his calendar-year maximum benefit. *Robert was also responsible for $ in out-of-pocket expenses associated with his General Practitioner Doctors visit. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

29 MMGAP_GA-PPT UAI0567 R0108 Jose & Marias Story Examples for illustrative purposes only. Rates vary by state. Charges vary by hospital and major medical provider.

30 MMGAP_GA-PPT UAI0567 R0108 Jose & Marias Story Jose and Maria, both 38 years old, are married with two teenagers. They have a major medical policy with a $500 annual deductible. Their policy also requires a copayment and coinsurance. Their monthly major medical premium for their family is $1,104. Rates vary by state. Examples for illustrative purposes only. A Foundation Signature Series does not guarantee payment of all charges. There may be expenses for which you will be responsible.

31 MMGAP_GA-PPT UAI0567 R0108 For illustrative purposes only. Jose & Marias Story Current Insurance Premium Situation Annual DeductibleMonthly Premium Major Medical$500$1,104

32 MMGAP_GA-PPT UAI0567 R0108 Jose & Marias Story Maria and Jose increased their major medical deductible from $500 to $5,000, which reduced their major medical monthly premium to $507. Then they purchases an MMGAP Hospital Inpatient Expense Policy with a $7,500 calendar-year maximum benefit for $150 in monthly premium. Previous Monthly Major Medical Premium – $1,104 New Monthly Major Medical Premium – $507 Foundation Monthly Premium – $150 For illustrative purposes only.

33 MMGAP_GA-PPT UAI0567 R0108 Jose & Marias Story For illustrative purposes only. Current Insurance Premium Situation Annual DeductibleMonthly Premium Major Medical$500$1,104 Foundation Signature Series Annual DeductibleMonthly Premium Major Medical$5,000$507 Foundation Signature Series $0$150 New Total Monthly Premium$657

34 MMGAP_GA-PPT UAI0567 R0108 Jose & Maria Saved $447 per month in premium For illustrative purposes only.

35 MMGAP_GA-PPT UAI0567 R0108 Hospital Outpatient Benefit Rider For $187 additional monthly premium, Jose & Maria added the Hospital Outpatient Benefit Rider to their MMGAP Policy. Their total monthly premium would be $844, which would still be a monthly premium savings of $260. For illustrative purposes only.

36 MMGAP_GA-PPT UAI0567 R0108 For illustrative purposes only. Current Insurance Premium Situation Annual DeductibleMonthly Premium Major Medical$500$1,104 Jose & Marias Story Foundation Signature Series Annual DeductibleMonthly Premium Major Medical$5,000$507 Foundation Signature Series $0$150 New Total Monthly Premium$657 Outpatient Rider$0$187 New Total Monthly Premium with Optional Outpatient Rider $844

37 MMGAP_GA-PPT UAI0567 R0108 How Jose & Maria Managed Their Expenses Jose & Maria have a major medical policy, a Foundation Hospital Expense Policy, plus the optional Hospital Outpatient Rider, and still managed to save $260 per month in premium! For illustrative purposes only.

38 MMGAP_GA-PPT UAI0567 R0108 Optional Life Policy Policy Forms: SWL or RT10

39 MMGAP_GA-PPT UAI0567 R0108 Optional Life Policy Available at an additional cost Whole Life Insurance Policy or 10-Year Renewable Term Life Insurance Policy Choose a face amount from $1,000 to $20,000 Whole Life: Level benefit for the life of the insured. Premiums never increase. Builds cash and loan value which you may use in many ways: Surrender your policy for cash, and spend however you wish. Convert your policy to life insurance where no premiums are ever due (such as reduced benefit paid-up insurance, or extended term insurance). Take a loan from your policys value. 10-Year Renewable Term Life: Level benefit term policy with premiums that stay the same for 10 years. The policy renews and premiums increase every 10 years. Renewable to age 121. Policy and Rider Forms: SWL or RT10; ABR1 *May vary by state.

40 MMGAP_GA-PPT UAI0567 R0108 Optional Life Insurance Riders Policy and Rider Forms: SWL or RT10; U4272; DFR

41 MMGAP_GA-PPT UAI0567 R0108 Optional Riders Available at an additional cost Deposit Fund Rider - Available only on 10-Year Renewable Term Life insurance policy. - Earn a guaranteed minimum of 3% interest on deposits made with premium payments. - Minimum deposit amount is $5. - Maximum account balance is limited to two times the policy face amount. Child Term Life Rider - Available with the purchase of an adult whole life or term life policy. - Choose $5,000 or $10,000 of coverage for children ages 0–23. Policy and Rider Forms: SWL or RT10; U4272; DFR. May vary by state.

42 MMGAP_GA-PPT UAI0567 R0108 Policy and Rider Forms: SWL or RT10; U4272; DFR. May vary by state. Automatic Benefit Terminal Illness Accelerated Death Benefit – Automatically added to either life policy at no additional charge*. We will pay you 50% of your life policy benefit if you are diagnosed with a qualifying terminal illness while your policy is in force. (If the policy owner is diagnosed with a terminal illness that will result in death within one year, we will pay 50% of the death benefit upon our receipt of due proof of terminal illness. This benefit is payable only once. Not approved in all states.)

43 MMGAP_GA-PPT UAI0567 R0108 UA Partners ® Our optional non-insurance discount health services program is also available for a $6.95 monthly fee. Receive discounts on: Chiropractic 20% to 40% Dental 10% to 50% Eye Care 20% to 60% Hearing Aids 10% to 20% Prescriptions Average of 20% Mail Order Pharmacy Save More $$ DISCLOSURE: This is NOT a health insurance policy. The plan provides discounts at certain health care providers of medical services. The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. This plan is administered by Best Benefits, Inc., (a discount medical plan organization) at 8420 W. Bryn Mawr, Suite 700, Chicago, IL 60631, You have the right to cancel and receive a full refund within 30 days. Plans may vary by state. Not available in Kansas, New York, or Vermont.

44 MMGAP_GA-PPT UAI0567 R0108 Thank You


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