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KeyMed A new impaired risk health plan The KeyMed SM plan provides limited benefits and has both specific annual and per condition benefit limits. This.

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Presentation on theme: "KeyMed A new impaired risk health plan The KeyMed SM plan provides limited benefits and has both specific annual and per condition benefit limits. This."— Presentation transcript:

1 KeyMed A new impaired risk health plan The KeyMed SM plan provides limited benefits and has both specific annual and per condition benefit limits. This is not a major medical insurance plan and is not a replacement for one. Applicants are individually underwritten and some individuals may not qualify. SM

2 New Sales Opportunity! KeyMed is a new impaired risk product that gives you the ability to: Increase your placement rateIncrease your placement rate Earn more commissionsEarn more commissions Accurately advise clients about plan options and ultimate priceAccurately advise clients about plan options and ultimate price Offer a plan to more individuals in a worksite settingOffer a plan to more individuals in a worksite setting Offer coverage through one carrier, for all family membersOffer coverage through one carrier, for all family members

3 Expand Your Customer Base with KeyMed Applicants with medical conditionsApplicants with medical conditions DiabetesDiabetes LeukemiaLeukemia Heart attackHeart attack Crohns diseaseCrohns disease HemophiliaHemophilia And more...And more... Higher weight limits than standard individual medical portfolioHigher weight limits than standard individual medical portfolio People participating in hazardous activitiesPeople participating in hazardous activities Not excluded from KeyMed coverage; however, no benefits are provided for claims related to these activities Not excluded from KeyMed coverage; however, no benefits are provided for claims related to these activities Applicants with medical conditionsApplicants with medical conditions DiabetesDiabetes LeukemiaLeukemia Heart attackHeart attack Crohns diseaseCrohns disease HemophiliaHemophilia And more...And more... Higher weight limits than standard individual medical portfolioHigher weight limits than standard individual medical portfolio People participating in hazardous activitiesPeople participating in hazardous activities Not excluded from KeyMed coverage; however, no benefits are provided for claims related to these activities Not excluded from KeyMed coverage; however, no benefits are provided for claims related to these activities Note: Each applicant is individually underwritten. While KeyMed provides a broader acceptance of risk, some applicants may not qualify.

4 Four Ways to Sell KeyMed 1.Initial proposal for hard-to-place applicants (know upfront not eligible for major medical) 2.Family sales with combined standard individual health portfolio and KeyMed applicants 3.An attractive counter-offer for people who have been declined or offered an exclusionary rider 4.Enhanced worksite sales opportunity 1.Initial proposal for hard-to-place applicants (know upfront not eligible for major medical) 2.Family sales with combined standard individual health portfolio and KeyMed applicants 3.An attractive counter-offer for people who have been declined or offered an exclusionary rider 4.Enhanced worksite sales opportunity

5 KeyMed Quick Facts No application feeNo application fee Same commissions as Individual MedicalSame commissions as Individual Medical KeyMed is only available through agentsKeyMed is only available through agents Quote can be ed via EASEQuote can be ed via EASE Not currently available with My Sales Link and My Web PageNot currently available with My Sales Link and My Web Page No application feeNo application fee Same commissions as Individual MedicalSame commissions as Individual Medical KeyMed is only available through agentsKeyMed is only available through agents Quote can be ed via EASEQuote can be ed via EASE Not currently available with My Sales Link and My Web PageNot currently available with My Sales Link and My Web Page

6 Assurant Health Value Assurant Health offers a broader range of products to meet the needs of your customersAssurant Health offers a broader range of products to meet the needs of your customers 95% of all applicants can now qualify for health coverage through various Assurant Health plans95% of all applicants can now qualify for health coverage through various Assurant Health plans Weve got your back...Weve got your back... A KeyMed quote is automatically provided for qualifying clients who are declined for a standard portfolio productA KeyMed quote is automatically provided for qualifying clients who are declined for a standard portfolio product Individual applicantsIndividual applicants One or more individuals within a familyOne or more individuals within a family Assurant Health offers a broader range of products to meet the needs of your customersAssurant Health offers a broader range of products to meet the needs of your customers 95% of all applicants can now qualify for health coverage through various Assurant Health plans95% of all applicants can now qualify for health coverage through various Assurant Health plans Weve got your back...Weve got your back... A KeyMed quote is automatically provided for qualifying clients who are declined for a standard portfolio productA KeyMed quote is automatically provided for qualifying clients who are declined for a standard portfolio product Individual applicantsIndividual applicants One or more individuals within a familyOne or more individuals within a family

7 State Availability AL, AZ, CO, IA, IL, MI, MO, NC, OH, PA, SC, TN, WI 13 States

8 Plan Overview Two plans to choose from: $100,000 or $50,000Two plans to choose from: $100,000 or $50,000 Provides benefits for prescriptions, office visits, lab tests, x-rays, hospitalization, surgery and more!Provides benefits for prescriptions, office visits, lab tests, x-rays, hospitalization, surgery and more! Includes PPO network (PHCS Healthy Directions) discounts to help lower out-of pocket costs – at no additional costIncludes PPO network (PHCS Healthy Directions) discounts to help lower out-of pocket costs – at no additional cost Two plans to choose from: $100,000 or $50,000Two plans to choose from: $100,000 or $50,000 Provides benefits for prescriptions, office visits, lab tests, x-rays, hospitalization, surgery and more!Provides benefits for prescriptions, office visits, lab tests, x-rays, hospitalization, surgery and more! Includes PPO network (PHCS Healthy Directions) discounts to help lower out-of pocket costs – at no additional costIncludes PPO network (PHCS Healthy Directions) discounts to help lower out-of pocket costs – at no additional cost

9 BENEFITS$100,000 PLAN$50,000 PLAN Inpatient Hospital (No deductible, coinsurance only) Facility Charges Up to: $4,000 per day for Sickness $4,500 per day for Accident $100,000 per condition maximum Up to: $2,000 per day for Sickness $2,500 per day for Accident $50,000 per condition maximum Outpatient (Deductible & coinsurance apply) Includes x-ray, lab, outpatient and surgical facility Up to $750 per calendar year Up to $500 per calendar year Office Visits – includes wellness i.e. Exam, immunizations and allergy injections $25 copay Up to 3 visits per calendar year $25 copay Up to 3 visits per calendar year OR $250 per calendar year Emergency Room $100 access fee waived if admitted $100 access fee, waived if admitted Up to $500 per visit 2 visits per calendar year $100 access fee, waived if admitted Up to $500 per visit 2 visits per calendar year Ambulance (Ground/Air) Up to $100 ground/$1,000 air 2 trips per calendar year Up to $100 ground/$1,000 air 2 trips per calendar year Prescription generic/pref brand/nonpref brand $15/$50/$75 copay Up to $250 per calendar year $15/$50/$75 copay Up to $250 per calendar year Surgical Services Surgical Procedure Anesthesia Asst. Surgeon Up to: Scheduled amount $10,000 per condition maximum 20% of schedule Up to: Scheduled amount $10,000 per condition maximum 20% of schedule Network – automatically included PHCS Healthy Directions Deductible (Outpatient Services only) Coinsurance (Inpatient and Outpatient) $200 80% $500 80% KeyMed Plan Design

10 Deductible waived Deductible waived 80% coinsurance applies 80% coinsurance applies Up to: Up to: – $ 4,000 a day for Sickness – $ 4,500 a day for Accident – $100,000 per condition maximum Inpatient Hospital KeyMed: $100,000 Plan BENEFIT No deductible No deductible $500 per day increase for accidents $500 per day increase for accidents Non-surgical physician expense is included in daily benefit Non-surgical physician expense is included in daily benefit Assurant Health Plan Advantages Deductible waived Deductible waived 80% coinsurance applies 80% coinsurance applies Up to: Up to: – $ 2,000 a day for Sickness – $ 2,500 a day for Accident – $50,000 per condition maximum KeyMed: $50,000 Plan

11 Hospital Benefit Illustration 5-day hospital stay for a sickness/$4,000 per day benefit $36,000 in expenses * Assumes a national average PHCS Healthy Discount * Assumes a national average PHCS Healthy Discount network discount of 30% reducing charges to $25,200 network discount of 30% reducing charges to $25,200 No Insurance KeyMed $100,000 plan (Network Provider) KeyMed $100,000 plan (Non-Network Provider) Benefit $0$20,000$20,000 Out-of-PocketCosts $36,000$5,200*$16,000

12 $200 deductible applies $200 deductible applies 80% up to $750 calendar 80% up to $750 calendar year maximum year maximumOutpatient Includes x-ray, lab, etc. Includes x-ray, lab, etc. KeyMed: $100,000 Plan BENEFIT Benefit renews each calendar year Benefit renews each calendar year This benefit is not reduced by any rider/endorsement This benefit is not reduced by any rider/endorsement Assurant Health Plan Advantages continued... $500 deductible applies $500 deductible applies 80% up to $500 calendar 80% up to $500 calendar year maximum year maximum KeyMed: $50,000 Plan

13 $25 office visit copay, 3 visits $25 office visit copay, 3 visits per calendar year per calendar year Includes exam, immunizations, Includes exam, immunizations, allergy injections allergy injections Office Visit KeyMed: $100,000 Plan BENEFIT Eligible expenses are covered after $25 copay Eligible expenses are covered after $25 copay Annual and preventive exams are eligible Annual and preventive exams are eligible Benefit renews each calendar year Benefit renews each calendar year This benefit is not reduced by any rider/endorsement This benefit is not reduced by any rider/endorsement Covered x-ray and labs performed in the office are eligible under the outpatient benefit Covered x-ray and labs performed in the office are eligible under the outpatient benefit Assurant Health Plan Advantages continued... $25 office visit copay, 3 visits $25 office visit copay, 3 visits per calendar year OR $250 in per calendar year OR $250 in benefits benefits Includes exam, immunizations, Includes exam, immunizations, allergy injections allergy injections KeyMed: $50,000 Plan

14 Same Same Up to $100 ground/ Up to $100 ground/ $1,000 air – per trip $1,000 air – per trip 2 trips per calendar year 2 trips per calendar year maximum maximum $100 access fee $100 access fee Up to $500 benefit per visit, Up to $500 benefit per visit, 2 visits per calendar year 2 visits per calendar year Access fee waived if Access fee waived if admitted admitted Ambulance Emergency Room KeyMed: $100,000 Plan BENEFIT Benefits renew each calendar year Benefits renew each calendar year Benefits are not reduced by any rider/endorsement Benefits are not reduced by any rider/endorsement Assurant Health Plan Advantages continued... KeyMed: $50,000 Plan

15 $15/$50/$75 copay $15/$50/$75 copay Up to $250 calendar year Up to $250 calendar year benefit maximum benefit maximumPrescriptions (3 tier plan) KeyMed: $100,000 Plan BENEFIT Medco drug card provides discounts for prescriptions even if calendar year benefit maximum is reachedMedco drug card provides discounts for prescriptions even if calendar year benefit maximum is reached Prescriptions for pre-existing conditions receive Medco discountsPrescriptions for pre-existing conditions receive Medco discounts Benefit renews each calendar yearBenefit renews each calendar year Drug benefit is not reduced by any rider/endorsementDrug benefit is not reduced by any rider/endorsement Assurant Health Plan Advantages continued... Same KeyMed: $50,000 Plan

16 Surgical schedule is the same for both plans Surgical schedule is the same for both plans Includes inpatient and outpatient surgeries Includes inpatient and outpatient surgeries Network discounts included at no extra cost Network discounts included at no extra cost PHCS Healthy Directions Network Up to scheduled amount $10,000 Up to scheduled amount $10,000 per condition maximum per condition maximum 20% of surgeons benefit 20% of surgeons benefit Surgical Surgical Procedure Surgical Procedure Anesthesia Anesthesia Asst. Surgeon Asst. Surgeon KeyMed: $100,000 Plan BENEFIT BENEFIT Assurant Health Plan Advantages continued... Same Same KeyMed: $50,000 Plan

17 Network Included! $Included at no additional cost $Typically offers better discounts than other impaired risk products... which means BIGGER savings for customers $Extensive national network of providers to maximize your customers benefits $No reduction in benefits for non-network services PHCS Healthy Directions To locate providers, clients can go to and select the Healthy Directions network.

18 Increase Value with Supplemental Products The following supplemental products are available with KeyMed plans: Dental InsuranceDental Insurance Dental-Vision Discount PlanDental-Vision Discount Plan SuiteSolutions ® – includes SecureSolution and SelectSolutionSuiteSolutions ® – includes SecureSolution and SelectSolution The following supplemental products are available with KeyMed plans: Dental InsuranceDental Insurance Dental-Vision Discount PlanDental-Vision Discount Plan SuiteSolutions ® – includes SecureSolution and SelectSolutionSuiteSolutions ® – includes SecureSolution and SelectSolution

19 KeyMed Approach for Impaired Risk Market Allows many conditions to be taken standardAllows many conditions to be taken standard Coverage is provided to people with serious medical conditions with a rating and/or a Modified Benefit Endorsement (MBE)Coverage is provided to people with serious medical conditions with a rating and/or a Modified Benefit Endorsement (MBE) Market approach varies by state. Market approach varies by state. Allows many conditions to be taken standardAllows many conditions to be taken standard Coverage is provided to people with serious medical conditions with a rating and/or a Modified Benefit Endorsement (MBE)Coverage is provided to people with serious medical conditions with a rating and/or a Modified Benefit Endorsement (MBE) Market approach varies by state. Market approach varies by state.

20 Modified Benefit Endorsement (MBE) Overview MBE provides benefits for medical condition(s)MBE provides benefits for medical condition(s) No coverage is provided for ridered condition(s) for first 185 daysNo coverage is provided for ridered condition(s) for first 185 days After first 185 days, coverage is provided for the ridered conditionAfter first 185 days, coverage is provided for the ridered condition 25% reduction in hospital and surgical benefits for the ridered condition25% reduction in hospital and surgical benefits for the ridered condition All other benefits are paid the same as any other illnessAll other benefits are paid the same as any other illness Applicant can accept MBE onlineApplicant can accept MBE online Saves chasing signaturesSaves chasing signatures Allows policy to be issued fasterAllows policy to be issued faster Multiple conditions on one MBEMultiple conditions on one MBE Saves obtaining multiple acceptanceSaves obtaining multiple acceptance Less paper to juggleLess paper to juggle MBE provides benefits for medical condition(s)MBE provides benefits for medical condition(s) No coverage is provided for ridered condition(s) for first 185 daysNo coverage is provided for ridered condition(s) for first 185 days After first 185 days, coverage is provided for the ridered conditionAfter first 185 days, coverage is provided for the ridered condition 25% reduction in hospital and surgical benefits for the ridered condition25% reduction in hospital and surgical benefits for the ridered condition All other benefits are paid the same as any other illnessAll other benefits are paid the same as any other illness Applicant can accept MBE onlineApplicant can accept MBE online Saves chasing signaturesSaves chasing signatures Allows policy to be issued fasterAllows policy to be issued faster Multiple conditions on one MBEMultiple conditions on one MBE Saves obtaining multiple acceptanceSaves obtaining multiple acceptance Less paper to juggleLess paper to juggle

21 Medical Conditions Taken Standard Examples include: Acid refluxAcid reflux AllergiesAllergies Headaches and migrainesHeadaches and migraines Irritable bowel syndromeIrritable bowel syndrome Mild asthmaMild asthma And moreAnd more Examples include: Acid refluxAcid reflux AllergiesAllergies Headaches and migrainesHeadaches and migraines Irritable bowel syndromeIrritable bowel syndrome Mild asthmaMild asthma And moreAnd more

22 KeyMed Rates There is only one class of rates – no preferred rates or non-smoker discountsThere is only one class of rates – no preferred rates or non-smoker discounts Rates shown are base rates – PRIOR to any underwriting load for medical conditions and any applicable association feesRates shown are base rates – PRIOR to any underwriting load for medical conditions and any applicable association fees Each applicant receives their own rate, including each dependent childEach applicant receives their own rate, including each dependent child Rates include access to PHCS Healthy Directions network and drug cardRates include access to PHCS Healthy Directions network and drug card

23 KeyMed Rates - Ohio There is only one class of rates – no preferred rates or non-smoker discountsThere is only one class of rates – no preferred rates or non-smoker discounts Rates shown are base rates – PRIOR to any underwriting load for medical conditions and any applicable association feesRates shown are base rates – PRIOR to any underwriting load for medical conditions and any applicable association fees Each applicant receives their own rate, including each dependent childEach applicant receives their own rate, including each dependent child Rates include access to PHCS Healthy Directions network and drug cardRates include access to PHCS Healthy Directions network and drug card Monthly Premium AgeMaleFemaleMaleFemale Dep. Child119$ $ 88$ $ $ 186$ 103$ 131$ $ 219$ 116$ 159$ $ 234$ 121$ 171$ $ 244$ 138$ 177$ $ 267$ 159$ 196$ $ 290$ 193$ 211$ $ 330$ 223$ 237$ $ 359$ 264$ 262$ $ 398$ 299$ 289$ KeyMed Rates - Ohio (applicable in most states) $100,000 Plan $50,000 Plan

24 Product Positioning KeyMed is the Solution KeyMed provides impaired-risk individuals with reimbursement type benefits vs. indemnity plans. It also provides more comprehensive benefits. KeyMed offers network discounts at no extra charge and provides Rx benefits at no additional cost. These are not common features of the products in the impaired risk market today. Head-to-Head with Other Impaired Risk Plan Competitors KeyMed is crucial for worksite sales, providing a plan option for impaired-risk individuals who would not otherwise be eligible for coverage. Worksite Sale KeyMed may be a preferred option for applicants who specifically want coverage for the ridered condition(s). Major Medical with Exclusionary or CSD Rider KeyMed is a viable offering for many conditions declined by Major Medical. It may provide more cost efficient coverage than state high risk plans while paying a normal commission rate. Major Medical Decline POSITIONINGSCENARIO

25 Business As Usual Insure more clients without changing the way you do business! Same application options as Individual Medical: EASEEASE SoftwareSoftware PaperPaper Insure more clients without changing the way you do business! Same application options as Individual Medical: EASEEASE SoftwareSoftware PaperPaper

26 Application Submission Options Submit application with all medical conditions identified upfront using Quick ToolSubmit application with all medical conditions identified upfront using Quick Tool Ensures most accurate quoteEnsures most accurate quote Eliminates re-selling of ratesEliminates re-selling of rates Fastest way to get policy issuedFastest way to get policy issued Submit application to underwriting to have rating and/or MBE assigned prior to policy issuanceSubmit application to underwriting to have rating and/or MBE assigned prior to policy issuance Submit application with all medical conditions identified upfront using Quick ToolSubmit application with all medical conditions identified upfront using Quick Tool Ensures most accurate quoteEnsures most accurate quote Eliminates re-selling of ratesEliminates re-selling of rates Fastest way to get policy issuedFastest way to get policy issued Submit application to underwriting to have rating and/or MBE assigned prior to policy issuanceSubmit application to underwriting to have rating and/or MBE assigned prior to policy issuance Easiest and fastest option!

27 Selling Made Easy! Quick Tool to help determine if the standard portfolio or KeyMed is the best choiceQuick Tool to help determine if the standard portfolio or KeyMed is the best choice Ability to add medical conditions to KeyMed members to get a more accurate quoteAbility to add medical conditions to KeyMed members to get a more accurate quote Combined quote available for standard portfolio and KeyMed for family membersCombined quote available for standard portfolio and KeyMed for family members MBEs can be e-signed online – resulting in quicker policy issueMBEs can be e-signed online – resulting in quicker policy issue Demographic information only needs to be provided once for a familyDemographic information only needs to be provided once for a family View quotes and underwriting status for both KeyMed and standard portfolio plans – with the click of a buttonView quotes and underwriting status for both KeyMed and standard portfolio plans – with the click of a button Billing address information pre-fills for a family when you submit both applications through EASEBilling address information pre-fills for a family when you submit both applications through EASE Quick Tool to help determine if the standard portfolio or KeyMed is the best choiceQuick Tool to help determine if the standard portfolio or KeyMed is the best choice Ability to add medical conditions to KeyMed members to get a more accurate quoteAbility to add medical conditions to KeyMed members to get a more accurate quote Combined quote available for standard portfolio and KeyMed for family membersCombined quote available for standard portfolio and KeyMed for family members MBEs can be e-signed online – resulting in quicker policy issueMBEs can be e-signed online – resulting in quicker policy issue Demographic information only needs to be provided once for a familyDemographic information only needs to be provided once for a family View quotes and underwriting status for both KeyMed and standard portfolio plans – with the click of a buttonView quotes and underwriting status for both KeyMed and standard portfolio plans – with the click of a button Billing address information pre-fills for a family when you submit both applications through EASEBilling address information pre-fills for a family when you submit both applications through EASE NEW!

28 KeyMed Capabilities continued... All individual medical submission methods accepted All individual medical submission methods accepted Ability to a quote from EASE and have applicant apply online Ability to a quote from EASE and have applicant apply online Ability to quote – both online and offline Ability to quote – both online and offline Payment methods – monthly, quarterly, semi-annual, annual, and list billing Payment methods – monthly, quarterly, semi-annual, annual, and list billing Express Underwriting is available (Does not include ExpressYes) Express Underwriting is available (Does not include ExpressYes) The features you like with IM sales are available with KeyMed too!

29 Important Dates Sales Implementation: December 15 thImplementation: December 15 th Effective Dates: December 16 th and laterEffective Dates: December 16 th and laterSales Implementation: December 15 thImplementation: December 15 th Effective Dates: December 16 th and laterEffective Dates: December 16 th and later

30 Marketing Materials Brochure – Supply and InternetBrochure – Supply and Internet Sales Sheet – Internet onlySales Sheet – Internet only IM Agent Guide (Addendum for KeyMed included) – Internet onlyIM Agent Guide (Addendum for KeyMed included) – Internet only KeyMed Underwriting Field Guide – Internet onlyKeyMed Underwriting Field Guide – Internet only Sample Contracts – Internet onlySample Contracts – Internet only State Variations – Internet/Software/EASEState Variations – Internet/Software/EASE Brochure – Supply and InternetBrochure – Supply and Internet Sales Sheet – Internet onlySales Sheet – Internet only IM Agent Guide (Addendum for KeyMed included) – Internet onlyIM Agent Guide (Addendum for KeyMed included) – Internet only KeyMed Underwriting Field Guide – Internet onlyKeyMed Underwriting Field Guide – Internet only Sample Contracts – Internet onlySample Contracts – Internet only State Variations – Internet/Software/EASEState Variations – Internet/Software/EASE

31 Marketing Materials Availability Supply – November 14 th Supply – November 14 th Internet (agent sales site) – December 15 th Internet (agent sales site) – December 15 th EASE – December 15th EASE – December 15th Software – December 15th Software – December 15th

32 Managing Multiple Plans within a Family

33 $284.00$200 Related Quotes Find Saved Quote/Client Screen

34 View Related Quote Quote Summary Screen Sara Black

35 Icon indicates there is a related application 6 Related Application Status Screen

36 Click to see the related application status and information 12/16/2007 Related Application Application Status Detail Screen

37 Quoting KeyMed

38 Starting a KeyMed Quote

39 KeyMed Quote / Special Risk Plan

40 Adding Medical Conditions

41 Thank You! For agent use only. Not for distribution to consumers. Assurant Health is the brand name for products underwritten and issued by Time Insurance Company and John Alden Life Insurance Company. J (11/2007) Available via Internet only. © 2007 Assurant, Inc. All rights reserved.


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