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Supplemental Insurance Protection

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Presentation on theme: "Supplemental Insurance Protection"— Presentation transcript:

1 Supplemental Insurance Protection
SB Accident Companion Dir Approval date: 05/07/2014 Code: Supplemental Insurance Protection Direct Series Accident Companion Form CH IP (01/11), or its state variation See Separate Presentation for State Specific Variations ©2014 SureBridge® Product Training Materials | Proprietary and Confidential. For more plan details, refer to the product materials. The benefits described in this presentation are subject to all provisions, terms, definitions, and limitations and exclusions of the applicable policy. Supplemental plans serve a specific purpose in the insurance market. These plans are not intended as substitutes for accident and sickness health insurance and should not be construed as such.

2 Supplemental Products Availability
SureBridge has the largest portfolio of supplemental products including critical illness, cancer, accident, disability, dental and vision policies. We also have the broadest marketing footprint. AK WA ID MT ME OR ND MN NH WI NY VT MI WY SD CA MA RI NV CT UT NE IA PA IL OH IN NJ CO WV DE MO VA KS MD KY HI DC AZ NC NM OK TN TX AR SC GA MS AL All products available Subset of products available No products available LA FL

3 Accident Companion Superior Client/Broker Experience
Quoting Compare packages with different combinations of supplemental products Present total price for solution Commissions First month’s premium is taken at time of application This results in faster commission payments Book of Business report available on the SureBridge Broker Portal Application Single e-app for any combination of supplemental products Flexibility to select different products and/or benefit options for each family member on app Smart app – only the questions for the products selected are asked Simplicity – all questions are yes/no Outlines of coverage provided Claims Claim form provided with complete instructions for submission Claim forms are received, analyzed and adjudicated within a 7 day turn-around time

4 Accident Companion Superior Client/Broker Experience
Changes in the market present opportunities to sell supplemental plans Essential Health Benefits Plans can have out of pocket expenses as high as $6,350 for individuals or $12,700 for families. This leaves large gaps in coverage which can be filled with supplemental plans. Advanced premium tax credits for EHB plans are available for individuals or families making up to 400% of the federal poverty level. Tax credits can be used to purchase extra coverage and fill the gaps left by high deductibles and coinsurance on EHB plans. Number of family members Poverty Guideline for family income (as of 2013) Can still qualify for a subsidy under the ACA with an income up to 1 $11,490 X 400% $45,960 2 $15,510 $62,040 3 $19,530 $78,120 4 $23,550 $94,200 5 $27,570 $110,280 Tax credits can be seen as a way to pay for Supplemental Plans and reduce coverage gaps. Need a subsidy calculator? Try

5 Accident Companion Sales Pitch
The Accident Companion plan is a piece of the puzzle to help fill in gaps caused by high out of pocket expenses and lost wages. Coverage Gap Health Coverage Fixed Indemnity Direct On the right health insurance is supplemented by the following: Fixed Indemnity Direct for hospital coverage, Critical Illness Direct* for lump-sum illness protection, Accident Companion* for lump sum accident protection. Critical Illness Direct Accident Companion *See the appropriate training documents for more details on these other products.

6 Accident Companion Product Comparison
Hospital Confinement Benefit Emergency Treatment Benefit Major Diagnostic Exam Benefit Follow-up Treatment Benefit Follow-up Physical Therapy Benefit The Accident Companion plan is designed to provide customers a lump sum cash benefit. For an accidental injury only For inpatient and outpatient hospital care There is no annual deductible A comparison of benefits to the Accident Direct is shown to the right. Accident Direct Hospital Confinement Benefit Common Accidental Injury Benefit Outpatient Accidental Injury Benefit

7 Accident Companion Navigation?
The Accident Companion is located under the Accident Tab of the SureBridge Point of Sale Tool.

8 Accident Companion Benefit Schedule
Daily Benefits Description Plan1 Plan2 Plan3 Plan4 Hospital Confinement One-Time Lump Sum Hospital Confinement Benefit. Must begin within 30 days of Accidental Injury. Limited to one benefit, per Insured Person, per Policy Year. $2,500 $5,000 $7,500 $10,000 Emergency Treatment Accidental Injury Emergency Treatment Benefit. Treatment must be received at a Hospital Emergency Room or Urgent Care Center within 72 hours of Accidental Injury. Limited to one benefit, per Insured Person, per Accidental Injury. $250 $500 $750 $1,000 Major Diagnostic Exam Diagnostic CT scan, MRI or EEG in a Hospital or Urgent Care Center when due to an Accidental Injury. Limited to one diagnostic exam per Insured Person, per Policy Year.

9 Accident Companion Benefit Schedule
Daily Benefits Description Plan1 Plan2 Plan3 Plan4 Follow-Up Treatment* Accidental Injury Follow-Up Treatment Benefit. Treatment must follow ER or Urgent Care Center treatment and must begin within 30 days of initial onset of Accidental Injury. Limited to one Benefit Amount per visit, per Insured Person, not to exceed 5 visits per Policy Year (for all Accidental Injuries combined). Does not include chiropractic or alternative medicine services. $50 $100 Follow Up Physical Therapy* Accidental Injury Follow-Up Physical Therapy Benefit. Limited to one Benefit Amount per visit, per Insured Person, not to exceed 5 visits per Policy Year (for all Accidental Injuries combined. *Accidental Injury Follow-Up Treatment and Follow-Up Physical Therapy received on the same day will only receive one benefit.

10 Accident Companion Claims Example
Jenny Heart, age 43, had a car accident. Jenny fractures her skull, suffers a concussion, and has multiple contusions. Jenny’s daughter drives her to the nearest Emergency Room where an MRI and X-rays are taken. Due to the fracture in her skull, Jenny is then admitted for 3 days to monitor swelling of the brain. Luckily, in addition to her bronze level EHB health insurance, Jenny has a Level 4 Accident Companion plan. BILL After PPO Discounts Emergency Room (1 Day) Outpatient Diagnostic Imaging Hospital Room (3 Days) $1,000 $2,000 $4,500 Paid By Health Plan $0 $1,150 Out of Pocket $1,000 $2,000 $3,350 The Bronze EHB plan only paid $1,150, leaving Jenny OOP $6,350. SureBridge paid $12,000, covering the gap left by the EHB plan and giving Jenny money to help with her lost wages. Paid By SureBridge Plan $1,000 $10,000 $6,350 $12,000

11 Accident Companion Renewability
The policy is guaranteed renewable to age 65, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy. Eligible Dependents Under our business rules, Eligible Dependents covered under the policy may continue coverage until age 26, subject to the termination provisions of the policy.

12 Accident Companion Accident Companion FAQs
New Business and Underwriting This product cannot be sold with another Accident Companion offered by MEGA, Midwest, or CLICO. No application questions apply to this product. Claim Payment Cash benefit to the member – no assignment of benefits. No coordination of benefits with a health plans. No Subrogation No Pre-Existing Condition Limitation No Waiting Period

13 Accident Companion Pricing Examples
Rates can change. These rates come from the generic brochure dated August 2013: CH ACC COM 813. The chart below is only an illustration of benefit and premium options per covered person for plans. Premiums may vary by state. Monthly Premiums Plan 1 Plan 2 Plan 3 Plan 4 Per Covered Person $7.50 $15.00 $21.50 $28.00 Sample Premiums do not vary by age, tobacco status or sex.

14 Accident Companion This presentation is not inclusive of all policy provisions. See product materials for complete details and any additional state variations regarding Termination of Coverage, Renewability, Premium Changes, Eligible Dependents, Exclusions and policy Definitions. SureBridge® is a registered trademark used for both insurance and non-insurance products offered by subsidiaries of HealthMarkets, Inc. Supplemental insurance products are underwritten and administered by The Chesapeake Life Insurance Company®. Administrative offices are located in North Richland Hills, TX. The insurance product referenced in this document is underwritten by The Chesapeake Life Insurance Company. SureBridge products are individual supplemental products and are not available as group coverage. There is no list bill and premiums may not be paid by employers for employees. This material cannot be copied or used in any way for advertising or presentation purposes. THIS POLICY PROVIDES LIMITED BENEFITS. This type of plan is not considered “minimum essential coverage” under the Affordable Care Act and therefore an Accidental Injury Only Insurance Policy does not satisfy the individual mandate that you have health insurance coverage. This is not Medicare Supplement Insurance. Benefits may vary by state. See state variations and product materials for more detail.

15 Accident CompanionDirect Thank You For Everything You Do!
Accident Injury Only Insurance Policy


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