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Premier Short Term Product Quoting Process INK Verification

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Presentation on theme: "Premier Short Term Product Quoting Process INK Verification"— Presentation transcript:

1 Premier Short Term Product Quoting Process INK Verification
Agenda Premier Short Term Product Quoting Process INK Verification

2 Our Products

3 Premier STM Underwritten by: Unified Life Insurance Company Rated B++ (Good) by A.M. Best Company

4 Product Highlights Unlimited doctor & specialist copays
Next-day coverage available Selectable maximum benefit of $25,000 up to $1,000,000 with Out-of-Pocket Maximum of $5,000 or $10,000 6 and 11 month terms available no rate differential Flexible deductible options of $500, $1,000, $2,500, or $5,000 Coinsurance is 80/20 DRAFT- FOR TRAINING PURPOSES ONLY

5 Product Highlights Children only policy available
Dependent coverage available until 26 - no full-time student status required Open Network – Freedom to choose any doctor or hospital No waiting period for sickness Choose any effective date of the month Unlimited 6-month and 11-month term re-writes – Earn 1st year commissions State Specific Reapply Restrictions Nevada: You must wait 6 months before you can reapply for new STM insurance, if you have been insured under 3 or more STM policies in the past 12 month period. North Carolina: You must wait 6 months before you can reapply if you have been covered by any STM in the past 6 months. Oregon: You must wait 60 days before you can reapply for new STM insurance. DRAFT- FOR TRAINING PURPOSES ONLY

6 Product Overview Customize plan options to meet your customer’s budget and needs. Deductible and Coinsurance will be waived for any Eligible Expenses for which a Copayment is specified. This is a short term medical group insurance policy underwritten by Unified Life Insurance Company that pays benefits based on the schedule in the policy and is separate from the NCE Membership. This insurance does not meet the requirements of the PPACA. ** Deductible per Coverage Period per Insured Family: Three (3) times the Insured Person Deductible. Limitations and Exclusions may apply. DRAFT- FOR TRAINING PURPOSES ONLY

7 Product Benefits Doctor’s Office Visits Benefit: Unlimited Visits per Insured Person per Coverage Period (subject to selected copay) Urgent Care Benefit: $50 (In additional to any deductible and coinsurance amount and does not accumulate toward out-of-pocket maximum) Emergency Room Benefit: $200 (In additional to any deductible and coinsurance amount and does not accumulate toward out-of-pocket maximum) Sports Benefit: Intramural and non-school sponsored sports coverage DRAFT- FOR TRAINING PURPOSES ONLY

8 Product Highlights Knock Out Questions
Are you or any dependent to be insured currently pregnant or receiving infertility treatments, or if insuring dependents, are you an expectant father or in the process of adoption or in the process of surrogate pregnancy? Within the last five (5) years, have you or any dependent to be insured been hospital confined for any reason (other than bodily injury) for four (4) consecutive days or longer? Are you or any dependent to be insured overweight AND been diagnosed with high blood pressure (whether or not treated or controlled)? Overweight is any male over 300 pounds or female over 250 pounds. Are you or any dependent to be insured overweight AND been diagnosed with elevated cholesterol (whether or not treated or controlled)? Overweight is any male over 300 pounds or female over 250 pounds. DRAFT- FOR TRAINING PURPOSES ONLY

9 Product Highlights Knock Out Questions
Within the last five (5) years, have you or any dependent to be insured, seen or been treated by any medical professional, or been recommend to see a medical professional, or received diagnostic testing, or received medication, or received abnormal test results for, or been diagnosed with, any of the following conditions? Within the last twelve (12) months, have you or any dependent to be insured been advised by any medical professional to have any medical treatment, diagnostic testing or surgery that has not been completed? If all persons to be insured are United States citizens, please answer “No” to this question. If any person to be insured is not a United States citizen, has that person resided outside the United States at any time over the last 24 months? Requires SS# Alcohol Abuse, Alcoholism, Chemical Dependency or Substance Abuse; Cancer or Tumor (excluding basal cell); Chronic Obstructive Pulmonary Disease, Cystic Fibrosis, Emphysema, Pulmonary Embolism or Tuberculosis; Diabetes; Organ or Tissue Transplant; Blood disorder – including but not limited to hemophilia or leukemia; Heart disorder – including but not limited to chest pain, heart failure, rhythm disturbances or heart attack; Circulatory system disorder – including but not limited to stroke or deep vein thrombosis/phlebitis (does not include high blood pressure); Immune disorders – including but not limited to Lupus, Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC); Kidney or Liver disorder – including but not limited to Hepatitis, Polycystic Kidney Disease or Renal Failure; Nervous System disorder – including but not limited to Muscular Dystrophy; or Mental/Nervous disorder requiring hospitalization. DRAFT- FOR TRAINING PURPOSES ONLY

10 RX – Discount Card There are no fees or charges to enroll, and it never expires It’s Smart Save an average of 46%*. You can use this card for the whole family, including pets. It’s Easy Save at more than 60,000 pharmacies nationwide, including Walmart, Target, Walgreens and more. Agile Discount Rx Disclaimer: DISCOUNT ONLY - NOT INSURANCE. Discounts are available exclusively through participating pharmacies and providers. The range of the discounts will vary depending on the type of provider and services rendered. This program does not make payments directly to providers. Members are required to pay for all health care services. You may cancel your registration at any time or file a complaint by contacting Customer Care. This program is administered by Medical Security Card Company, LLC of Tucson, AZ.** Based on 2013 national program savings data. 10

11 Agile Discount Rx Rx benefit given to all Premier STM members
WELCOME LETTER & ID CARD Rx benefit given to all Premier STM members Immediately available in the member’s back office to download and print. Included with welcome letter (Please allow 7-10 business days.)

12 Lowest Rx Helpline Price*
Prescription savings program to help your customers save money on prescription medications. Example Savings: Drug Common Use Average Price (30-day) Lowest Rx Helpline Price* % Savings Hydrochlorothiazide (12.5mg) Blood Pressure $15 $4 73% Clopidogrel (75mg) Blood Thinner $120 $11 93% Detrol La (4mg) Overactive Bladder $310 Free 100% Nexium (40mg) Heartburn $305 Crestor (10mg) Cholesterol $245 DRAFT- FOR TRAINING PURPOSES ONLY

13 Teledoc Stay healthy throughout the year with Teladoc!!
What is Teladoc? Benefit that gives you 24/7/365 access to U.S. board-certified doctors who can resolve many of your medical issues via phone or online video When can use Teladoc? When you need care now If you’re considering the ER or urgent care center for a non-emergency issue On vacation, on a business trip, or away from home For short-term prescription refills What can I use it for? Cold and flu symptoms Bronchitis Respiratory infection Sinus problems Allergies Urinary tract infection Pink eye Ear infection

14 State Availability Premier STM is available in the following states up to 11 months: Premier STM is available in the following states up to 6 months: AL, AR, AZ, CT, DE, FL, GA, HI, IA, IL, IN, KS, KY, LA, MA, MS, MT, NC, ND, NE, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY. DRAFT- FOR TRAINING PURPOSES ONLY

15 NCE Guidelines REWRITING Nevada: They must wait 6 months before they can reapply for new STM insurance, if they have been insured under 3 or more STM policies in the past 12 month period. North Carolina: They must wait 6 months before they can reapply if they have been covered by any STM in the past 6 months.   Oregon: They must wait 60 days before they can reapply for new STM insurance. DRAFT- FOR TRAINING PURPOSES ONLY

16 Contact Information Benefit and Claim Questions Allied National - GlobalCare Provider: Billing Questions - HII Monday-Friday 8:30am to 7:00 p.m EST Annette Dahlke National Account Executive


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