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HealthMarkets Rollout – Aetna Senior Supplemental Plans

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Presentation on theme: "HealthMarkets Rollout – Aetna Senior Supplemental Plans"— Presentation transcript:

1 HealthMarkets Rollout – Aetna Senior Supplemental Plans
Training Webinars 12/16 and 12/17 First Sale Date: 1/1/2014 All information is subject to change

2 Overview Sales Requirements Appointment Process
All information is subject to change Sales Requirements Appointment Process New Business / Policy Visibility Compensation Contact Information

3 Sales Requirements All information is subject to change
Agents must have a valid health license Agents must be approved to sell Senior/Medicare plans for Insphere/HealthMarkets Insurance Agency Agents must be certified to sell Aetna’s Senior Supplemental plans Insphere Orientation (if not already complete) Insphere Health Pre-Requisite (if not already complete) CLI Senior Supplemental specific Product Training This is a separate training / certification from Aetna Med Supp plans Agents attending this webinar will be considered certified  Sales Assistants should log attendance at webinar and create a class in NetExam called “Aetna Senior Supplemental Product ILT” and enter agents who attended the webinars for certification Agents who did not attend and need to get certified can access and take the Aetna Senior Supplemental Products Self Study which will be posted on NetExam by the end of this year Check NetExam transcript to confirm certification (Eligible to Sell Report and My Profile page on RC will not be updated until in mid January)

4 Appointment Process Agents who are already appointed with CLI, ACI, or AHLIC for Med Supp need to do nothing Your CLI appointment will be processed automatically Use your existing Producer code for CLI/ACI or AHLIC Agents who are not currently appointed to sell Aetna Med Supp Follow instructions and complete the paperwork posted on the Aetna Medicare carrier page of the Resource Center under Aetna Med Supp and Sr Supp Appointment Info. Submit to – Do not submit direct to the carrier Do NOT sell until you have been appointed, have your producer code and are certified on these products Timeframe for appointment is days from receipt by carrier Appointment will be on RC on My Profile Page when available Appointment letters sent by carrier direct to agent w/ producer code on initial appointment

5 Quoting, Applying & Tracking Applications
All information is subject to change Product Availability – See Product Availability chart New Business Business is submitted via paper applications / wet signature only 1st sale date = 1/1/2014 Applications should be sent directly to the carrier at the address/fax specified on the application – this will be covered in more detail in the upcoming Product training Keep a copy of each paper application in a secured location for tracking purposes Application Visibility Agents can access their book of business on the Aetna Senior Products portal (updated daily) Policies will be updated on the Insphere PID report and in CRM once a week

6 Marketing Materials All information is subject to change An initial supply of welcome kits/materials was ordered for each office and should be arriving soon Agents can access marketing materials, brochures, forms and other documents from the carrier site at Or Agents/SAs/AMs can order materials by calling Aetna Agent Services Line

7 Compensation For Compensation information, please go to:
All information is subject to change For Compensation information, please go to: Resource Center > Compensation Tab > Compensation-Related Documents > Contract & Addendums > Insphere Commission Schedule Please allow 1-2 weeks for the commission schedules to be updated on the RC. Insphere is contracted for and launching all Senior Products through Aetna/CLI except for: Final Expense – agents should not sell and will not be compensated for Final Expense policies Advances – Follows standard supplemental advance rules Payment of commissions could take up to 90 days from the effective date of the policy or receipt of premium by the Carrier Contest being offered – details to come; paid direct to agent by Aetna

8 Contact information All information is subject to change Product, Sales and Training: Contact your Regional Sales VP New Business, Underwriting and Materials: Contact Agent Services Team For questions regarding the policies and commissions, please contact: Insphere Agent Services InTouch Hotline: Option 1 8

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11 Aetna Senior Supplemental Insurance
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Senior Supplemental Insurance Includes all products underwritten by: American Continental Insurance Company (ACI) Continental Life Insurance Company of Brentwood, Tennessee (CLI) Medicare Supplement insurance underwritten by: Aetna Health and Life Insurance Company (AHLIC)

12 Why Aetna? For Agent Use Only. Not To Be Used As A Sales Tool.

13 Why Aetna? American Continental Insurance Company (ACI) and Continental Insurance Company (CLI), both Aetna companies. Aetna Health and Life Insurance Company has not been rated by A.M. Best. For Agent Use Only. Not To Be Used As A Sales Tool.

14 Aetna Senior Supplemental*
Over 30 years specializing in the senior market Focused on being a distributor preferred company, supporting long term success for our valued producers A small company personality with big company capability Proven “personalized” customer service Products to cross sell that will help grow your business Attractive commissions Diverse product portfolio that meet the unique needs of your clients Qualify for sales incentives (all products help qualify - state compensation rules vary) Consumer Lead Referral Program * Includes all products underwritten by American Continental Insurance Company (ACI) and Continental Insurance Company of Brentwood, Tennessee (CLI), Aetna companies; and Medicare Supplement products underwritten by Aetna Health and Life Insurance Company (AHLIC), For Agent Use Only. Not To Be Used As A Sales Tool.

15 Senior Supplemental Insurance
Final Expense (whole life) Valued protection from a trusted company Medicare Supplement A product consumers know and trust Underwritten by Aetna Health and Life Insurance Company, American Continental Insurance Company, Continental Life Insurance Company of Brentwood, Tennessee, all Aetna Companies. Underwritten by American Continental Insurance Company, Continental Life Insurance Company of Brentwood, Tennessee..

16 Complementary Health Insurance Products*
Continental Care (Hospital Indemnity) Short Term Home Care Short Term Nursing Facility Care Cancer Plus (First Occurrence Cancer) *Products and benefits vary by states. Underwritten by Continental Life Insurance Company of Brentwood, Tennessee For Agent Use Only. Not To Be Used As A Sales Tool.

17 Product Availability Based on the applicant’s state of residence Launch updates available on aetnaseniorproducts.com

18 Medicare Supplement Products
Offering Plans A, B, F, High Deductible F, G, and N Plan availability varies by state 5% Household Discount Not available in all states No pre-existing condition limitations 12-month rate guarantee Guaranteed renewable Competitive commissions Vary by state Full commission on plans issued to ages 65+ Underwritten by Aetna Health and Life Insurance Company (AHLIC) , American Continental Insurance Company (ACI) , Continental Life Insurance Company of Brentwood, Tennessee (CLI) For Agent Use Only. Not To Be Used As A Sales Tool.

19 Final Expense (Whole Life)
Peace of mind Provides funds when needed most Affordable coverage Rates do not increase Level, graded or modified death benefit plans Plan options vary by state Point of sale pre-approval Telephone based Jet Pre-Approval process Client applies knowing what coverage level he/she can qualify for Reduces declined applications Can expedite issuance of the policy Pre-Approval does not guarantee an application will be approved Coverage through a company with proven financial strength and commitment to the senior market Underwritten by American Continental Insurance Company (ACI) and Continental Insurance Company of Brentwood, Tennessee For Agent Use Only. Not To Be Used As A Sales Tool.

20 Sales Tools That Help Sell Final Expense
Documents Information A Family Member Will Need To Know When a Loved One Dies Record of family history Who is to be notified - Family - Attorney Where important documents are stored - Will - Insurance policies - Financial records Final arrangements - Funeral home and cemetery selection - Funeral services Included In Each Final Expense Sales Kit For Agent Use Only. Not To Be Used As A Sales Tool.

21 Establish Client’s Needs – Questions to Ask
The average funeral costs $10,000+. Have you considered the health costs associated with end of life health care? Are you aware that Social Security currently pays only $255 as a death benefit? Have you taken care of your final expenses? Can your family afford to bear the costs of your funeral? Have you considered other expenses that may occur? Out-of-pocket medical expenses including hospice or skilled care Estate Probate Funeral costs including grave marker, etc. Other debts Note: This is not a pre-paid funeral plan For Agent Use Only. Not To Be Used As A Sales Tool.

22 Determine Level Of Coverage
Sample Health Questions Section 3 of application Available coverage levels (and application form) vary by state If applicant can answer “no” to all questions in Section 3A,” the client qualifies for some level of coverage Modified Coverage level Requires a “No” answer for all questions in Modified (where available) Section 3A Graded Sections 3A and 3B Level Sections 3A, 3B and 3C Graded Level Sample shown is an application when all coverage levels are available For Agent Use Only. Not To Be Used As A Sales Tool.

23 Benefit Plans Death Benefits Issue Ages Maximum Benefit* Level 45 – 65
Full Benefit Immediately 45 – 65 66 – 80 81 – 85 86 – 89 $35,000 $25,000 $15,000 $10,000 Graded Accidental Death Non-accidental Death Policy Year 1: 40% of benefit amount Policy Year 2: 75% of benefit amount Policy Year 3: Full death benefit Modified Policy Years 1 and 2: ROP plus 10% Policy Year 3: full death benefit 66 – 75 All levels not available in all states. Note: $3,000 minimum benefit amount for all ages For Agent Use Only. Not To Be Used As A Sales Tool.

24 Dedicated Final Expense Toll Free Number
CALL 877 JET.2759 ( ) Select menu option based on the type of Final Expense inquiry Option 1: Jet Pre-Approval Team Time Zone Monday – Friday Hours Saturday Hours Eastern 8:00 a.m. – 10:00 p.m. 10:00 a.m. – 4:00 p.m. Central 7:00 a.m. – 9:00 p.m. 9:00 a.m. – 3:00 p.m. Mountain 6:00 a.m. – 8:00 p.m. 8:00 a.m. – 2:00 p.m. Pre-Approval is required and conducted by telephone at the point-of-sale with the client (or by 3-way conference if agent is not face-to-face with the applicant during normal hours of operation). Option 2: FE Specialist Team New Business Underwriting Policy status Time Zone Monday – Friday Hours Eastern 8:30 a.m. – 5:30 p.m. Central 7:30 a.m. – 4:30 p.m. Mountain 6:30 a.m. – 3:30 p.m. For Agent Use Only. Not To Be Used As A Sales Tool.

25 Continental Care (Hospital Indemnity)
The Opportunity Anyone concerned with paying expenses that may be incurred as a result of a hospital stay and temporary skilled nursing facility stay such as: The self employed A small business owner - list bill available A primary caregiver The primary market for Continental Care is individuals ages 30 to 64 For Agent Use Only. Not To Be Used As A Sales Tool.

26 Continental Care Can Help
Policyholder has the freedom to use the benefits to: Help pay out of pocket medical expenses, related to hospital or skilled nursing confinements Help pay for travel or lodging for loved ones Offset childcare and/or family care expenses Cost of equipment or services that may or may not be medically necessary and not covered by insurance Help pay for other incidental expenses Use however they may choose! For Agent Use Only. Not To Be Used As A Sales Tool.

27 Hospital Benefits Hospital indemnity (HI) benefits
Pays a lump sum benefit for a hospital confinement of 24 hours or more Select from three benefit options $500, $750, or $1000 Payable once for each new Period of Care Additional daily benefit – (an optional benefit) Pays for each day of hospital confinement Select benefit in increments of $10 From $30 to $250 per day of confinement Benefits for up to 90 days per Period of Care Private hospital room benefit Pays benefits of $25 per day (in addition to HI benefit) Pays up to 30 days for each Period of Care Private room must be medically necessary For Agent Use Only. Not To Be Used As A Sales Tool.

28 Continental Care Also Includes…
Skilled Nursing Facility Indemnity Benefit* For each day of confinement in a skilled nursing facility Select in Increments of $10 From $50 to $150 per day of Confinement Elimination Period Options 0-Day, 20-Day, 100-Day Pays Benefits for up to 90 days for each Period of Care Must follow a Hospital stay of at least 3+ days* Registered Nursing Care Pays $30 per shift up to 2 shifts per day Up to a maximum of $60 per day For up to 30 days per Period of Care Periods of service within the same day which total 8 hours or less will be considered one shift Services Must Be… Certified by a physician that care is medically necessary Provided by a private-duty, graduate or registered nurse * Skilled Nursing Facility Benefit not available in South Carolina For Agent Use Only. Not To Be Used As A Sales Tool.

29 Other Policy Features Period of Care Waiver of monthly premium
Begins the first day of confinement in a hospital due to a covered injury or sickness Ends when you have been out of the hospital or skilled nursing facility for 60 continuous days Benefits are then fully restored No lifetime maximum on the number of Periods of Care for which benefits are restored Waiver of monthly premium After 8 continuous weeks of a covered hospital or skilled nursing facility stay where Continental Care benefits are being paid Guaranteed renewable Issue age premiums Portable Benefits paid directly to policyholder Unless assigned to a healthcare provider For Agent Use Only. Not To Be Used As A Sales Tool.

30 Agents Should Use Care *Continental Care cannot be marketed or advertised as a… Replacement for a Major Medical plan Supplement to Medicare or a Medicare Supplement plan Wrap or gap-filler for a Medicare Advantage plan Continental Care is not designed to… Replace the need for primary health insurance Supplement any type of insurance Pay co-payments or deductibles *When explaining the benefits of this product to a client agents should not refer to the product as a “wrap,” “gap-filler,” “supplement,” or imply that it functions as one. For Agent Use Only. Not To Be Used As A Sales Tool.

31 Nursing Facility and Home Care
Benefits are straightforward and easy to understand Clients can select from different benefit amounts to design coverage that suits their individual needs Pays indemnity benefits directly to the policyholder - unless they elect to assign benefits to a healthcare provider Affordable premiums Provides peace of mind Attractive Aetna branded sales materials For Agent Use Only. Not To Be Used As A Sales Tool.

32 The Opportunity Anyone concerned about the expenses that can arise while recovering from an accident or illness. Expenses associated with short term (less than 1 yr.) confinement in a hospital, nursing facility, or nursing care provided at home For example, recovery and/or rehabilitation services following a hospital confinement (such as, care needed when recovering from a heart attack, stroke or following major surgery such as a hip replacement, bypass surgery, etc.). Other “non-medical” expenses that may arise should a hospital or nursing facility confinement be necessary These products should not be sold as a substitute for Long Term Care or as a supplement to Medicare Supplemental Insurance. They are designed for Short Term Recovery Care received in either a hospital, nursing facility or at-home. For Agent Use Only. Not To Be Used As A Sales Tool.

33 Nursing Facility Care Benefits
Offers coverage for medically necessary professional nursing services received while confined in a… Nursing facility Hospital Pays for all levels of nursing facility care Skilled Intermediate Custodial Includes full restoration of nursing facility benefits After 180 days of non-confinement and no longer in need of medically necessary care For Agent Use Only. Not To Be Used As A Sales Tool.

34 Nursing Facility Confinement Benefits
Basic plan pays $120.00/day Any level of nursing care 24 hour in-patient stay required Must be medically necessary and doctor prescribed Choose an Elimination Period 0-Day, 20-Day, 100-Day Select a Benefit Period 90-Day, 180-Day, or 360-Day No limit on the number of Periods of Care Begins the first day of covered confinement Ends 180 consecutive days after the confinement is no longer medically required Benefits are restored automatically after the end of a Period of Care For Agent Use Only. Not To Be Used As A Sales Tool.

35 At-Home Confinement Benefits
Select a weekly benefit of $150*, $300, $450, $600 or $750 per week Up to 26 weeks per period of care Covered benefits Requires 3 or more Home Health Care (HHC) visits per week to occur on separate days Provided by Licensed HHC Provider Services must be Received at home Medically necessary and reasonable for the treatment of a covered illness or injury Full restoration of Home Care benefits After 180 days of non-confinement and no longer in need of medically necessary care For Agent Use Only. Not To Be Used As A Sales Tool.

36 Hospital Confinement Benefit
Basic coverage pays $10.00/Day * for each day of confinement Lifetime maximum of 365 days Daily base maximum benefit amounts vary by state ID $40/per day IL $30/per day Additional coverage of up to $150.00/day Available in $10 increments No elimination period required 24 hour in-patient stay required Care must be medically necessary * Minimum daily hospital benefit varies by state. In most states the minimum benefit is $10/day with additional coverage available. For Agent Use Only. Not To Be Used As A Sales Tool.

37 Registered Nursing Care Benefits
For nursing care received In a hospital (Home and NHF Care) In a nursing facility (NHF Care Only) At-Home (Home Care only) Pays Up to $30 per shift Maximum of 2 shifts per day Up to a total $60.00/day Maximum 30 days per benefit period Services must be medically necessary Services received from a private duty, graduate, or Registered Nurse are covered No prior hospital stay required For Agent Use Only. Not To Be Used As A Sales Tool.

38 Nursing Facility Care - Affordable Rates
Issue age rates vary by state Applicants ages 50-89* * Rates available for ages 18 to 89 in PA A one time non-commissionable policy fee applies. Policy fee may vary by state. For Agent Use Only. Not To Be Used As A Sales Tool.

39 Home Care - Affordable Rates
Issue age rates vary by state For Applicants ages 50-89* * Rates available for ages 18 to 89 in PA; $ Benefit Option not available in ID A one time non-commissionable policy fee applies. Policy fee may vary by state. For Agent Use Only. Not To Be Used As A Sales Tool.

40 Home Care AND Nursing Facility Care -

41 Examples Of Affordable Monthly Rates
Nursing Facility and Home Care Ages Nursing Facility Care 0-Day Elimination 90-Day Benefit Period $120 /Day Nursing Facility $10/ Day Hospital Benefit Home Care Weekly Indemnity Benefit $450/Week Home Care Indemnity $10/Day Hospital Benefit Total Premium 64 $12.80 $24.59 $37.39 65-69 $21.41 $32.84 $54.25 *A $20 (one time only) policy fee will apply for each issued policy. Additional Hospital Indemnity Benefit can be added to either the Nursing Facility or the Home Care product but not both. For Agent Use Only. Not To Be Used As A Sales Tool.

42 Underwriting Inform applicants that a telephone interview will be required Normal underwriting procedures Underwriter asks the same health questions as those shown on the application Phone Interview on all applicants age 75 or older At the underwriters’ discretion for applicants age 74 or younger Call home office should you have questions prior to submitting application , Option 4 (Underwriting) Do not submit applications with a “yes” answer to a health question – policy will be declined Pre-existing conditions are not covered for the first six months the policy is in effect For Agent Use Only. Not To Be Used As A Sales Tool.

43 Cancer Plus – First Occurrence Cancer
Did You Know? Cancer is the second leading cause of death in the United States Your lifetime risk of being diagnosed with cancer is significant Approximately 1 in 2 for Men and 1 in 3 for Women The risk of cancer becomes greater with age Nearly 77% of all cancers are diagnosed in persons 55+ years of age Sources: 2007 and 2008 Cancer Facts & Figures Insurance Cost Related Barriers to Cancer Care, American Cancer Society®, 2008 Cancer Statistics Presentation, American Cancer Society® HealthCare data presented at American Society of Clinical Oncology conference, October 2008. For Agent Use Only. Not To Be Used As A Sales Tool.

44 Surviving Cancer Can Be Costly
Average costs for first year cancer treatment has more than doubled since % of the treatment costs are associated with indirect medical expenses not covered by traditional health Insurance Source: HealthCare data presented at American Society of Clinical Oncology conference, October 2008; 2007 and 2008 Cancer Facts & Figures, Insurance and Cost-Related Barriers to Cancer Care American Caner Society®; 2008 Cancer Statistics Presentation, American Cancer Society® For Agent Use Only. Not To Be Used As A Sales Tool.

45 Can Provide The Funds Needed To Pay
For Agent Use Only. Not To Be Used As A Sales Tool.

46 Features Benefit paid once cancer is first diagnosed
Hospitalization or other medical expense not required Benefit paid directly to the policyholder in lump sum In most situations, benefits are not included in taxable income Agents should advise applicant to consult with their Tax Advisor to determine whether the benefits would be taxable in their situation Pays regardless of other insurance, including Medicare Insurance covers most cancer types, including Leukemia and Hodgkin’s Disease Skin cancer is not covered except malignant melanoma Guaranteed renewable For Agent Use Only. Not To Be Used As A Sales Tool.

47 Affordable Coverage For Everyone!
Coverage from $5,000 to $25,000 Increments of $5,000 Ages 18 to 79 Annual Rates $20 Policy Fee (first year only) - $10 in Tennessee; $6 in Mississippi; No fee in KY For Agent Use Only. Not To Be Used As A Sales Tool.

48 Claim Filing Claim must be accompanied with a pathology report indicating that cancer is present and when it was first diagnosed No hospital or medical expenses need to be incurred to file a claim Generally, check is issued within 7-14 days of receipt of claim Policy is automatically terminated once lump sum benefit is paid For Agent Use Only. Not To Be Used As A Sales Tool.

49 Current Cancer Plus Application*
Sample *Applications vary by state For Agent Use Only. Not To Be Used As A Sales Tool.

50 Need Assistance? Contact Agent Services aetnaseniorproducts.com
, Option 3, 1 (Sales) Order supplies Assistance completing application Product availability Order supplies Track qualification for sales incentives Block of business reports News bulletins For Agent Use Only. Not To Be Used As A Sales Tool.

51 Thank you


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