Presentation on theme: "The Cure for Healthcare"— Presentation transcript:
1 The Cure for Healthcare UNICAREThe Cure for HealthcareStart
2 health care company for the last two years UNICARE is part of WellPoint Health Networks, Inc., one of the largest health care companies in the nation!WellPoint is a Fortune 500 company, and has been recognized as Fortune’s “Most Admired”health care company for the last two years
3 UNICARE is reinventing the Individual and Small Group insurance market!
4 Public versus corporate points of view... What's the state of the industry?Public versus corporate points of view...
5 INDIVIDUALS (non-Poor) Range of existing Plans Assumed PriceINDIVIDUALS (non-Poor)19-2930-3940-4950-5950%Range of existing PlansWilling To Pay1) A recent California Healthcare Foundation study identified that virtually all uninsured people over 200% of FPL overestimate the price of individual coverage - but within a defined range2) Half of those indicate that they WOULD buy at prices currently in the market3) Great opportunity to sell - but what happens if rates go up more?Source: California Healthcare Foundation
6 Hospital Physician Pharmacy $200$300$400$500$6001993199519971999200120032005Hospital PhysicianSource: Health Care Financing Administration, 1999, Scott-Levin, 1999$45$85$125$165$205PharmacyPharmacyHospitalPhysicianPhysicianHospitalPharmacy1) We’re all aware of Drugs, and up until ‘98 that was the only real component of cost “beginning to get out of hand”2) Now however, every component of medical cost is in the act.3) Remember the early and mid ‘80’s. That’s the last time we saw cost up at this rate coming off of a A SOFT pricing market.4) YIKES!
7 $12,000 8% 70% $1,200 24% 23% $150 68% 7% PRICE Average Annual Usage Source: Watson Wyatt WorldwideAverage Annual Usage% of Americans% of Total Dollars$12, % 70%1) 68% of our a typical population (ie: our insured business) is SO healthy, their sense of value is VERY impacted by this new cost/price trendUninsured are as healthy (if not more, than insured)Value of “protection” is very lowLoosing over price means loosing the 68% category of members/small groups - big problem….2) (Wellpoint dis-enrollment research) 1/2 of Small Groups and nearly 3/4 of individuals lapse because of price - 1 in 5 individuals and 1 of 8 small groups go uninsured afterwards$1, % 23%PRICE$ % 7%
10 Our Individual Medical Plans Offer Lifetime maximum of up to $5 millionWide choice of plansPreventive CareOut-of-Pocket Maximums provide protection against catastrophic expensesMedCall® 24-hour nurse hotlineNo claim forms with network providers
11 Individual Plan Choices UNICARE Saver 2000 PlanHigh Deductible for Medical Savings Accounts(MSAs)UNICARE Plans offer several deductibles:$2,000$1,500$1,000$500UNICARE Premier No Deductible PlanTerm Life Coverage
12 We offer LOW-MEDIUM-HIGH plan options based on plan design and premium! Please note: New sales brochures present benefits andshare of costs in a “you pay (this)” format
13 Medical Plans Features Individual & FamilyMedical Plans FeaturesSaver 2000 Plan provides in-hospital coverage with $2,000 deductibleDeductible plans with choice of 5 deductibles!Premier No Deductible Plan (with NO Annual Deductible!)$30 Co-Pays for in-network physician office visits on all plans!Office visit co-pay excludes lab and x-rays
14 Individual UNICARE Saver 2000 Plan Features Covers hospitalization and provides some limited benefits2 office visits to participating providers per member, per year (adult) before deductible is met for a $30 CopayNo preventive care benefit(except for babies and children through age 6)Employment-related accidental injury or illness covered (unless covered by Worker’s Compensation Insurance or Employer liability laws)No Maternity
15 Individual UNICARE Saver 2000 Plan Share of Costs Drug Co-pays:Retail (30 days):$10 for Generic$25 for Brand NameMail order (up to 60 days):$20 for Generic$50 for Brand$2,000 medical deductibleUNICARE pays 70%, you pay 30% for inpatient facility and eligible professional charges$200 Brand Name drug deductible$500 Drug Maximum, per member per year (in- and out- of network)
16 Individual UNICARE Deductible Plans Four separate plans with a choice of deductibles and in-network coinsurance levelsUp to 4 office visits to participating providers per member (adult) before deductible is met for a $30 copay$200 worth of covered charges for Preventive Care for children and adults *(subject to deductible and coinsurance)Employment-related accidental injury or illness covered(Unless covered by Worker’s Compensation Insurance or Employer liability laws)* Other than mandated benefits
17 Individual UNICARE Deductible Plans Share of Costs $2,000$1,500$1,000$50080/20 to $3,000 in-network out-of-pocket max.* on the $500 and $1,000 plans70/30 to $3,000 in-network out-of-pocket max.* on the $1,500 and $2,000 plans* Must also meet deductible
18 Individual UNICARE Deductible Plans Prescription Drug Share of Costs Brand Name Drug DeductiblesAccording to Plan:Plan DeductibleUNICARE 500 $50UNICARE 1,000 $100UNICARE 1,500 $150UNICARE 2,000 $200Drug Co-Paysfor all plansRetail (30 days):$10 for Generic$25 for Brand NameMail order (up to 60 days):$20 for Generic$50 for Brand Name
19 Individual UNICARE Premier No-Deductible Plan Features Rich benefits and no annual deductibleUnlimited office visits$200 worth of covered charges for preventive care for adults*(subject to any coinsurance or copay)Employment-related accidental injury or illness covered (Unless covered by Worker’s Compensation Insurance or Employer Liability Laws)* Other than mandated benefits
20 Individual UNICARE Premier No-Deductible Plan Share of Costs No brand name drug deductibleNo drug maximum limitationDrug Co-pays:Retail (30 days):$10 for Generic$25 for Brand NameMail order (up to 60 days):$20 for Generic$50 for Brand$30 Copay80/20 to $3,000 in-network out-of-pocket maximum** Must also meet deductible
21 Other Common Elements Office Visits Annual Out-of-Pocket Maximum* Individual$3,000* on all plans for in-network charges!$10,000* on all plans for out-of-network charges!Family$6,000* on all plans for in-network charges!$20,000* for out-of-network charges on all plans!Office Visits$30 office visit copay excludes lab and x-rays*Must also meet deductible
23 Affordable Term Life Insurance Individual Term Life insurance is available to anyone who qualifies for one of our medical plansEasy to apply for: Have applicant check the box on application form and complete the Term Life Insurance Application Addendum
24 Marketing Strategies70% of those in the market don’t have a Life insurance agentWindow of opportunity: people don’t buy Term Life insurance unless YOU sell them Term Life insuranceSound financial planning; Term Life is a “financial safety net” for your clients and those who depend on them
26 Key Features to Look For in an Agent Agreement Future renewals based on commission schedule in force when case was written.Look for these key provisions in your agent agreements.Renewals guaranteed to be based on schedule in force when you placed the case with a carrier.No time limitation on renewals.Ability to assign or sell your business.Which is better for you to own your business – or the carrier to own your business.Renewals paid for as long as case is in force.Ownership and assignment provisions.
27 Our Commitment to You: Your UNICARE Agent Agreement Ownership contract(six cases issued)Corporations can be licensedNo limitations on renewalsDo not accept agent of record on individual business
28 UNICARE: Compare the difference! UNICARE CompetitorPlans PlansFirst Year Commission % ?Contract Ownership Yes! ?Free Quoting Software Yes! ?Access to Underwriters Yes! ?AgentOnline/AgentConnect Coming ?
29 Supplemental Income Example of individual production at one case per week. Average premium of $150 per case, 20%commission first year-accruing scale.Month 1 $120Month 2 $240Month 3 $360Month 4 $480Month 5 $600