EBRM Authorized Uni. Care General Agent
About Us Since 1976, Employee Benefit Risk Management Services (EBRM) has driven itself to a leadership position in marketing services to the insurance industry
About Us EBRM’s staff commits resources and time to becoming thoroughly up-to-date in new federal health insurance legislation. As you are no doubt aware, federal regulation is a “moving target” under continuous scrutiny. Our job is to stay on top of the congressional and departmental ebb and flow SO YOU CAN FOCUS ON YOUR CUSTOMERS
About Us • Your success is our mission. EBRM’s business philosophy is based on two assumptions: – Growth opportunities exist in both the individual and group marketplace – The need for efficient distribution is critical in a highly competitive marketplace
About Us We market the following products through professional, independent insurance agents and brokers Health Disability Dental Major Medical Senior Care Life Annuities
About Us • Our agents are guaranteed to receive 100% of the writing agent’s commissions • Our agents are eligible to receive any incentives/bonus offers from the companies we represent
About Us • We understand that in an atmosphere of change, the needs of agents, brokers and their clients also change • We supply you the tools, knowledge and assistance to help grow your business and maintain a solid relationship with your clients
About Us • Agent Services we provide: – Same Day Quoting – Competitive product analysis – Sales, Enrollment and Renewal Assistance – Underwriting Review / Application submissions – Toll free agency service line – Commissions paid directly to writing agents
About Us • Some Companies we represent: – Blue Cross Blue Shield of Illinois – Uni. Care
About Us • Our Location: – Oak Brook, IL 823 Commerce Drive Oak Brook, IL 60523 (phone: 800 -982 -EBRM) – Email:
Economic Impacts • Our country’s current economic status has a direct impact on who can afford healthcare • With the rising cost of the basic necessities, insurance coverage is being overlooked or discarded • Results could be totally devastating for any family or business…
Economic Impacts • Choice and Affordability are the keys to obtain and maintain insurance coverage – Offer multiple plan options – Offer higher deductibles and co-pays – Offer HSA plans – Offer Limited Benefit Plans – Maintain affordable premiums
Looking to the Future Insurance or health maintenance organization (“HMO”) coverage underwritten by Uni. Care Life & Health Insurance Company, Uni. Care Health Insurance Company of Texas, Uni. Care Health Plans of Texas, Inc. (HMO only in Texas), Uni. Care Health Plans of the Midwest, Inc. (HMO only in IL/IN) or Uni. Care Health Insurance Company of the Midwest (IN and IL only) registered mark and SM service mark of Well. Point, Inc. 2005 Well. Point, Inc.
Looking to the Future Uni. Care offers innovative solutions – Business. Flex • Defined Contribution • Member. Flex Options • 12 small group medical plan designs – Dental and Life products • 9 Member. Flex Options • 3 Voluntary Options – Composite rating
Wellpoint, Inc • Parent Company: Well. Point, Inc. – – NYSE: WLP Headquartered in Indianapolis, Indiana More than 42, 000 associates nationwide Approximately 34 million medical members • Blue Cross and/or Blue Cross and Blue Shield – 14 Blue Plans • Blue Cross of California, Blue Cross Blue Shield of Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin • Health. Link and Uni. Care – Non Blue Strategy • Broad range of specialty businesses
Wellpoint, Inc • The nations largest publicly traded commercial health benefits company in terms of membership in the United States • More than 42 billion in premium revenue expected in 2005 – ranked #97 of FORTUNE 500 list this year • 4% combined anticipated membership growth in 2005 – highest among major health benefits companies
Uni. Care, A Healthy Dose of Innovation Introducing. . • All information and charts described in this presentation are brief descriptions of features and benefits of the plans when using participating providers, unless otherwise noted. For a more detailed description of the plans’ features, benefits, exclusions and limitations, please refer to the specific Plan Booklet and/or Certificate of Coverage. • In addition, should there be any discrepancies between the information provide herein and the specific Plan Booklet and/or the Certificate of Coverage, the terms of the Plan Booklet and/or the Certificate of Coverage shall govern.
Uni. Care, A Healthy Dose of Innovation SM
500 Ded 80% Coin 1000 Ded 80% Coin 2500 Ded 70% Coin Saver 1000 70% Coin Rich Benefits Maximum Protection 1000 Ded – 80% Coinsurance 2650 Ded – 80% Coinsurance 5000 Ded – 100% Coinsurance 2650 Ded – 100% Coinsurance 1000 Ded 80% Coin 2000 Ded 80% Coin Saver 2000 70% Coin Lower Cost Core Benefits
Business. Flex Key Features – Defined Contribution Options – Member. Flex Options – Section 125 Premium Only Plan (POP)
Defined Contribution Options Designed to help employers manage the contribution level toward employee benefits • Defined Contribution (DC) gives employers more power to control benefit costs and to better plan budgets for their growing businesses • For Medical Benefits, employers may choose from four contribution levels (DC 80, DC 100, DC Select & Traditional) • For Dental Benefits, employers may choose from three contribution levels (DC 15, DC Select & Traditional)
Defined Contribution Options • Defined Contribution 80 limits employer share of monthly premium to no more than $80 per employee • Defined Contribution 100 limits employer share of monthly premium to no more than $100 per employee • Defined Contribution Select empowers employer to contribute any fixed monthly amount in excess of $100 per employee (in increments of $5. 00) • Traditional Contribution enables employers to contribute 50% or more of the total monthly premium per employee
Business. Flex Key Features – Defined Contribution Options – Member. Flex Options – Section 125 Premium Only Plan (POP)
Member. Flex Option SM Designed to give your employees choices • Employers can offer one, a few or all 12 plans to their employees • Employees can choose from rich-benefit plans with low deductibles, economy plans with high deductibles and HSA-Compatible (HDHP) plans • By extending to employees the ability to choose their coverage, everyone can get the protection they need at a price they can afford
Business. Flex Key Features – Defined Contribution Options – Member. Flex Options – Section 125 Premium Only Plan (POP)
Section 125 P. Option POP offers you and your employees the opportunity to save tax dollars • Employees can use pre-tax dollars to pay their premiums • Employers can reduce their taxable payroll, FICA and other tax obligations • $125 annual fee Administrative services for the Premium Only Plan are provided by Ceridian Benefits Services, Inc. , an independent company that is not affiliated with Uni. Care does not provide tax advice. For tax information please consult your legal counsel or qualified tax advisor.
Michigan Small Group Plans • Small Group plans are grouped into three categories: • Premier Flex Plans • Flex Advantage Plans • HSA-Compatible Plans (High Deductible Health Plans)
Michigan Small Group Plans – Premier Flex Plans – Flex Advantage Plans – HSA-Compatible Plans (High Deductible Health Plans)
Michigan Small Group Plans • Premier Flex (PF) Plans for groups of 2 -99 Lives – PF PPO plans consist of five (5) plans with selected deductibles and varying co-insurance offering rich, valuable benefits that are competitively priced.
Michigan Small Group Plans – Premier Flex Plans – Flex Advantage Plans – HSA-Compatible Plans (High Deductible Health Plans)
Michigan Small Group Plans • Flex Advantage (FA) Plans for groups of 2 -99 Lives – FA PPO plans consist of three (3) plans with selected deductibles and varying co-insurance; all offering important core benefits that are affordably priced to meet the growing demands of employees and employers in today’s rising health care market.
Michigan Small Group Plans – Premier Flex Plans – Flex Advantage Plans – HSA-Compatible Plans (High Deductible Health Plans)
First a word about HSAs. . . Health Savings Accounts (HSAs) • Health Savings Accounts are not insurance policies, but separate agreements between an eligible individual and a qualified financial institution. For convenience, Uni. Care has partnered with JPMorgan Bank, N. A. (Chase) who can offer this service to your clients, however, it is not a requirement to use the Chase HSA to apply for Uni. Care’s HSA-Compatible Plans. Your clients may establish an account with any qualified financial institution.
Health Savings Accounts (HSAs) • President Bush signed into law on December 8 th as part of the Medicare RX bill (Eff. 1/1/2004) • Who is eligible to open an HSA? • Anyone who is covered under a qualified High Deductible Health Plan (HDHP) • Generally anyone under the age of 65 (not Medicare eligible) • Cannot be claimed as dependent on another person’s tax return • Not covered by any other health plan
Health Savings Accounts (HSAs) What are the contribution rules and tax treatment of an HSA? • An HSA is generally exempt from tax (like an IRA) as long as a HDHP exists • Contributions may be made annually up to the lesser of the HDHP deductible amount or $2700 Individual ($5450 Family) • Individuals, employees or employers may contribute to the HSA account • The HSA account is owned by the individual, not an employer • Withdrawals may be made without tax consequences to pay for medical expenses and in some instances for insurance premiums • Un-used account balances may carry over from year to year
HSA-Compatible Plans (High Deductible Health Plan) What is an HDHP? • In order to qualify for an HSA, your client must be enrolled in a qualified HDHP. An HDHP is a health insurance plan that meets the following U. S. Treasury requirements: – Annual Deductible of at least $1, 050 ($2, 100 family) – Annual Out of Pocket not in excess of $5, 250 ($10, 500 family) – No first dollar benefits-Deductible must apply to all benefits
HSA- Compatible Plans (HDHPs) HSA HDHPs for small groups 2 -99 – Uni. Care’s HSA-Compatible (HDHP) PPO Small Group Plans consist of four (4) plans with selected deductibles and varying co-insurance, which when coupled with a Health Savings Account, offers premium savings, tax advantages*, and investment opportunities. *Uni. Care does not offer tax advice. For further information please consult your attorney or qualified tax advisor.
HSA-Compatible Plans • More information regarding HSA Administration Services can be found on the following Web sites: – www. hsainsider. com – www. nahu. org • Uni. Care/Well. Point Integrated HSA Program with JP Morgan Chase Bank
Ancillary Products • EBRM also offers a wide variety of Ancillary products. Ask us for details We are proud to be your Authorized Uni. Care General Agent Thank you for participating
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