- Количество слайдов: 33
Insurance Carrier ¡ Guarantee Trust Life Insurance Company l l l l Founded in 1936 Headquartered in Glenview, Illinois Mutual legal reserve company with over $2 billion life insurance in force Rated B+ (Very Good) by A. M. Best 1. 2 million insureds Licensed in 49 states Visit www. realfastservice. com to learn more
Reinsurance ¡ Munich Re Group l l l 2 nd Largest Reinsurance Company Founded in 1880 Headquartered in Munich, Germany 5, 000 insurance companies in 150 countries rely on Munich Re's expertise and financial strength Affiliated companies in 23 countries Visit www. munichre. com to learn more
Individual Major Medical – A Growing Market ¡ ¡ 45 million uninsureds 15 million uninsureds with an annual household income of $50, 000 and above Medical inflation has driven premiums out of the reach of many – increasing the number of uninsureds Smaller and larger companies are dropping their group coverage and encouraging employees to purchase insurance on their own The growth and opportunities in this market is enormous
Assur-Care Series ¡ Comprehensive major medical coverage for individuals and families ¡ Choice of 2 major medical plans ¡ Flexibility (choices in deductibles and coinsurance)
Assur-Care Series ¡ ¡ Advantage Benefits are richer l Cost is higher ¡ ¡ Complete Benefits are very attractive, and very affordable • Coverage is available for eligible individuals, families and even children alone. • Substandard cases may be issued with rate ups or riders.
Additional Features on Both Plans ¡ The policy will pay 100% of covered expenses up to the Lifetime Maximum after the out-of-pocket maximum expenses are met by the insured
Additional Features on Both Plans ¡ Rx Discount Card On the Advantage Plan, while you are meeting your Rx Co-pay Drug Card deductible, if applicable, and, on both plans, for drugs not covered under the Rx benefit rider, simply present your Rx Discount Card at an affiliated network pharmacy to receive a discount on drug purchases. ¡ The Rx discount is not an insurance benefit. The Rx discount is not available for drugs purchased at pharmacies not affiliated with Express Scripts.
Additional Features on Both Plans ¡Routine Physical Exams Advantage Plan - Covered after insured 90 days; up to $150 maximum benefit per examination per covered member/spouse per benefit period (every two years), including lab tests (blood/urine) associated with the same routine physical exam. Subject to coinsurance only. Complete Plan - Covered after insured 12 months; up to $100 maximum benefit per examination per covered member/spouse per benefit period (every two years), including lab tests (blood/urine) associated with the same routine physical exam. Subject to coinsurance only. Example: Cost of physical is $200. Insured has Advantage Plan at 80/20 to $10, 000 coinsurance. In this case, carrier will pay 80% of the $200 only up to $150. The actual 80% of the $200 comes to $160, so the insured is responsible for the additional $50, which does not go toward any deductible or coinsurance stop-loss.
Additional Features on Both Plans ¡ Child Health Supervision l ¡ Pap Smear l ¡ One baseline ages 35 -39. Age 40 and over covered yearly Prostate Cancer Screening (PSA) Tests l ¡ One screening per calendar year Mammograms l ¡ Includes immunization. Specific age intervals from birth to 6 years One per calendar year for males age 40 and over Colorectal Cancer Screenings* l One screening, including sigmoidoscopies or fecal occult blood testing, every 3 years for persons at least 50 years old. *excluding Colorado All above covered subject to deductible, service deductibles, copayments and coinsurance (unless rider selected). Optional Enhanced Routine Preventive Care Benefits Rider: Covers above benefits subject to coinsurance only, with no waiting periods! Subject to age intervals as outlined above.
Additional Features on Both Plans ¡ Lab. One* is another cost containment program. It does not replace existing lab benefits. Lab. One is a fully accredited and certified laboratory which offers significant savings over other labs. At the time of service, simply request that lab work be sent to Lab. One for processing. There will be a Lab. One card sent with each insured’s policy/certificate. Lab. One will submit claims for services directly to Guarantee Trust Life or the plan administrator. If a provider is unable to collect the specimen, Lab. One has contracted draw sites available. You will receive Lab. One discounts when your lab specimens are sent to Lab. One for testing. Covered expenses are subject to calendar year deductible, coinsurance and any applicable service deductibles. Client Services: 1 -800 -750 -1253 www. laboneselect. com *Not available in all states.
Additional Features on Both Plans ¡ Initial 12 Month Rate Guarantee Initial premium rates, excluding fees, are guaranteed for 12 months. Initial premium rates may change if you move, change your plan or add/delete covered dependents
Additional Features on Both Plans ¡ 24 -Hour Occupational Coverage To be eligible for this optional Rider, the applicant and/or spouse must be: (1) A sole proprietor, partner, owner or other individual gainfully employed in an occupation eligible for the Rider; and (2) Eligible to opt out of Workers’ Compensation by their state law and have done so. This optional Rider provides benefits for injuries or sicknesses, that arise out of or in the course of employment, on the same basis as any other covered illness. Benefits are payable provided the covered person is not insured or required to be covered under any Workers’ Compensation or similar law, the expenses are incurred while the Rider is inforce and the covered person's occupation and employment status as listed on the application for this benefit has not changed after the covered person's effective date under the Rider.
Additional Features on Both Plans ¡ ¡ Family Premium Discount Preferred Health Discount Family premium discount of 5% applies when a certificate is issued with two or more eligible family members applying together. Preferred health discount of 20% applies to qualified individuals ages 18 through 39.
Additional Features on Both Plans ¡ Calendar Year Deductible Carryover Covered expenses incurred during the last three months of a calendar year that are applied to the medical plan’s calendar year deductible will also apply toward the following year’s calendar year deductible. This does not apply to the separate Rx Drug Card deductible.
Additional Features on Both Plans ¡ Common Accident Deductible If two or more covered persons sustain an injury in the same accident, only one calendar year deductible will be applied to all covered medical expenses arising out of that accident.
Additional Features on Both Plans ¡ Medical Emergencies Medical benefits for emergency services (as defined in the policy) will be considered for payment at participating provider benefit level, limited to the usual, reasonable and customary charge. Emergency services must be provided within 72 hours following the onset of the injury or illness. Medically Necessary Covered Services Not Available From A PPO Provider - and referred to a Non-PPO provider will be considered for payment at PPO level, limited to the usual, reasonable and customary charge.
Pre-Existing Conditions Limitation An illness or injury of a covered person for which the covered person has received medical advice, treatment, services, diagnostic tests, consultation or medication during the twelve (12) months prior to the covered person’s effective date of coverage under the policy. Benefits will be payable for a pre-existing condition, unless the condition is specifically excluded under the policy or excluded by endorsement or rider attached to the policy or certificate, if at the end of a continuous 12 -month period commencing on or after the effective date of the covered person’s coverage, the person has not received medical advice, treatment, services, diagnostic tests, consultation or medication in connection with such illness or injury; or, at the end of the two (2) year period commencing on the effective date of the covered person’s coverage, the person has been covered under the policy. Health conditions duly disclosed in the application for coverage of the covered person and otherwise covered by this policy, unless the condition is specifically excluded by endorsement or rider attached to the policy or certificate, are covered from the effective date of coverage under the policy.
Preferred Provider Organization (PPO) Networks The Most Extensive PPO Networks Available in the Industry: ¡ Features National and Popular Regional Networks ¡ www. gtlplans. com now displays the available PPO networks by state ¡ Each network has a link to their website, phone number and also displays Network Factor ¡ This makes it as easy as a click of your mouse to find out if your client’s physician is participating in one of the available networks
Ameri. Benefit Plan 16476 Chesterfield Airport Rd 2 nd Floor Chesterfield, MO 63017 Email: [email protected] com Phone: (888) 416 -2815
Ameri. Benefit Plan Membership* benefits include: *ABP Membership is optional in CO/GA. The above benefits, including the Accident Medical Expense Benefit, are only available to members of Ameri. Benefit Plan. ¡ ¡ ¡ Accident Medical Insurance – Choice of $1, 000 coverage with a $100 deductible or $5, 000 coverage with a $250 deductible Gym. America. com – On-line interactive exercise and diet program Vitamin and Nutritional Supplement Discounts – 15% discount on a wide range of products Hop. The. Shops. com – Cybermall featuring over 100 high quality e-tailers and stores with special discounts and features. Pre-Employment Background Reports/Investigative Services – Special discounts on these services provided by an internationally renowned investigative and consulting agency Powernet Global – Long distance rate of 4. 9 cents per minute state to state, twenty-four hours a day, seven days a week Emergency Medical Info Card – Wallet-size card provides personal medical profile in case of emergency Penny Wise Office Supplies Discounts – Up to 36% off already discounted prices on a large selection of items ITC-50 Hotel Discounts – A network of over 4, 000 hotels that offer a 50% discount Theme Park Discounts – Provides members access to discounts at theme parks
Major Competitive Advantages in Plan Benefits ¡ ¡ ¡ ¡ Physical, Respiratory and Speech Therapy for Rehabilitative Treatment – no limits Transplants – no separate maximum benefit Rx Benefit – no limits Home Health Care (in lieu of a covered hospital confinement) Up to 40 visits person per calendar year Spinal Manipulation and other Manipulative Therapy - Up to $500 maximum benefit per covered person per calendar year Covers Emergency Care received outside the U. S. – no time limits or maximums 24 Hour Occupational Coverage – no charge for those who qualify
Who are your Prospects? • Uninsureds • Offer them affordable health insurance • Insureds • Save them money • Younger ages • Affordable and comprehensive coverage • Families • Affordable for the family • Doctor office visits and Rx benefits
Field Tools To Assist You Reference Guide l Quick Reference Guide: Height and Weight Chart ¡ Ineligible Occupations ¡ New Business Guidelines ¡ Administrative Guidelines ¡ Customer Service Information ¡ Claims Information ¡
Underwriting Reviews the enrollment application. ¡ Based on answers, additional information, telephone verification or medical records may be ordered. ¡ All underwriting notes on a case are available on line so you can easily see what the case status is. ¡
Underwriting ¡ Depending on the condition of the applicant, several things can happen: l l l Case issued standard Case issued with rate up Case issued with exclusionary rider* Case pended for medical records Case declined * Note: Consumers can call into underwriting to verbally accept exclusionary riders and/or rateups!
Effective Date and Billing Information ¡ ¡ ¡ ¡ 1 st and 15 th of the month Monthly Bank Draft (automated checking debit) Monthly Credit Card (Visa or Master. Card) - $7 billing fee Monthly Direct - $7 billing fee Quarterly - $7 billing fee Semiannual - $7 billing fee List Bill (except in these states): l CO, MI, MO, TN, VA, WI
What happens after the application is submitted? ¡ After online application is submitted, the consumer is emailed a confirmation with a link to their application. ¡ The agent will be sent an email confirming we received the application, date, confirmation #, plan selected, premium amount and link to web site. ¡ The consumer email will tell them to call the 800# for the telephone verification ¡ The underwriter will automatically call the applicant for the TI if the applicant has not already called in. (5 times)
Policy Fulfillment and Issue ¡ ¡ ¡ Once the case is issued, an approval letter is sent from underwriting to the insured. The agent can check on case issuance and the date the kit was mailed via the web site. A fulfillment kit with certificate/policy, ID card, ABP brochure, welcome letter, etc. is mailed within 24 -48 hours.
On Line Tools for Submitting and Managing Business ¡ Prepare a quote proposal (view, save, print, email) ¡ Apply on line (easy process) l ¡ ¡ A confirmation email is sent to the agent and the applicant Look up your application status on line Status, notes, letters and correspondence associated with your applications are at your fingertips
Doing Business with Insurance Benefit Group is Easy ¡ On line-applications (or paper). ¡ Quick turnaround time in underwriting. ¡ Innovative web site for agents to track and manage their business. ¡ Sales tools to support your marketing efforts.
Summary l Comprehensive Coverage l Flexibility of Benefits l Competitive Rates l Easy enrollment
GTL - 4 Pillars ¡ Doc Co. Pay l l ¡ $40 Co. Pay Unlimited Visits Wellness l 5 Benefits ¡ l l ¡ ¡ Mammogram, Pap Smear, PSA Test, Colorectal Cancer Screening; Child Immunization No Deductible (Coinsurance Only) No Waiting Period Organ Transplants – no separate maximum benefit Physical, Respiratory and Speech Therapy for Rehabilitative Treatment – no separate maximum benefit