HEALTH INSURANCE INNOVATIONS Short Term and Limited Med Annette Dahlke National Account Executive Office: 813-397-1197.

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Presentation transcript:

HEALTH INSURANCE INNOVATIONS Short Term and Limited Med Annette Dahlke National Account Executive Office:

Who is Health Insurance Innovations Niche Markets Cross Selling Short Term Products Limited Med Products Health Insurance Innovations

About Us MGU, Third Party Administrator & Reinsurer 30 years experience; founder previously owned HPA & sold to IHC Developer of proprietary niche insurance products Administrator for technology, billing, commission, compliance, broker service & customer service Best in class online quoting, applications, instant issue & policy cards Home office located in Tampa Florida Fully licensed in 50 states

HII’s partners both underwrite and distribute products. HII has several partnerships with “A” to “A++” A.M. Best rated carriers with over One Billion in assets including: Companion Life Starr Indemnity & Liability Co. United States Fire Insurance Co. US Health Group Markel Insurance Co. Security Life Insurance Co. ING Carrier Partners

The Largest Underserved Market Customers Who Can’t afford Major Medical purchase individual health policies Are Uninsured Of the 45M are Uninsurable Choose not to purchase primarily due to Unaffordability Source – Kaiser Family Foundation; “survey of people who purchase their own insurance”, June 2010

Challenges of HealthCare Reform For the Individual Health Market Consumer Rates will likely double between now and 2014 to price for guarantee issue Affordability problem is getting worse Between now & 2014: underwriting getting tighter More rate ups Higher not taken rates

Unique Affordable Solution Unique advantages of HII’s Short Term Medical Plans: Up to 12 months coverage (in most states) Doctor office copays Lowest cost in most markets Unlimited re-applies in most states 95% placement rate 7 or 5 question app with instant approval and ID cards 44 states including states with limited supply; OR, CA, HI, RI, NH, ME E-signature or voice signature

Rate Comparison Post Health Reform 43 Husband, 42 Wife with 4 children living in Indianapolis, IN Source eHealthInsurance.com: Best Seller Anthem BCBS $2,500 deductible 80/20 plan: $ per month

Rate Comparison Post Health Reform 43 Husband, 42 Wife with 4 children living in Indianapolis, IN Source: eHealthInsurance.com Best Seller: HII: Med Plus Short Term Medical plan $2,500 deductible 80/20 plan: $ per month

Tradeoffs HII Short Term Medical plan is $ less per month than the BCBS plan. What are the tradeoffs for saving $ per month? Short term coverage vs. permanent You can re-apply but the plan in not automatically renewable Short term does not cover pre-existing conditions for past 5 years Preventative care is not covered – Exceptions MedPlus Wellness - Indiana - Mammography; one or more a year as recommended by a Doctor for women at risk; one baseline for any woman inclusive; one every other year for women inclusive; one every year for women 50 or older. Coinsurance percentage, not subject to deductible. -Routine Child Healthcare from birth to age 16. Includes a history, physical examination, developmental assessment, anticipatory guidance and appropriate immunizations and laboratory tests. Coinsurance percentage, charges subject to the deductible with the exception of immunizations. 1 st Med – Indiana No mandates

Plan Comparison - STM vs. MM 43 husband, 42 wife and 4 kids in Indianapolis, IN HII Med Plus STM Premier $2,500 deductible 80/20 coinsurance = $ BCBS Premier Plus $2,500 deductible 80/20 coinsurance = $ EHealthInsurance.com Only one MM plan under $300 with a $10,000 deductible and mainly hospital/surgical coverage $ /Mo

Niche Markets for STM Consumers who can’t afford major medical HII STM plans are 50% less expensive Offer alternative 12 month STM to 30 day old prospects Review your old leads Children Only Plans – age 2 to 18 Maternity; husband & kids Borderline Decline Cases 95% placement STM vs. 65% placement Major Med Early retirees; age Medicare guarantee issue plan at 65 In between jobs (temps, part time, seasonal, new hire waiting period)

Individual Medical Insurance Consumer Filter

Major Medical Rating Process Source: AHIP, A Comprehensive Survey of Individual Health Policies, 2009

Impact on rated Up Major Medical Plans Husband & Wife age 40 in Dallas, TX HII 12 month Short Term Major Medical: $5,000 deductible 80/20, $50 copay Popular Major Medical plan: $5,000 deductible 80/20, $35 copay Preferred rating (36% of applicants) Popular Major Medical plan: $5,000 deductible 80/20, $35 copay Standard rating (29% of applicants) Popular Major Medical plan: $5,000 deductible 80/20, $35 copay Higher than Standard rating (34% of applicants) $347.84$ $ $ Which plan will fit their budget?

#1 concern for a consumer considering a 12 month STM plan as an affordable alternative to major medical; “What happens if I get cancer in month 12?” Now that the Supreme Court has upheld ACA/ObamaCare; major medical carriers’ are required to accept all individuals regardless of their health starting in 2014….the risk is mitigated. Clients have a safety net in Starting in 2013 it will be a “no brainer” for most consumers to choose a 12 month STM as an affordable alternative priced 30-60% less than the expensive government mandated major medical plans. 12 month STM: Affordable Bridge Plan to

Health Insurance Coverage of the Nonelderly Population Current US Population (July 2012): 311M * SOURCE: KCMU/Urban Institute analysis of 2011 ASEC Supplement to the CPS. Employer Sponsored Insurance 56%* = 174M Uninsured 18.50%* = 57M Medicaid/Other Public 19.80%* = 61M Private Non-Group 5.5%* = 17M

* SOURCE: :How US Health Care Reform will Affect Employee Benefits” Mckinsey and Company Employer Sponsored Insurance 26%* = 81M Uninsured 18.50% = 57M Medicaid/Other Public 19.80% = 61M Private Non-Group 35.5%* = 110M + 30% Health Insurance Coverage of the Nonelderly Population 30% from Employee Sponsored to Private Non-Group Current US Population (July 2012): 311,591,917

The Short Term Medical Family at HII Health Insurance Innovations offers the following 3 Short Term Insurance plans through the Med-Sense Guaranteed Association. Not all states require participation in the association, please refer to state availability chart for exact state coverage.

Med Plus Short Term Medical Underwritten by: Starr Indemnity and Liability Company Starr Indemnity & Liability Company (Starr Indemnity) provides customized property and casualty insurance and accident & health insurance products together with accompanying loss control, claims management, administrative and reinsurance services to its policyholders. Starr Indemnity has an A. M. Best financial strength rating of A (Excellent). AL, AK, AZ, AR, CO, DE, DC, FL, GA, HI, IL, IN, IA, KY, LA, MA, MS, MO, MT, NE, NV, NM, ND, OH, OK, OR, PA, SC, SD, TN, TX, VA, WV, WI AND WY

Med Plus Short Term Medical - Benefits Exclusive Features: Up to $2,000,000 Lifetime Maximum per Covered Person Coverage periods of up to 12 months at a time* Dr. Office & Urgent Care Center Visits - $50 Co-Pays, not subject to the deductible or coinsurance, up to 3 per covered person Deductible options: $250, $500, $1,000, $2,500, $5,000, $7,500 or $10,000 Coinsurance Options: 50% or 80% up to Coinsurance max of $5,000 or $10,000 Foreign travel up to $25,000 after $250 deductible Outlook Vision discount, average discounts 10% to 50%. Over 10,500 provider locations (All 50 states and Puerto Rico) *Not available in all states

Med Plus Short Term Medical - Benefits Exclusive Features (continued): *$10,000 AD&D included for primary member *$500 Accident Medical Expense included No limited to the number of covered accidents per covered period. Coverage is for primary member only Cover Mammograms SS# is required Freedom to choose any doctor or hospital Network Discounts – inpatient/outpatient hospital PHCS If an uncovered expense, they will also receive the discount on the outpatient/inpatient facility charges if they use a network provider. *Not available in all states

MedCare USA Prescription Discount Card 4-tier and 100% of discounted price at participating pharmacies. Because it is a discount program there are: NO claim forms NO reimbursement procedure NO pre-existing NO waiting periods NO benefit maximums Members receive an average of 15% off retail price of many brand name and up to 54% on generic prescriptions. All three short term plans have this discount card. Rx – Discount Card

Medical and Eligibility Questions Only 7 easy YES or NO questions Client can complete application process in 5 minutes Instantly

1 st Med Short Term Medical Underwritten by: Companion Life Insurance Company Companion Life Insurance Company is a customer-focused organization acting in the best interest of it’s policy holders and marketing partners, earning them an A.M. Best rating of A+. AL, AK, AZ, CO, DE, DS, FL, ID, IL, IN, IA, KS, KY, LA, MI, MN, MS, NE, NH, NM, OH, OK, PA, RI, SD, TN, TX, VA, WV, WI, AND WY

1 st Med Short Term Medical - Benefits Exclusive Features: Up to $2,000,000 Lifetime Maximum per Covered Person Coverage periods of up to 12 months at a time* Unlimited Dr. Office & Urgent Care Center Visits – after a $50 Co-Payment the coinsurance will apply – deductible will not Deductible options: $250, $500, $1,000, $2,500, $5,000 or $7,500 Coinsurance Options: 50% or 80% up to Coinsurance max of $5,000 *$25,000 AD&D – association states - ING Cover mammograms Freedom to choose any doctor or hospital Network Discounts – inpatient/outpatient hospital PHCS If an uncovered expense, they will also receive the discount on the outpatient/inpatient facility charges if they use a network provider. Outlook Vision discount, average discounts 10% to 50%. Over 10,500 provider locations (All 50 states and Puerto Rico) 3 day wait for sickness No SS# required *Not available in all states

Medical and Eligibility Questions Only 5 easy YES or NO questions Client can complete application process in 5 minutes Instantly

Sensible Med Short Term Medical Underwritten by: Markel Insurance Company Markel Corporation is an international property and casualty insurance holding company headquartered in Richmond, VA. Focusing on specialty products and niche market strategy has enabled the company to develop expertise and specialized market knowledge. This has awarded Markel with a rating of “A” (Excellent) by A.M. Best. CA, CO, CT, KS, MN, NH, ND, RI, SD, UT, AND WA

Sensible Med Short Term Medical - Benefits Exclusive Features: Up to $1,000,000 Lifetime Maximum per Covered Person Doctor office and urgent care visits subject to deductible and coinsurance Coverage periods of up to 6 months at a time Deductible options: $250, $1,000, $2,000, $3,000 or $5,000 Coinsurance Options: 50% or 80% up to Coinsurance max of $10,000 Outlook Vision discount, average discounts 10% to 50%. Over 10,500 provider locations (All 50 states and Puerto Rico) Mammograms and Pap Smears (not subject to the deductible) Freedom to choose any doctor or hospital PPO re-pricing for hospitals and physicians - PHCS They are eligible for a discount on all services, whether covered or non- covered, if they use a network provider.

Medical and Eligibility Questions Sensible Only 5 easy YES or NO questions Client can complete application process in 5 minutes Instantly

#1 Advantage of HII Short Term The #1 way for agents to earn a profit post health reform is by cross- selling ancillaries Negative underwriting decisions with major medical often blow up both your base medical deal & your ancillary deals Stop losing 25-30% of your medical & ancillary deals to adverse underwriting decisions 31

Bundling Ancillary Products The Options Page is a one click shopping for bundling health insurance products.

Extra Care Package Exclusive Features: Careington POS Dental Discounts Average annual savings of $1,200 per family on dental work Over 62,000 providers nationwide Save 20% to 50% on most dental procedures including routine oral exams, unlimited cleanings, and major work such as dentures, root canals, and crowns. Call MD CallMD members have 24/7 access to connect with a consulting physician or specialist Medical doctors available for consultation and may write a prescription for a non-narcotic or non-controlled medication at anytime day or night. Member can use CallMD services 12 times per year. Better Living Now Medical & Diabetic Supplies CareNet 24 Hour Nurse Line Direct Labs Cost $19.50 $29.00 Member + one $29.00 Family

Accident Medical Expense and AD&D Benefits Freedom Access -Offers the following Benefits add on to Short Term: Benefit ScheduleAME $1,000 $29.95 AME $3,000 $39.95 AME $5,000 $49.95 AME $10,000 $59.95 Lifetime Cert Maximum$5,000$15,000$20,000 Medical Expense Max Benefit Per Covered Ins Per Accident $1000$3,000$5,000$10,000 Excess Med Expense Deductible Per Insured Per Accident $100$200$250 AD&D Max per Accident Loss of Life Loss of two of more Limbs Loss of Speech and Loss of Hearing (both Ears) Loss of Sight (both Eyes) Loss of one Limb Loss of Speech Loss of Hearing (both Ears) Loss of one Hand Los of Hearing (one Ear) Loss of Thumb and Index Finger (same Hand) $2, % 50% 25% $2, % 50% 25% $2, % 50% 25% $2, % 50% 25%

Critical Illness, ER and In-Hospital Benefits Freedom Access Offers the following Benefits: Benefit ScheduleChampion In-Patient Hospital Benefit Daily Confinement Days per calendar year $ Hospital Emergency Room Visits per year Visits per calendar year $1,000 1 Blanket Critical Illness Benefit Rider Maximum Critical Illness Benefit per Insured$2,500 The Maximum Critical Illness Benefit is paid if an Insured has a First Occurrence and Definitive Diagnosis of a Specified Critical Illness while covered under the Blanket Group Indemnity Insurance Policy

Critical Illness, ER and In-Hospital - Rates Freedom Access Monthly Membership CostChampion Member Only$52.99 Member + One$ Family$ Monthly admin fee $7.00

United Teachers Associates (UTA) United Teacher Associates (UTA) is the underwriter of the “First Diagnosis Cancer” plan UTA’s First Diagnosis Cancer Benefit Policy A lump Sum benefit Cancer policy payable on first diagnosis of internal cancer or malignant melanoma. Benefit amounts are state specific and range from $10,000, $25,000 and $50,000*. Issue ages 2- to 84**. *$25,000 minimum in KS (Reduced benefits after age 65 in FL & PA) ** 20 to 64 in CA and 20 to 65 in FL

Policy Description UTA’s First Diagnosis Cancer Benefit Policy Policy Features: The benefit is paid direct in one lump sum Pays regardless of any other insurance Guaranteed renewable for life Premiums do not increase when moving to a higher age bracket Premiums will be based on the age of the oldest insured Coverage is available for Individuals, Single Parent, or Family Dependent Children are covered to age 21, unless they are enrolled as a full time student, then coverage is extended to age 25, or until date of marriage

After the base plan quote has been agreed on by your client, the selection to include this coverage will be available in Health Insurance Innovations Options Page in your links for business. If the client qualifies for the Short Term Medical underwriting questions including: Height and Weight Social Security Number 1 more additional cancer related question the Cancer plan will be also available to them. Who qualifies and how do they apply?

Customer Payments The customer is charged immediately during the purchase of the plan. The Extra Care Package becomes available on the 1st day of the month following the day the application was submitted Monthly payments will be processed on the same day each month but shown as separate purchases. The Extra Care Package is charged separately and processed on the 28th of every month and will continue to be billed monthly until it is cancelled by the customer Ancillary Products will continue to be billed after the STM terms, the customer will need to cancel if they no longer wish to continue their membership

HII Short Term Coverage can begin as early as 12:01 am the day after submission or up to 60 days forward One time payment, can choose the days (minimum of 30 days). Draft premium immediately Single and monthly payments (credit card, debit card & ACH) Termination date of policy Extension of benefits if hospitalized (refer to the cert) 60 day if MedPlus 90 day if Companion

Member Fulfillment Immediately after purchase, the member will receive an with log in information where they instantly have access to: Enrollment Form Fulfillment Kit and Association Guide Welcome letter and ID Card Schedule of Benefits Certificate of Insurance (where applicable) RX ID Card US Mail arrives 3-5 days later Health Essentials Welcome and fulfillment packet Freedom Welcome and fulfillment packet

Member Online Services Members have the ability to log in and change payment information, print ID cards.

STM State Availability – 6 vs. 12 months 12 Month States Med Plus STM (Starr): AL, AK, AZ, AR, DE, DC, FL, GA, HI, IL, IN, IA, KY, MS, MO, NE, NM, OK, PA, SC, TN, TX, VA, WV, WI, and WY. 1 st Med STM (Companion): AL, AK, AZ, DE, CD, FL, ID, IL, IA, KS, KY,, MS, NE, NM, OK, PA, RI, TN, TX, VA, WV, WI and WY.

Re-apply Rates Annual Persistency: Major Medical annual persistency with call center: 55% Major Medical annual persistency with MGA field agents: 65% Short Term Medical persistency with 12 month HII Short Term Medical: 60% Re-apply rates: Average re-apply rate for HII 12 month short term with just our auto- program sent to both client & agent = 30% Average re-apply rate for HII 12 month short term for call centers who proactively make calls to help customers re-apply: 50% Unlimited re-applies in most states How does Short Term Medical retention and re-apply rates compare to Major Medical?

STM Renewal Dear First Last, Please be advised your Med Plus STM insurance coverage, underwritten by Starr Indemnity & Liability Company, ID#: STT , Effective , is scheduled to terminate on This insurance coverage is important and you can reapply for another period of coverage with the convenient link provided below. This link enables you to quote your own plan options and apply online. However, you will have a new effective date and a new preexisting conditions clause will apply. Click Here: If you purchased the Extra Care Package (ECP), your payment for the ECP will continue to be processed on the same day of the month. The ECP includes the Careington Dental Network Discounts & Services, and CallMd services for Physician Telephone Consultations 24/7 – that includes 12 free physician telephone consultations per year. These plus the other benefits are listed in your Extra Care Package fulfillment booklet, found at your login. Feel free to call our Customer Service Department with any questions. PS: Some states have rules related to the ability to reapply. See list below: Colorado: We cannot issue coverage to anyone who has had 3 or more STM policies in the last 12 months. Maine: If you combined your policy with all prior short term policies, it cannot exceed 12 months on uninterrupted coverage. Michigan: Your coverage cannot exceed 185 days in any 365 day period. Nevada: We cannot issue 3 or more policies in a 12 month period. AGENTS LINK CC: Automatically sent 15,10 and 4 days prior to term date Sent to both client and agent When client or agent completes the application it’s considered new business. Typical re-apply rate is 30% to 50%

Top States CompanionStarr TX FLWA PAFL OHCO AZSC MNGA KSIN COOH INPA VAAZ ILOR LAIL WIMO MILA

Production by Plan Companion Coinsurance DeductibleCoinsuranceMaximum / / / / / / Starr Coinsurance DeductibleCoinsuranceMaximum / / / / / / / / / Top Deductibles/Coins By Product

Platinum Health Essentials Freedom Access

Limited Med Product Markets Cannot secure traditional health insurance due to health conditions Declines Want to supplement coverage customer who already has: High deductible and out of pocket Traditional insurance to expensive Need insurance coverage immediately

Who is the Carrier – Limited Medical – Health Essentials United States Fire Insurance Company Division of Crum & Forster $1 Billion in capital Founded in 1896 Main lines – property & casualty Nationally licensed Rated A (excellent) by A.M. Best Product Available (36 states) – AL, AZ, AR, CA, CO, DE, DC, FL, HI, ID, IL, IN, IA, KY, LA, MN, MS, MO, NE, NV, NM, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, WV, WI, AND WY

Limited Med Product Description –Health Essentials Guaranteed issue – ages Basic 500, Plus 750, Choice 1000, Max 1500 In Hospital Services – indemnity payout $500, $750, $1,000, $1,500 Surgery, anesthesia, lab, Xray, ER benefits based on in hospital choice Doctor Office Visits $65 for all options … Max 1500 you get $75 5 visits per year for illness/injury 1 visit per year for wellness Accidental Injury $2,000 Maximum number of injuries per year 2 Deductible per accident $100 Pre-x 12 months prior to effective date of coverage are not covered 12 months following the effective date of the covered person’s limited medical indemnity benefits. This applies ONLY to Hospital semi-private room, Hospital ICU/CCU, Surgery and Anesthesia Benefit.

Limited Med Product Description –Health Essentials MedCare drug discount card included in product Waiting periods – none for accidents, 30 days for sickness Use ANY doctor or hospital ◦ Multiplan network to receive additional discounts ◦ Discounts are on in network providers and hospitals. ◦ This would include non-covered claims from network providers/hospitals. AD&D benefit built in - $10,000 for primary insured Extra care package upsell opportunity Monthly payments – Credit or debit card, ACH Vision discount card included No social security # is required (must be legal resident of the US for the past 12 months) Reimbursement to the client

Platinum Health Essentials - Limited Medical Benefit Grid – Pg 1 Benefits Per Covered Person Platinum Basic 500 Platinum Plus 750 Platinum Choice 1000 Platinum Max 1500 Waiting Periods Accidental Injuries Sickness None 30 Days None 30 Days None 30 Days None 30 Days Pre-Existing Conditions Applies to Hospital Semi-Private Room, Hospital ICU/CCU, Surgery and Anesthesia Benefits only. Conditions existing up to 12 months prior to effective date of coverage are not covered for 12 months following date of coverage 12/12 Inpatient Hospital Indemnity Maximum Amount Per Day Maximum Days per Policy Year $ $ $1, $1, Surgery Inpatient Outpatient Maximum allowable Surgery Per Policy Year $1,000 1 $1,500 $750 1 $3,000 $1,500 1 See Surgical Schedule Anesthesia Inpatient Outpatient Maximum Per Year NA $225 $150 1 $450 $200 1 See Surgical Schedule

Platinum Health Essentials - Limited Medical Benefit Grid – Pg 2 Benefits Per Covered Person Platinum Basic 500 Platinum Plus 750 Platinum Choice 1000 Platinum Max 1500 Doctor Office Visits (Injury or sickness) Benefit Maximum Per Policy Year $65 5 $65 5 $65 5 $75 5 Doctor Office Visit (Wellness) Benefit Maximum Per Policy Year NA $65 1 $65 1 $75 1 Diagnostic X-Ray Labs Maximum Per Visit Maximum Visits Per Policy Year NA $50 5 $50 5 $75 5 Emergency Room Visits Maximum Per Visit Maximum Visits Per Policy Year $50 1 $50 1 $50 1 $50 1 Ambulance Maximum Per Visit Maximum Visits Per Policy Year $50 1 $50 1 $50 1 $50 1

Platinum Health Essentials - Limited Medical Benefit Grid – Pg 3 Benefits Per Covered Person Platinum Basic 500 Platinum Plus 750 Platinum Choice 1000 Platinum Max 1500 Accidental Injury Maximum Benefit Amount Per Injury Maximum Number of Injuries Per Year Deductible Per Accident $2,000 2 $100 $2,000 2 $100 $2,000 2 $100 $2,000 2 $100 Accidental Death and Dismemberment Principal Amount Covered Spouse Covered Dependent $10,000 $5,000 $2,500 $10,000 $5,000 $2,500 $10,000 $5,000 $2,500 $10,000 $5,000 $2,500

Who is the Carrier – Limited Medical – Freedom Life Ins Company National Foundation Life Ins Company Founded in 1956 UsHealthGroup partner for claims Serving over 15 million customers Paying more than $1B in claims Underwrites many of the hottest products in the call center/agency environment Products available –AL, AK, AZ, AR, CA, CO, DE, DC, FL, GA, IL, IN, IA, KY, LA, MI, MS, MO, MT, NE, NV, OH, OK, PA, SC, TN, TX, VA, WV, AND WY

Limited Med Product Description – Freedom Access Guaranteed issue – ages Ultra, Deluxe, Preferred, Classic, Quality and Champion In hospital daily indemnity payout – $1,500, $1,000, $750, $500, $250, $100 Waiting periods – none for accidents or sickness Surgery, anesthesia, lab, x-ray, wellness, ER & ambulance benefits based on in hospital choice. Dr. office indemnity payout ranging from $ 50 to $100 a year (5/year) Outlook vision discounts Outpatient RX Careington upsell opportunity

Limited Med Product Description - Freedom Use ANY doctor or hospital – Multiplan network to receive additional discounts – Discounts is on in network providers and hospitals. – This would include non-covered claims from network providers/hospitals Monthly payments – Credit or debit card, ACH No social security # is required (must be a legal resident of the US for the past 12 months. Reimbursement to the client

Freedom Access - Limited Medical Benefit Grid – Pg 1 Benefits Per Covered Person UltraDeluxePreferredClassicQuality Waiting Periods Accidental Injuries Sickness None Pre-Existing Conditions Conditions existing up to 12 months prior to effective date of coverage are not covered for 12 months following date of coverage 12/12 Inpatient Hospital Indemnity Maximum Amount Per Day Maximum Days per Policy Year $1, $1, $ $ $ Surgery Benefit Varies by Procedures Maximum allowable Surgery Per Policy Year $100 to $10,000 2 $60 to $6,000 2 $40 to $4,000 2 $40 to $4,000 2 $40 to $4,000 2 Anesthesia Percentage of Surgical Procedure Maximum number of Procedures per Calendar Year 20% 2 20% 2 15% 2 15% 2 15% 2

Freedom Access - Limited Medical Benefit Grid – Pg 2 Benefits Per Covered Person UltraDeluxePreferredClassicQuality Doctor Office Visits (Injury or sickness) Benefit Maximum Per Policy Year $100 5 $100 5 $75 5 $50 5 $50 5 Health Screen Benefit (Wellness) Benefit Maximum Per Policy Year $100 $50 None $0 None $0 Outpatient Prescription Drug Benefit Benefit per Prescription - Generic Benefit per Prescription - Brand Maximum Prescriptions per Calendar Year $10 $20 25 $10 $20 25 $10 $0 25 $10 $0 25 $10 $0 25 Emergency Room Visits Maximum Per Visit Maximum Visits Per Policy Year $200 1 $200 1 $100 1 $100 1 $100 1 Ambulance Ground Ambulance Maximum Number of Ground Trips per Calendar Year Air Ambulance Maximum Number of Air Trips per Calendar Year $100 1 $100 1 $100 1 $100 1 $100 1 $100 1 $100 1 $100 1 None 0 None 0

Freedom Access - Limited Medical Benefit Grid – Pg 3 Benefits Per Covered Person Platinum Basic 500 Platinum Plus 750 Platinum Choice 1000 Platinum Max 1500 Blanket Critical Illness Benefit Maximum CI Onetime, lump sum Benefit Per Insured$2,500 As a MSGA member with Freedom Access Limited Medical Fixed Indemnity benefits, you cannot be disqualified or turned down for the benefits of this program due to any pre-existing condition. The membership does have a 12 month waiting period before you will be eligible for any payable benefits under the scheduled medical benefit health plan for any condition that is pre-existing. However, if you had prior Creditable Coverage and are able to provide a valid Certificate of Creditable Coverage from your previous carrier, your waiting period may be reduced according to the length of time you were covered under your previous plan. Creditable Coverage is coverage that is qualified as a HIPAA eligible plan (most commonly individual health insurance or group insurance) for which there has not been a break in coverage of 63 days or more. Association membership coverage and scheduled medical benefit plans do not qualify as HIPAA eligible coverage. Short term DOES count.

Med-Sense Guaranteed Association ID Resolutions Identity Theft Service Gateway Medicard Vitamin Discount LenseCrafters Vision Club 24 hour Roadside Assistance Travel Assistance Plan Savers Club Book Office Depot Office Supplies and Furniture Floral Discounts Discount Hearing Service Carperks Buying Network Customized Web Services UPS Express Delivery Services Sprint-Wireless/Cellular and Mobile Broadband Car Rental Discounts GymAmerica.com Hewlett-Packard Computer and Digital Equipment Members of the MSGA enjoy savings on $100s and even $1,000s on Health, Travel and Lifestyle discounts:

10 Day Free Look Period Health Insurance Innovations offers members to review their purchased memberships for a period of ten days after their effective date. The member shall receive a full refund of membership fees if membership is cancelled within those first 10 days. For cancellations the member sill need to call Hii’s Customer Service, phone calls are recorded for quality assurance: Customer Service phone number: and follow the prompts.

Questions?? Thank you!