Bundling UHOne STM and Fixed Indemnity

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Presentation transcript:

Bundling UHOne STM and Fixed Indemnity Welcome to the UnitedHealthcare 2015 ACA Health Insurance Plans webinar. November 15, 2014 marks the beginning of open enrollment for the 2015 ACA health plans. Individuals and families will need assistance from brokers like you as they shop for a health plan that fits their family’s need. Today we’ll talk about the 2015 ACA on-exchange health plans, state availability, and related information that can help you prepare for Open Enrollment. This presentation will last approximately 45 minutes. It has been placed in “listen only” mode so you can hear the information without background interruptions. Let’s begin.

When is 2 + 2 more than 4? When it’s UnitedHealthOne’s Health Protector Guard indemnity plan plus their short term 3x2 Combining these two plans gives access to a nationwide network of 6,000 hospitals and an average 50% claims discount Also offers security of comprehensive coverage. One plan offers first-dollar reimbursement of claims, while the other protects against the big expenses Total cost is much less than major medical coverage

Why Choose Us? Carrier Strength UHC Brand, Size & Strength Industry Experience Highly Rated Reliable & Recognized Top Tier Networks “Persistency Pays”

Short Term Medical

Short Term Medical Benefits Nationwide UHC Network: 1 Million Health Care Professionals 6,000 Hospitals Up to 50% average discount % No balance billing Flexible portfolio: Multiple Plans, Deductible, Coinsurance & Premium Choices No unnecessary benefits: Not Minimum Essential Coverage Simplified Underwriting: Primarily yes or no questions Next-day Effective Date Apply Anytime: No OEP/SEP Enrollment Periods Affordability Network driven competitive pricing

Short Term Medical by the Numbers $173 $104 1.67 Average premium Average premium per member Average members per policy 2.2 months Average duration of coverage Updated as of 1/22/18

Health Protector Guard

What has made HPG so successful? HPG Differentiators The application consists of approximately 20 questions, and is issued on an Accept or Reject basis. Medical records are not required for review, however Underwriting will rely on the application and the verification call. Your client must be able to answer “NO” to all medical questions. Before your client’s policy can become effective, the client is required to answer a few questions with representative from plan’s support administrator, the Loomis Company. Verification phone calls are conducted on all applications. Your client should allow 24 hours from the time the application was submitted before calling. The phone number and call instructions will be provided in your client’s “Application Received” email. Application reviews are typically completed within 3-4 days after the verification call has been completed. What has made HPG so successful? Built in retention benefits Rollover doctor office benefit (up to 5 per year) Increasing Injury reimbursement benefit Up to $5,000 daily inpatient hospitalization benefit ICU benefits pay in addition to daily inpatient benefit (not in lieu of) Four-tiered surgical payout schedule Allows maximization of surgical benefit payout (versus more common used flat amount) The UHC brand & product persistency The recognition of our name/brand helps with sales & persistency UHC isn’t going to put their name on a product unless the product is high quality Average persistency of HPG is currently modeling out at 12+ months! Other carriers are typically stating 9-10 months Spend your time writing NEW customers and not re-writing same customers

What does HPG cover? No lifetime maximum benefit Pre-x covered after 12 months Use any doctor/hospital No coordination of benefits with other forms of insurance Client is paid a fixed amount for covered services regardless of other health insurance they do/don’t have Age 18-64 eligibility High commission and bonus earnings potential Contact The Brokerage for more compensation details

Doctor Visits New Rollover Benefit How it works Choice Value Choice Plus Select Value Primary Preferred Select Preferred Select Plus Premier Plus Dr. Office Visit/ Urgent Care Plan pays: $100 (2 visits) (5 visits) $100 (10 visits) 2nd Surgical Opinion $250 (1 day) $500 New Rollover Benefit How it works Members can roll over up to 5 unused doctor office visits to next year’s available benefits. Plans with effective dates prior to July 1 may roll over up to 5 unused doctor office visits per person to next year’s benefits.

Wellness | Preventive Care Visits Annual physical examination; Pap smear Mammogram Blood screening including, Prostate antigen testing, Colorectal screening Immunizations, other than a flu shot; Routine non-surgical cancer screening tests such as mammography or digital rectal examination; or Blood screenings including but not limited to prostate-specific antigen testing. Choice Value Choice Plus Select Value Primary Preferred Select Preferred Select Plus Premier Plus Wellness/ Preventive benefits Plan pays: $100 (1 day) $200 $250 Eligible Covered Expenses How it works Pap Smear Mammogram Immunizations PSA testing Colorectal screening 6 month waiting period Benefits are per calendar year Per person

Pharmacy Drug Discount Card RX benefits 12 fills per calendar year Choice Value Choice Plus Select Value Primary Preferred Select Preferred Select Plus Premier Plus Outpatient Prescriptions Plan pays: Discount Card only Generic: $20 Brand: $40 12 fills/year Generic: $10 Drug Discount Card RX benefits National Prescription Savings Network Up to 75% savings Ready for member to use RX plan benefits not required Discount program only 12 fills per calendar year Member submits claim Reimbursement paid to member PDL: searchrx.com/UHO or Call 81-877-890-8077

Hospital Services | Inpatient Choice Value Choice Plus Select Value Primary Preferred Select Preferred Select Plus Premier Plus I/P - Illness Plan pays: $1,000 $2,000 $3,000 $4,000 $5,000 I/P Injury Year 1 I/P Injury Year 2 $1,250 $2,500 $3,750 $6,250 I/P Injury Year 3 $1,500 $4,500 $6,000 $7,500 I/P Injury Year 4 $1,750 $3,500 $5,250 $7,000 $8,750 I/P Injury Year 5+ $8,000 $10,000 Intensive Care Unit or Critical Care Unit per day (31 days) (60 days) ICU/CCU benefit amounts are in addition to I/P Hospital Confinement Benefits. Physician Visit per day during I/P Confinement $100 (1 visit/day) Emergency Room per day (maximum per calendar year) $200 (2 visits) $300 $400 $500

Health Protector Guard Benefits Example Client Scenario #2 30 year old male in Orlando, FL 32804 Emergency Room Visit with outpatient testing resulting in: Hospital Confinement for 35 days (15 days in ICU) & Inpatient (Tier 2) Surgery Benefit Category Choice Value Plus Select Primary Preferred Select Preferred Premier Emergency Room Visit (1 day) $200 $300 $400 $500 Outpatient Diagnostic Test $100 IP Hospital Conf. (35 days) $35,000 ($1,000/day) $70,000 ($2,000/day) $105,000 ($3,000/day) $140,000 ($4,000/day) $175,000 ($5,000/day) ICU Confinement (15 days) $30,000 ($2,000) $60,000 ($4,000) $90,000 ($6,000) $120,000 ($8,000) $150,000 ($10,000) Inpatient Physician Visits (3) $300 ($100) Inpatient Tier 2 Surgery $5,000 Total Benefit Paid $70,700 $135,700 $200,900 $175,700 $210,700 $266,000 $331,100 Plan Premium $60.23 $90.32 $102.14 $104.15 $113.06 $141.75 $156.96

Health Protector Guard by the Numbers $151 $231 1.5 Average Monthly Premium Per Person Average Monthly Premium Per Policy Average Members Per Policy 33 50/50 Average Issue Age Average % by gender of Applicants Updated as of 1/22/18

Bundle Example (Husband & Wife, age 35, 75057 zip) $168.15 $300.71 STM Value ($12,500 ded, $5K coinsurance HPG Select Value ($3K/day hospital) $468.86 Total cost $791 for a Bronze, $910 for a Silver Plan Updated as of 1/22/18

Commission to the Broker Bronze $9,492 annual premium x 3% = $284.76 annual comm. Silver $10,920 annual premium x 3% = $327.60 annual comm. Short Term Major Med $168.15 x 27% = $45.40 Hospital Protector Guard $300.71 x 35% = $105.24 Total Monthly Commission $150.65 x 12 months = $1,807.78 $1,480.20 more annual commission to the agent Saves client $5,293.68 per year in Silver plan premium Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

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