1 INDIANA Short-Term Policy for Individuals & Families from UNICARE Life & Health Insurance Company (Product Training Course) -Effective: May 15, 2003 Version 1.3

2 Who Needs Short-Term Coverage? Those who need immediate coverage: Between jobs After graduation While waiting for permanent coverage Employees currently satisfying an employer waiting period

3 Who Is Eligible? Most residents of Indiana and a resident of the United States for at least 6 months Age 15 days to 64 1/2 years Qualified dependents as follows:

4 Who Is Eligible? The following are considered qualified dependents: 1.Legally married spouse of the applicant 2.The applicant’s child(ren), adopted child(ren) or stepchild(ren) between ages of 15 days and 19 years old 3.The applicant’s unmarried child(ren) or stepchild(ren) between the ages of 19 and 23, if they are full-time students

5 Short-Term Plans Offer Coverage from 30 to 180 days Choice of 4 PPO deductibles: $250, $500, $1000 or $2000 per member Easy application process and FAST issue Streamlined underwriting Choice of providers Pharmacy benefits

6 Short-Term Plan Features $2,000,000 Lifetime maximum per person $1000/member Out-of-Pocket Maximum (plus deductible) Participating & Non-Participating Providers Combined Non-renewable policy, however, if need still exist after termination of initial policy the applicant may re-apply for another STP. Max of 2 elections of the STP. After 2 elections the applicant must wait 6 months to apply for another STP.

7 Short-Term Plan Covers UNICARE pays 80% after deductible is met for comprehensive in-network benefits or 60% of reasonable charges after deductible for out-of- network benefits, including : Emergency Care Ambulance ($ maximum) Hospital Inpatient and Outpatient Services Professional Services, X-ray and Lab work Office Visits

8 Short-Term Plan Prescription Benefit Generic Drugs No limit $15 Co-pay (30-day supply) Brand-Name Drugs Maximum benefit of $1,000 per member $ Deductible (per member) 60% (30-day supply)

9 Benefits Not Covered or Limited (Please review “Exclusions & Limitations” in the Policy booklet.) Short-Term Plan Does Not Cover –Normal Pregnancy or Maternity Care –Preventive Care (except for mammograms) –Hospice Care –Mental, emotional or nervous disorders Short-Term Plan Limits include (subject to deductible): –Ambulance ($ maximum/insured) –Brand Name Prescriptions ($500 separate deductible & maximum $1000 per insured) –Physical & Occupational Therapy and/or Acupuncture (max 6 visits) –Skilled Nursing Facility ($200 per day up to 50 days per policy) –Home Health Care (maximum 30 visits with authorization)

10 Portability for Clients Leaving Group Coverage Note on Portability for the Client Leaving a Group Plan – A requirement for HIPAA eligibility is that a client has been most recently covered under an employer plan. –The Short-Term Plan is NOT an employer plan –Therefore, coverage under this Short-Term Plan will make a person ineligible for a HIPAA guaranteed issue plan.

11 The Role of the Agent Requirement: Client MUST be able to answer all health- related application questions “No”: If any health question is answered “YES” the policy will not be issued. Agent’s Next Steps Calculate full premium based upon the per day rate for the length of coverage and type of policy (i.e. Single, Family, etc.) Decide on the method of payment ( i.e., VISA, MC, Discover Card or check)

12 The Role of the Agent How to calculate the premium…………. 1. Identify the Zip code of your client’s residence address; 2. Choose the deductible; 3. Find age range of the applicant* on effective date to determine the “per day rate”; then 4. Multiply per day rate by number of days selected. *Use age of older spouse for Family plans and the age of youngest child for Children-only policies.

13 The Role of the Agent –Leave the client a conditional receipt; –verify answers to the health questions; –if payment method selected is check, mail the application and premium check to UNICARE in custom color preprinted envelope; –or submit via fax if client used the credit card payment method.

14 What if the Need for Short-Term Coverage Continues? Short-Term coverage is non-renewable Your client may apply for additional Short-Term coverage after his or her policy expires. Your client may elect a total of 2 Short-Term policies with less than 6 months lapse in between. After that, there is a mandatory 6-month waiting period before your client can take out another Short Term Policy.

15 What Happens After You Submit the Application? The UNICARE Membership Department validates Application information Full premium payment is enclosed or authorized Coverage becomes effective At 12:01 a.m. the day after the U.S.Postal Service postmark date stamped on the envelope or date client specifies after the signature date Client receives a plastic ID card first then Policy booklet with specification page in a 2 nd mailing.

16 Commissions UNICARE pays 15% broker commissions on STP sales. Each sale adds ½ point toward conference qualifications. The STP was created to help your clients by providing options for coverage in times of need. Make your sales efforts more productive by cross-selling this new plan with other products you currently market.

17 Thank you for Attending!