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CONFIDENTIAL Dan Christoffers and Annette Dahlke March 6, 2013.

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Presentation on theme: "CONFIDENTIAL Dan Christoffers and Annette Dahlke March 6, 2013."— Presentation transcript:

1 CONFIDENTIAL Dan Christoffers and Annette Dahlke March 6, 2013

2 CONFIDENTIAL Today’s Agenda Meet GoHealth  Who We Are  GoHealth Facts  Benefits of Joining Our Team HII Product Training  Product Suite  Application process  Benefits of selling short-term major medical  How to get appointed through GoHealth VMO  How you can get $200 with your first issued HII policy! Q & A

3 CONFIDENTIAL GoHealth Facts  Founded on July 9 th, 2009  Currently Over 3,500+ Producing Agents  $175M in issued premium 2012  2 nd largest insurance distributor in the country  1M visitors per month to GoHealthInsurance.com  250K qualified leads generated per month  Provided to GoHealth agents to incentivize production

4 CONFIDENTIAL HII Available on the Norvax QE

5 CONFIDENTIAL National Third Party Administrator & Reinsurer Home office located in Tampa, Florida 30 years in business Went public – NASDAQ February 8 th !! Developer of proprietary niche insurance products; STM, Fixed Indemnity & Ancillaries Administrator for technology, billing, commission, compliance, broker service & customer service Offer 12 month Short Term plans in 40 states All of our STM carriers are A or A+ rated with AM Best Companion Life, Starr Indemnity, Markel 400% organic growth since passage of Health Reform About Health Insurance Innovations

6 CONFIDENTIAL 12 MONTH SHORT TERM MEDICAL AFFORDABLE BRIDGE PLAN FROM NOW TO 2014

7 CONFIDENTIAL Impact of Health Care Reform on Major Medical Plans Perfect storm for major medical plans: 80% Medical Loss Ratio (MLR) Expensive mandated benefits; 100% preventive care, guarantee issue children, no lifetime maximums Guarantee acceptance for all starting in 2014 Underwriting rate ups increasing and placement rates decreasing Impact to Agents: Comp for distributors cut in half Monthly premium rates for consumers doubling Preferred rates: 36%, Standard rates: 30% and Higher than Standard Rates: 34% (according to AHIP; averages for all carriers) Closing rates & taken rates dropping like a rock 12 month short term plans: exempt from Health Care Reform (ACA)

8 CONFIDENTIAL STM Exemption HII STM products exempt from ACA Law: § 300gg–91. Definitions Group health plan… (5)Individual health insurance coverage “the term “individual health insurance coverage” means health insurance coverage offered to individuals in the individual market, but does not include short term limited duration insurance.” For more information see Appendix C

9 CONFIDENTIAL 2013 Strategy: Bridge to 2014 2013 Strategy for 12 Month STM Affordable bridge plan to 2014 30-50% less expensive than major medical Risk of buying a temporary policy is mitigated starting 1-1-2013: Obamacare requires all major medical carriers to accept any pre- existing conditions in 2014 Families with kids: HII 12 month STM plans are $50-$100 less per month than major medical for each child 25% higher taken rates than major medical: 7 yes/no questions Commissions 2-3 times higher than major medical plans

10 CONFIDENTIAL Source: “The Requirement to Buy Coverage Under the Affordable Care Act Beginning in 2014 ” Kaiser Family Foundation 2012 and HII Company management.Note: The penalty is pro-rated by the number of months without coverage, though there is no penalty for a single gap in coverage of less than 3 months in a year. The penalty cannot be greater than the national average premium for Bronze level coverage in an Exchange. After 2016, penalty amounts are increased annually by the cost of living. STM plans not expected to qualify as coverage under Healthcare Reform STM plans will still provide an attractive alternative to IMM coverage to a large portion of the U.S. population Cost of HII product + penalty significantly less than exchange-based policies for a broad range of incomes Open enrollment Oct-Dec – STM plans will provide an affordable gap solution Short-Term Medical Insurance in 2014 and Beyond 2014 Penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1.0% of family income, whichever is greater. 2015 Penalty is $325 per adult and $162.50 per child (up to $975 for a family) or 2.0% of family income, whichever is greater. 2016 and Beyond Penalty is $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of family income, whichever is greater.

11 CONFIDENTIAL Comparison of Exchange-Based Health Insurance Plans to HII's STM Calculations assumes family of four (2 adults age 40, 2 children) $12,000 annual cost for exchange-based Bronze plan The cost of HII’s STM product offers significant savings, even after tax penalties are fully phased-in in 2016 Source:Kaiser Family Foundation and HII Company management. (1)Net of $2,579 government subsidy. (2)12-month SRM policy; 80% coinsurance ($5,000 coinsurance maximum); $2,500 deductible; insured by Companion Life. Note:Maximum tax penalty for not buying a qualified health plan: 1% of household income in 2014, 2% of household income in 2015, 2.5% of household income in 2016.

12 CONFIDENTIAL Unique Affordable Solution Unique advantaged of HII’s Short Term Medical Plans: Up to 12 months coverage Doctor office copays Lowest cost in most markets (best seller on eHealth) Unlimited re-applies in most states Full first year compensation on re-apply 85% placement rate (submitted, issued & stick for 30 days) 4 or 7 question app with instant e-approval and e-policy / ID cards 44 states E-signature or voice signature ½ cost of major med enables huge increase in ancillary sales Dental, Accident, Critical Illness, Cancer, Life Insurance, etc.

13 CONFIDENTIAL 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 Borderline Decline Cases – Write short term Early retirees; age 63-64 Medicare guarantee issue plan at 65 In between jobs (temps, part-time, seasonal, new hire waiting period) Key Market – self-employed; contractors, small business owners

14 CONFIDENTIAL Rate Comparison Post Health Reform Husband, 43; Wife, 42; with 4 children living in Indianapolis, IN 46123 Leading Online Health Insurance Quoting Company: Best Seller Anthem BCBS $2,500 deductible 80/20 plan: $956.56 monthly

15 CONFIDENTIAL Rate Comparison Post Health Reform Husband, 43; Wife, 42; with 4 children living in Indianapolis, IN 46123 Leading Online Health Insurance Quoting Company: Best Seller: HII: Med Plus Short Term Medical plan $2,500 deductible 80/20 plan: $215.99 per month

16 CONFIDENTIAL Tradeoffs What are the tradeoffs? HII Short Term Medical plan is $740.57 less per month than the BCBS plan. What are the tradeoffs for saving $740.57 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 Are the tradeoffs worth $8,886.84 in annual savings? Survey says 50-60% choose 12 month STM when all of the facts are fully disclosed

17 CONFIDENTIAL Out of Pocket Maximum & Bankruptcy in US Case Study: Rick & Amy Stone 30 year old husband & wife with 2 kids in Dallas, TX 75201 Household income: $50K (US average) Lives paycheck to paycheck and only has $3,800 in savings (US average) Facts about Bankruptcy in U.S. 62.1% of all bankruptcy’s filed were related to medical illness 78% of those individuals had health insurance The average out of pocket expenses that led to bankruptcies were $17,943 (includes: deductibles, coinsurance, uncovered services, etc.)

18 CONFIDENTIAL Leading Major Medical Best Sellers: OOP Max & Cost DeductibleCoinsurance Total Out of Pocket (per person/per year) Monthly Cost (super preferred rate) $5,000 70/30 to $5,000 out of pocket coinsurance max $10,000$480.44 $7,500 70/30 to $5,000 out of pocket coinsurance max $12,500$406.82 $10,000 70/30 to $5,000 out of pocket coinsurance max $15,000$350.63

19 CONFIDENTIAL HII 12 month Companion Life STM: OOP Max & Cost Add Accident Medical Expense benefit of $3,000 = $39.95 Add Colorado Bankers Critical Illness benefit of $50,000 for husband/wife = $34.96 DeductibleCoinsurance Total Out of Pocket (per person/per year) Monthly Cost (for anyone who qualifies) $2,500 80/20 to $1,000 out of pocket coinsurance max $3,500$330.23 $5,000 80/20 to $1,000 out of pocket coinsurance max $6,000$280.27

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

21 CONFIDENTIAL Impact on Rated Up Major Medical Plans Husband & Wife age 40 in Dallas, TX 75201 HII 12 month Short Term Major Medical: $5,000 deductible 80/20, $50 copay (No rate ups) 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 $478.300$565.74$694.30 Which plan will fit their budget? Field underwrite; if your client is heading toward higher than preferred rates offer 12 month STM to save the case

22 CONFIDENTIAL 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.

23 CONFIDENTIAL 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, WA, WV, WI, AND WY

24 CONFIDENTIAL 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.Coverage periods of up to 12 months at a time* 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

25 CONFIDENTIAL Med Plus Short Term Medical - Benefits Exclusive Features (continued): *$10,000 AD&D included for primary member Mammogram 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

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

27 CONFIDENTIAL 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, MN, MS, NE, NH, NM, OH, OK, PA, RI, SD, TN, TX, VA, WV, WI, AND WY

28 CONFIDENTIAL 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

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

30 CONFIDENTIAL 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

31 CONFIDENTIAL 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.

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

33 CONFIDENTIAL Cross-Selling Technology – MedPlus, 1 st Med, and Sensible

34 CONFIDENTIAL For Agent Use Only Cigna Alliance Innovative Partnership: Strategic Alliance with Cigna Supplemental Benefits creates more comprehensive healthcare solution Simplified Issue offers competitive advantage when sold with STM or LM 15 different critical illnesses trigger lump sum cash payout Underwritten by: Loyal American Life Insurance Company, a subsidiary of Cigna Corporation

35 CONFIDENTIAL For Agent Use Only Product Details Simplified Issue (Yes/No questions): NO MIB Check NO Medical Exam NO Medical Records NO Verification NO Rx Check Sold as stand-alone or add-on Health based CI: Guarantee renewable until age of 75. (Not a term plan)

36 CONFIDENTIAL Face Amounts Pays a lump sum cash benefit if client is diagnosed with any of the 15 critical illnesses listed in the policy Benefit Amounts available from: $10,000 - $50,000** Add-on*: $10,000 $20,000 $25,000 $50,000 *If you want to do an add-on in increments that is not on the pre-select page, you can do it as a stand-alone with no additional charges or set up fee ** Benefit amounts may vary by state Stand-alone* : $10,000 $15,000 $20,000 $25,000 $30,000 $40,000 $50,000 This policy is guaranteed renewable to age 75

37 CONFIDENTIAL What Does This Policy Cover? Three Benefit Categories Each of the three categories has a per category maximum benefit (selected at time of application). Cancer Heart/Stroke Conditions Other Critical Illness

38 CONFIDENTIAL Now Available Phase I - AK, HI, IA, MS, NV, NC and WI. Now available with effective date February 1, 2013 Phase II – AL, OH, OK, TN, WV Now available with effective date April 1, 2013 Phase III - KS, NE, KY, ME, ND, RI, VT, DE, WY Phase IV – All other states

39 CONFIDENTIAL Sample PHCS PPO Discounts

40 CONFIDENTIAL Dear First Last, Please be advised your Med Plus STM insurance coverage, underwritten by Starr Indemnity & Liability Company, ID#: STT1234567, Effective 11-11-1111, is scheduled to terminate on 11-11-1111. 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: https://www.hiiquote.com.link.link.link.linkhttps://www.hiiquote.com.link.link.link.link 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 www.hiiquotecustomers.com login. www.hiiquotecustomers.com Feel free to call our Customer Service Department 1-877-376-5831 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 https://www.hiiquote.com.link.link.link.link.linkhttps://www.hiiquote.com.link.link.link.link.link CC: yourname@youragency.net, adahlke@hiiquote.com, slingle@hiiquote.comyourname@youragency.netadahlke@hiiquote.comslingle@hiiquote.com Automatically sent 15, 10 & 5 days prior to expiration Sent to client and agent Typical re-apply rate is 30% to 50% Agent earns 100% of 1 st year comp STM Renewal E-Mail

41 CONFIDENTIAL Easy access to direct quote, underwriting questionnaire and payment processing. QUOTE & PAY Quoting Process

42 CONFIDENTIAL Innovative Electronic Sales Platform, allows your clients to Quote their Short Term Medical, Buy and Print their policy documents and ID cards in real time. Insurance Application w/ Medical History Q&A, Selected Options, Agreement and Agent Information Welcome Letter and ID Card Schedule of Benefits Quote-Buy-Print

43 CONFIDENTIAL Member Fulfillment Immediately after purchase, the member will receive an email 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 fulfillment arrives 3-5 days later Health Essentials Welcome letter and ID cards Freedom Welcome Email Call customer service for hard copy

44 CONFIDENTIAL 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, WA, WV, WI, and WY. 1 st Med STM (Companion): AL, AK, AZ, DE, DC, FL, ID, IL, IA, KS, KY, MS, NE, NM, OK, PA, RI, TN, TX, VA, WV, WI and WY.

45 CONFIDENTIAL Most competitive states for HII 12 month short term plans 1.Washington 2.Colorado 3.Texas 4.Oregon 5.Indiana 6.Arizona 7.Florida 8.Ohio 9.Illinois 10.Wisconsin 11.Missouri 12.Georgia 13.Nevada 14.Pennsylvania 15.South Carolina States with Best Pricing

46 CONFIDENTIAL Top Deductibles/Coins By Product

47 CONFIDENTIAL Advantages of Selling HII’s Short Term Medical Reach consumers who can’t afford Major Medical; 50% less expensive Reach consumers who can’t qualify for Major Medical; 25% higher taken rates No underwriting/ instant issue: no exclusion riders or rate ups to hassle with The HII online apps is 7 questions and takes 5 minutes vs. 30 minutes with Major Medical Instant issue with instant e-delivery of policy and ID cards vs. up to 30 day underwriting time service with Major Medical Automated email sent to client & agent to re-apply. When customer re-applies you earn 100% first year compensation. Because the price of 12 month short term plans are 50% less it is much easier to cross- sell ancillaries which pay much higher comp


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