Download presentation
Presentation is loading. Please wait.
1
Supplemental Insurance Protection
SB Hospital Confinement Dir Gen Approval Date: 06/04/2014 Code : Revised: 09/25/2015 Supplemental Insurance Protection Hospital Confinement Direct Policy Form CH IP (01/10), or its state variation See Separate Presentation for State Specific Variations ©2015 SureBridge® Product Training Materials | Proprietary and Confidential. For more plan details, refer to the product materials. The benefits described in this presentation are subject to all provisions, terms, definitions, and limitations and exclusions of the applicable policy. Supplemental plans serve a specific purpose in the insurance market. These plans are not intended as substitutes for accident and sickness health insurance and should not be construed as such.
2
Supplemental Products Availability
Chesapeake’s SureBridge product suite is one of the largest supplemental insurance portfolios in the industry and includes critical illness, cancer, accident, disability income, hospital and fixed indemnity, dental and vision policies1. Chesapeake also has one of the broadest marketing footprints in the industry through its producer distribution systems. AK WA ID MT ME OR ND MN NH WI NY VT MI WY SD CA MA RI NV CT UT PA NE IA IL OH IN NJ CO WV DE MO VA KS MD HI KY DC AZ NC NM OK TN TX AR SC GA MS AL All products available Subset of products available No products available LA FL 1 Product Availability varies by state.
3
Supplemental Products Superior Client/Broker Experience
Quoting Compare packages with different combinations of supplemental products Present total price for solution Commissions Initial Premium and any application fee are taken upon policy issue Most policies issued within 24 hours Book of Business report available on your Broker Portal Application Single e-app for any combination of supplemental products Flexibility to select different products and/or benefit options for each family member on app Smart app – only the questions for the products selected are asked Simplicity – all questions are yes/no Product Brochure provided Claims Claim form provided with complete instructions for submission Claim forms are typically analyzed and adjudicated within 7 days after receipt
4
Supplemental Products Sales Pitch
Changes in the market present opportunities to sell supplemental plans During 2015, Essential Health Benefit (EHB) plans can have out-of-pocket limits as high as $6,600 for individuals and $13,200 for families (increased in 2016 to as high as $6,850 for individuals and $13,700 for families). This can leave large gaps in coverage which may be filled with supplemental plans. Advanced premium tax credits for EHB plans are available for individuals or families making up to 400% of the federal poverty level. Premium dollars saved due to premium tax credits may allow your customer to purchase supplemental insurance that can help fill gaps left by high deductibles and coinsurance on EHB plans. Number of family members Poverty Guideline for family income (as of 2015) Can still qualify for a subsidy under the ACA with an income up to 1 $11,770 X 400% $47,080 2 $15,930 $63,720 3 $20,090 $80,360 4 $24,250 $97,000 5 $28,410 $113,640 Premium dollars saved due to tax credits can be used to pay for supplemental plans and help reduce coverage gaps. Need a subsidy calculator? Try
5
Hospital Confinement Direct Sales Pitch
The Hospital Confinement Direct plan is a piece of puzzle that can help fill in gaps caused by high out-of-pocket expenses or to supplement lost wages. On the right, health insurance is supplemented by the following: Hospital Confinement Direct for hospital coverage, CancerWise®* for lump-sum cancer coverage, Accident Companion* for lump sum accident coverage Coverage Gap Health Coverage Accident Companion Cancer Wise Hospital Confinement Direct *See the appropriate training documents for more details on these other products.
6
Hospital Confinement Direct Product Comparison
Fixed Indemnity Direct Hospital Confinement Benefit Intensive Care/Cardiac Care Unit Confinement Benefit Continuous Care Benefit Outpatient Surgery Benefit Emergency Room Benefit Outpatient Diagnostic, X-Ray, and Laboratory Procedures Benefit Ambulance Benefit Physician Office Visit Benefit (on some plans) The Hospital Confinement plan is designed to provide customers a daily cash benefit for hospital or ICU confinements. For inpatient hospital care For a sickness or injury There is no annual deductible A comparison of benefits to the Fixed Indemnity Direct is shown to the right. Hospital Confinement Direct Hospital Confinement Benefit Intensive Care/Cardiac Care Unit Confinement Benefit
7
Hospital Confinement Direct Navigation
Hospital Confinement Direct is located under the Illness tab of the SureBridge Point of Sale Tool.
8
Hospital Confinement Direct Understanding Guaranteed Issue (GI) Products
Underwriting Changes Guaranteed issue (GI) products are lower benefit levels which can be selected at the point of sale for some products, including: Hospital Confinement Direct Critical Illness Direct Accident Disability Direct Income Protection Direct A customer can also check a box on the app to get a GI version of these products, should they not qualify for their original selection. These plans do not have height, weight or any medical Underwriting questions. Eligibility questions still apply, such as citizenship, income or blue or white collar. Claim Adjudication There is no impact to claims processing if a plan is guaranteed issue (GI). If a plan was subject to pre-ex or waiting periods as a non-GI plan, it is still subject to pre-ex and waiting periods as GI plan. All exclusions and limitations and other plan provisions from the non-GI plan also apply to the GI plan. State Applicability GI products are available in the following states: AL, AR, CO, GA, IA, ID, IL, IN, KS, LA, ME, MI, MO, MS, NC, NE, NH, NV, OH, OK, PA, SC, TN, TX, UT, WI, WY
9
Hospital Confinement Direct Benefit Schedule
Daily Benefits GI Option Option1 Option 2 Option 3 Lifetime Maximum 365 days (per insured) Applies to all options Waiting Period Sickness – 30 days Injury – 0 days Daily Benefit Amount $250 $500 $750 $1000 Hospital Confinement Benefit Days 1 – 5: 100% of Daily Benefit Amount Days 6-10: 50% of the Daily Benefit Amount Days 11 +: Fixed amount per day $125 $100 $375 Note Confinement means an Insured Person’s admission to and subsequent continued stay in a Hospital for which a daily charge for room and board is made for each day of Confinement with no discharge or interruption in such Hospital Stay.
10
Hospital Confinement Direct Benefit Schedule
Daily Benefits GI Option Option1 Option 2 Option 3 Intensive Care/Cardiac Care Unit Confinement Benefit Days 1-2: 200% of Daily Benefit Amount Days 3-10: 100% of Daily Benefit Amount Days 11-30: 50% of the Daily Benefit Amount Days 31 +: Fixed amount per day Note: Paid in lieu of Hospital Confinement Benefit $500 $250 $125 $100 $1000 $1500 $750 $375 $2000 Waiver of Premium Monthly premiums due for the policy will be waived after the primary insured has been hospital confined for at least 30 consecutive days. Applies to all options Pre-Existing Condition Limitation Yes
11
Hospital Confinement Direct Claims Example
Jenny Heart, age 43, had a car accident. Jenny fractures her skull, suffers a concussion, and has multiple contusions. Due to the fracture in her skull, Jenny is confined in the hospital for 7 days. She spends the first and second day in an ICU room to monitor for swelling of the brain and spends the third through seventh days in a regular hospital room. Luckily, in addition to her bronze level EHB health insurance, Jenny has a Level 3 Hospital Confinement Direct plan. Paid By SureBridge Plan (1st - 2nd day) $4,000 (3rd – 7th day) BILL After PPO Discounts ICU Room (1st - 2nd Day) Hospital Room (3rd – 7th Day) $6,000 $4,500 Paid By Health Plan $0 $4,150 Out of Pocket $6,000 $350 The Bronze EHB plan only paid $4,150, leaving Jenny OOP $6,350. SureBridge paid $8,000, covering the gap left by the EHB plan and giving Jenny money to help with her lost wages. $6,350 $8,000
12
Hospital Confinement Direct Renewability
The policy is guaranteed renewable to age 65, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.
13
Hospital Confinement Direct Hospital Confinement Direct FAQs
New Business and Underwriting This product cannot be sold with another Hospital Confinement plan offered by CLICO. Minimal application questions apply to this product. Claim Payment Cash benefit to the member – no assignment of benefits. No coordination of benefits with any health plans. No network of providers. Maternity is not covered. Average claim processing time is 7 business days unless an additional review is conducted for provisions of the coverage (i.e. pre-existing, etc.)
14
Hospital Confinement Direct Underwriting Quick Reference
Question Summary Applies to Hospital Confinement Direct Applies to Hospital Confinement Direct GI Applicants Info, Height/Weight Per Height Weight Chart - Abnormal test results Yes Impending test Cancer history: full HIV AIDS Prescription ADL (Activities of Daily Living) Cholesterol/Blood Pressure Mental Diseases or Disorders Heart Brain and Circulatory System Renal System Endocrine System Organ Transplant Important Information Summarized questions are based on the generic 2015 application. See the Hospital Confinement Direct section of the Chesapeake Underwriting and Product Guide for detailed application question information.
15
Hospital Confinement Direct Pricing Examples
Rates can change. These rates come from the generic brochure dated August 2015 CH HP CON DIR 815. The chart below is only an illustration of benefit and premium options per covered person for plans. Premiums may vary by state. Monthly Premiums¹ GI Option Option 1 Option 2 Option 3 30 Year old Male $6.36 $10.17 $15.25 $20.34 30 Year old Female $4.99 $7.98 $11.97 $15.96 45 Year old Male $12.81 $20.49 $30.74 $40.99 45 Year old Female $9.88 $15.80 $23.70 $31.60 Sample ¹ The chart above is only an illustration of benefit and premium options per non-tobacco covered person. Premiums may vary by state.
16
Hospital Confinement Direct
This presentation is not inclusive of all policy provisions. See product materials and/or state-specific training presentation for complete details and any additional state variations regarding Termination of Coverage, Renewability, Premium Changes, Eligible Dependents, Exclusions and Policy Definitions. SureBridge® is a registered trademark used for both insurance and non-insurance products offered by subsidiaries of HealthMarkets, Inc. Supplemental insurance products are underwritten by The Chesapeake Life Insurance Company®. Administrative offices are located in North Richland Hills, TX. SureBridge products are individual supplemental products and are not available as group coverage. This material cannot be copied or used in any way for advertising or presentation purposes. THIS POLICY PROVIDES LIMITED BENEFITS. This type of plan is not considered “minimum essential coverage” under the Affordable Care Act and therefore a Hospital Confinement Indemnity Insurance Policy does not satisfy the individual mandate that you have health insurance coverage. This is not Medicare Supplement Insurance. Benefits may vary by state. See state variations and product materials for more detail.
17
Hospital Confinement Direct Thank You For Everything You Do!
Hospital Confinement Indemnity Insurance Policy
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.