Download presentation
Presentation is loading. Please wait.
1
Supplemental Insurance Protection
SB Income Protection Dir Gen Approval Date: 05/30/2014 Code : Revised: 09/25/2015 Supplemental Insurance Protection Income Protection Direct 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
Income Protection Direct Sales Pitch
The Income Protection Direct plan is a piece of the puzzle to 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: Income Protection Direct for, a monthly total disability benefit, Hospital Confinement Direct* for hospital coverage, Critical Illness Direct* for lump sum illness coverage for qualifying events. Coverage Gap Health Coverage Critical Illness Direct Income Protection Direct Hospital Confinement Direct *See the appropriate training documents for more details on these other products.
6
Income Protection Direct Product Comparison
The Income Protection Direct plan is designed to provide a Monthly Total Disability benefit if the insured becomes Totally Disabled within 30 days of an Illness or Injury while covered under the policy and is Actively at Work: Must be Actively at Work Medical advice, consultation or treatment must commence within 30 days of the Sickness or Injury which caused Your Total Disability Total Disability for a full month provides for the lesser of The Monthly Indemnity Benefit; or 60% of the insured’s gross prior monthly income Total Disability for a partial month is 1/30 per day of the Monthly Indemnity Benefit For Illness or Accidents A comparison of benefits to the Accident Disability Direct is shown to the right. Income Protection Direct Accident Illness Accident Disability Direct Accident Only
7
Income Protection Direct Navigation?
Income Protection Direct is located under the Disability tab of the SureBridge Point of Sale Tool.
8
Income Protection 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
Benefit cannot exceed 60% of gross monthly earnings.
Income Protection Direct Benefit Options vs. Average Gross Income (AGI) Annual Gross Income Maximum Monthly Indemnity Benefit that can be selected $0 - $19,999 No coverage available1 $20,000 - $29,999 $500, $1000 $30,000 - $39,999 $500, $1000, $1500 $40,000 - $49,999 $500, $1000, $1500, $2000 $50,000 and over $500, $1000, $1500, $2000, $2500 Benefit cannot exceed 60% of gross monthly earnings. 1Important Note: If you do not meet the minimum income requirements, you still cannot get guaranteed issue coverage.
10
Income Protection Direct Benefit Schedule
GI Option Option1 Option 2 Option 3 Option 4 Availability Ages 19-60 Benefit Options Due to Injury or Sickness that occurs after the effective date of coverage Must be Actively at Work Medical advice, consultation, or treatment must commence within 30 days of the Sickness or Injury which caused Your Total Disability Total Disability for a full month provides for the lesser of The Monthly Indemnity Benefit; or 60% of the insured’s prior gross monthly income Total Disability for a partial month is 1/30 per day of the Monthly Indemnity Benefit $500 $1,000 $1,500 $2,000 $2,500
11
Income Protection Direct Benefit Schedule
GI Option Option1 Option 2 Option 3 Option 4 Availability Ages 19-60 Maximum Period Payable Options Selected independent of Benefit Amount Benefit continues through end of Maximum Period Payable selected as long as Total Disability continue 12 Month 12 or 24 Months Elimination Period Options 90 Days 14 or 30 Days
12
Income Protection Direct Benefit Schedule
Ages 19-60 Waiver of Premium When an insured has been continuously disabled as defined for 90 days and receiving benefits, future premiums will be waived for the remainder of the disability period. Insured must resume premium payments within 31 days when no longer eligible for waiver of premium to keep coverage in force. Recurrent Disability When the insured is disabled after a Period of Total Disability and has not been actively at work for at least 6 months following the end of the preceding disability, New elimination period not required Subject to the Maximum Period Payable that started with the preceding Period of Total Disability If the Maximum Period Payable has ended, no benefits will be payable for a recurrence Concurrent Disability If a Total Disability is caused by more than one injury or sickness, benefits are paid as only one injury or sickness Pre-Existing Condition 1 Year
13
Income Protection Direct Claims Example
Jenny Heart, at age 45, was diagnosed with Stage III Breast Cancer. Although Jenny had been going for her annual mammograms and one had required additional review by a pathologist, this was her first diagnosis of internal cancer. As a result, a surgery was performed and she was treated with chemotherapy and radiation for the next 12 months. After she was released from the hospital, Jenny was unable to work for the 12 months following her surgery and also while she received her chemotherapy and radiation treatments. Luckily for Jenny, she has an Option 4 Income Protection Direct plan to supplement her Bronze EHB health insurance. The Bronze EHB plan paid $50,150, leaving Jenny OOP $6,350 in medical expenses. Jenny’s monthly benefit did not exceed 60% of her gross monthly so SureBridge paid Jenny $30,000 over the 12 month period and waivered her premium for 9 of the 12 months. This amount covered the gap left by the EHB plan and gave Jenny $30,000 to help with her lost wages and other incidental expenses such as her mortgage and car payment. Paid By SureBridge Plan Outpatient Surgery Facility Surgery Radiation $3,000 $2,500 $30,000 $20,000 TOTALS $1,000 BILL After PPO Discounts $0 $30,000 $20,000 $50,150 $150 Paid By Health Plan Out Of Pocket $3,000 $2,500 $0 $6,350 $850 Anesthesia Anesthesia Chemotherapy Chemotherapy $6,350 $30,000
14
Income Protection 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.
15
Income Protection Direct Income Protection Direct FAQs
New Business and Underwriting Cannot be sold with another Income Protection Direct or Accident Disability Direct offered by CLICO. Claim Payment Cash benefit paid to the member on a monthly basis – includes coordination of benefits with Worker’s Comp, Employer Disability and Social Security Disability. 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.) Initial benefit requires completed disability form* signed by the Member, Physician, and Employer. Ongoing benefits require follow-up treatment plan by the Physician. *Form with complete instructions can be found in the Member’s policy packet and online through the Member Portal.
16
Income Protection Direct Underwriting Quick Reference
Important Information Summarized questions are based on the generic 2015 application. See the Income Protection Direct section of the Chesapeake Underwriting and Product Guide for detailed application question information. Question Summary Applies to Income Protection Direct Applies to Income Protection Direct GI Applicants Info, Height/Weight Per Height Weight Chart - Occupation/duties of Primary Applicant Yes Occupation/duties of Spouse Applicant Abnormal test results Impending test Felony activity Cancer history: full HIV AIDS Prescription ADL (Activities of Daily Living) Cholesterol/Blood Pressure Mental Diseases or Disorders Question Summary Applies to Income Protection Direct Applies to Income Protection Direct GI Heart Brain and Circulatory System Yes - Renal System Endocrine System Organ Transplant Primary unemployment Yes – Primary Spouse/domestic partner unemployment Primary income See Income Rules Spouse/domestic partner income Spine joint surgery Disability claim history Disability prone
17
Income Protection Direct Pricing Examples
Rates can change. These rates come from the generic brochure dated August 2015: CH INC PROT DIR 815. The chart below is only an illustration of benefit and premium options for plans. Premiums may vary by state. Monthly Premiums¹ GI Option Option 1 $1,000 Option 2 $1,500 Option 3 $2,000 Option 4 $2,500 30 Year old Male (White Collar) $12.54 $21.51 $33.17 $45.20 $57.60 30 Year old Female (White Collar) $17.39 $29.82 $46.00 $62.68 $79.87 30 Year old Male (Blue Collar) $31.21 $53.53 $82.56 $112.50 $143.35 30 Year old Female (Blue Collar) $43.28 $74.23 $114.48 $156.00 $198.78 45 Year old Male (White Collar) $18.89 $32.40 $49.98 $68.10 $86.78 45 Year old Female (White Collar) $23.41 $40.15 $61.92 $84.38 $107.51 45 Year old Male (Blue Collar) $47.02 $80.65 $124.39 $169.50 $215.98 45 Year old Female (Blue Collar) $58.26 $99.92 $154.11 $210.00 $267.58 Sample
18
Income Protection 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 Disability Income 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.
19
Income Protection Direct Thank You For Everything You Do!
Disability Income Insurance Policy
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.