1. Solutions For The Individual Market For Anthem Producers
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

2. Why Specialty Products with Anthem/IHC
Volatile individual major medical market has increased demand for alternatives
Short term medical sales have increased by 134% each year since 2014
Limited medical plan sales have increased by 147% each year since 2015
With decreased ACA plan options for 2018, the sales outlook for STM, limited medical and other ancillary plans look positive
© IHC Group 2017

3. The Anthem/IHC Partnership Brings Solutions to Producers and Consumers
Multiple product options that can be custom tailored to fit the need and budget of the prospect
Products that are easy to understand and easy to sell
Products that can be quoted and enrolled by the producer quickly and efficiently
Products that are in heavy demand in virtually every market
Products that allow a producer to generate a lucrative income stream
We’ll explore each of these bullets during this presentation…..
© IHC Group 2017

4. Who Does What?
Some but not all of these offerings are privately labeled with the Anthem logo IHC and it’s third-party affiliate partners do all aspects of administration to the plans offered through the Anthem/IHC partnership
© IHC Group 2017

5. The Product Line Up Fixed Indemnity Fixed Indemnity + STM
Short Term Medical plans (STM)
Critical Illness / Accident
Rx Benefits
Telemedicine
Dental
These products are not qualifying health coverage (“Minimum Essential Coverage”) that satisfies the health coverage requirement of the Affordable Care Act. If you don't have Minimum
Essential Coverage, you may owe an additional payment with your taxes. The termination or loss of this policy does not entitle you to a special enrollment period to purchase a health
benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. These products may include a pre-existing condition exclusion provision.
© IHC Group 2017

6. Interim Coverage Short Term Medical
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

7. Top Reasons Individuals Buy Interim Short Term Medical Coverage
They can buy it any time
they want
They only need coverage for
a short period of time
Short Term Medical costs less
than a traditional ACA plan
They like the ability to see any
medical provider or facility
They are buying coverage for
the things that are important
to them
Availability of next-day
coverage
© IHC Group 2017

8. Coverage Benefits Interim Coverage
Office visit copay
The number of copays available is determined by the selected plan duration
$50 copay per visit
Deductible
Family deductible is 3x the individual deductible
$1,000
$1,800
$2,500
$5,000
Coinsurance percentage
Out-of-pocket
Does not include the plan deductible, precertification penalties or expenses not covered
20%
30%
50%
$2,000
$3,000
$4,000
$1,500
$4,500
$6,000
$7,500
$10,000
Maximum Benefit per policy period
$2 million
© IHC Group 2017

9. Coverage Benefits Interim Coverage 2.0
Office visit copay
The number of copays available is determined by the selected plan duration
$50 copay per visit
Deductible
Family deductible is 3x the individual deductible
$1,000
$1,800
$2,500
$5,000
$10,000
Coinsurance percentage
Out-of-pocket
Does not include the plan deductible, precertification penalties or expenses not covered
20%
30%
50%
$2,000
$3,000
$4,000
$1,500
$4,500
$6,000
$7,500
Maximum Benefit per policy period
$2 million
© IHC Group 2017

10. Just How Affordable is Interim Short Term Medical Coverage?
ACA Plan vs. Short Term Medical
Male, 37 years old*
ACA Plan
(Silver)
Deductible
Monthly Premium
$5,000
$388.29
$2,750
$567.06
Short Term
Medical
Deductible
Monthly Premium
$5,000
$115.66
$2,500
$139.28
Zip code + effective date
These products are not qualifying health coverage (“Minimum Essential Coverage”) that satisfies the health coverage requirement of the Affordable Care Act. If you don't have Minimum Essential Coverage, you may owe an additional payment with your taxes. The termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period. These products may include a pre-existing condition exclusion provision.
© IHC Group 2017

11. Interim Coverage Eligibility
Primary insured up to age 65
A spouse between the ages of 18-65
Dependent children under the age of 26
Child-only plans are available for children ages 2-18
© IHC Group 2017

12. Interim Coverage Duration
Coverage can be purchased in durations between 30 – 90 days
Coverage may be rewritten in most states – rules and policies vary by state. If a policy is rewritten, new pre-existing condition limitations and deductibles/out-of-pocket will apply
© IHC Group 2017

13. Interim Coverage Producer Compensation
18% paid monthly
Commission may vary by state
*Enrollment (if any) and monthly admin fee not included
© IHC Group 2017

14. Brought to you by: Anthem and The IHC Group
Fixed Benefit Plan
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

15. Top Reasons Individuals buy the Fixed Benefit Plan
They can buy it any time
they want
They are looking for a
permanent insurance plan
Fixed Benefit Plans cost less
than a traditional ACA plan
They like the ability to see any
medical provider or facility
They are buying coverage for
the things that are important
to them
They are looking for first
dollar benefits with no
front end deductible
© IHC Group 2017

16. Fixed Benefit Plan - Limited Medical Plan
Highlights & Features:
Three plans to choose from
Pays fixed-benefit amounts to protect against covered medical expenses resulting from hospitalization, surgery, chemotherapy and radiation services
Guaranteed renewable; an insured cannot be singled out for a rate increase or cancellation based on health
Inpatient surgical service benefits covered up to $6,000
Outpatient surgical services covered up to $3,750
Enroll anytime! Fixed Benefit Plan does not have open enrollment periods
© IHC Group 2017

17. Fixed Benefit Plan Inpatient Benefit Example
$12,250
$ 5,875
Difference = $6,375
Theoretically a check back to insured since price wasn’t equal or greater
than total benefits paid!
*Medical cost data provided by Health Care Blue Book ( Blue Book prices illustrated is based on the national average discounted fees that providers accept as payment from insurance companies (i.e. PPO Discounted Prices). Healthcare Bluebook example is based on procedures performed in Pinellas County, FL, Zip
© IHC Group 2017

18. Fixed Benefit Plan Sample Rates
40 year old female in Indianapolis, IN
Plan 1
Plan 2
Plan 3
$103.77
$168.61
$234.40
* For illustrative purposes only. Rates as of
© IHC Group 2017

19. Verification Call is Required for Fixed Benefit Plan
At the conclusion of the application process, the applicant will be instructed to call to complete the application process
The call typically takes about two to three minutes
If the applicant does not call, outbound verification calls will be made to the applicant
Among others, the following questions will be asked:
Did you or your spouse, if applying for coverage, sign or authorize the use of your name(s) as valid signatures on the application?
Do you or your spouse, if applying for coverage, now adopt the electronic signatures on the application as your own?
Do you understand and accept that coverage being applied for is a Fixed Indemnity Hospital and Surgical Limited Benefit Plan and is not major medical coverage or a Medicare Supplement plan, and that it is not an ACA qualified "Obamacare Plan"?
If V-Call does not take place, application does not go into effect
© IHC Group 2017

20. Fixed Benefit Plan Producer Compensation
20% paid monthly
Commission may vary by state
*Enrollment (if any) and monthly admin fee not included
© IHC Group 2017

21. Balance Critical Illness & Accident Plans
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

22. Balance
Guaranteed issue product that complements your clients medical plan
Provides a package of insurance coverage, services and discounts, including:
Critical Illness
Medical expenses due to accidents
Hospital confinement due to accidents
Disability income due to accidents
Doctor on Demand
Association based non-insurance services such as emergency road-side reimbursement and legislative hotline
Insurance benefit payments go directly to your client unless assignment to a medical provider is requested
Association membership in Communicating For America, Inc. (CA) is required
© IHC Group 2017

23. Top Reasons Individuals buy the Balance Plan
They can buy it any time
They can use the payments that
they receive for anything they
wish
It’s affordable
They like the ability to see any
medical provider or facility
They don’t like or can’t afford
their ACA deductible
They are looking for first dollar
benefits with minimal front
end deductible
© IHC Group 2017

24. Balance Benefits
Individual monthly cost of no more than $65; family monthly cost of no more than $110
Critical illness benefits up to $10,000
Accident Disability Income Insurance up to $1,000 per month for primary insured
Accident Hospital Confinement benefits are available for up to 30 days when hospital confined due to a covered injury
Deductible for covered accidents ranging from $100-$500
Payments may be assigned to providers or paid directly to insured
Critical illness and accident plans assist in funding out-of-pocket costs or daily living expenses
© IHC Group 2017

25. Balance Rates Monthly Cost Balance One Balance Two Three Four
(Effective date: 11/1/17)
Balance One
Balance
Two
Three
Four
Individual
$34.95
$44.95
$54.95
$64.95
Family
$51.95
$69.95
$89.95
$109.95
*Rates do not vary by zip code, age or gender
© IHC Group 2017

26. Balance Producer Compensation
26% paid monthly directly from IHC
Commission may vary by state
© IHC Group 2017

27. Brought to you by: Anthem and The IHC Group
Product Bundling
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

28. Why Bundle Products? Let’s see an example.. It’s good for the insured
Multiple coverages help minimize out of pocket exposure and helps cover them for the benefits that matter to them
It’s good for the producer
By helping your client you are helping your commission revenue stream
It’s common
Over 50% of the short-term medical sales IHC received this year were sold with another IHC product
It’s easy
How easy? If you can click a mouse you can product bundle
Let’s see an example..
© IHC Group 2017

29. Product Bundling Example – For the Customer
Short term medical is commonly sold with the Balance product
Not a bad rate, but he
isn’t crazy about the
$10,000 exposure
Male, 42
CA, Zip 95201
Producer
Tackles issue by selling Balance
Plan 4 which provides:
$10,000 critical illness and
accident benefit
$1,000 per day accident
disability income
for
$64.95
per month
Buys STM plan with:
$5,000 deductible
50% coinsurance
$5,000 OOP
for
$218.26
per month
© IHC Group 2017

30. Product Bundling Example – For the Producer
Short Term Medical Commission = $39.29 monthly
($ X 18%)
Balance Commission = $12.99 monthly
($64.95 X 20%)
Total = $52.28 or $ for both products of a three month period
© IHC Group 2017

31. Product Bundling Example – For the Producer See how the commissions can add up*
Short Term Medical Commission = $39.29 monthly
($ X 18%)
Balance Commission = $12.99 monthly
($64.95 X 20%)
Total = $52.28 or for both products of a three month period
*Based upon an average case duration of just three months
Short Term Medical
With Balance Added
50 Sales
$ 5,893.00
$ 7,842.00
100 Sales
$ 11,787.00
$ 15,684.00
150 Sales
$ 17,680.00
$ 23,526.00
200 Sales
$ 23,574.00
$ 31,368.00
250 Sales
$ 29,467.00
$ 39,210.00
© IHC Group 2017

32. Fixed Benefit Plan Combo & Interim Coverage Combo
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017

33. Fixed Benefit Plan Combo Interim Coverage Combo
Fixed indemnity meets short-term medical insurance
Coverage for medical expenses ranging from minor to catastrophic
$0 deductible hospital benefits with large-claim coverage
Inpatient benefits up to $6,000
Outpatient benefits up to $3,500
Two plans: one easy enrollment and one claim

34. Fixed Benefit Plan Combo Benefits
Plan A
Plan B
Plan C
Inpatient hospital confinement
$500
$2,000
$3,000
Inpatient ICU/CCU confinement
$750
$4,000
Total benefit for inpatient surgical service
$1,500
$6,000
Total benefit for outpatient surgical service
$1,000
$2,600
$3,500
Critical illness benefit
$7,500
Maximum benefit
$2,000,000

35. How Fixed Benefit Plan Combo Works
Insured has selected Fixed Benefit Plan C with Interim Coverage Plan 3
$4,000 inpatient surgery benefit
$3,000 per day hospital confinement benefit
Step 1:
One inpatient surgery = $4,000 benefit
Three hospital confinement days = $9,000 ($3,000 x 3)
Total benefit $13,000

36. How Fixed Benefit Plan Combo Works
Insured has selected Fixed Benefit Plan C with Interim Coverage Plan 3
$4,000 inpatient surgery benefit
$3,000 per day hospital confinement benefit
Total benefit = $13,000
Step 2:
Total amount billed for surgery and hospital confinement: $22,000
Network discount brings the amount to $18,000

37. How Fixed Benefit Plan Combo Works
Insured has selected Fixed Benefit Plan C with Interim Coverage Plan 3
$4,000 inpatient surgery benefit
$3,000 per day hospital confinement benefit
Total benefit = $13,000
Total amount billed for surgery and hospital confinement: $22,000
Network discount brings the amount to $18,000
Step 3:
$13,000 total benefit is applied to the $18,000 amount due
$5,000 remains the responsibility of insured
$18,000 of the $20,000 (Plan 3) deductible is deemed fulfilled

38. Fixed Benefit Plan Combo Producer Compensation
Producer compensation for the Fixed Benefit Plan Combo Plan is 20%
Compensation for the Interim Coverage Plan Combo is 18%
Commission will vary based on product and state
*Enrollment and monthly admin fee not included
© IHC Group 2017

39. Getting Started
You must be contracted with The IHC Group and Anthem in order to sell these products
Contracting is available from your Anthem representative or at the Anthem Coverage Resource Center
Select desired state of business to see marketing materials
© IHC Group 2017

40. Quoting and Enrollment
Visit
Enroll and assist customers online
proposals with application links for clients to self enroll
Only allows you to quote plans that are available in your state
View brochures
View product information
Access your activity reports
Case status
View policy information
Download policy information
Quick DEMO of the IHC agent portal-
© IHC Group 2017

41. Enrollment Continued E-signatures are acceptable
Producer can complete the application including the medical questions on behalf of the client or allow them to complete themselves
At the end of the enrollment process, the application needs to be reviewed for accuracy
All policy documents and fulfillment are provided electronically
© IHC Group 2017

42. Questions?
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2017