1. Supplemental Insurance Protection
Premiere Vision State Variations Chart
Approval Date: 08/07/2015
Code :
Revised: 09/30/2014
Supplemental Insurance Protection
Premiere Vision
Policy Form CH IP (01/12), or its state variation
State Specific Variations Charts
©2014 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. Premiere Vision Before You Begin
This list is time-sensitive and may not be all-inclusive. See product materials for complete details and any additional state variations regarding the Premiere Vision Policy.
Due to the many variations of the Premiere Vision plan, the state-specific and generic power points have been combined into one single presentation.

3. Supplemental Products Availability
SureBridge has the largest portfolio of supplemental products including critical illness, cancer, accident, disability, dental and Premiere Vision policies. We also have the broadest marketing footprint. AK WA ID MT ME OR ND MN NH WI NY VT MI WY SD CA MA RI NV CT UT NE IA PA IL OH IN NJ CO WV DE MO VA KS MD KY HI DC AZ NC NM OK TN TX AR SC GA MS AL
All products available
Subset of products available
No products available LA FL

4. Premiere Vision State Availability
Legend
 = Released in state at time of training publication +
State / Availability
Gen SS
Alabama AL 
Kentucky KY
North Dakota ND
Alaska AK
Louisiana LA
Ohio OH
Arizona AZ
Maine ME
Oklahoma OK
Arkansas AR
Maryland MD
Oregon OR
California CA
Massachusetts MA
Pennsylvania PA
Colorado CO
Michigan MI
Rhode Island RI
Connecticut CT
Minnesota MN
South Carolina SC
Delaware DE
Mississippi MS
South Dakota SD
District of Columbia DC
Missouri MO
Tennessee TN
Florida FL
Montana MT
Texas TX
Georgia GA
Nebraska NE
Utah UT
Hawaii HI
Nevada NV
Vermont VT
Idaho ID
New Hampshire NH
Virginia VA
Illinois IL
New Jersey NJ
Washington WA
Indiana IN
New Mexico NM
West Virginia WV
Iowa IA
New York NY
Wisconsin WI
Kansas KS
North Carolina NC
Wyoming WY

5. Supplemental Products Superior Client/Broker Experience
Quoting
Compare packages with different combinations of supplemental products
Present total price for solution
Commissions
First month’s premium is taken at time of application
This results in faster commission payments
Book of Business report available on the SureBridge 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
Outlines of coverage provided
Claims
Claim form provided with complete instructions for submission
Claim forms are received, analyzed and adjudicated within a 7 day turn-around time

6. Supplemental Products Sales Pitch
Changes in the market present opportunities to sell supplemental plans
Essential Health Benefits Plans can have out of pocket expenses as high as $6,350 for individuals or $12,700 for families.
This leaves large gaps in coverage which can 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. Tax credits can be used to purchase extra coverage and fill the gaps left by high deductibles and coinsurance on EHB plans.
Number of family members
Poverty Guideline for family income (as of 2013)
Can still qualify for a subsidy under the ACA with an income up to 1
$11,490
X 400%
$45,960 2
$15,510
$62,040 3
$19,530
$78,120 4
$23,550
$94,200 5
$27,570
$110,280
Tax credits can be seen as a way to pay for Supplemental Plans and reduce coverage gaps.
Need a subsidy calculator? Try

7. Premiere Vision Sales Pitch
The Premiere Vision plan is a good companion to health and PPO Dental insurance. In addition, try SureBridge supplemental insurance to help fill in gaps caused by high out of pocket expenses and lost wages. For example, Accident Direct is as inexpensive as $1 a month.
On the right, health insurance is supplemented by the following:
Premiere Vision
PPO Dental *
Accident Direct* for lump sum accident coverage
Coverage
Gap
Health Coverage
PPO Dental
Premiere Vision
Accident
Direct
*See the appropriate training documents for more details on these other products.

8. Premiere Vision Navigation
Premiere Vision is located under the Dental/Vision and Senior tab of the SureBridge Point of Sale Tool.

9. Premiere Vision Marketing and Plan Information
Senior Market
Maximum Issue Age: 65-99
Dependent Issue Age: 0-99
Application: CH APP (10/13)
Non-Senior Market
Maximum Issue Age: 0-64
Dependent Issue Age: 0-64
Application: CH APP (10/13)

10. Premiere Vision Marketing Guidelines for the Senior Market
Important Information
Medicare Advantage plans may contain benefit provisions that could potentially duplicate the Premiere Vision policy benefits.
If you are offering the Premiere Vision policy in the senior market, you must determine if the potential applicant has existing vision coverage (refer to the application question regarding other coverage).
Do not offer a Premiere Vision policy to a customer who has an existing Medicare Advantage plan with vision benefits or other existing vision coverage.

11. Premiere Vision Out of Network Plan Differences
Generic Premiere Vision Plan
Covers non-network eye exams up to $30 a year
OON corrective spectacle lenses, frames and contact lenses are not covered.
State – specific differences can apply. See the benefit charts on the following pages for details.
State Specific Premiere Vision Plan
Covers non-network eye exams up to $30 a year
OON corrective spectacle lenses, frames and contact lenses are covered.
State – specific differences can apply. See the benefit charts on the following pages for details.

12. Premiere Vision Benefit Schedule
Network Benefits
Non-Network Benefits
State-Specific Differences
Examination
Includes eye exam, refraction and dilation as necessary
Limited to one exam every 12 months from last date of service, per insured person
100 % Comprehensive Eye Examinations per Insured Person
100 % up to a maximum of $30 per Comprehensive Eye Examination, per Insured Person
AR – Non-Network: 75%.
FL, GA – Network: 100% up to $30.
Corrective Spectacle Lenses
Standard, uncoated plastic lenses
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective contact lenses
Single Vision Lenses, Bifocal Lenses and Trifocal Lenses paid at 100%
Not Covered
CT, ID, IL, KS, KY, MD, MO, NC, NM, NV, OH, OK, PA, TX, UT – Non-Network: Single Vision lenses 100% up to $35, Bifocal lenses 100% up to $55, and Trifocal lenses 100% up to $90
FL, GA, ME – Network and Non-Network: Single Vision lenses 100% up to $35, Bifocal lenses 100% up to $55, and Trifocal lenses 100% up to $90;
Frames
Paid at 100% up to $120
AR – Non-Network: 100% up to $90
CT, FL, ID, IL, KS, KY, MO, NC, NM, NV, OH, OK, PA, TX, UT – Non-Network: 100% up to $60
GA – Non-Network: 100% up to $84
MD – Non-Network: 100% up to $120
ME– Non-Network: 100% up to $100

13. Premiere Vision Benefit Schedule
Network Benefits
Non-Network Benefits
State-Specific Differences
Corrective Contact Lenses
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective spectacle lenses and frames
Contact lens fitting and follow-up visits are not covered.
Paid at 100% up to $120
Not Covered
AR, CT, FL, GA, ID, IL, KS, KY, MD, ME, MO, NC, NM, NV, OH, OK, PA, TX, UT – Non-Network: Paid at 100% up to $120
Contact Lens Fitting
Follow-up Visits

14. Premiere Vision Renewability
State Specific Differences
The policy is guaranteed renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.
FL, IA, KS, KY, TN, VA: Replaces ‘guaranteed’ with ‘conditionally’’
TX: Removes “guaranteed”
Under our business rules, Eligible Dependents covered under the policy may continue coverage until age 26, subject to the termination provision of the policy.
FL: Eligible Dependents covered under the policy may continue coverage until age 31
IL, SD: Eligible Dependents covered under the policy may continue coverage until age 30.
NE: Eligible Dependents covered under the policy may continue coverage through age 29
OH: Eligible Dependents covered under the policy may continue coverage until age 28.
CT, WI: Eligible Dependents covered under the policy may continue coverage until age 27.
Termination Age Standard
State Specific Differences
Termination Age: Non-Senior
No termination age
Termination Age: Senior

15. Premiere Vision Exclusions & Limitations#
Exclusion & Limitation
State Specific Differences 1
Orthoptic or Premiere Vision training and any associated supplemental testing 2
Plano lenses 3
Lens coating 4
Two pair of glasses, in lieu of bifocals or trifocals 5
Medical or surgical treatment of the eyes 6
Any type of corrective Premiere Vision surgery, including LASIK surgery 7
Any eye examination, or any corrective eyewear, required by an employer as a condition of employment 8
Any services or supplies when paid under any Workers’ Compensation or similar law
NC – revised to “any injury or sickness arising out of, or in the course of, employment for wage or profit, for which benefits are paid under the Worker’s Compensation Act, Occupational Disease Act, or similar act or law and if determined by a final adjudication of the claim, the employee, employer, or Workers Compensation Carrier under such Article or by an order of the NC Industrial Commission, is liable/responsible for such charges, unless the Insured is self-employed.”

16. Premiere Vision Exclusions & Limitations#
Exclusion & Limitation
State Specific Differences 9
No-line bifocal or progressive lenses 10
Photochromic, transition, or polycarbonate lenses 11
Lenticular lenses 12
Sub-normal Premiere Vision aids or non-prescription lenses 13
Services rendered or supplies purchased outside the U.S. or Canada, unless the insured person resides in the U.S. or Canada and the charges are incurred while on a business or pleasure trip 14
Eyeglasses when the change in prescription is less than .5 Diopter 15
Experimental or investigational or non-conventional treatment or device 16
Eyeglass lens treatments, including “add-ons”, UV coating, anti-reflective coating, scratch resistant coating, tinting, edge polishing 17
Oversized lenses 18
High index lenses of any material type 19
Fitting for contact lenses 20
Follow-up visits 21
Charges incurred after the policy has terminated or coverage has ended

17. Premiere Vision Premiere Vision FAQs
New Business and Underwriting
Cannot be sold with any other Vision Plan offered by MEGA or CLICO.
May be sold with a Non-Senior Vision for a different applicant.
No underwriting questions apply to this product.
Claim Payment
Benefits are paid to the Provider if assigned.
The Premiere Vision plan offers access to thousands of network providers nationwide through EyeMed Vision Care’s “Select” Network of independent providers and retail chains including: LensCrafters®, Sears Optical®, Target Optical®, JCPenney Optical® and Pearle Vision® locations.

18. Premiere Vision Underwriting Quick Reference
Important Information
No underwriting questions apply to this product.
See the Premiere Vision section of the Chesapeake Underwriting and Product Guide for more information.

19. Premiere Vision Pricing Examples
Rates can change. These rates come from the generic brochure dated March 2014: CH PR VIS 314 (OON, generic, Senior and non-senior versions). The chart below is only an illustration of benefit and premium options per covered person for plans.
Monthly Premiums
Non-Senior
Senior
Individual
$9.00
$10.00
Two Persons
$16.00
$18.00
Family
$25.00
N/A
Sample
Rates do not vary from Generic vs State Specific versions.

20. Premiere Vision
This presentation is not inclusive of all policy provisions.
See product materials for complete details and any additional state variations regarding Termination of Coverage, Renewability, Premium Changes, Eligible Dependents, 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 and administered by The Chesapeake Life Insurance Company®. Administrative offices are located in North Richland Hills, TX. The insurance product referenced in this document is underwritten by The Chesapeake Life Insurance Company.
SureBridge products are individual supplemental products and are not available as group coverage.
There is no list bill and premiums may not be paid by employers for employees.
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 Vision Insurance Policy does not satisfy the individual mandate that you have health insurance coverage.
This is not Medicare Supplement Insurance.

21. Premiere Vision Thank You For Everything You Do!
Vision Insurance Policy