1. Supplemental Insurance Protection
Protect FitPlus
Florida
SB Study Guide
Date Approved: 1/13/2012
Code:

2. Agenda
Supplemental overview
Protect FitPlus
Business Rules

3. Objectives Introduce the Protect FitPlus supplemental packages
Understand the covered services for the plan
Explain the benefits provided by the plans

4. Introduction
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 presented as such

5. Introduction
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 products are individual supplemental products and are not available as group coverage
No list bill or employer pay
Association membership is not required

6. Overview
Supplemental plans are separate from base health plans and require additional premium
Most plans pay a benefit directly to the insured, and benefits are in addition to any other existing coverage
Benefits paid to the insured may be used for any purpose

7. Product Positioning Designed on the Aflac model
Lower monthly premium for supplemental coverage
Benefits designed to replace short periods of lost income and incidental expenses
Good fit for someone who has health coverage with another carrier and not looking to switch
No child primaries
Plans issued to primaries ages 18 to 64

8. Accidental Injury Only Insurance Policy
ProtectFit Plus
Accidental Injury Only Insurance Policy

9. ProtectFit Plus Plan Design
Inpatient
Outpatient
Emergency/
Diagnostic
Follow-up/
Restorative
AD&D/
Transport/
Other
Disability
Income Protection
Daily Hospital Confinement
Daily ICU Confinement
Lump Sum Hospital & ICU
Emergency Room/ Urgent Care Facility Treatment
Major Diagnostic Exams
Lump-Sum Injury
Physician Follow-up
Physical Therapy
Rehabilitation
Appliances
Prostheses
Blood/Plasma/ Platelets
AD&D
Common Carrier Accident
Ground/Water Ambulance
Air Ambulance 9

10. Inpatient Hospital Confinement Benefits
Within 30 days of a covered accident
High Plan
Low Plan
Lump Sum Hospital (1 per person, per policy year)
$1,000
$500
Daily Hospital (365 days per person, per accident)
$300
$150
Lump Sum ICU (1 per person, per policy year)
$2,000
Daily ICU (15 days per person, per policy year)
$250

11. Outpatient, Emergency & Diagnostics Benefits
Treatment must be received within 72 hours of the accident
High Plan
Low Plan
Emergency Treatment (Primary and spouse 1 benefit per accident)
$150
$100
Emergency Treatment (Covered dependent children 1 benefit per accident)
$50
Major Diagnostic Examinations (One per person, per policy year)
$200
Major diagnostic exams include necessary CT Scans, MRI’s or EEG’s related to an accidental injury

12. Lump-Sum Accidental Injury
Covered accidents include dislocations, fractures, concussions, burns and lacerations
Treatment must begin within 72 hours of the injury unless otherwise stated in the schedule of benefits
Benefit payments range from $25-$6,250 on the low plan and $35-$12,500 on the high plan
Refer to the schedule of benefits for specific payment amounts

13. Inpatient Hospital Rehabilitation
Up to 30 days per injury and up to 60 days per policy year for hospital rehabilitation unit
Low plan $75 per day
High plan $150 per day

14. Follow-up Benefits
Benefits are per visit and must begin within 30 days of the injury
Follow-up treatment or physical therapy (must follow ER or urgent care treatment)
Low plan $25 per visit, 5 visit maximum per policy year
High plan $35 per visit, 10 visit maximum per policy year
Chiropractic care is excluded

15. Restorative Benefits High Plan Low Plan Appliances $150 $100
Prostheses
$750
$375
Blood, Plasma and Platelets (one benefit per person, per accident)
$200

16. Accidental Death and Dismemberment
High Plan
Low Plan
Death benefit (primary and spouse)
$50,000
$25,000
Death benefit (covered dependent children)
$15,000
$7,500
Common Carrier Death benefit (primary and spouse)
$150,000
$75,000
Common Carrier Death benefit (covered dependent children)
$12,500
Dismemberment (primary and spouse)
$3,000 up to $50,000
$1,500 up to $25,000
Dismemberment (covered dependent children)
$1,000 up to $15,000
$500 up to $7,500
Benefits are payable only if death or loss occurs within 90 days of a covered accident ,

17. Emergency Ambulance Benefits
Benefits payable for one trip per person, per accident
High Plan
Low Plan
Ground or Water Ambulance
$250
$125
Air Ambulance
$2,500
$1,250

18. Disability Income Protection
Only available on the high benefit plan for working primary and working, dependent spouse
Provides $500 per month up to 12 months
Disability must occur within 60 of the accident
Subject to a 21-day elimination period

19. The savage tale of Jimminy Gilchrist
While enjoying a leisurely donkey trek on his vacation to the Grand Canyon, 40-year old Jimminy Gilchrist suffers a most unfortunate fall
He is rushed to St. Filigree Hospital via ground ambulance, where he is admitted overnight for observation
Jimminy suffered the following injuries due to his accident
Dislocated shoulder
Fractured wrist
Concussion
He purchased the ProtectFit Plus High plan

20. Big Money What benefits is Jimminy eligible to claim?
Lump-sum hospitalization
$1,000
Daily hospitalization (1 day)
$300
Ground ambulance
$250
Dislocated shoulder
$500
Fractured wrist
$475
Concussion
$50
Total
$2,575

21. Business Rules

22. Business Rules No child primaries
Plans issued to primaries ages 18 to 64
May be sold as a stand alone or with other SureBridge products

23. Billing
Effective and billing dates are only the 1st and 15th of each month
Premium drafted on submission of application
Billing modes are monthly, quarterly, semi-annual or annual
Initial payment will be ACH or credit card only
ACH only in North Carolina
Billing types will be ACH or e-bill only
Paper bills will be generated due to insufficient funds

24. Underwriting Issued as accept/reject All plans will look at
No rate ups or waivers
All plans will look at
Height and weight
Hazardous occupations
Residency for foreign nationals
Primary ages 18-64
Extreme hobbies (except PersonalFit Plus)
HospitalFit Plus and PersonalFit Plus
Additional 7 medical questions 24

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