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Presentation on theme: "How to use this presentation"— Presentation transcript:

1 How to use this presentation
What’s covered This presentation is designed to cover the following: Unum history, market position Definition of specified disease insurance How it works Plan design Reasons to buy, guarantee issue, exclusions, etc. Customizable This presentation is designed to be customized according to plan design offered Remove slides that do not apply to the case offering or slides that do not apply to your policy. Red text implies that text is variable − can be removed if not offered Notes pages Please read the notes page (click on view on the menu bar, click on notes page) to determine if a slide applies to your case and policy Enroller: Please delete this slide.

2 Group Specified Disease insurance
Underwritten by: First Unum Life Insurance Company Group Specified Disease insurance An overview of the benefits Enroller Notes: Suggested introduction: Hello. My name is _________. I’m a benefits representative with Unum. I’m here on behalf of [Company Name] to give you some helpful information about a new benefit available to employees – it’s called Specified disease insurance. Your HR department wants to make sure you understand enough about this benefit to decide whether it is right for you. So I will spend the next [10] minutes…. - Giving you an overview of the plan… - Explaining how this plan could benefit you and your family… - And answering any questions you may have. Since I don’t work on commission, there’s no pressure for you to buy anything. My goal today is to provide you with the information you need so you can make the best decision concerning this benefit. Are there any questions before I begin? Transition statement – Before we talk about Specified disease insurance, let me introduce you to Unum, the company (employer name) has chosen to provide this valuable coverage to you. Presenter’s name | Month, Year EN-1197–NY (5-13) 2

3 Why Unum? Proven experience
A heritage of more than 160 years in the insurance industry We listen to you Our benefit specialists understand how an illness can affect your life We put people first Professional, prompt, courteous service during difficult times Financial stability Solid financial ratings, even in today’s tough economy We put people first Professional, prompt, courteous service during difficult times Speaker Notes: [Refer to slide.] With more than 160 years of benefits experience, we back our products with a commitment to providing high-quality service. We have received excellent financial strength ratings that reflect our stability, even in a tough economy. Most of all, we are a company of people serving people. You can trust that if you have to file a claim, we will be there with responsive service – when you need us most Transitional statement: You probably already have health insurance, as well as dental and vision coverage. You might think, “I’m young and healthy -- a serious illness isn’t going to happen to me.” But take a look at the real risk. 3

4 Who needs specified disease insurance?
Who is at risk? Every 25 seconds someone in America will have a coronary event.1 Every 40 seconds someone in America will have a stroke.2 The risk of developing cancer during a lifetime is nearly 1 in 2 for men and 1 in 3 for women.3 Speaker Notes: We’d all like to think we’re not going to become critically ill, but statistics show that it can happen. While certain individuals are more susceptible to specific conditions, in general, critical illnesses don’t discriminate – regardless of age, gender, race, or occupation. They can strike anyone at any time. Consider these facts: [review “Who is at risk” bullets] Transition statement: Unfortunately, having health insurance may not be enough. There are some medical expenses that your medical insurance won’t cover. Let’s take a closer look…. 1,2 American Heart Association, “Heart Disease and Stroke Statistics — 2012 Update: A Report from the American Heart Association,” Circulation (Dec. 15, 2011). 3 American Cancer Society, Cancer Facts & Figures (2012).

5 Health insurance typically covers Health insurance may not cover
Why buy specified disease insurance? Health insurance typically covers The costs for care and treatment of a critical illness Prescription copays Diagnostic tests Rehabilitation Transportation to health facilities Private nursing or home health care Alternative or experimental treatments Health insurance may not cover If you are ill and can’t work, how would you pay for everyday expenses such as: Mortgage Car payment Credit card payments Household expenses Dependent care Speaker Notes: Thanks to modern medicine, more people are surviving heart attacks, strokes and other critical health problems. But the “cure” often comes at a high price. Even with medical insurance, you could face thousands of dollars in out-of-pocket costs such as: [review bullets] It’s also important to remember that if you are seriously ill and can’t work, you still have everyday expenses. Your mortgage, a car payment, credit card payments, household expenses, child care – the list can really add up. Unum’s Specified disease insurance is designed to help provide the additional financial protection you may need if a sudden illness strikes. Transition statement: So, how can Specified disease insurance help?

6 Could your wallet survive a serious illness?
Specified disease insurance can help you keep your finances in check, by providing a benefit when the expenses of a serious illness start to add up. Lisa’s story: Lisa was planning her daughter’s wedding when a stroke disrupted her plans. Thanks to her specified disease coverage, Lisa was able to afford the out-of-pocket costs her medical insurance didn’t cover. Lisa’s specified disease insurance helped cover the cost Because she had selected a benefit amount of $20,000, her plan paid her that amount in a lump sum, regardless of what she spent. Lisa could use it for her out-of-pocket costs and to help pay the bills while she was unable to work. Lisa was able to focus on her goal for recovery: to dance at her daughter’s wedding! Speaker Notes: Let me show you how this benefit works. [Go over illustration in slide] Specified disease insurance can pay a lump sum benefit if you’re diagnosed with a covered illness. You get to choose the level of coverage that best meets your needs and budget. It can be anywhere from $5,000 to $50,000. The lump-sum benefit is paid directly to you -- not to a medical provider, such as a doctor or hospital. That means you can use your benefit any way you see fit, such as paying bills, groceries and even child care. The specified disease benefit can reduce financial pressures on you, so you can focus on getting well, rather than on your bills. And, you receive your full benefit amount – even if your health insurance pays for some of your treatment. Transition statement: Now that you understand how critical illness insurance works, let’s talk about what specified diseases are covered under this plan.

7 Specified disease insurance
Advantages Employee-paid coverage is portable Automatic coverage for dependent children at 25% of the employee benefit amount Each category of conditions payable once per lifetime per covered individual The skin cancer benefit pays an additional $250 benefit per covered person per lifetime Additional benefits for remaining specified diseases if listed under another category and medically unrelated Speaker Notes: One of the greatest advantages of having this policy is that you can use this coverage more than once. If you receive a full benefit payout for a covered illness, your coverage can be continued for the remaining categories. Let’s take a closer look at the illnesses and events covered under the specified disease policy. [go over list on slide] All the medical conditions listed are paid at 100% of the purchased benefit amount with the exception of coronary artery disease and carcinoma in situ, which are paid at 25% of the purchased benefit amount. The skin cancer benefit pays a $250 benefit per covered person per lifetime. This is not part of the 100% payout. Keep in mind your coverage is also portable – which means if you retire or leave the company, you take the coverage with you…. And, if you obtain this coverage your children are automatically covered at no additional cost to you! Transition statement: Let’s review some more advantages that are including within this plan… 1 Carcinoma in situ is defined as cancer that involves only cells in the tissue in which it began and that has not spread to nearby tissues 7

8 Wellness benefit Each covered individual will automatically receive the wellness benefit, which can pay [$50, $75, $100] per calendar year per insured individual1 if a covered health screening test is performed. Screening tests include, but are not limited to: Colonoscopy Mammography Pap smear Skin cancer biopsy PSA (blood test for prostate cancer) Chest X-rays Stress test on a bicycle or treadmill [Enroller note: only include this slide in the presentation if the employer has elected this rider. Keep in mind that the wellness benefit can pay $50, $75 and $100, chosen at the ER level . Elect the correct benefit amount. ] Speaker notes: You’ll also receive additional coverage with your policy through the Wellness benefit. This benefit pays [$50, $75 , $100] per calendar year if a covered health-screening test is performed, including blood tests, chest X-rays, stress tests, mammograms and colonoscopies. …So, in most cases just by having your yearly physical or wellness visit and tests, you’ll qualify for this additional benefit payment. Also, if you obtain coverage for your family, then, each family member covered will be automatically eligible to receive the benefit per calendar year- of course- if a covered health screening test is performed to them. These are just a few of the tests covered under this rider, your policy will come with the complete list with all the tests that are covered. Transition statement: [ if Recurrent benefit is offered then modify this statement accordingly] We mentioned you can apply for coverage for family members…. Let’s talk about your coverage options. . 1 Insured individuals are eligible for benefits 30 days after the effective date of coverage.

9 Family coverage options
Available family coverage Who can have it? Benefit Employees who are actively at work and are U.S. citizens $5,000 to $50,000 in $1,000 increments Children Newborn to age 26, regardless of marital or student status. All eligible children are automatically covered at 25% of the employee benefit amount (no additional cost) Spouse ages 17 through 64 with purchase of employee coverage $5,000 to $30,000 in $1,000 increments Enroller Note: Delete spousal coverage information if not offered. Speaker Notes: [go over information on slide] Your spouse and children can keep coverage as long as you keep yours, no matter where (or if) you work. Children are covered automatically at 25% of your benefit amount. Any questions? Transition statement: Now that you have a good understanding of the specified disease insurance benefits, advantages and coverage options; it’s important to take some time to review the exclusions and limitations … All applicants (employee, spouse, children) must be covered by a qualified major medical health plan before applying for specified disease insurance.

10 Policy provisions Waiting period* Pre-existing limitation
This coverage is subject to a 30-day waiting period. Pre-existing limitation Unum will not pay benefits for a claim that is caused by, is contributed to by or occurs as a result of a pre-existing condition. Enroller notes: Delete the provision s that have been waived- depending on your specific enrollment offering. Go over slide points. Avoid getting into specific claim scenarios. Each claim is different and it will be reviewed based on it’s own merits. Speaker Notes: Let’s take a look at some of the policy provisions. Waiting period – benefits are payable for the diagnosis of a specified critical disease 30 days after your coverage effective date. Pre-existing condition limitation- Benefits for a pre-existing condition (defined as a sickness or injury for which the insured received medical treatment, consultation, care or services, including diagnostic measures) for which the date of diagnosis is in the first 6 months after the insured's coverage effective date. This limitation will not apply to any date of diagnosis for specified disease or date of diagnosis for skin cancer that occurs 6 months after the insured's coverage effective date. Transition statement: So why should you buy this coverage at work? *The waiting period does not apply to wellness benefit.

11 Why buy at work? Competitive rates available through your employer
Convenience of payroll deduction Valuable benefits for you and your family Coverage is portable1 – you may take the coverage with you if you leave the company or retire without having to answer new health questions. Unum will bill you directly. Enroller Note: Employees can port this coverage if they had it in force for less than 12 months; there are no time limitation. Speaker Notes: By applying for Unum’s specified disease insurance at the workplace, you’ll have access to a variety of valuable policy features. Let’s review what this plan can offer you. [refer to slide] This benefit allows you to make a personal choice. Choose the coverage that is right for you and your family, what you need and what you can afford. You receive the benefit of group rates but can take the coverage with you if you leave the company or retire, as long as the premium is paid on time. And while you are at your company, your premiums will be automatically deducted from your paycheck, making premiums easy to pay and easy to figure into your budget. Use this if GI is offered: Help protect your insurability: Sign up during the initial enrollment period and obtain coverage up to your Guarantee Issue amount without answering medical questions (if you meet eligibility requirements). If you decline coverage now and decide to apply for coverage in the future, you will be required to submit medical evidence of insurability regardless of the amount of the coverage you choose. Any questions? Transition statement: Let’s discuss what to do next to get enrolled in this valuable benefit… 1 Employee paid coverage is portable with no qualifying health questions and no change in rates. Ported coverage is not impacted should the employer terminate the plan.

12 Eliminate any paragraphs that don’t apply
How can you enroll? Review your enrollment materials. Meet with a benefit counselor today to apply for this benefit.  Call: [toll free #] to speak to a benefits representative during [specify enrollment dates]: 8 a.m.−8 p.m. ET Monday − Friday  Go online to your enrollment website: [enter URL]  Complete your enrollment form and return it to appropriate contact. Eliminate any paragraphs that don’t apply Call enrollment line Instruct audience how to enroll contacting a BES-T representative Enroll online Instruct audience how to enroll using self service enrollment tool Paper applications Exception only and/or traditional products with Benefit Credits Does anyone have any questions? If you don’t feel comfortable asking them in front of the group, I’m happy to meet with you in person after this meeting is over. 12

13 GROUP SPECIFIED DISEASE INSURANCE PROVIDES LIMITED BENEFITS.
Underwritten by: First Unum Life Insurance Company, New York, New York This policy provides limited benefit health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department Eligibility for, entitlement to, and amount of actual benefits will be determined according to the terms of the voluntary group specified disease insurance policy. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability. Unum complies with all state civil union and domestic partner laws when applicable. unum.com © 2013 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. EN-1197-NY (5-13) FOR EMPLOYEES


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