1. Bundling UHOne STM and Fixed Indemnity
Welcome to the UnitedHealthcare 2015 ACA Health Insurance Plans webinar.
November 15, 2014 marks the beginning of open enrollment for the 2015 ACA health plans.
Individuals and families will need assistance from brokers like you as they shop for a health plan that fits their family’s need.
Today we’ll talk about the 2015 ACA on-exchange health plans, state availability, and related information that can help you prepare for Open Enrollment.
This presentation will last approximately 45 minutes. It has been placed in “listen only” mode so you can hear the information without background interruptions.
Let’s begin.

2. When is more than 4?
When it’s UnitedHealthOne’s Health Protector Guard indemnity plan plus their short term 3x2
Combining these two plans gives access to a nationwide network of 6,000 hospitals and an average 50% claims discount
Also offers security of comprehensive coverage. One plan offers first-dollar reimbursement of claims, while the other protects against the big expenses
Total cost is much less than major medical coverage

3. Why Choose Us? Carrier Strength UHC Brand, Size & Strength
Industry Experience
Highly Rated
Reliable & Recognized
Top Tier Networks
“Persistency Pays”

4. Short Term Medical

5. Short Term Medical Benefits
Nationwide UHC
Network:
1 Million Health Care Professionals
6,000 Hospitals
Up to 50% average discount %
No balance billing
Flexible portfolio:
Multiple Plans, Deductible,
Coinsurance & Premium Choices
No unnecessary benefits:
Not Minimum Essential Coverage
Simplified Underwriting:
Primarily yes or no questions
Next-day Effective Date
Apply Anytime:
No OEP/SEP Enrollment Periods
Affordability
Network driven competitive pricing

6. Short Term Medical by the Numbers
$173
$104
1.67
Average premium
Average premium per member
Average members per policy
2.2 months
Average duration of coverage
Updated as of 1/22/18

7. Health Protector Guard

8. What has made HPG so successful?
HPG Differentiators
The application consists of approximately 20 questions,
and is issued on an Accept or Reject basis.
Medical records are not required for review, however
Underwriting will rely on the application and the verification call.
Your client must be able to answer “NO” to all medical questions.
Before your client’s policy can become effective, the client is required to answer a few questions with representative from plan’s support administrator, the Loomis Company. Verification phone calls are conducted on all applications. Your client should allow 24 hours from the time the application was submitted before calling. The phone number and call instructions will be provided in your client’s “Application Received” .
Application reviews are typically completed within 3-4 days after the verification call has been completed.
What has made HPG so successful?
Built in retention benefits
Rollover doctor office benefit (up to 5 per year)
Increasing Injury reimbursement benefit
Up to $5,000 daily inpatient hospitalization benefit
ICU benefits pay in addition to daily inpatient benefit (not in lieu of)
Four-tiered surgical payout schedule
Allows maximization of surgical benefit payout (versus more common used flat amount)
The UHC brand & product persistency
The recognition of our name/brand helps with sales & persistency
UHC isn’t going to put their name on a product unless the product is high quality
Average persistency of HPG is currently modeling out at 12+ months!
Other carriers are typically stating 9-10 months
Spend your time writing NEW customers and not re-writing same customers

9. What does HPG cover? No lifetime maximum benefit
Pre-x covered after 12 months
Use any doctor/hospital
No coordination of benefits with other forms of insurance
Client is paid a fixed amount for covered services regardless of other health insurance they do/don’t have
Age eligibility
High commission and bonus earnings potential
Contact The Brokerage for more compensation details

10. Doctor Visits New Rollover Benefit How it works
Choice Value
Choice Plus
Select Value
Primary Preferred
Select Preferred
Select Plus
Premier Plus
Dr. Office Visit/
Urgent Care
Plan pays:
$100
(2 visits)
(5 visits)
$ (10 visits)
2nd Surgical Opinion
$250
(1 day)
$500
New Rollover Benefit
How it works
Members can roll over up to 5 unused doctor office visits to next year’s available benefits.
Plans with effective dates prior to July 1 may roll over up to 5 unused doctor office visits per person to next year’s benefits.

11. Wellness | Preventive Care Visits
Annual physical examination;
Pap smear
Mammogram
Blood screening including, Prostate antigen testing,
Colorectal screening
Immunizations, other than a flu shot;
Routine non-surgical cancer screening tests such as mammography or digital rectal examination; or
Blood screenings including but not limited to prostate-specific antigen testing.
Choice Value
Choice Plus
Select Value
Primary Preferred
Select Preferred
Select Plus
Premier Plus
Wellness/
Preventive benefits
Plan pays:
$100
(1 day)
$200
$250
Eligible Covered Expenses
How it works
Pap Smear
Mammogram
Immunizations
PSA testing
Colorectal screening
6 month waiting period
Benefits are per calendar year
Per person

12. Pharmacy Drug Discount Card RX benefits 12 fills per calendar year
Choice Value
Choice Plus
Select Value
Primary Preferred
Select Preferred
Select Plus
Premier Plus
Outpatient Prescriptions
Plan pays:
Discount Card only
Generic: $20
Brand: $40
12 fills/year
Generic: $10
Drug Discount Card
RX benefits
National Prescription Savings Network
Up to 75% savings
Ready for member to use
RX plan benefits not required
Discount program only
12 fills per calendar year
Member submits claim
Reimbursement paid to member
PDL:
searchrx.com/UHO or
Call

13. Hospital Services | Inpatient
Choice Value
Choice Plus
Select Value
Primary Preferred
Select Preferred
Select Plus
Premier Plus
I/P - Illness
Plan pays:
$1,000
$2,000
$3,000
$4,000
$5,000
I/P Injury Year 1
I/P Injury Year 2
$1,250
$2,500
$3,750
$6,250
I/P Injury Year 3
$1,500
$4,500
$6,000
$7,500
I/P Injury Year 4
$1,750
$3,500
$5,250
$7,000
$8,750
I/P Injury Year 5+
$8,000
$10,000
Intensive Care Unit or
Critical Care Unit per day
(31 days)
(60 days)
ICU/CCU benefit amounts are in addition to I/P Hospital Confinement Benefits.
Physician Visit per day
during I/P Confinement
$100
(1 visit/day)
Emergency Room per day
(maximum per calendar year)
$200
(2 visits)
$300
$400
$500

14. Health Protector Guard Benefits Example
Client Scenario #2
30 year old male in Orlando, FL
Emergency Room Visit with outpatient testing resulting in:
Hospital Confinement for 35 days (15 days in ICU) & Inpatient (Tier 2) Surgery
Benefit Category
Choice
Value
Plus
Select
Primary Preferred
Select Preferred
Premier
Emergency Room Visit (1 day)
$200
$300
$400
$500
Outpatient Diagnostic Test
$100
IP Hospital Conf. (35 days)
$35,000 ($1,000/day)
$70,000 ($2,000/day)
$105,000 ($3,000/day)
$140,000 ($4,000/day)
$175,000 ($5,000/day)
ICU Confinement (15 days)
$30,000 ($2,000)
$60,000 ($4,000)
$90,000 ($6,000)
$120,000 ($8,000)
$150,000 ($10,000)
Inpatient Physician Visits (3)
$300 ($100)
Inpatient Tier 2 Surgery
$5,000
Total Benefit Paid
$70,700
$135,700
$200,900
$175,700
$210,700
$266,000
$331,100
Plan Premium
$60.23
$90.32
$102.14
$104.15
$113.06
$141.75
$156.96

15. Health Protector Guard by the Numbers
$151
$231
1.5
Average Monthly Premium
Per Person
Average Monthly Premium Per Policy
Average Members Per Policy 33
50/50
Average Issue
Age
Average % by gender
of Applicants
Updated as of 1/22/18

16. Bundle Example (Husband & Wife, age 35, 75057 zip)
$168.15
$300.71
STM Value ($12,500 ded, $5K coinsurance
HPG Select Value ($3K/day hospital)
$468.86
Total cost
$791 for a Bronze, $910 for a Silver Plan
Updated as of 1/22/18

17. Commission to the Broker
Bronze $9,492 annual premium x 3% = $ annual comm.
Silver $10,920 annual premium x 3% = $ annual comm.
Short Term Major Med $ x 27% = $45.40
Hospital Protector Guard $ x 35% = $105.24
Total Monthly Commission $ x 12 months = $1,807.78
$1, more annual commission to the agent
Saves client $5, per year in Silver plan premium
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

18. Easy Online Quotes and Bundling Products for Delivery