1. 50th Anniversary Celebration
Lower Rates New Freedom Essentials Plan Agent Bonus Plan
Effective 10/1/2019
12174s0719

2. Topics for Today New “Freedom Essentials” Plan Agent and GA Bonus Plan
Lower Rates Starting 10/1/2019
Reminders, Updates and Extras
Balance Bill Legal Support
New Total Out-of-Pocket
HealthChoices Reminder and Update
1099s Now Accepted

3. Freedom Essentials Key Objectives: Lower health plan costs
Remove high-cost low-frequency specialty drug risks
Maintain MEC & MV ACA Compliance

4. Freedom Essentials Plan
Target rate reduction – 20%
No coverage for Tier IV Specialty Drugs*
Reduce office visit copay benefit from $500 to $ (for Essentials Only)
Require $35 or $40 office visit copay
Minimum RX deductible = $250
HealthChoices is mandatory
Reference-based pricing is mandatory – it’s a Freedom Plan!
* Since Tier IV are excluded member may be eligible for discounts and coupons through the drug company.

5. Freedom Essentials Plan
Quoting available for Oct. 1 effective dates from Allied
Software update in 1 week

6. Allied National Golden Anniversary Bonus Plan
Bonus Period - 10/1/2019 to 3/1/2020
Agent Bonus for all Allied group plans
Freedom Traditional or PPO
Freedom Essentials
Cost Saver
Dental

7. Agent Dental Bonus $50 for every new dental certificate issued
No limit on certs or cases during bonus period

8. Agent Cost Saver Bonus Case Size Bonus 2 to 10 $ 1,000 11 to 24
Bonus for EVERY new group written based on the number of employee lives at the time of issue. No limit on the number of bonuses during bonus period.
Case Size
Bonus
2 to 10
$ 1,000
11 to 24
$ 2,000
25 to 49
$ 3,000
50 to 64
$ 4,000
65+
$ 5,000

9. Funding Advantage – Major Medical (including Essentials)
New Agent First Major Medical Case Bonus
Employee Lives at Issue
Bonus
2 to 10
$ 1,000
11 to 24
$ 2,000
25 to 49
$ 3,000
50 to 64
$ 4,000
65+
$ 5,000

10. Funding Advantage – Major Medical (including Essentials) Multiple Major Medical Case Bonus for All Agents Requires a Minimum of 4 New Major Medical Cases in Bonus Period
Total Employee
Lives at Issue All Cases
Bonus
2 to 10
$ 1,000
11 to 24
$ 2,000
25 to 49
$ 3,000
50 to 64
$ 4,000
65+
$ 5,000
A new agent can earn BOTH the new agent and multiple case bonuses!

11. Funding Advantage Rate Reductions by State
Reduced Rates
No Change
Oklahoma - 15% Indiana - 10% South Carolina - 10% Wyoming - 7% Illinois - 5%
Kansas %
Texas %
Virginia %
Missouri - 2%
Arizona
Georgia
Alabama
Idaho
New Mexico
Ohio
Tennessee

12. Member Balance Bill Legal Support
Freedom Plans
Member Balance Bill Legal Support
For Freedom Traditional or Essential Plan members who have been balance billed
Legal Support handles all balance bill collection issues
Offered at no cost to the member
Eliminates need for members to deal with unfair collection attempts
For all Freedom Plans effective or renewing beginning 10/1/2019.

13. Member Balance Bill Legal Support
Freedom Plans
Member Balance Bill Legal Support
Result
Once legal support engaged, your members are completely done
They can no longer be contacted by providers or bill collectors
Providers can no longer use member pressure as part of price negotiation

14. Funding Advantage HealthChoices Benefit Option Members must be ENGAGED
Immediate 6.5% discount on monthly premium
Plan members are required to use HealthChoices Services
Enhanced benefits for use – covered by health plan
Penalties for non-compliance
Members must be ENGAGED

15. Members receive a 2nd ID card with HealthChoices instructions for them and the provider
Pre-notification requirements are included
Required for best benefits

16. Total “Out-of-Pocket” vs. Max “Out-of-Pocket”
New TOOP vs. MOOP
Total “Out-of-Pocket” vs. Max “Out-of-Pocket”
No more “coinsurance out-of-pocket” terminology
Moving to industry standard of “total out-of- pocket”
All copays + deductible + coinsurance = TOOP
TOOP options will always be Federal MOOP or lower

17. 1099s Now Acceptable Subject to:
No more than 50% of group participants may be 1099.
Employer signs disclaimer acknowledging risk of providing employer benefits to 1099 contractors.

18. Sales – 888.767.7133 sales@alliednational.com
Questions?
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