1. The Cure for Healthcare
UNICARE
The Cure for Healthcare
Start

2. health care company for the last two years
UNICARE is part of WellPoint Health Networks, Inc., one of the largest health care companies in the nation!
WellPoint is a Fortune 500 company, and has been recognized as Fortune’s “Most Admired”
health care company for the last two years

3. UNICARE is reinventing the Individual and Small Group
insurance market!

4. Public versus corporate points of view...
What's the state of the industry?
Public versus corporate points of view...

5. INDIVIDUALS (non-Poor) Range of existing Plans
Assumed Price
INDIVIDUALS (non-Poor)
19-29
30-39
40-49
50-59
50%
Range of existing Plans
Willing To Pay
1) A recent California Healthcare Foundation study identified that virtually all uninsured people over 200% of FPL overestimate the price of individual coverage - but within a defined range
2) Half of those indicate that they WOULD buy at prices currently in the market
3) Great opportunity to sell - but what happens if rates go up more?
Source: California Healthcare Foundation

6. Hospital Physician Pharmacy
$200
$300
$400
$500
$600
1993
1995
1997
1999
2001
2003
2005
Hospital Physician
Source: Health Care Financing Administration, 1999, Scott-Levin, 1999
$45
$85
$125
$165
$205
Pharmacy
Pharmacy
Hospital
Physician
Physician
Hospital
Pharmacy
1) We’re all aware of Drugs, and up until ‘98 that was the only real component of cost “beginning to get out of hand”
2) Now however, every component of medical cost is in the act.
3) Remember the early and mid ‘80’s. That’s the last time we saw cost up at this rate coming off of a A SOFT pricing market.
4) YIKES!

7. $12,000 8% 70% $1,200 24% 23% $150 68% 7% PRICE Average Annual Usage
Source: Watson Wyatt Worldwide
Average Annual Usage
% of Americans
% of Total Dollars
$12, % 70%
1) 68% of our a typical population (ie: our insured business) is SO healthy, their sense of value is VERY impacted by this new cost/price trend
Uninsured are as healthy (if not more, than insured)
Value of “protection” is very low
Loosing over price means loosing the 68% category of members/small groups - big problem….
2) (Wellpoint dis-enrollment research) 1/2 of Small Groups and nearly 3/4 of individuals lapse because of price - 1 in 5 individuals and 1 of 8 small groups go uninsured afterwards
$1, % 23%
PRICE
$ % 7%

8. Opportunity is knocking!

9. Individual and
Family Medical Plans

10. Our Individual Medical Plans Offer
Lifetime maximum of up to $5 million
Wide choice of plans
Preventive Care
Out-of-Pocket Maximums provide protection against catastrophic expenses
MedCall® 24-hour nurse hotline
No claim forms with network providers

11. Individual Plan Choices
UNICARE Saver 2000 Plan
High Deductible for Medical Savings Accounts
(MSAs)
UNICARE Plans offer several deductibles:
$2,000
$1,500
$1,000
$500
UNICARE Premier No Deductible Plan
Term Life Coverage

12. We offer LOW-MEDIUM-HIGH plan options based on plan design and premium!
Please note: New sales brochures present benefits and
share of costs in a “you pay (this)” format

13. Medical Plans Features
Individual & Family
Medical Plans Features
Saver 2000 Plan provides in-hospital coverage with $2,000 deductible
Deductible plans with choice of 5 deductibles!
Premier No Deductible Plan (with NO Annual Deductible!)
$30 Co-Pays for in-network physician office visits on all plans!
Office visit co-pay excludes lab and x-rays

14. Individual UNICARE Saver 2000 Plan Features
Covers hospitalization and provides some limited benefits
2 office visits to participating providers per member, per year (adult) before deductible is met for a $30 Copay
No preventive care benefit
(except for babies and children through age 6)
Employment-related accidental injury or illness covered (unless covered by Worker’s Compensation Insurance or Employer liability laws)
No Maternity

15. Individual UNICARE Saver 2000 Plan Share of Costs
Drug Co-pays:
Retail (30 days):
$10 for Generic
$25 for Brand Name
Mail order (up to 60 days):
$20 for Generic
$50 for Brand
$2,000 medical deductible
UNICARE pays 70%, you pay 30% for inpatient facility and eligible professional charges
$200 Brand Name drug deductible
$500 Drug Maximum, per member per year (in- and out- of network)

16. Individual UNICARE Deductible Plans
Four separate plans with a choice of deductibles and in-network coinsurance levels
Up to 4 office visits to participating providers per member (adult) before deductible is met for a $30 copay
$200 worth of covered charges for Preventive Care for children and adults *(subject to deductible and coinsurance)
Employment-related accidental injury or illness covered
(Unless covered by Worker’s Compensation Insurance or Employer liability laws)
* Other than mandated benefits

17. Individual UNICARE Deductible Plans Share of Costs
$2,000
$1,500
$1,000
$500
80/20 to $3,000 in-network out-of-pocket max.* on the $500 and $1,000 plans
70/30 to $3,000 in-network out-of-pocket max.* on the $1,500 and $2,000 plans
* Must also meet deductible

18. Individual UNICARE Deductible Plans Prescription Drug Share of Costs
Brand Name Drug Deductibles
According to Plan:
Plan Deductible
UNICARE 500 $50
UNICARE 1,000 $100
UNICARE 1,500 $150
UNICARE 2,000 $200
Drug Co-Pays
for all plans
Retail (30 days):
$10 for Generic
$25 for Brand Name
Mail order (up to 60 days):
$20 for Generic
$50 for Brand Name

19. Individual UNICARE Premier No-Deductible Plan Features
Rich benefits and no annual deductible
Unlimited office visits
$200 worth of covered charges for preventive care for adults*
(subject to any coinsurance or copay)
Employment-related accidental injury or illness covered (Unless covered by Worker’s Compensation Insurance or Employer Liability Laws)
* Other than mandated benefits

20. Individual UNICARE Premier No-Deductible Plan Share of Costs
No brand name drug deductible
No drug maximum limitation
Drug Co-pays:
Retail (30 days):
$10 for Generic
$25 for Brand Name
Mail order (up to 60 days):
$20 for Generic
$50 for Brand
$30 Copay
80/20 to $3,000 in-network out-of-pocket maximum*
* Must also meet deductible

21. Other Common Elements Office Visits Annual Out-of-Pocket Maximum*
Individual
$3,000* on all plans for in-network charges!
$10,000* on all plans for out-of-network charges!
Family
$6,000* on all plans for in-network charges!
$20,000* for out-of-network charges on all plans!
Office Visits
$30 office visit copay excludes lab and x-rays
*Must also meet deductible

22. Affordable
Term Life Insurance
for Individuals

23. Affordable Term Life Insurance
Individual Term Life insurance is available to anyone who qualifies for one of our medical plans
Easy to apply for: Have applicant check the box on application form and complete the Term Life Insurance Application Addendum

24. Marketing Strategies
70% of those in the market don’t have a Life insurance agent
Window of opportunity: people don’t buy Term Life insurance unless YOU sell them Term Life insurance
Sound financial planning; Term Life is a “financial safety net” for your clients and those who depend on them

25. UNICARE stands
behind you!

26. Key Features to Look For in an Agent Agreement
Future renewals based on commission schedule in force when case was written.
Look for these key provisions in your agent agreements.
Renewals guaranteed to be based on schedule in force when you placed the case with a carrier.
No time limitation on renewals.
Ability to assign or sell your business.
Which is better for you to own your business – or the carrier to own your business.
Renewals paid for as long as case is in force.
Ownership and assignment provisions.

27. Our Commitment to You: Your UNICARE Agent Agreement
Ownership contract
(six cases issued)
Corporations can be licensed
No limitations on renewals
Do not accept agent of record on individual business

28. UNICARE: Compare the difference!
UNICARE Competitor
Plans Plans
First Year Commission % ?
Contract Ownership Yes! ?
Free Quoting Software Yes! ?
Access to Underwriters Yes! ?
AgentOnline/AgentConnect Coming ?

29. Supplemental Income Example of individual production at one case per
week. Average premium of $150 per case, 20%
commission first year-accruing scale.
Month 1 $120
Month 2 $240
Month 3 $360
Month 4 $480
Month 5 $600

30. Thank you and
Good Selling!