Listening, Learning, Responding and Caring
Always Care Introduction Presentation 2009
Jun 24, 2015
2009 AlwaysCare Company Information and Benefit Offerings
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Listening, Learning, Responding and Caring
AlwaysCare Benefits, Inc.
o Home office based in Baton Rouge, LAo Dental, Vision, Hearing, Life & Disabilityo 400,000+ covered memberso Privately owned and operated
oRecognized by Inc Magazine as one of the fastest growing privately owned companies
o Customer first culture
Confidential
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50,000
100,000
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200,000
250,000
2000
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2008
E
Strong membership growth (primary insureds)
Confidential
Our metrics
o 92%+ group retentiono 99%+ claims processing accuracyo 95% of inquiries resolved on first contacto New groups implemented in 5 days (avg.)o 95% overall Customer satisfaction rateo 90%+ of survey respondents will recommend
AlwaysCare to a family member or friendo Claim processing time: 4-5 business days
Confidential
The AlwaysCare Target Market
o Group Dental and Vision
oAvailable for groups of 2 or more
o Strong Niche: Blue collar and service type industries
o 2-9 shelf plans and rates
oAverage case size for block is 78 employees
oLargest case 30,000 eligible
The AlwaysCare Difference Makers
o Online Serviceso Website
o AlwaysAssist
o Consumerism & Transparency
o Account Management Serviceso Enrollment assistance
o Welcome calls/letters
Difference-Makers: Group Dental
o Plan Design Flexibilityo Choice of deductible options including $100 lifetime
o Cosmetic Riders – bleaching, porcelain crowns
o Endosteal Implantso Covered under major services
o Available on all plans and case sizes
o Carryover Benefit o Carrying over benefit dollars for future needs
o One preventive visit per year required
o Available for all group sizes
o Ease of Administrationo Employer determines contribution level
o Paperless enrollment available
Dental Details
o DenteMax networko 80,000 providers nationwide
o Passive/blind PPO model
o Active PPO options available
o Participation guidelineso 2-9 75% of eligibles
o 10+ greater of 5 or 20% of eligibles
o Rate bands 20-49%; 50-79% and 80% or higher
o Periodontics & endodonticso Basic or major services
o Annual maximumso $500, $750, $1000, $1200, $1500 and $2000
Dental Product Updates
Wellness Benefit Enhancements
Additional Cleaning for pregnant women in their 2nd or 3rd trimesters (Standard Benefit)
Members 40+ years of age who demonstrate risk factors for oral cancer or suspicious lesions are entitled to one adjunctive, pre-diagnostic test per year (Standard Benefit)
Members diagnosed with diabetes are eligible for 2 extra cleanings every twelve months (Optional Benefit)
Dental Questions to Ask
o When and what age limits have you recently changed to your contract?
o Have you made any changes to benefit frequencies?
o Do you split up simple vs. complex periodontic/ endodontic procedures?
o How do you handle UCR? Can you provide me your top 10 ADA codes?
Difference-Makers: Group Vision
o Two and Three Tier Network Plans
o Standard in and out-of-network plan with copay flexibility
o Three tier Wal-Mart vision plan option
o Mail Order contact lenses via the web
o Use their contact benefit
o Great discounts
o Materials-Only Plan Options with hearing rider
o Great add-on for medical plan that covers annual vision exam
o High value and low cost
Vision Product Updates Simply need 5 enrolled if packaging with dental 3 year rate guarantees for 50+ enrolled
5% load Costco added to the network
Member will need to file claim on their own behalf Specialty lenses and material upgrades only for First Look
Network
Provides identified as Value Add (VA) or Service Plus (SP) on website
Lens Options: UV, scratch resistance and anti-reflective coating, tinting, polarized, polycarbonate, etc.
Second pair of glasses or contact lenses with preferred pricing
AlwaysHearing – Delivering Value
o Hearing Modelo Traditional PPO plans – in and out-of-network benefitso Optional rider to dental and/or vision
o Benefit Highlightso Covers hearing diagnosticso Allowance toward the cost of hearing aidso Free hearing diagnostics for Childreno Significant discounts on hearing aids – 40%+
o There is a needo Affects 31.5 million Americans; 68% under 65o iPod generation aging
New Products
Life/AD&D, STD and LTD Partnering with GroupRe Plus (a The Hartford company) Combined billing and package discounts will be available Great addition to our Dental and Vision products
Group Life Insurance
Basic Life
Available for 10+ enrolled
Choice of coverage amounts
Flat amount, % of earnings or combination benefit schedule available
Voluntary Life
Available for 10+ enrolled
Increments of $10,000
Guaranteed issue for greater of 10+ enrolled or 25% of eligibles (benefits based on size and participation)
Short Term Disability
STD Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) First Day Hospital Benefit
Benefits commence on first day of hospital confinement or date of Outpatient Surgical procedure
Elimination Period Accident as short as 0 Illness 7 or higher
Maximum Benefit Periods 13, 26 or 52 weeks
Weekly Benefit Amounts 50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $2500 Min Benefit $25
Long Term Disability LTD
Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) EAP service included
Up to 5 visits per policyholder Elimination Period
90 or 180 days (other options available) Definition of Disability Options
2 year ‘own’ occ and ‘any’ occ thereafter (other options available) Monthly Benefit Amounts
50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $6000 (other amounts available) Min Benefit: amount is greater of 10% of group’s monthly benefit or $50
Difference-Makers: Web-Based Tools
o AlwaysAssist - Online Group Administrationo Adds and deletes of employeeso View bills
o AlwaysAssist - Member Accesso Claims statuso Print temporary and request additional ID cardso Dental Cost Estimator o Change of addresso Track annual maximum and deductible levels
o AlwaysAssist - Providerso Check eligibility o Verify benefits
o Dental Health Center - Consumerism Toolso Provider locator of in-network and extended network certified
providerso Frequently Asked Questions of Dentists and ‘Ask A Dentist’
Questions & Answers
Thank You
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