Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation. © IHC Group 2015 PPT Balance 1015
Jan 20, 2016
BalanceCritical Illness & Accident Plans
Brought to you by:
Anthem and The IHC Group
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
The Partnership
Anthem and The IHC Group have partnered together to offer critical illness and accident plans for your clients, designed to help consumers cover everyday expenses, such as mortgage payments and daycare. This is accomplished by building four membership levels:
Balance 1
Balance 2
Balance 3
Balance 4
Partners: Producers, Anthem, Designated Agent Company and The IHC Group
Designated Agent Company is a General Agency owned by Anthem
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
The IHC Group Corporate Overview
Madison National Life Insurance Company, Inc. (MNL) is the underwriting carrier for Balance, rated A- by A.M. Best
Ebix Health Administration Exchange, a member of The IHC Group, administers Balance
New York Stock Exchange traded company (NYSE:IHC)
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Communicating For America
Association membership in Communicating For America (CA) is required
CA is a national 501(c) non-profit corporation
Members across all 50 states
Separate board of directors not affiliated with The IHC Group, or SSL. National headquarters in Fergus Falls, Minn.
Since 1972, more than 100,000 consumers have trusted CA to help them find gap plans to stretch their healthcare dollar.
Continues to advocate on behalf of its members with insurance companies, regulators and lawmakers.
Cost of the association is included in the monthly retail rate
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Balance
Guarantee issue product that complements your clients medical plan
Provides a package of insurance coverage, services and discounts, including:
Critical Illness
Medical Expenses due to Accidents
Hospital Confinement due to Accidents
Disability Income due to Accidents
Doctor on Demand
Association based non-insurance services such as emergency road-side reimbursement and legislative hotline
Insurance benefit payments go directly to your client unless assignment to a medical provider is requested
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Consumer Perspective
No coordination of benefits with the members health plan
Critical illness and accident plans assist in funding out-of-pocket costs or daily living expenses
Payments may be assigned to providers or paid directly to insured
Critical illness and Accident Medical Expense benefits can provide income in excess of plan out-of-pocket to help defray the impact of significant illnesses on family budgets
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
The Broker Perspective
Single product source No need to deal with multiple underwriters or administrators for
ancillary plans
Outstanding customer service for all bundled Balance products at one location
Lower cost Bundling ancillary products lessens the impact of selection
Lower administrative cost due to multiple products on single bill Product ease
Co-branding arrangement with Anthem limits client confusion Online policy fulfillment
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
State Availability Map
AccidentBenefit Levels
Balance 1 Balance 2 Balance 3 Balance 4
Critical illness $2,500 $5,000 $7,500 $10,000
Accident medical $2,500 $5,000 $7,500 $10,000
Accident hospital confinement
$150 per day
$150 per day
$150per day
$150per day
Accident disability income
$1,000per month
$1,000per month
$1,000per month
$1,000per month
Individual monthly cost $34.95 $44.95 $54.95 $64.95
Family monthly cost $51.95 $69.95 $89.95 $109.95
Exclusions and limitations apply
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Accident Medical Expense
Balance 1 Balance 2 Balance 3 Balance 4
Accident medical insurance $2,500 $5,000 $7,500 $10,000
Deductible per accident $100 $250 $500 $500
Coverage eligibility A family membership covers the primary member, spouse and all dependents up to age 26
Coverage duration After the deductible, benefits are payable for medical expenses incurred as a result of each
covered accident
Pays medical expenses resulting from a covered accident
The benefit payment is up to the amount of the medical expense
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Accident Medical ExpenseExample - Balance 2
$5,000 AME
Deductible $250
Customer submits bill for full claim amount after network discounts (if in-network)
IHC reimburses up to cost of discounted medical expenses or plan maximum whichever is less
Total claim expense/cost $6,000
Insured receives an EOB from their medical insurance company
Insured sends a completed accident medical claim form and any additional requirements to IHC
IHC reviews, and if approved, sends a check for $4,750 to the client unless payment is assigned to the provider
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
AccidentHospital Confinement
Balance 1 Balance 2 Balance 3 Balance 4
Accident hospital confinement $150
Per day
For training purposes only. Not for public distribution or solicitation.
Coverage eligibility A family membership covers the primary member, spouse and all dependents up
to age 26
Coverage duration Benefits are available for up to 30 days when hospital confined due to a covered
injury
© IHC Group 2015
PPT Balance 1015
Accident Disability Income
Balance 1 Balance 2 Balance 3 Balance 4
Accident Disability Income Insurance
$1,000 per month
Coverage eligibility This benefit is available only to the primary insured
Coverage duration Pays a monthly benefit up to 12 months for disability due to a covered
accident
After a 90 day elimination period
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Critical IllnessBenefit Levels
Heart attack
Kidney failure
Paralysis
Stroke
Coma
Coronary bypass
Loss of sight, speech or hearing
Major organ transplant
Life-threatening cancer
Severe burn*
Balance 1 Balance 2 Balance 3 Balance 4
Critical Illness Coverage
$2,500 $5,000 $7,500 $10,000
Pays a lump sum benefit upon diagnosis of:
For training purposes only. Not for public distribution or solicitation.
*Amount payable is a percentage of the benefit based on the area burned
The amount payable will be reduced by 50 percent if the covered person is age 65 or older on the date the benefit becomes payable.Covered illnesses may vary by state
© IHC Group 2015
PPT Balance 1015
Critical IllnessContinued
Coverage eligibility A family membership covers the primary insured and spouse only
Dependent children are not covered for Critical Illness Coverage
Subject to a 12 month pre-existing condition limitation (based on date of first
diagnosis)
Benefit varies by type of illness and other terms; benefit reduces by 50% when the
insured attains age 65
Coverage terminates at age 70
Coverage duration 30 Day Waiting Period / 90 Days for Life Threatening Cancer diagnosis
Critical illnesses diagnosed in the first 30 days of coverage will have the lesser of a
$500 benefit or 10 percent of the amount that it would have paid for the condition if
first diagnosed more than 30 days after the insured person’s effective date.
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Critical IllnessExample
1. Member suffers from a stroke
2. Member completes a claim form and sends all requirements to Ebix Health Administration Exchange
3. Ebix Health Administration Exchange Reviews
4. Ebix Health Administration Exchange(on behalf of MNL) sends check for a lump sum to the insured member
Request and complete claim form
for Balance
Ebix Health Administration Exchange Reviews
Check sent to customer if claim is approved
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Getting Started
For training purposes only. Not for public distribution or solicitation.
You must be contracted with The IHC Group and Anthem in order to sell Balance
Contracting is available from your Anthem representative or at the Anthem Coverage Resource Center www.healthedeals.com/ccc-ic
Click “Get set up to sell”
You must have an active Health license in each state that you do business and be appointed by the carrier
© IHC Group 2015
PPT Balance 1015
Your Personalized Link
Once contracted, you will receive a welcome email which will provide you with a unique link to quote and enroll your clients.
Bookmark your link for easy continued access
This personalized link will ensure that you receive credit for your sales; do not share with other agents to sell from.
Publish and access your link with the “Link Creation Tool” at any time
Post your link on your website
Place a banner in your email signature
Email to a client so they can self-enroll
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Quoting and Enrollment
www.myihcgroup.com
Enroll and assist customers online
Email proposals with application links for clients to self enroll
Only allows you to quote plans that are available in your state
View brochures
View product information
Access your activity reports
Case status
View policy information
Download policy information
© IHC Group 2015
PPT Balance 1015For training purposes only. Not for public distribution or solicitation.
Compensation
Standard writing agent compensation is 30%*
*Enrollment and monthly admin fee not included
© IHC Group 2015
PPT Balance 1015For training purposes only. Not for public distribution or solicitation.
Important InformationTHIS PLAN IS NOT CONSIDERED TO BE MINIMAL ESSENTIAL COVERAGE AS DEFINED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA). ENROLLING IN AND MAINTAINING THIS PLAN WILL NOT EXEMPT YOU FROM THE SHARED RESPONSIBILITY PAYMENT (TAX) THAT MAY APPLY IF YOU DO NOT HAVE PLAN WITH ACA-COMPLIANT COVERAGE.
Communicating for America, Inc. (CA) is a national non-profit advocacy organization that supports affordable healthcare for all Americans. Since 1972, more than 100,000 consumers have trusted CA to help them find affordable health insurance and GAP plans to stretch their healthcare dollar while advocating on their behalf with insurance companies, regulators and lawmakers.
About Madison National Life Insurance Company, Inc. Madison National Life Insurance Company, Inc. (Madison National Life), domiciled in Wisconsin is licensed to sell insurance products in 49 states, the District of Columbia, Guam, American Samoa and the U.S. Virgin Islands. Its core products and services are health insurance, group life and disability income, employer stop-loss, specialized individual life and annuity products to military and government personnel. It is rated A- (Excellent) for financial strength by A.M. Best Company, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations (an A++ rating from A.M. Best is its highest rating).
Ebix Health Administration ExchangeEbix Health Administration Exchange is a full service administrative services company that operates in 50 jurisdictions in the individual and employer markets, and provides state of the art and highly efficient open health insurance exchanges through its affiliation with Ebix Incorporated, and, through an affiliate, is the provider of pet insurance solutions that provide pet parents, specialty pet hospitals and universities and general veterinary practices with the only open exchange in the country for all interested constituencies.
About The IHC Group The IHC Group is an organization of insurance carriers and marketing and administrative affiliates that has been providing life, health, disability, medical stop-loss and specialty insurance solutions to groups and individuals for over 30 years. Members of The IHC Group include Independence Holding Company (NYSE:IHC), American Independence Corp. (NASDAQ: AMIC), Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company. Each insurance carrier in The IHC Group has a financial strength rating of A- (Excellent) from A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations. (An A++ rating from A.M. Best is its highest rating.) Collectively, the companies in The IHC Group provide insurance coverage to more than one million individuals and groups. For more information about The IHC Group, visit www.ihcgroup.com.
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015
Thank you
Questions? Please reach out to your Anthem representative, call 855-632-9003 or email [email protected]
For training purposes only. Not for public distribution or solicitation.
© IHC Group 2015
PPT Balance 1015