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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
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Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

Jan 20, 2016

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Page 1: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 2: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 3: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 4: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 5: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 6: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 7: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 8: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Balance 1015

State Availability Map

Page 9: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 10: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 11: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 12: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 13: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 14: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 15: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 16: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 17: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 18: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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

Page 19: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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.

Page 20: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For 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.

Page 21: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For 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

Page 22: Balance Critical Illness & Accident Plans Brought to you by: Anthem and The IHC Group For training purposes only. Not for public distribution or solicitation.

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