Mar 28, 2015
Insurance coverage underwritten by UniCare Life & Health Insurance Company. Registered Mark and SMService Mark of
WellPoint, Inc. 2005 WellPoint, Inc.
Introducing...........Introducing...........
Michigan Individual PlansMichigan Individual Plans
Individual plans are grouped Individual plans are grouped into three categories;into three categories;
UniCare PPO PlansUniCare PPO Plans The Saver PlanThe Saver Plan High Deductible Health Plans High Deductible Health Plans
(HSA-Compatible)(HSA-Compatible)
Six (6) UniCare PPO Plans offering the Six (6) UniCare PPO Plans offering the following deductibles:following deductibles:– $5,000$5,000 - $1,500- $1,500– $3,000$3,000 - $1,000- $1,000– $2,000$2,000 - $ 500- $ 500
The UniCare Saver 2000 PlanThe UniCare Saver 2000 Plan
Four (4) High Deductible Health Four (4) High Deductible Health Insurance Plans (HDHP) for Health Insurance Plans (HDHP) for Health Savings Accounts (HSAs)Savings Accounts (HSAs)
Dental PlansDental Plans
Term Life CoverageTerm Life Coverage
Individual PlanIndividual Plan ChoicesChoices
Lifetime maximum of up to $5 million per Lifetime maximum of up to $5 million per membermember
FamilyFlex ®FamilyFlex ®
Each family member can have a different planEach family member can have a different plan
Preventive CarePreventive Care Out-of-Pocket Maximums provide protection Out-of-Pocket Maximums provide protection
against catastrophic expensesagainst catastrophic expenses
MedCall® and HealthyExtensions MedCall® and HealthyExtensions smsm programsprograms
No claim forms with network providersNo claim forms with network providers
Our Individual Medical Plans Our Individual Medical Plans OfferOffer
– UniCare PPO PlansUniCare PPO Plans
– UniCare Saver PlanUniCare Saver Plan
– UniCare High Deductible Health UniCare High Deductible Health Insurance PlansInsurance Plans (HSA-Compatible)(HSA-Compatible)
Michigan Individual PlansMichigan Individual Plans
Michigan Individual PlansMichigan Individual Plans
UniCare PPO PlansUniCare PPO Plans
– Consisting of six (6) plans with selected Consisting of six (6) plans with selected deductibles and varying co-insurance, deductibles and varying co-insurance, these plans offer rich and valuable these plans offer rich and valuable benefits; yet they are competitively benefits; yet they are competitively priced. priced.
500 1000 1500 2000 3000 5000
Member $500 $1,000 $1,500 $2,000 $3,000 $5,000Family
Member
Family
80% 80% 70% 70% 70% 70%
80% 80% 70% 70% 70% 70%
$50 $100 $150 $200 $300 $500
$30 for 20 visits per member per year (par and non-par combined)
$200 Max covered expense per member par and non-par combined
80% 80% 70% 70% 70% 70%
of Maximum Covered Expense After DeductibleGround services up to Max of $1,000 per trip
Air services up to Max of $5,000 per trip
Prescription Drug Benefit
Rx Deductible Brand Name only
Generic prescriptions: $10 co-pay per Rx, No DeductibleBrand Name, formulary: $30 co-pay per Rx, above deductible applies
Brand Name, Non-formulary: $50 co-pay per Rx, above deductible applies
Professional Svcs, Lab & Xray and
Out & Inpatient Care
Other RoutineCare Services
Office Visits
AmbulanceServices
Physical & Occupational Therapy, Acupuncture
$30 Co-pay per visit per member, Unlimited number of visits with Deductible waived
$6,000 plus Deductible per year
UniCare PPO Plans
Max Out of Pocket
$5 Million per memberAnnual
Deductible
Individual Plans
Maximum 2 deductibles per family per year
$3,000 plus Deductible per year
Lifetime Maximum
– UniCare PPO PlansUniCare PPO Plans
– UniCare Saver PlanUniCare Saver Plan
– UniCare High Deductible Health UniCare High Deductible Health Insurance PlansInsurance Plans (HSA-Compatible)(HSA-Compatible)
MichiganMichigan IndividualIndividual PlansPlans
Individual UniCareIndividual UniCareSaver 2000 Plan FeaturesSaver 2000 Plan Features
This is a hospital plan with two office This is a hospital plan with two office visits and some limited outpatient visits and some limited outpatient pharmacy and lab & xraypharmacy and lab & xray
Benefits include 2 office visits to Benefits include 2 office visits to participating providers per member per participating providers per member per year year beforebefore deductible is met at a $30 deductible is met at a $30 CopayCopay
Preventive care benefitPreventive care benefit
Individual UniCareIndividual UniCareSaver 2000 Plan BenefitsSaver 2000 Plan Benefits
$2,000 medical deductible$2,000 medical deductible UniCare pays 70%, you UniCare pays 70%, you
pay 30% for inpatient pay 30% for inpatient facility and eligible facility and eligible professional chargesprofessional charges
$200 Brand Name drug $200 Brand Name drug deductibledeductible
$500 Drug Maximum, per $500 Drug Maximum, per member per year member per year (in- and out- of (in- and out- of network)network)
Two office visits per Two office visits per member per yearmember per year
Drug Co-pays:Drug Co-pays:
RetailRetail ( (30 days supply30 days supply))$10$10 for Generic with for Generic with No DeductibleNo Deductible$30 $30 for Brand Name for Brand Name
FormularyFormulary$50$50 for Brand Name for Brand Name
Non-Non-formularyformulary
– UniCare PPO PlansUniCare PPO Plans
– UniCare Saver PlanUniCare Saver Plan
– UniCare High Deductible Health UniCare High Deductible Health Insurance PlansInsurance Plans (HSA-(HSA-Compatible)Compatible)
MichiganMichigan IndividualIndividual PlansPlans
Health SavingsHealth Savings AccountsAccounts ((HSAsHSAs))• Health Savings Accounts are not
insurance policies, but separate agreements between an eligible individual and a qualified financial institution. For convenience, UniCare has partnered with JPMorgan Bank, N.A. (Chase) who can offer this service to you, however, it is not a requirement to use the Chase HSA to apply for UniCare’s HDHP. You may establish your account with any qualified financial institution.
First a word about HSAs...........
Health SavingsHealth Savings AccountsAccounts ((HSAsHSAs)) President Bush signed into law on President Bush signed into law on
December 8December 8thth as part of the Medicare as part of the Medicare RX bill (RX bill (Eff.Eff. 1/1/20041/1/2004))
Who is eligible to open an HSA?Who is eligible to open an HSA? Anyone who is covered under a High Anyone who is covered under a High
Deductible Health Plan (HDHP)Deductible Health Plan (HDHP) Generally anyone under the age of 65 Generally anyone under the age of 65
(not Medicare eligible)(not Medicare eligible) Cannot be claimed as dependent on Cannot be claimed as dependent on
another person’s tax returnanother person’s tax return Not covered by any other health planNot covered by any other health plan
What are the contribution rules and What are the contribution rules and tax treatment of an HSA?tax treatment of an HSA?
An HSA is generally exempt from tax (like an An HSA is generally exempt from tax (like an IRA) as long as a HDHP existsIRA) as long as a HDHP exists
Contributions may be made annually up to the Contributions may be made annually up to the lesser of the HDHP deductible amount or $2650lesser of the HDHP deductible amount or $2650
Individuals, employees or employers may Individuals, employees or employers may contribute to the HSA accountcontribute to the HSA account
The HSA account is owned by the individual, not The HSA account is owned by the individual, not an employeran employer
Withdrawals may be made without tax Withdrawals may be made without tax consequences to pay for medical expenses and in consequences to pay for medical expenses and in some instances for insurance premiumssome instances for insurance premiums
Un-used account balances may carry over from Un-used account balances may carry over from year to yearyear to year
Health Savings Accounts Health Savings Accounts (HSAs)(HSAs)
More information regarding HSA More information regarding HSA Administration Services can be Administration Services can be found on the following Web sites:found on the following Web sites:
– www.hsainsider.comwww.hsainsider.com– www.nwww.nahu.orgahu.org
UniCare/WellPoint Integrated HSA UniCare/WellPoint Integrated HSA Program through Chase BankProgram through Chase Bank
Health Savings Accounts Health Savings Accounts (HSAs)(HSAs)
What is an HDHP?What is an HDHP?
In order to qualify for an HSA, you In order to qualify for an HSA, you must be enrolled in a qualified HDHP. must be enrolled in a qualified HDHP. An HDHP is a health insurance plan An HDHP is a health insurance plan that meets the following U.S. Treasury that meets the following U.S. Treasury requirements:requirements:
– Annual Deductible of at least $1,000 Annual Deductible of at least $1,000 ($2,000 family)($2,000 family)
– Annual Out of Pocket not in excess of Annual Out of Pocket not in excess of $5,100 ($10,200 family)$5,100 ($10,200 family)
– No first dollar benefits-Deductible must No first dollar benefits-Deductible must apply to all benefitsapply to all benefits
High Deductible Health PlanHigh Deductible Health Plan(HSA-Compatible)(HSA-Compatible)
UniCare’s High Deductible Health UniCare’s High Deductible Health Insurance Plans consist of four (4) plans Insurance Plans consist of four (4) plans with selected deductibles and varying with selected deductibles and varying co-insurance which, when coupled with co-insurance which, when coupled with a Health Savings Account, offers a Health Savings Account, offers premium savings, tax advantages*, and premium savings, tax advantages*, and investment opportunities.investment opportunities.
High Deductible Health PlanHigh Deductible Health Plan(HSA-Compatible)(HSA-Compatible)
*UniCare does not offer tax advice. For further information please consult your attorney or qualified
tax advisor.
Single Family Single Family Single Family Single Family
$1,000 $2,000 $2,650 $5,250 $2,650 $5,250
$5,000 $10,000 $5,000 $10,000
GroundAir
Rx Ded.Generic
Brand (formulary)
Brand (non-form)
Plan 4Plan 3
100%
$30
80% 100%
After Plan Ded
$30 for 20 visits per member per year, par and non-par combined
100%
Up to Max of $5,000 per trip
After Plan Ded
You pay nothing after the Plandeductible is met
You pay nothing after deductible is met
100%
UniCare's HDHP
$10
Physical Therapy, Occupational Therapy, Acupuncture
80%
Plan 2Plan 1
80%
Annual Deductible*
Maximum Out of P ocket
*Plans 1, 2 & 3 feature a variable deductible that will adjust each year to reflect annual changes in the U.S. Treasury requirements
$50
After Plan Ded
$5 Million per member
(HSA-Compatible)Lifetime Maximum
Professional Svcs, Lab & Xray Radiation Therapy, Out & Inpatient
Care and Office Visits
Preventive CareImmunizations (Children through age 6), adult pap smear, annual mammogram, PSA screening.
80% 80% 100%
After Plan Ded$10$30$50
PrescriptionDrug
Benefit
$5,000 $10,000
Ambulance Services
Up to Max of $1,000 per trip
100%
80%
UniCare’s Dental Insurance Plan UniCare’s Dental Insurance Plan provides affordable coverage for dental provides affordable coverage for dental care including: care including:
Access to quality care at discounted feesAccess to quality care at discounted fees A wide range of dental services for preventive, A wide range of dental services for preventive,
diagnostic, basic and major dental carediagnostic, basic and major dental care Freedom to choose any dentistFreedom to choose any dentist Additional savings for visiting an independently Additional savings for visiting an independently
contracted, in-network dentistcontracted, in-network dentist Annual deductible of $50 per person or $150 per family, Annual deductible of $50 per person or $150 per family,
waived for preventive and diagnostic services performed waived for preventive and diagnostic services performed by a contracted dentistby a contracted dentist
Affordable Term Life Affordable Term Life Insurance Insurance
Individual Term Life insurance is Individual Term Life insurance is available to available to anyoneanyone who qualifies for who qualifies for one of our medical plansone of our medical plans
Easy to apply for:Easy to apply for: Have applicant check Have applicant check the box on application form and the box on application form and complete the Term Life Insurance complete the Term Life Insurance Application AddendumApplication Addendum
Marketing StrategiesMarketing Strategies
70% of those in the market don’t 70% of those in the market don’t have a Life insurance agenthave a Life insurance agent
Window of opportunity: people don’t Window of opportunity: people don’t buy Term Life insurance buy Term Life insurance unless unless YOU YOU sell them Term Life insurance sell them Term Life insurance
Sound financial planning; Term Life is Sound financial planning; Term Life is a “financial safety net” for your a “financial safety net” for your clients and those who depend on clients and those who depend on themthem
KeyKey FeaturesFeatures toto LookLook ForFor inin anan AgentAgent AgreementAgreement
Future renewals based on commission Future renewals based on commission schedule in force when case was written.schedule in force when case was written.
Renewals paid for as long as case is in force.Renewals paid for as long as case is in force.
Ownership and assignment provisions.Ownership and assignment provisions.
OurOur CommitmentCommitment to You:to You:Your UniCare Agent AgreementYour UniCare Agent Agreement
Ownership contractOwnership contract
(six cases issued)(six cases issued) Corporations can be Corporations can be
licensedlicensed
UniCare does not UniCare does not accept accept agent of record agent of record changeschanges on individual on individual businessbusiness
UniCareUniCare Competitor Competitor PlansPlans
PlansPlans
First Year Commission*First Year Commission* 20%20% ?? Renewal Commision*Renewal Commision* 10%10% ?? Contract OwnershipContract Ownership Yes!Yes! ?? Free Quoting SoftwareFree Quoting Software Yes!Yes! ?? Access to UnderwritersAccess to Underwriters Yes!Yes! ?? AgentOnline/AgentConnectAgentOnline/AgentConnect Yes!Yes! ??
UniCare: Compare the difference!UniCare: Compare the difference!
* Based on level 1 premium
Example of individual production atExample of individual production at one case per week.one case per week. Average premium of $150 per case,Average premium of $150 per case, 20% commission20% commission first year-accruing scale.first year-accruing scale.
Month 1Month 1 $120$120Month 2 Month 2 $240$240Month 3Month 3 $360$360Month 4Month 4 $480$480Month 5Month 5 $600$600
SupplementalSupplemental IncomeIncome
ThankThank Y UY U forfor
AttendingAttending