Title: Insurance Carrier
1Insurance Carrier
- Guarantee Trust Life Insurance Company
- Founded in 1936
- Headquartered in Glenview, Illinois
- Mutual legal reserve company with over 2 billion
life insurance in force - Rated B (Very Good) by A.M. Best
- 1.2 million insureds
- Licensed in 49 states
- Visit www.realfastservice.com to learn more
2Reinsurance
- Munich Re Group
- 2nd Largest Reinsurance Company
- Founded in 1880
- Headquartered in Munich, Germany
- 5,000 insurance companies in 150 countries rely
on Munich Re's expertise and financial strength - Affiliated companies in 23 countries
- Visit www.munichre.com to learn more
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4Individual Major Medical A Growing Market
- 45 million uninsureds
- 15 million uninsureds with an annual household
income of 50,000 and above - Medical inflation has driven premiums out of the
reach of many increasing the number of
uninsureds - Smaller and larger companies are dropping their
group coverage and encouraging employees to
purchase insurance on their own - The growth and opportunities in this market is
enormous
5Assur-Care Series
- Comprehensive major medical coverage for
individuals and families - Choice of 2 major medical plans
- Flexibility (choices in deductibles and
coinsurance)
6Assur-Care Series
- Advantage
- Benefits are richer
- Cost is higher
- Complete
- Benefits are very attractive, and very affordable
-
- Coverage is available for eligible individuals,
families and even children alone. - Substandard cases may be issued with rate ups or
riders.
7Additional Features on Both Plans
- The policy will pay 100 of covered expenses up
to the Lifetime Maximum after the out-of-pocket
maximum expenses are met by the insured
8Additional Features on Both Plans
- Rx Discount Card
- On the Advantage Plan, while you are meeting
your Rx Co-pay Drug Card deductible, if
applicable, and, on both plans, for drugs not
covered under the Rx benefit rider, simply
present your Rx Discount Card at an affiliated
network pharmacy to receive a discount on drug
purchases. - The Rx discount is not an insurance benefit. The
Rx discount is not available for drugs purchased
at pharmacies not affiliated with Express
Scripts.
9Additional Features on Both Plans
- Routine Physical Exams
- Advantage Plan - Covered after insured 90 days
up to 150 maximum benefit per examination per
covered member/spouse per benefit period (every
two years), including lab tests (blood/urine)
associated with the same routine physical exam.
Subject to coinsurance only. - Complete Plan - Covered after insured 12 months
up to 100 maximum benefit per examination per
covered member/spouse per benefit period (every
two years), including lab tests (blood/urine)
associated with the same routine physical exam.
Subject to coinsurance only. - Example Cost of physical is 200. Insured has
Advantage Plan at 80/20 to 10,000 coinsurance.
In this case, carrier will pay 80 of the 200
only up to 150. The actual 80 of the 200 comes
to 160, so the insured is responsible for the
additional 50, which does not go toward any
deductible or coinsurance stop-loss.
10Additional Features on Both Plans
- Child Health Supervision
- Includes immunization. Specific age intervals
from birth to 6 years - Pap Smear
- One screening per calendar year
- Mammograms
- One baseline ages 35-39. Age 40 and over covered
yearly - Prostate Cancer Screening (PSA) Tests
- One per calendar year for males age 40 and over
- Colorectal Cancer Screenings
- One screening, including sigmoidoscopies or fecal
occult blood testing, every 3 years for persons
at least 50 years old. excluding
Colorado -
- All above covered subject to deductible, service
deductibles, co-payments and coinsurance (unless
rider selected). - Optional Enhanced Routine Preventive Care
Benefits Rider - Covers above benefits subject to coinsurance
only, with no waiting periods! Subject to age
intervals as outlined above.
11Additional Features on Both Plans
- LabOne
- LabOne is another cost containment program. It
does not replace existing lab benefits. LabOne is
a fully accredited and certified laboratory which
offers significant savings over other labs. At
the time of service, simply request that lab work
be sent to LabOne for processing. There will be a
LabOne card sent with each insureds
policy/certificate. - LabOne will submit claims for services directly
to Guarantee Trust Life or the plan
administrator. If a provider is unable to collect
the specimen, LabOne has contracted draw sites - available.
- You will receive LabOne discounts when your lab
specimens are sent - to LabOne for testing. Covered expenses are
subject to calendar year - deductible, coinsurance and any applicable
service deductibles. - Client Services 1-800-750-1253
www.laboneselect.com -
- Not available in all states.
12Additional Features on Both Plans
- Initial 12 Month Rate Guarantee
Initial premium rates, excluding fees, are
guaranteed for 12 months. Initial premium
rates may change if you move, change your plan or
add/delete covered dependents
13Additional Features on Both Plans
- 24-Hour Occupational Coverage
- To be eligible for this optional Rider, the
applicant and/or spouse must be - (1) A sole proprietor, partner, owner or other
individual gainfully - employed in an occupation eligible for the Rider
and - (2) Eligible to opt out of Workers Compensation
by their state - law and have done so.
- This optional Rider provides benefits for
injuries or sicknesses, that arise out of - or in the course of employment, on the same basis
as any other - covered illness.
- Benefits are payable provided the covered person
is not insured or required - to be covered under any Workers Compensation or
similar law, the expenses - are incurred while the Rider is inforce and the
covered person's occupation and - employment status as listed on the application
for this benefit has - not changed after the covered person's effective
date under the Rider.
14Additional Features on Both Plans
- Family Premium Discount
- Preferred Health Discount
- Family premium discount of 5 applies when a
certificate is issued with - two or more eligible family members applying
together. - Preferred health discount of 20 applies to
qualified individuals ages 18 through 39.
15Additional Features on Both Plans
- Calendar Year Deductible Carryover
- Covered expenses incurred during the last three
months of a calendar year that are applied to
the medical plans calendar year deductible will
also apply toward - the following years calendar year
- deductible. This does not apply to the
- separate Rx Drug Card deductible.
16Additional Features on Both Plans
- Common Accident Deductible
- If two or more covered persons sustain an injury
in the same accident, only one calendar - year deductible will be applied to all
- covered medical expenses arising out of that
accident.
17Additional Features on Both Plans
- Medical Emergencies
- Medical benefits for emergency services (as
defined in the policy) will be considered for
payment at participating provider benefit level,
limited to the usual, reasonable and customary
charge. Emergency services must be provided
within 72 hours following the onset of the injury
or illness. -
- Medically Necessary Covered Services Not
Available From A PPO Provider - and referred to a
Non-PPO provider will be considered for payment
at PPO level, limited to the usual, reasonable
and - customary charge.
18Pre-Existing Conditions Limitation
- An illness or injury of a covered person for
which the covered person has - received medical advice, treatment, services,
diagnostic tests, consultation - or medication during the twelve (12) months prior
to the covered persons - effective date of coverage under the policy.
Benefits will be payable for a - pre-existing condition, unless the condition is
specifically excluded under - the policy or excluded by endorsement or rider
attached to the policy or - certificate, if at the end of a continuous
12-month period commencing - on or after the effective date of the covered
persons coverage, the person - has not received medical advice, treatment,
services, diagnostic tests, - consultation or medication in connection with
such illness or injury or, at - the end of the two (2) year period commencing on
the effective date of - the covered persons coverage, the person has
been covered under the - policy.
- Health conditions duly disclosed in the
application for coverage of - the covered person and otherwise covered by this
policy, unless the - condition is specifically excluded by endorsement
or rider attached - to the policy or certificate, are covered from
the effective date of - coverage under the policy.
19Preferred Provider Organization (PPO) Networks
- The Most Extensive PPO Networks Available in the
Industry - Features National and Popular Regional Networks
- www.gtlplans.com now displays the available PPO
networks by state - Each network has a link to their website, phone
number and also displays Network Factor - This makes it as easy as a click of your mouse
to find out if your clients physician is
participating in one of the available networks
20AmeriBenefit Plan
AmeriBenefit Plan16476 Chesterfield Airport
Rd2nd FloorChesterfield, MO 63017Email
info_at_ameribenefitplan.comPhone (888) 416-2815
21AmeriBenefit PlanMembership benefits
includeABP Membership is optional in CO/GA.
The above benefits, including the Accident
Medical Expense Benefit, are only available to
members of AmeriBenefit Plan.
- Accident Medical Insurance Choice of 1,000
coverage with a 100 deductible or 5,000
coverage with a 250 deductible - GymAmerica.com On-line interactive exercise and
- diet program
- Vitamin and Nutritional Supplement Discounts
- 15 discount on a wide range of products
- HopTheShops.com Cybermall featuring over 100
high quality e-tailers and stores with special
discounts and features. - Pre-Employment Background Reports/Investigative
Services Special discounts on these services
provided by an internationally renowned
investigative and consulting agency - Powernet Global Long distance rate of 4.9 cents
per minute state to state, twenty-four hours a
day, seven days a week - Emergency Medical Info Card Wallet-size card
provides personal medical profile in case of
emergency - Penny Wise Office Supplies Discounts Up to 36
off already discounted prices on a large
selection of items - ITC-50 Hotel Discounts A network of over 4,000
hotels that offer a 50 discount - Theme Park Discounts Provides members access to
discounts at theme parks
22Major Competitive Advantages in Plan Benefits
- Physical, Respiratory and Speech Therapy for
Rehabilitative Treatment no limits - Transplants no separate maximum benefit
- Rx Benefit no limits
- Home Health Care (in lieu of a covered hospital
confinement) Up to 40 visits per person per
calendar year - Spinal Manipulation and other Manipulative
Therapy - Up to 500 maximum benefit per covered
person per calendar year - Covers Emergency Care received outside the U.S.
no time limits or maximums - 24 Hour Occupational Coverage no charge for
those who qualify
23Who are your Prospects?
- Uninsureds
- Offer them affordable health insurance
- Insureds
- Save them money
- Younger ages
- Affordable and comprehensive coverage
- Families
- Affordable for the family
- Doctor office visits and Rx benefits
24Field Tools To Assist You
- Reference Guide
- Quick Reference Guide
- Height and Weight Chart
- Ineligible Occupations
- New Business Guidelines
- Administrative Guidelines
- Customer Service Information
- Claims Information
25Underwriting
- Reviews the enrollment application.
- Based on answers, additional information,
telephone verification or medical records may be
ordered. - All underwriting notes on a case are available on
line so you can easily see what the case status
is.
26Underwriting
- Depending on the condition of the applicant,
several things can happen - Case issued standard
- Case issued with rate up
- Case issued with exclusionary rider
- Case pended for medical records
- Case declined
- Note Consumers can call into underwriting to
verbally accept exclusionary riders and/or
rate-ups!
27Effective Date and Billing Information
- 1st and 15th of the month
- Monthly Bank Draft (automated checking debit)
- Monthly Credit Card (Visa or MasterCard) - 7
billing fee - Monthly Direct - 7 billing fee
- Quarterly - 7 billing fee
- Semiannual - 7 billing fee
- List Bill (except in these states)
- CO, MI, MO, TN, VA, WI
28What happens after the application is submitted?
- After online application is submitted, the
consumer is emailed a confirmation with a link to
their application. - The agent will be sent an email confirming we
received the application, date, confirmation ,
plan selected, premium amount and link to web
site. - The consumer email will tell them to call the
800 for the telephone verification - The underwriter will automatically call the
applicant for the TI if the applicant has not
already called in. (5 times)
29Policy Fulfillment and Issue
- Once the case is issued, an approval letter is
sent from underwriting to the insured. - The agent can check on case issuance and the date
the kit was mailed via the web site. - A fulfillment kit with certificate/policy, ID
card, ABP brochure, welcome letter, etc. is
mailed within 24-48 hours.
30On Line Tools for Submitting and Managing Business
- Prepare a quote proposal (view, save, print,
email) - Apply on line (easy process)
- A confirmation email is sent to the agent and the
applicant - Look up your application status on line
- Status, notes, letters and correspondence
associated with your applications are at your
fingertips
31Doing Business with Insurance Benefit Group is
Easy
- On line-applications (or paper).
- Quick turnaround time in underwriting.
- Innovative web site for agents to track and
manage their business. - Sales tools to support your marketing efforts.
32Summary
- Comprehensive Coverage
- Flexibility of Benefits
- Competitive Rates
- Easy enrollment
33GTL - 4 Pillars
- Doc CoPay
- 40 CoPay
- Unlimited Visits
- Wellness
- 5 Benefits
- Mammogram, Pap Smear, PSA Test, Colorectal Cancer
Screening Child Immunization - No Deductible (Coinsurance Only)
- No Waiting Period
- Organ Transplants no separate maximum benefit
- Physical, Respiratory and Speech Therapy for
Rehabilitative Treatment no separate maximum
benefit