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Assurant Health Product Portfolio
- 1. Assurant Health Core Product Portfolio
- 2. Individual Medical Plansin our portfolio MaxPlan CoreMed RightStart One Deductible SaveRight Affordable Health Access *Limited Benefit Plan Special Features Patient Care * TelaDoc Healthy Discount * One Decreasing Deductible Suite Solutions * available with select plans
- 3. Quality is theFramework All major medical plans in the Assurant Health portfolio begin with a quality framework of: Security. Convenience. Cost savings. All plans include: Worldwide coverage, 24 hours-a-day Initial 12-month rate guarantee Your choice of doctors and hospitals No referrals necessary to see a specialist Single deductible for accidents No limits on Intensive Care Unit (ICU) Ground and air ambulance Transplant coverage Preventive Services Healthy Discount Patient Care
- 4. Patient Care Experiencednational leader in independent health care advocacy services Provides a point of contact who serves as: An Advocate — working with insureds to answer questions, help reduce frustration and confusion, and better understand their health care benefits A resource — providing cost and quality information to better inform insureds A problem solver — working with health care entities to work through issues — thus taking customers out of the middle
- 5. *TelaDoc doesn’t replacea primary care physician— but when a physician isn’t available, TelaDoc is there.
- 6. TelaDoc—Convenient Access 24hours a day, 365 days a year Clients call toll free or go online Medical records stored securely and available online Client can update Client can share with their doctor Available for patients 12 years and older
- 7. TelaDoc—Cost-effective With MaxPlanSM and CoreMed SM Plans Three FREE consultations per person each year $35 fees for additional consultations are covered subject to deductible and coinsurance Pay securely by credit card, debit card, or electronic payment With OneDeductible Plans $35 consultation fees are covered subject to deductible and coinsurance Pay securely by credit card, debit card, or electronic payment All terms, limits, and conditions of the Assurant Health contract apply.
- 8. How it worksTelaDoc Physicians: Provide diagnosis Recommend treatment Prescribe short-term medication* Examples of common conditions physicians consult and treat: Sinusitis/respiratory infections Urinary tract infections Allergies Answer medical questions When appropriate, prescribe convenience (limited-quantity) refills* *TelaDoc does not prescribe DEA-controlled substances.
- 9. How it worksConsultation process*—a TelaDoc physician: Reviews medical record Calls client—typically within an hour Recommends treatment or refers client to primary care physician Updates medical record Prescribes a short-term medication, if appropriate TelaDoc calls the prescription in to client’s pharmacy * Prior to contacting TelaDoc, client fills out medical history disclosure.
- 10. TelaDoc Assurant Healthis the first national IM carrier to offer plans with TelaDoc Medical Services Available with MaxPlan, CoreMed, and OneDeductible plans Available with new business effective September 1, 2008, and later Not available on plan designs with an Office Visit Copay option Not available in CT, FL, GA, ID, KY, MN, MT, NH, NV, OK, OR, SC, or TN
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- 12. Suite Solutions OverviewCash benefits that help pay out-of-pocket expenses Available through membership in Health Advocates Alliance Who is it for? Clients who have a high deductible Clients concerned about accidents (typically clients with children) Client Benefit “ Gap” coverage provides security and savings Portable Easy Suite Solutions
- 13. Product Options SecureSolutionAccident Medical Expense Benefit Accidental Death and Dismemberment Benefit Weekly Accident Indemnity Benefit SelectSolution Accident Medical Expense Benefit Critical Illness Expense Benefit Accidental Death and Dismemberment Benefit Weekly Accident Indemnity Benefit Identity Network Child Safety Services Identity Theft Benefit Discounts on dental, vision and more Suite Solutions
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- 15. MaxPlan SM ValueProposition: Maximum protection to achieve security and predictability Most extensive benefits Many options Who is it for? MaxPlan is ideal for clients who: understand the value of protecting both their health and their assets want no limits on how often they see their doctor – always at a set price are highly concerned about having an adequate level of protection MaxPlan SM
- 16. MaxPlan SM Highlights Doctor office visit copay option Unlimited visits at $35 /visit Preventive services Eligible from 1 st day of coverage $1,000 per person/calendar year (no limits on Mammograms, Pap tests & PSA) Generic prescription drugs Convenient $15 copay on generics with no deductible , no limit Brand name prescription drugs $500 deductible $25 copay and 20% coinsurance Family deductible Only 2X individual deductible Lifetime maximum Up to $15 million *state variations apply* MaxPlan SM
- 17. MaxPlan SM Details MaxPlan SM $3 million or $15 million Lifetime Benefit Maximum $0 to $7,500 depending on coinsurance Out-Of-Pocket Maximum Available with $2,500 or higher deductibles 24 and 36 Month Rate Guarantee 100/0, 80/20, 70/30, 50/50 Plan Structures $500, $1,000, $1,500, $2,500, $3,500, $5,000, $10,000, $15,000 or $25,000 (Family deductible maximum is two times the deductible and is met collectively by two or more persons) Deductibles
- 18. CoreMed SM ValueProposition: Broad coverage at the best value No inside limits The plan clients ask for Most flexible Most requested Most sold Who is it for? Excellent for people who want to control premiums without sacrificing benefits Appeals to a wide range of individuals and families CoreMed SM
- 19. CoreMed SM Highlights Office visit copay option Four visits/person/year − just $35 per visit Preventive services $500/person/year-6 month wait Generic prescription drugs Convenient $15 copay on generics with no deductible, no limit Brand name prescription drugs $500 deductible $25 copay and 50% coinsurance Family deductible Only 2X individual deductible CoreMed SM
- 20. CoreMed SM Details See brochure for complete details CoreMed SM *not available in KS, MN, MS, NM, ND or OR • Outpatient: $0 or $200/outpatient surgery Inpatient: $0, $200 or $750 per day for the first three days Facility Fees $2 million or $15 million Lifetime Benefit Maximum $0 to $7,500 depending on coinsurance Out-Of-Pocket Maximum Available with $2,000 or higher deductibles 24 and 36 Month Rate Guarantee* 100/80, 80/20, 70/30, 50/50 Plan Structures $500, $1,000, $1,500 , $2,000, $3,500, $5,000, $10,000 or $25,000 (Family deductible maximum is two times the deductible and is met collectively by two or more persons) Deductible Options 15% cheaper than $1000 deductible! 50% to $4000 Out-Of-Pocket = 16% Savings!
- 21. RightStart SM ValueProposition: Basic benefits plus added protection against serious illnesses and injuries Most affordable plan Who is it for? Uninsured individuals and families Individuals and families considering dropping current coverage because of price Prospective clients with limited budgets RightStart SM
- 22. RightStart SM Highlights Doctor office visit copay option 2 visits at $25/visit Generic prescription drugs Convenient $15 copay on generics with no deductible, optional limit up to Annual Maximum amount Brand name prescription drugs $500 deductible $25 copay with 50% coinsurance RightStart benefit Many combinations to keep premium within budget Annual maximum Outpatient services maximum Prescription drug maximum Also available as a non-PPO plan RightStart SM
- 23. RightStart SM Details See brochure for complete details RightStart SM Available with $2,000 or higher deductibles 24 and 36 Month Rate Guarantee* $2 million Lifetime Benefit Maximum $50,000, $100,000 or $250,000 Annual Maximum $2,500, $5,000 Outpatient Services Maximum $2,500 with 50/50 plan $4,500 with 75/25 plan Out-Of-Pocket Maximum $25,000 increase in outpatient services State Availability varies Optional Cancer Benefit 75/25, 50/50 Plan Structures $500, $ , $2,000 or $3,000 (Family deductible maximum is three times the deductible and is met collectively by three or more persons) Deductible
- 24. OneDeductible- availablewith or without an HSA Value Proposition: Convenient: One common deductible for ALL covered expenses – even prescriptions – for everybody on the plan Simple: Easiest-to-understand plan Extensive Benefits: Most robust HSA plan Smart Financial Choice: Higher deductible and lower premiums than conventional plans Who is it for? People who view health insurance as a financial decision as well as a healthcare decision Those willing to fund their everyday expenses, but who want extensive catastrophic coverage People who value the tax savings associated with an HSA OneDeductible
- 25. OneDeductible Highlights Simple − One deductible for all family members Preventive services $1,000 annual preventive services benefit Optional first-dollar preventive services benefit $500/person/year after 12 months Lifetime maximum benefit Up to $15 million HSA account administration options HSA Tools- now free for all clients, online enrollment HSA Fundamentals One Decreasing Deductible 10% deductible credit 2Xs per year- January 1 st , July 1 st Available with deductibles of $2850 ind/$5700 family & higher Deductible can decrease as low as $1500 ind/$3000 family
- 26. OneDeductible Details Seebrochure for complete details OneDeductible *not available in KS, MN, MS, NM, ND or OR $0 to $2,500 depending on coinsurance Out-Of-Pocket Maximum $3 million or $15 million Lifetime Benefit Maximum Available with $2,100 deductible & higher 24 and 36 Month Rate Guarantee* 100/0, 80/20, 50/50 Plan Structures Individual plan:$1,200, $1,600, $2,100, $2,850,$3,750 or $5,000 Family plan: $2,400, $3,200, $4,200, $5,700, $7,500 or $10,000 Deductibles
- 27. SaveRight- available withor without am HSA Value Proposition: Most economical HSA-qualified plan Premium savings can be used to help fund the HSA Who is it for? Those whose top priority is premium savings People willing to assume greater risk but want catastrophic coverage People who want the tax benefits of an HSA plan and low premiums SaveRight
- 28. SaveRight Highlights Prescriptiondrugs Covered Lifetime maximum $2 million HSA account administration Comes with HSA Tools Flexible options to keep premiums low Outpatient services maximum options available Also available as a non-PPO plan SaveRight
- 29. SaveRight Details 100%plan now available with $3,000 deductible. Saves more than 10% vs. comparable OneDeductible design! See brochure for complete details SaveRight *not available in KS, MN, MS, NM, ND or OR $2 million Lifetime Benefit Maximum None Annual Maximum $15,000 or $25,000 Outpatient Services Maximum $0 to $3,000 depending on coinsurance Out-Of-Pocket Maximum Options Available with all deductibles 24 and 36 Month Rate Guarantee* 100/0, 75/25, 50/50 Plan Structure $2,300, $3,000 or $5,100 (Family deductible maximum is two times the deductible and is met collectively by two or more persons) Deductible
Editor's Notes
- #6 With the 9-1 release, we are including TelaDoc Medical Services on several Assurant Health Individual Medical plans. Clients will receive access to TelaDoc, a network of licensed, board-certified primary care physicians who provide around-the-clock access to nonemergency medical care by telephone, 365 days a year. TelaDoc offers Assurant Health clients convenient, credible, and cost-effective access to care.
- #7 The doctor’s office, urgent care, and emergency rooms are good traditional choices for medical care. But each one can cost money and time that your clients might not spend if there was a sensible alternative. And if it’s a holiday, a weekend, or the middle of the night, an urgent care facility or a doctor may not be available. With TelaDoc Medical Services, clients have a convenient added option for medical care. They have access to physicians 24 hours a day, 365 days a year. To contact TelaDoc, clients simply call toll free or go online. Medical records are stored securely and available to clients online. Clients can access medical records to update or to share with their local doctor if they choose. TelaDoc services are available for patients 12 and older.
- #8 In addition to convenience, TelaDoc provides cost savings. Consultations are only $35 each. Clients who choose Assurant Health’s MaxPlan or CoreMed plan without an Office Visit Copay option receive three FREE consultations per person each year. If additional consultations are needed, the $35 fees are covered subject to deductible and coinsurance. Clients can pay securely using one of a number of electronic payment options. For clients choosing a OneDeductible Plan, the $35 consultation fees are covered subject to deductible and coinsurance and they pay securely using one of a number of electronic payment options such as a Health Savings Account debit card.
- #9 TelaDoc physicians provide diagnosis, recommend treatment, and prescribe short-term medication—typically for conditions such as: • Sinusitis and other respiratory infections Urinary tract infections and • Allergies The physicians also answer medical questions and, when appropriate, prescribe convenience refills—limited quantities of maintenance medications until clients can contact their doctor or pharmacy.
- #10 Prior to contacting TelaDoc, a client will fill out a medical history disclosure. When a client contacts TelaDoc via toll-free number or online to request a consultation, a TelaDoc physician: Reviews the client's medical record Calls the client—typically within an hour Recommends treatment or refers the client primary care physician Updates the client’s medical record and Prescribes a short-term medication , if appropriate. Then TelaDoc calls the prescription in to the client’s pharmacy. And if the client has paid for the consultation, TelaDoc submits the claim to Assurant Health and makes available a standard claim form for the client’s records.