Balance Critical Illness & Accident Plans Confidential and Proprietary – may not be used or...

BalanceCritical Illness & Accident Plans

Confidential and Proprietary – may not be used or distributed without Anthem consent

Brought to you by:

Anthem and The IHC Group

CO/NV


What is Balance?

Anthem brokers now have access to a guaranteed issue product that is a great complement to your client’s medical plan - Balance

• Balance is an association membership that provides a package of insurance coverage, services and discounts, which include:

• Critical Illness

• Medical Expenses Due To Accidents

• Hospital Confinement Due To Accidents

• Disability Income Due To Accidents

• Balance helps members “Balance” their finances in the wake of a critical illness or accident

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Balance

• With four membership levels, Balance allows your clients to focus on getting well because payments help cover everyday expenses such as:

• Mortgage payments

• Daycare

• Household bills

• Credit cards

• Balance insurance benefit payments go directly to your clients

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Affordability is still an

issue

• Average deductible in 2010 for single coverage on individual plans was $2,632 and $3,531 for a family¹

• Higher deductibles and out-of-pocket limits disproportionately impact those with lower incomes²

• 21 percent of adults surveyed indicated that they paid a medical bill late in the past 12 months³

• Anecdotal information indicates that employees are choosing not to insure their dependents on employer sponsored plans due to cost

Health Care Reform: Consumer Perspective

1 eHealth Insurance Cost Report; 2 NHEA (Centers for Medicare and Medicaid Services & Deloitte Analysis); 3 Harris Poll, National Quorum telephone survey

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Critical Illness and Accident

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Source: Eastbridge Consulting's annual “U.S. Worksite Sales Report”

• Carriers are developing more new products than years past

• Critical Illness and Accident plans leading the way

• The heightened burdens and costs of regulation imposed by healthcare reform on health insurance is leading carriers to explore other products and means of providing protection from illness, accident or injury.


Health Care Reform: Consumer Perspective

How Balance HelpsHow Balance Helps

• Critical illness and accident plans assist in funding out-of-pocket cost

• Payments may be assigned to providers or paid directly to insured

• Critical illness can provide income in excess of plan out-of-pocket to help defray the impact of significant illnesses on family budgets

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Balance Participants

Communicating For

America

Madison National & Independ-

ence Holding

Co.

Anthem

Brokers

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Communicating for America Association

• Approximately 50,000 members across all 50 states

• Separate board of directors not affiliated with The IHC Group or Madison National Life Insurance Company

• Offices in Fergus Falls, Minn. and Minneapolis, Minn.

• National membership organization founded in 1972

• Active in the Alliance for International Educational and Cultural Exchange

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Why Balance? The Broker Perspective

Single Product Source

• No need to deal with multiple underwriters or administrators for the ancillary plans

• Outstanding customer service for all bundled Balance products at one location

Low Cost

• Bundling ancillary products lessens the impact of selection

• Lower administrative cost due to multiple products on single bill

Product Ease

• Guaranteed issue products

• Co branding arrangement limits client confusion

• Online policy fulfillment

Balance is easy to sell and service

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Why Balance? The Broker Perspective

Commissions

• Balance values you and your client – commissions of 30%

• Supplements your medical commissions

Broker Benefits

• Diversifies your book of business• Improves retention and monthly sales

Balance benefits you directly

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Balance Is Technology Focused

• Interested brokers (in good standing with Anthem) can be easily appointed with MNL by simply submitting a sub-agent agreement

• Each broker will receive a unique URL that allows him or her to enroll customers online*

• If a client applies online through the Anthem site they will be offered the opportunity to enroll in Balance at the end of the medical application

• The broker number is carried over from the Anthem enrollment site through secure web services

• Policies are fulfilled online immediately upon payment verification

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*Multiple URL’s are possible if writing broker has multiple parent TINs


Balance Plan Benefits

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Balance

Bundled guaranteed issue insurance coverage consisting of:

• Critical illness• Medical Expenses Due To Accidents• Hospital Confinement Due To Accidents• Disability Income Due To Accidents

Additional benefits include:• Teledoc• Low-rate student loans• Reimbursement for towing and emergency roadside

services• Discounts on remote meeting, remote PC access and

backup• Legislative hotline to let your voice be heard in

Washington

Balance membership includes:

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Balance Benefits Appeal To:

• Families with children looking for accident medical expense coverage

• Those over the age of 45 in need of critical illness insurance

• Sole proprietors and the self employed who cannot find disability coverage

• Consumers who want the convenience of guaranteed issue coverage, online enrollment and credit card payment

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Critical Illness and Accident benefit levels

Exclusions and limitations apply

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

*Underwritten by Madison National Life Insurance Company, a Wisconsin Insurance company. All benefits terminate at age 70 and coverage is not available in all states. Accident Medical Expense benefits are reduced by benefits payable under other insurance plans. Additional limitations andexclusions apply and provisions may vary by state. Refer to the policy form number GAO-P-1207 for a complete listing of benefits, exclusions andlimitations.

15Confidential and Proprietary – may not be used or distributed without Anthem consentConfidential and Proprietary – may not be used or distributed without Anthem consent


Critical Illness

Pays a lump sum benefit upon diagnosis of:

• Coma• Coronary bypass• Loss of sight,

speech or hearing

• Major organ transplant

• Paralysis• Severe burn

• Life-threatening cancer

• Heart attack• Kidney failure• Stroke

Balance 1 Balance 2 Balance 3 Balance 4

Critical Illness Coverage

$2,500 $5,000 $7,500 $10,000

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Critical Illness

Some additional points regarding Critical Illness Coverage:

• 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

• Unless otherwise noted, coverage must be in effect for 30 days before benefits are payable 17

Accident Medical Expense

• 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

• Non-duplication of benefits: The benefit is reduced by the amount paid by any other health care plan

• A family membership covers the primary member, spouse and all dependents up to age 26


Accident medical insurance $2,500 $5,000 $7,500 $10,000

Deductible per accident $100 $250 $500 $500

18Confidential and Proprietary – may not be used or distributed without Anthem consent

Accident Hospital Confinement

• Benefits are available for up to 30 days when hospital confined due to a covered injury

• A family plan covers the primary member, spouse and all dependents to age 26


Accident hospital confinement $150

Per day


Accident Disability Income

• Pays a monthly benefit up to 12 months for disability due

to a covered accident

• After a 90 day elimination period

• This benefit is available only to the primary insured

Balance 1

Balance 2

Balance 3

Balance 4

Accident Disability Income Insurance

$1,000 per month


Critical Illness Example

• Member suffers from a stroke

• Member completes a claim form and sends to IHC

• IHC Reviews

• IHC (on behalf of Madison National) sends check for a lump sum (depending on plan selection) to the member

Request and complete claim form for IHC

IHC Reviews

Check sent to customer


Accident Medical Expense

Example - $5,000 claim:

The member’s major medical coverage:

$5,000 deductible

Balance plan selected: •Balance 1 ($2,500)

Insured receives an EOB from their medical insurance company

Insured sends a completed accident medical claim form to IHC with copy of medical EOB

IHC reviews, and on behalf of MNL, sends a check to the client

for $2,250 ($2,500 minus the $250 deductible)



Member Welcome Kit

Your member will receive a welcome kit via email that will include:

• A contact list including information on how to submit a claim

• A brief explanation of the Balance ancillary services• Link to specific set of critical illness and accident

certificates (based on membership level purchased)

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Commissions – External Broker

The average monthly cost of a Balance Plan is $60. If you sell 5 memberships a week, you could earn $90 in commissions. Here’s the math:In a week:• $60 x 5 memberships = $300 premium• $300 x 30% = $90 commission each week

In a month:• $90 x 4 weeks = $360 commission

In a year:• $90 x 52 weeks = $4,680 each year!

Let’s take a look at what you could be earning:

As you can see, Balance plans can be a good source of supplemental income!

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How do I sign up?

Broker Appointment Process

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External Broker Contracting & Appointment Process

Here’s how the contracting and appointment process will work:

Broker completes the sub-agent

agreement

Start

Note: Anthem’s Licensing and Credentialing department will need to confirm the broker is active w/ Anthem and is in good standing before logging the contract and

sending the file to IHC.

Broker sends signed contract to Anthem via fax or email to Licensing and Credentialing

Anthem sends daily file of

brokers to IHC

IHC loads brokers into their admin

system

IHC will send NV broker to DOI for

appointment (This step is not necessary in CO)

IHC sends welcome email

with personalized broker URL within 4 business days

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Once appointed by IHC – External Brokers

Broker receives a welcome email that includes their IHC broker number and instructions to access the IHC website (www.ihcsales.com/balance). This website is the online source for:

• Viewing new business case status/application• Downloading forms• Statements• Accessing compensation statements (external broker) • IHC Broker Support

Brokers should include the IHC broker number on all Balance correspondence and paper applications to ensure sales are properly credited, and commissions are paidBroker receives an email that contains their unique URL for forwarding to customers to apply for Balance

• Available to current medical clients who wish to add Balance, and clients without medical coverage

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http://www.ihcsales.com/balance


How do my customers sign up?

Application Process

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PlanFinder

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Critical Illness and Accident Coverage offered through BalanceBalance is a package of benefits designed to supplement your health insurance plan and give you additional financial support when you need it most. Balance is provided by Communicating for America which provides financial benefits to help you recover from a covered critical illness or accident as well as other valuable services.

When an applicant visits Planfinder, they will see a new icon on all Medical Plans/Deductibles. Hovering over the icon will provide a description.

Confidential and Proprietary – may not be used or distributed without Anthem consent 30

PlanFinder – Final Confirmation Page

By clicking continue, the applicant will be taken to the Balance website to startthe application process. There, they will fill out a short, simple application.Broker number will carry over from Planfinder.


Upon selecting the continue button, the applicant will see a pop-up message:

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PlanFinder – Final Confirmation Page

Disclaimer:

Disclaimer at bottom of page: Balance is a membership in Communicating for America, Inc. and includes benefits underwritten by Madison National Life Insurance Company, Inc., along with valuable discounts and services. Association membership services are provided by Communicating for America, Inc. There is no ownership affiliation between Madison National Life Insurance Company, Communicating for America or Anthem Blue Cross and Blue Shield. Each entity is separate, independent and unaffiliated with Anthem Blue Cross and Blue Shield and its products and services Anthem Blue Cross and Blue Shield, or its affiliates, may receive compensation from membership fees or otherwise in connection with association membership.

“You are now leaving Anthem’s website and will be routed to the IHC Secure Website to complete the Balance application. If you do not wish to apply

for Balance, please click cancel.”


IHC URL

• A second way to direct applicants to the Balance website is to email them the Balance URL link directly. This will take them directly to the website, and will credit the sale to your IHC Broker Number.

EASY ENROLLMENT PROCESS!

• Whether the applicant arrives at the Balance website via Planfinder or by clicking on the IHC link, the application process will be the same. The applicant will then complete the enrollment process on the Balance website.

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Once the applicant arrives at the IHC Website, the application process is quick and easy!

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Balance Website – Application Process


Step 1 – Applicant completes basic demographic information

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Step 2 – Payment information

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Step 3 – SummaryIt’s as easy as that!

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Balance – Payment Methods

Monthly Payment Options Include:

• Automatic Withdraw From Checking Account• Recurring Credit Card Payment

(Paper Billing is not an option)

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Balance – Effective Dates

Possible Effective Dates Include:

• 1st, 8th, 15th, and 22nd. • Example:

• If the application is submitted prior to 9:00 PM Mountain time on the 1st, the applicant will receive the 1st as the effective date (unless they request a later date.) If the application is submitted after 9:00 PM Mountain time on the first, the effective date will default to the 1st of the following month (unless otherwise specified.)

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Member Collateral

There are two places where brokers can view and download Balance brochures:

• AgentAccess Site• IHC Agent Website

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Event Date

PlanFinder Availability 5/21/12

First Available Effective Date 6/01/12

First Commission Payments Made

3rd business day of the month*

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Important Dates

*Commissions will be paid once commissions reach $25


Disclaimer

The information included in this training is an outline of features, plan provisions, benefits and other information about the Balance membership benefit packages. Plans offered may be subject to change and terms and limitations apply. Availability and benefits may vary based on state of residence.

This training is not intended to serve as legal interpretation of benefits. Benefits exclusive to the Balance series are provided under master policies (GAO-ACC-C-1207, GAO-CI-C-1207, GAO-P-1207) issued to Communicating for America, Inc. and underwritten by Madison National Life Insurance Company, Madison, Wisconsin. Policy form numbers may vary by state.

Refer to the insurance policies all riders for complete eligibility information, termination provisions and a full list of exclusions and limitations.

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Thank you!

Go get ‘em!

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