United American Insurance Company Proudly Serving Americans Since 1947 UAUHP R704 Agent Training.

United American Insurance Company

Proudly Serving Americans Since 1947

UAUHP R704

Agent Training

What United American Stands For…

Stability — Meeting the life and health insurance needs of the public for over half a century

Financial Strength

Quality Protection — Insurance coverage to protect you and your family now as well as in years to come

Superior Service — One-on-one personal service for the life of your policy, backed by Home Office support staff

That’s our way… the United American way.

• “A+ Superior” financial strength rating from A.M. Best*

• “AA Very Strong” financial strength rating from Standard & Poor’s*

*ratings as of 6/04

What are the headlines saying?

Health care costs still rising faster than the economy!

&

More people uninsured!

Sources: Health Affairs, June 2003AHIP, “2004 Elections: Medicare, the Uninsured, and Rising Costs Take Center Stage in Health Care Debate”, January/February 2004

Americans Face a Healthcare Crisis!

Health care costs continue to advance much faster than the rest of the U.S. economy:• a 8.5% increase in 2001• a 9.3% increase in 2002

Sources: Health Affairs, June 2004National Coalition on health Care, “Facts on Health Insurance Cost,” 2003

These costs are more than 5 times the rate of general inflation!

The Cost of Health Care

Insurance premiums have risen at a rate even greater than the rate of health care inflation.

According to experts, “Consumers can expect to pay more for greater access to health care.”

Sources: PricewaterhouseCoopers, April 2002

Increased Consumer Demand

15%

Government Mandates & regulations

15%

Rising Provider Expenses

18%

Drugs, Medical Devices & Other

Medical Advances22%

General Inflation18%

Litigation & Risk Management

7%

Other5%

Factors Driving Rising Costs in Healthcare 2001-2002

Persons Without Health Insurance

Rising costs in health care are pushing up health insurance premiums and forcing Americans into the ranks of the uninsured.

1988 — 30.6 million

1992 — 34.1 million

1996 — 40.9 million

2002 — 41.2 million

2003 — 43.6 million

It becomes a problem if you are

a Member of the Uninsured!Source: United States Department of Commerce News, September 30, 2003

United American Insurance CardIn order to receive non-emergency or post-stabilization treatment, consumers must demonstrate an ability to pay …

This is when your United American health insurance cardis most valuable!

Name: PAULA C. HOLDER

Policy PolicyNumber 57300876888 Effective 01-25-03

The Problem becomes finding affordable health insurance.

Where Do the Largest Medical Expenses Occur?

Hospital Confinement

Surgical Expenses

Emergency Room Charges

Source: American Medical Association 2001 Annual Report

Hospital Confinement vs. Doctor’s Office Bills

• Odds are 1 in 7 that you or a family member will have a hospital stay this year.

• Average hospital confinement includes room/board, surgical, miscellaneous and emergency expenses.

• Average cost of a 5-day hospital stay is $17,032

Source: Current Trends in Health Care and Dental Costs Utilization, 2003 Edition, Mutual of Omaha

As compared to the Larger Medical Expenses above,the average cost of a Doctor Office Visit in 2002 was relatively low. It was only $77!

Therefore, the most important areas to cover are:

Hospital Confinement

Surgical Expenses

Emergency Room Charges

• Guaranteed renewable individual policies, not collectively renewable

• Issue age pricing, not attained age pricing

• No Pre-authorization

• Top industry ratings & claim paying abilities

• No associations or association dues

• Use anywhere in the USA

• Local Home Office and Agent support

• No Lifetime Maximums

• Freedom of choice

Choosing a Healthcare Insurance Policy

Important things to consider!

It’s YOUR health!

YOU choose your health care providers.

WHO? WHAT? WHEN? WHERE?

These are questions that YOU answer!

With United American, you are in control of your health care — no gate keepers, no primary care physicians, no pre-certification, no worries about using out-of-network providers which could run up huge co-payment obligations.

UA’s Freedom of Choice

That’s our way… the United American way!

United American’sGOOD SENSE

PLAN

Finally, an Affordable Health Insurance Policy that makes good sense!

GSPSpecified Benefit Hospital and Surgical Expense Coverage

for Individuals & Families

DRB* Maximum $400 Issue Ages 0-63**

*Daily Hospital Room Benefit**Ages 0-60 in CA

Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.

GSP Eligible Hospital and Surgical Expenses

Daily Room Benefit $400 per/day up to $292,000

Benefits are payable for as long as two years for each covered injury or sickness beginning with the first day of hospital confinement. Benefits renew for each new covered injury or sickness.

Intensive Care Benefit $800 per/day up to $72,000 Two times the Daily Room Benefit is payable in lieu of Daily Room Benefit for up to 90 days of confinement in an intensive care unit of a hospital for each injury or sickness. Benefits renew for each new covered injury or sickness.

Surgical Expense Benefit up to $7,500Benefits are payable for surgical operations due to each injury or sickness per schedule (up to $7,500). Benefits renew for each new covered injury or sickness.

Assistant Surgeon’s Benefit up to $1,500 20% of the surgical benefit payable.



Administration of Anesthetic Benefit up to $1,875 Benefits are payable for administration of anesthetic up to 25% of the surgical benefit payable. Benefits renew for each new covered injury or sickness.

Radiotherapy Benefit up to $7,500Benefits are payable in lieu of other policy benefits for radiotherapy treatment IN or OUT of hospital for each injury or sickness. Benefits renew for each new covered injury or sickness.

Registered Nurse Benefit up to $15,300Benefits are payable for full-time private duty services of a Registered Nurse (R.N.) up to $85.00 per 8-hour shift for 2 shiftsper day for up to 90 days for each injury or sickness. Benefits renew for each new covered injury or sickness.

Ambulance Benefit up to $150Benefits are payable for ambulance expense for each injury or sickness. Benefits renew for each new covered injury or sickness.



In-Hospital Medical Expense Benefit up to $2,000Benefits are payable for expenses incurred up to $35 per visit, one visit each day, up to $2,000 for doctor’s visit for each injury or sickness not requiring surgery. Benefits renew for each new covered injury or sickness.

Miscellaneous Hospital Expense up to $25,000 Benefits are payable for miscellaneous hospital expense (less $500 deductible) at the rate of 80% of the expense incurred, other than room charges or physician fees, up to $25,000 (plus $500 if the maximum is reached) for each injury or sickness. This benefit is payable during a hospital confinement or when surgery is performed in a hospital on an outpatient basis. Benefits renew for each new covered injury or sickness.



Outpatient Hospital Benefit up to $200Benefits are payable for treatment at a hospital for any one covered injury or sickness not requiring confinement as a resident patient. (Except when a larger benefit would result from miscellaneous hospital expense benefit because of surgery performed in the hospital on an outpatient basis.) Benefits renew for each new covered injury or sickness.

Additional benefits available in most statesMales over 50 — yearly prostate cancer screeningFemales over 35 — yearly mammogramBreast reconstructive surgeryAll insureds — diabetic equipment, supplies and training

• Guaranteed renewable •• Individually owned policy •

• Issue age pricing •Policy Form GSP1. Plans/benefits may vary by state. This policy has some limitations and exclusions.


Accidental Death BenefitThe premiums paid for an Insured’s coverage will be refunded if the Insured’s death results from accidental bodily injury.

Example: $200 a month premium x 12 months x 5 years = $12,000 Refunded


LIMITATIONS AND EXCLUSIONS

We will not pay benefits under this policy for:

1. Normal pregnancy (including childbirth); or

2. Rest cure, custodial care or functional nervous or mental disorders; or

3. Any Hospital Stay or other service for which You or a Family Member do not incur a charge; or

4. Any loss covered by any Worker’s Compensation or Employers’ Liability Law; or

5. Any Hospital Stay or other service that is not medically necessary; or

6. Any expense incurred in excess of the usual, customary and regular charges for any service or materials in the geographic area where furnished; or

7. Charges incurred for professional radiological or pathological interpretation; or

8. Rehabilitative care services received at a facility not meeting the definition of a Hospital.

AdditionalBenefitspaid under

Policy Form UA-250

Plans/benefits may vary by state.


Policy Form CILS

Plans/benefits may vary by state. See application/brochure for Limitations & Exclusions


Policy Form CANBThis is a cancer only policy.



Policy Form SMXC



Policy Form SSXC



Policy Form HMXC


UA Partners® Program

• Dental • Vision • Hearing Aid • Chiropractic • Prescription Drug • 24-Hour Nurse HelpLine• Travel Assist

Our optional discount service program includes:

Nationwide discount health services program with savings for:

Chiropractic

Dental

Eye Care

Hearing Aids

Prescriptions

Mail OrderPharmacy

0% 10% 20% 30% 40% 50%

Up to 40%

Up to 50%

Up to 50%

Up to 20%

Up to 30%

Save More $$



Provider Network Program

UA Partners members and their families have access to negotiated rates with over 300,000 physicians, and over 4,100 hospitals across the country through a network of providers.

These network programs are offered by Competitive Health, which was founded in 1996 and is one of the leading administrators of discount medical health benefits in the nation.

How does the Provider Network Program work?

Member calls 1-800 for nearest provider and makes an appointment

Member presents the UA Partners with PPO ID card to physician’s office

Member presents the Provider Letter to the provider at the first appointment

Physician’s office calls toll-free number and enters UA Partners member ID number, physician’s tax ID number and CPT-4 code

The repriced amount is calculated in seconds Provider collects repriced amount from patient

Why United American?• Providing quality health protection since 1947• Top ratings with A.M. Best & S&P• Fast policy issue (4-6 weeks)• Local office• Personal support (always deal with a live person, either Home Office

staff or Agent)• Individual qualification (not a group plan)• Guaranteed renewable policies• Issue age pricing• No Lifetime Maximums on GSP• No associations or association dues• Freedom of Choice• Use anywhere in the U.S. and outside• UA Partners to help drive down the cost of Health Care Services

United American Insurance Company Proudly Serving Americans Since 1947 UAUHP R704 Agent Training.

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Transcript of United American Insurance Company Proudly Serving Americans Since 1947 UAUHP R704 Agent Training.