American Select Corporate Overview

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American Select Corporate Overview

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Title: American Select Corporate Overview


1
URL Financial
Bridging the gap to new sales and increased
commissions TC/TC1 8/01/07
2
Presented by
Dave Ward
  • Senior Vice President and Senior Product Officer
    with American Select, with over 25 years
    experience in the health insurance industry.

3
AGENDA
  • Who is American Select
  • Carrier Partners and Administration
  • Supporting Our Distribution
  • PPO Information
  • Product/State Availability
  • Target Markets
  • Product Review
  • Value Added Advantages
  • Distribution and Contact Information

4
American Select Strategic Alliance Program
5
Who We Are What We Do
American Select is a management company that
manages, through strategic alliances with the
best partners in the industry, the entire product
line from beginning to end, including design,
filings, pricing, reinsurance, marketing,
underwriting, administration and risk management
(collectively referred to as our Strategic
Alliance Program)
6
Who Are The Alliance Partners
  • Our reinsurance partner, Munich Re America, is a
    member of the Munich Re Group, the 3rd largest
    financial services company in the world and one
    of the worlds and Americas leading reinsurers,
    meeting the needs of its clients since 1880.
    Munich Re America has 3.9 billion in statutory
    surplus and 17.5 billion in high-quality assets
    to provide clients with outstanding balance sheet
    strength, stability, and the liquidity to pay
    claims promptly.

7
Carrier
  • 1. Founded in 1936
  • Headquartered in Glenview, IL (suburb of Chicago)
  • A.M. Best Rating B (Very Good)
  • A Mutual Reserve Company
  • Over 2,000,000,000 life insurance in force
  • 1,500,000 insureds
  • Over 400,000,000 paid in claims in last five
    years
  • Licensed in 49 states, DC and Puerto Rico

8
Who Are The Alliance Partners
  • Underwriting
  • Inforce Administration
  • Claims
  • Commission Payments

Our administrative service partner, Insurers
Administrative Corporation (IAC), was founded
in March 1978, IAC is one of the largest
third-party administrators in the United States,
with more than 400 employees specializing in
individual health insurance administration.
9
American Select Insurance Management Corporation
  • Supporting Our Distribution
  • Electronic Tools -
  • Select Xpress Online Service (quoting and
    submission)
  • Select Faxing Service
  • Online Contracting Available
  • Agent Website Tools
  • Up-to-date Info on all products and PPO Lists
  • Printable Forms, Brochures, Applications,
    Underwriting Guides and procedures, Specimen
    Policies, etc.
  • Case Status in Underwriting
  • Expedite the Processing of Your Cases
  • Availability of Production and Business Summary
    Reports
  • Online commission statements and renewal reports

10
PPO Networks
  • Choose from Multiple PPO networks, including two
    national PPO networks
  • No balance billing when utilizing PPO providers
  • No claim forms to complete when utilizing PPO
    providers
  • Medical Emergency Services, (as defined in the
    policy), paid at PPO level of benefits (subject
    to usual, reasonable and customary)
  • Medically necessary services not available from a
    PPO provider and referred to a Non-PPO provider
    considered for payment at PPO level(subject to
    usual, reasonable customary)
  • Utilizing PPO providers will result in lower
    out-of-pocket costs to you.

11
The Most Extensive PPO Network Availability in
the Industry
  • Features National and Popular Regional Networks
  • SelectXpress 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

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14
Phase I - Approved and Released
  • Florida
  • Ohio
  • Pennsylvania
  • Virginia
  • Mississippi
  • Missouri
  • Wisconsin
  • Illinois
  • Indiana
  • Michigan
  • South Carolina
  • Texas
  • West Virginia
  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Georgia
  • Nebraska

Phase II - Will be released as state approvals
are received
  • Kentucky
  • Kansas
  • California
  • Nevada
  • Tennessee
  • Oklahoma
  • New additional states as requested by
    distribution - as approved

15
Target Markets
  • Individuals who are looking for Tax Relief, a
    sound investment portfolio and excellent Single
    Deductible Comprehensive Major Medical Coverage
    our TrustCare One HSA Qualified High Deductible
    Health Plan
  • Individuals looking for Excellent major medical
    coverage with flexibility for various benefit
    levels and pricing (consumer driven health care)
    TrustCare Comprehensive and Popular plans.
  • Individuals looking for the most affordable
    healthcare and are willing to accept the
    responsibility for most routine healthcare, but
    coverage with the best protection for severe and
    long term expenses TrustCare Economical Plan.

16
Products
17
2007 Product Summary
  • TrustCare One HSA Qualified Plans

18
2007 Product Summary
  • TrustCare One HSA Qualified Plans
  • Express Scripts Discount Card Included
    (Outpatient Rx Covered after deductible)
  • Routine Physical Exam - only 90 day wait
  • Initial 12 month rate guarantee included
  • Optional On-the-Job Coverage

19
Funding Your HSA
  • Individual Contribution Limit 2,850.
  • Family Contribution Limit 5,650.
  • If you are 55 or older you are eligible to
    contribute an additional 800 in 2007, increasing
    by 100 each year until 2009.
  • You, your employer and/or another interested
    individual can make contributions to your HSA.
    However, all contributions can not exceed the
    annual contribution limit.
  • Individuals or families who become covered under
    an HSA eligible plan in a month other than
    January can make the maximum HSA contribution
    limit in the first year of eligibility regardless
    of the effective date of their insurance
    coverage.
  • You have until April 15 or the tax-filing
    deadline to contribute the allowable limit for
    the previous tax year.
  • Annual deductibles and contributions are subject
    to annual cost of living adjustments as may be
    required by the Federal Government to coincide
    with the Consumer Price Index (CPI).

20
2007 HSA Qualified Product Summary
  • 5,000,000 Lifetime Maximum
  • 100 PPO - 75/25 Non-PPO
  • 80/20 PPO - 60/40 Non-PPO
  • 50/50 PPO - 50/50 Non-PPO
  • Deductible Choices of
  • 1,100 Individual - 2,200 Family
  • 1,750 Individual - 3,500 Family
  • 2,700 Individual - 5,450 Family
  • 3,500 Individual - 7,000 Family
  • 5,000 Individual- 10,000 Family
  • 100 plans only

21
2007 Product Summary
  • TrustCare Plan Series
  • 3 Plan Choices
  • Comprehensive
  • Popular
  • Economical

22
The TrustCare SeriesOur commitment is to
provide you and your clients with an affordable,
high quality comprehensive health product with
excellent service. Coverage is available for
eligible individuals, families and even children
alone.
23
Calendar Year Deductibles
  • Options from 1,000 to 5,000
  • Maximum of two deductibles (Comprehensive plan)
    or three deductibles (Popular Economical plans)
    per family per calendar year
  • Fourth Quarter Deductible Carryover Credit every
    year, not just the 1st year
  • No separate Non-PPO deductible
  • Common Accident Deductible

24
Important Features
  • Benefits
  • No separate benefit maximum for covered
    transplants
  • No calendar year limit on covered outpatient
    prescriptions (Comprehensive Popular and, if
    option elected, on Economical Plan)
  • Preventive Care Benefits included on all plans
  • Emergency Care received outside the U.S. covered
  • (Emergency as defined in the policy)
  • Optional 24-Hour Occupational Coverage (no
    additional premium in most states for most
    occupations)
  • Optional Supplemental Accident Benefits

25
Premiums
  • Family Premium Discount (whenever 2 or more
    family members issued together, even children
    only coverage)
  • 20 Preferred Health Discount for qualified
    individuals ages 18 through 39
  • Initial 12 Month Rate Guarantee Included
  • Premiums can not be increased on an individual
    basis because of claims experience

26
Whats covered or included?
  • All covered expenses are subject to any
    applicable calendar year deductible, Service
    deductibles, Co-payments, coinsurance, and policy
    maximums unless otherwise specified.

27
2007 TrustCare Series Plans
  • Preventive Care Benefits
  • Child Health Supervision (includes immunizations)
    - Specific age intervals from birth to 6 years.
    (immunizations are not subject to the calendar
    year deductible or service deductible in PA).
  • 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 Screening Ages 50 and above
    One screening every 3 years (not available in
    Colorado)

28
BENEFIT SET
  • Hospital Daily Room and Board (semi-private
    rate), Hospital Inpatient
  • Miscellaneous Medical Services and Supplies,
    Hospital Outpatient Services
  • Inpatient Psychiatric Care, Chemical Dependency,
    Substance Abuse, Alcohol and Drug Rehabilitation
    - Up to maximum benefit of 55 days of active
    treatment or or 2,000 per calendar year,
    whichever occurs first
  • Outpatient Psychiatric Care - 50 coinsurance up
    to 20 per visit with a maximum benefit of 55
    visits per calendar year
  • Organ Transplants or Replacements - For specific
    transplants or replacements up to lifetime
    Maximum
  • Oxygen and Rental of Equipment for its
    Administration

29
Whats Covered or Included?
  • Ambulance Service (maximum benefit 1,000 for
    ground/water, 5,000 air - per occurrence!)
  • Anesthetics and their Administration
  • Chemotherapy and Radiation Therapy
  • Dental Treatment to Sound Natural Teeth
    (resulting from a covered injury)
  • Dressings, Sutures, Casts, Splints, Trusses,
    Crutches
  • Rental of Durable Medical Equipment

30
Whats covered or included?
  • Physical, Respiratory and Speech Therapy for
    Rehabilitative Treatment no annual limits
  • Physician Charges - Inpatient and outpatient
  • Skilled Nursing Facility for Convalescent Care
  • Confinement in an Intensive, Intermediate,
    Observation or Specialized Care Unit - Popular
    and Economical Plans Up to 3x semi-private room
    rate Comprehensive Plan 3x semi-private room
    rate maximum is not applicable
  • Home Health Care (in lieu of a covered hospital
    confinement) Comprehensive and Popular Plans Up
    to 2,500 maximum per calendar year Economical
    Plan Up to 1,500 maximum per calendar year

31
Whats Covered or included?
  • Homeopathic Treatment - (by a licensed
    homeopathist)
  • Comprehensive Plan Up to 50 per visit up to
    500 per calendar year Popular and Economical
    Plans Up to 25 per visit to a maximum of 250
    per calendar year (All Plans supplies not
    covered)
  • Hospice Care - Comprehensive Plan Up to 5,000
    lifetime maximum benefit Popular Plan Up to
    2,500 lifetime maximum benefit Economical Plan
    Up to 2000 lifetime maximum benefit
  • Hospice Care Bereavement Counseling (not subject
    to calendar year deductible, service deductible,
    co-payments or coinsurance) - Covered up to 3
    months after covered persons death up to maximum
    benefit of 500

32
Whats covered or included?
  • Private Duty Nursing - Comprehensive Plan Up to
    2,000 maximum benefit per covered person per
    calendar year Popular and Economical Plans Up
    to 1,000 maximum benefit per covered person per
    calendar year
  • Spinal Manipulation and other Manipulative
    Therapy - Up to 500 maximum benefit per covered
    person per calendar year

33
2007 Product Summary
  • TrustCare Plan Series Comparison Calendar
    Deductibles

34
  • TrustCare Plan Series Comparison

35
  • TrustCare Plan Series Comparison

36
  • TrustCare Plan Series Comparison

37
  • TrustCare Plan Series Comparison

38
Pre-existing Conditions
  • An illness or injury of a covered person for
    which the covered person has received medical
    advice, services, treatment, diagnostic tests,
    consultation or medication during the twelve (12)
    months prior to the covered persons effective
    date of coverage under the policy.
  • Pre-Ex Benefits payable after 12 months
    (treatment free) or 24 months (with treatment)
  • 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.

39
Exclusions and Limitations
  • Special waiting period
  • Charges incurred prior to the date the covered
    person has been covered under the policy for six
    consecutive calendar months for the care or
    treatment of hernia tonsils adenoiditis any
    disease or disorder of the reproductive system
    any rectal disease or disorder gall bladder
    varicose veins or laminectomy, discectomy or
    spinal fusion. Any such condition may also be
    excluded as a pre-existing condition.
  • This limitation shall not apply to services
    provided for an emergency where such condition is
    not excluded as a pre-existing condition. This
    exclusion will not apply to a covered person
    receiving treatment due to a malignancy, provided
    such treatment is not being rendered to a
    pre-existing condition.

40
TrustCare Plan Series
All applications including Children Only
available for Online submission!
  • Single
  • Sample Rate for male age 32 Comprehensive
    Popular Economical
  • W/o Preferred Health Discount 102.15
    85.53 79.23
  • With Preferred Health Discount(PHD) 89.31
    75.38 69.52
  • Couple
  • Sample Rate for couple age 32
  • With Family Discount 193.68
    157.35 142.74
  • W/ Family Discount and PHD 166.15
    135.59 121.93
  • Children Only (youngest child rate based on male,
    18, non-smoker. Additional children at dependent
    child rates.)
  • Sample Rate for a 3 year old child
  • One Child 81.69 69.63
    66.15
  • Two children w/family discount
    121.42 100.86 93.60
  • Rates are for illustrative purposes only. Rates
    presented for MBD, TrustCare PPO 80/20-10k, 1500
    deductible, PHCS Network, zip 61108, standard
    risk. 3/15/07 effective date and Basic
    association membership. Comp. plan includes
    inherent 250 ded. Rx benefit, Pop. plan includes
    inherent 500 ded. Rx Benefit, Econ. plan
    includes optional 1000 ded. Rx benefit. Rates
    include applicable dues and fees.

41
New Online Proposal Tool
42
New Online Application
43
IAC Service Standards
IAC service standards for GTL in 2007
  • Underwriting turnaround
  • 2 to 7 calendar days from receipt---complete
    applications/no APS, etc.(No additional info
    necessary)
  • Online applications with verification call
    completed within hours of submission normally
    issued under 48 hours.
  • All correspondence is directed to client with a
    fax copy to agent (also posted on web site)
    allowing agents to focus on additional sales
    while we work with clients to expedite the
    underwriting process.
  • From receipt of final requirement to date policy
    package is mailed one calendar day
  • Claims average turnaround time 7 calendar days

44
Underwriting Advantages
  • Voice Acceptance of Exclusionary Riders
  • Preferred Health Discount (PHD) questions for
    Applicants 18-39 now part of the app If selected
    and qualified issued with 20 discount
  • Limited Medical Record Requests Recorded
    Telephone interviews when necessary
  • Quick Reference Guide available on-line from web
    site download area (Underwriting tables,
    rate-ups, procedures, riders, state mandates,
    information, etc.) www.amersel.com

45
Contact Information
  • American Select Web Site
  • www.amersel.com login with your American Select
    Agent Number For on-line quoting, submission,
    download supplies, and status information
    (password initially set as your social security
    number with no dashes you may change password)
    We also support your web site with links to our
    processes
  • Contracting and Service Information
  • URL Financial Group One-Stop Brokerage
  • 5320 Jaycee Ave, Harrisburg, PA 17112-4902
  • 800-926-8875 ext. 131 - Kristi Saul
  • Email KristiS_at_urlfinancial.com
  • Fax 717-541-8865 local phone 717-540-5690
    ext. 131
  • Ask for On-Line Contracting Instructions and GTL
    Quotes
  • Only 100,000 in Health Premium qualifies you for
    URLs Puerto Rico Sales Trip!!!

46
Thank you!
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