Assurant Health No matter how the industry changes, you can rely on us to keep you selling.

Assurant HealthNo matter how the industry changes, you can rely on us to keep you selling.

Individual Medical Plans2

Assurant HealthCommitted to showing you a way forward for success

• Part of Assurant, Inc., a Fortune 500 company • Rated A- (Excellent) by A.M. Best Company*• 120 years of experience**• Health insurance solutions for small

businesses and individuals nationwide

*Source A.M. Best Ratings and Analysis of Time Insurance and John Alden Life Insurance Company (December 2011)**Assurant Health is the brand name for products underwritten and issued by Time Insurance Company (est. 1892) and John Alden Life Insurance Company (est. 1961)

Competitive Differences

Complete Individual Medical Product and Price Point Portfolio

• Proven History – in the Individual Medical Market since 1892

• Focused – 75% of Business is Individual Medical

• Differentiated – Premium Product in a Look-Alike Market

• Nimble – No Other Carrier Can Adapt as Quickly

• Dedicated – to the individual consumer and independent agent

New Broader Network

Aetna relationship brings expanded options and cost savings

BIG—numbers, access, deal

A new relationship between Assurant Health and Aetna® provides Assurant Health individual and small group major medical customers access to Aetna Signature Administrators® national PPO network for expanded network options and cost savings


What difference does the new network make?

– Access to a broader, nationwide network• Almost one million providers and 7,500 hospitals and facilities

nationwide

– Better negotiated pricing• Lower cost of care for your customers

– Reduced rates!• Significant rate reductions in many markets throughout the country

A continued commitment to agents and the health insurance market

ASA Network Implementation• Feb release states

AK, AL, AZ, CT, FL,GA, IA, IL, LA, MD, MI, MO, NE, OK, PA, TX,

VA, WI, WV, WY

• May Release States– June 1 – Effective Date

• AR, DE, KY, ND, SC, – July 1 – Effective Date

• DC, MS, OH, TN

Assurant Health Individual MedicalHealth care financing solutions that provide the best value for your customers


What are your customers looking for?

• An affordable way to manage and reduce health care expenses

• A plan that fits their needs and budget yet still has all the benefits they value

• Your guidance to figure out what’s best for them


Assurant Health makes it easy to offer solutions for your customers

– Affordable• Build plans that fit with health care reform (PPACA)• Promote cost-effective alternatives to copay plans

– Valuable• Offer features that help your clients get the most for their

health care dollars

– Easy• Seamlessly combine supplemental products with IM plans

—Assurant Health is one of the only carriers in the IM market that makes it possible

Assurant Health Individual Medical Best value in the individual marketplace

• The old way…. • A new and better way…

MarketChanges

• Use copays for office visits and preventive care

• Customers could afford low deductibles

• Preventive paid at 100% — eliminates need for copay

• Higher deductibles offer premiums customers can afford

• Affordable supplemental plans help cover unexpected costs


Why copays no longer make sense

• Preventive office visits are now paid at 100% • Customers with non copay plans have

premium savings they can use to:– Pay for any non preventive office visits– Buy supplemental plans and enhance coverage

• Copays make the costs of office visits more predictable — not more affordable

Show your customers a better, more affordable way.


Preventive services — what’s included

• Preventive services recommended as part of PPACA and associated office visits are paid at 100%

• Here are just a few examples of recommended preventive services:

– Child immunizations to age 21– Well-baby and well-child visits to age 21– Annual Pap tests for women– Annual mammograms for women 40 and older


Preventive services examples

• Examples of included services– A woman goes for an annual exam with a Pap test. Both

the Pap test and the office visit will be paid at 100% as long as the main purpose of the exam is preventive

– A man goes for an annual physical and has his cholesterol tested as a preventive measure. Both the cholesterol test and the office visit will be paid at 100% if the main purpose of the exam is preventive

• Example of a not-included service– A man who has high cholesterol schedules an office visit

each year so his doctor can monitor his condition• The visit and tests are for his diagnosed condition, not a new

screening for the purposes of prevention• The services he receives, including cholesterol tests, will be subject

to deductible and coinsurance

What a copay saves • Average office visit charge: $136• Average network discount: 35%• Average discounted office visit charge: $88• Average office visit copay: $35• Average non preventive office visits per year: 1.6 • Average annual cost of non preventive office visits

– Without a copay: $141/yr– With a copay: $56/yr

• Savings from a copay is only $85/yr or $7/mo• Conclusion: A copay plan is an affordable option only when

priced within $85/yr (or $7/mo) of a comparable non copay plan


Drop the copay and enhance coverage by adding:• Assurant Supplemental Coverage

– Dental– Accident Fixed-Benefit– Accident Medical Expense– Term Life-Critical Illness*– Cancer and Heart/Stroke*

• SuiteSolutions– SecureSolution– SelectSolution*

• Dental-Vision Discount Plan

Products vary by state*Based on informal guidance from the IRS, Critical Illness plans may be incompatible with HSA plans. Clients should consult a tax advisor if they wish to purchase a Critical Illness plan and fund an HSA.


Extra protection and value for your customers

Current plan

New planWith Dental, Cancer

and Heart/Stroke and AME

Individual deductible $3,500 / 80% $5,000 / 50%

Monthly premium $578 $371

Dental coverage (Intermediate) $55 $55

Cancer and Heart/Stroke coverage ($30,000) $60

Accident Medical Expense coverage ($5,000 AME) $64

Total monthly payment $633 $550

Total Savings $83 per month

Adjust major medical to a higher deductible

Retain Dental coverage

Add Cancer and Heart/Stroke coverage

Add Accident Medical Expense coverage

See the savings

Extra protection

helps cover out-of-pocket

costs!

* Premiums based on male preferred/female standard age 42 and two children, with prior coverage, effective date of 5/1/2012 in ZIP code 75250. Individual major medical premiums reflect CoreMed plans with integrated Rx Coverage.


And higher compensation for youPlan Type Sold

Plan Design Details

Monthly Premium

First-year compensation

CoreMed Major Medical

$3,500 deductible; 80% coinsurance; prescriptions subject to plandeductible and coinsurance; $750 facility fee

$578$832

Compensation for medical plan

alone

Dental None

Accident Medical Expense

None

Cancer-Heart-Stroke

None

Total $578 $832Premiums based on male preferred/female standard age 42 and two children, with prior coverage, effective date of 5/1/2012 in ZIP code 75250. Agent compensation based on 2012 schedules. Numbers have been rounded to the nearest dollar and are used for illustration purposes only.



Plan Design Details

Monthly Premium




$472$680


alone

Dental Intermediate Plan $55 $347Accident Medical Expense

$5000 Benefit Amount; includes 24Hr, $250 deductible, and $5000 AD&D for each insured

$64 $374

Cancer-Heart-Stroke

$30,000 face amount for Cancer & Heart-Stroke $60 $432

Total after adding supplemental

$651 $1,833Premiums based on male preferred/female standard age 42 and two children, with prior coverage, effective date of 5/1/2012 in ZIP code 75250. Agent compensation based on 2012 schedules. Numbers have been rounded to the nearest dollar and are used for illustration purposes only.



Plan Design Details

Monthly Premium




$371$534


alone



$64 $374

Cancer-Heart-Stroke






Plan Design Details

Monthly Premium




$328$472


alone



$72 $421

Cancer-Heart-Stroke






Plan Design Details

Monthly Premium




$271$390


alone


$10,00 Benefit Amount; includes 24Hr, $250 deductible, and $5000 AD&D for each insured

$85 $497

Cancer-Heart-Stroke





Easy to add supplemental to any plan

It's easy to create bundled solutions that enhance your clients’ protection and increase your compensation. – Easy, online quotes and submissions– One integrated application for major medical

and supplemental products– No additional health questions

Assurant Health Individual Major MedicalProduct Portfolio

Major Medical Product Portfolio

• CoreMed – For those who want to control premium costs without

sacrificing benefits– Unique features help customers break the copay

addiction!

• OneDeductible– Simple — one deductible for all family members

• HSA-compatible options • Extra features that help maximize health care

dollars

CoreMedFlexible options and great value

Family deductible – just 2x per family!

Option to use Health Savings Account (HSA) to pay medical expenses with tax-free money!


CoreMed• For those who want to control premium costs

without sacrificing benefits• Offers tremendous flexibility with a wide array of

options, including the ability to pay medical expenses with tax-free money through a Health Savings Account (HSA)

• Clients can customize coverage to their family’s health care and financial needs

• Package with supplemental coverage to build a complete package that helps:– Manage and reduce health care expenses – Pay unexpected out-of-pocket costs


Deductible1 $2,000; $3,500; $5,000; $7,500; $10,000; $15,000 or $25,000

Coinsurance 100%, 80/20, 70/30 or 50/50 (Georgia: 60/40 vs. 50/50)

Coinsurance Out-of-Pocket Maximum1 $0 to $7,500 depending on coinsurance

Facility FeesGives clients another option to save premium dollars by not paying for services they don’t use.

Option 1: $750 per day for the first three days as inpatient, $200 per outpatient surgery

Option 2: No inpatient or outpatient facility fees

CoreMed plan design options

1 Family deductible and coinsurance out-of-pocket maximums are two times the individual amounts listed and are met collectively by two or more people.


HSA-Compatible Options (Deductible/Benefit Percentage/Coinsurance/ Coinsurance Out-of-Pocket Maximum)

1. Choose one plan design option:•$3,500/50%/50%/$2,000•$5,000/100%/0%/$02. Choose facility fees option 2

Preventive ServicesBenefits will be paid in accordance with the Patient Protection and Affordable Care Act; others subject to plan deductible and coinsurance

Office Visits Subject to plan deductible and coinsurance

Prescription Drugs Subject to plan deductible and coinsurance

Emergency Room $75 emergency room fee, waived if admitted to hospital

Home Health Care Limited to 160 hours

Air/Ground Ambulance

No limits on number of trips

Intensive Care Unit (ICU)

No daily limits

Transplant Coverage

Kidney, cornea, skin, bone marrow, heart, liver and lung transplants are covered as any other service. All transplants include the following:• As much as $10,000 toward travel expenses• As much as $10,000 toward donor expenses

CoreMed plan benefits

Availability of certain benefits varies by state.


Sample CoreMed ratesRates below for plans with prescriptions and office visits subject to the plan deductible/coinsurance, $750 facility fee

Deductible $3,500 $5,000 $10,000

Coinsurance 80% 50% 50%

OOP $3,500 $3,500 $3,500Single male 42 $191 $133 $96

Single Female 42 $247 $185 $135

Family 42 + 2 children

$550 $401 $294

Numbers have been manually entered. Premiums based on preferred rates with prior coverage. Effective date 5/1/2012. ZIP code 75250.

OneDeductibleSimplicity and savings


OneDeductible

• Simple — one deductible for all family members • Add an HSA

– Realize tax advantages – Multiple options for HSA administration

• As with CoreMed, package with supplemental coverage to build a complete package that helps:– Manage and reduce health care expenses – Pay unexpected out-of-pocket costs


OneDeductible plan design options

Deductible•Family shares one deductible•No separate deductibles

Individual plan options: $2,850, $3,750, $5,000 Family plan options: $5,700, $7,500, $10,000

Coinsurance 100%, 80/20, 50/50

Coinsurance Out-of-Pocket Maximum

$0 to $2,500 — depending on coinsurance

Prescription Drugs Subject to plan deductible and coinsurance


Preventive ServicesBenefits will be paid in accordance with the Patient Protection and Affordable Care Act; others subject to plan deductible and coinsurance

Emergency Room$75 emergency room fee, waived if admitted to hospital

Home Health Care Limited to 160 hours

Inpatient Rehabilitation Facility, Subacute Rehabilitation and Skilled Nursing Facilities

Limited to 90 days

Air and Ground Ambulance No limits on number of trips

Behavioral Health and Substance Abuse

Subject to plan deductible, then 50% coinsurance to out-of-pocket maximum;

100% coverage after out-of-pocket maximum

Intensive Care Unit (ICU) No daily limits

Transplant Coverage

Kidney, cornea, skin, bone marrow, heart, liver and lung transplants are covered as any other service. All transplants include the following:• As much as $10,000 toward travel expenses• As much as $10,000 toward donor expenses

OneDeductible plan benefits

Availability of certain benefits varies by state.


Sample OneDeductible rates

Deductible $2,850 $3,750 $5,000

Family Deductible

$5,700 $7,500 $10,000

Coinsurance 100% 100% 100%Single male 42 $xxx $xxx $xxx

Single female 42 $xxx $xxx $xxx

Family 42 + 2 children

$xxx $xxx $xxx

Numbers have been manually entered. Premiums based on preferred rates with prior coverage. Effective date xx/1/2012. ZIP code xxxxx.

More ways to optimize dollars


Health Savings Accounts (HSA’s) can be added for additional savings to qualified CoreMed and One Deductible plans. An HSA plan:• A qualified high-deductible health plan• A tax-favored savings account• Clients can use an HSA to pay medical expenses not paid by their high-

deductible health plan — including bills that go toward meeting the deductible and many other expenses

Client financial benefits:• No income tax on money deposited in HSA• No tax on interest or earnings as long as money withdrawn is for qualified

medical expenses• Unspent money rolls over year to year for future medical expenses or

supplementing retirement income — NOT “use it or lose it”• At age 65, clients can withdraw money from HSA for non-medical expenses

without penalty, paying only standard income tax

Assurant Health is not engaged in rendering tax advice. Please see a qualified tax professional.


Health Savings Account (HSA) administration

Assurant Health HSA administration advantages:– No account fees– Competitive interest rate– Automatic contribution (deposit) options– Checkbook and VISA debit card– HSA Tools — free online option to pay bills and manage

account

HSA administration options – HSA Tools– HSA Fundamentals– Any outside administrator you choose

NoSF

Funding an HSA is easy!Premium savings from

the high-deductible health insurance plan can be used to fund HSA contributions



2012 HSA law

• HSA contributions are allowed to the maximum amount ($3,100 / $6,250) for any HSA qualifying deductible

• Additional “catch-up” of $1,000 for those age 55 and older

• Allows a one-time rollover from an HRA and FSA into an HSA

• Allows a one-time rollover from an IRA to an HSA


References are to federal tax laws. State laws may differ.


Assurant Supplemental Coverage• Dental• Accident (Fixed-Benefit & Accident Medical

Expense)• Critical Illness & Cancer Heart/Stroke

– Benefits are paid in addition to other medical coverage– Benefits are paid directly to customer– Pays their portion of medical costs– Minimizes the amount customers pay out of their own

pockets – No additional medical questions/nominal underwriting

Other supplemental and discount options

SuiteSolutions® 2 benefit levels

– SecureSolutions– SelectSolution

• Protection from the financial effects of accidents and disability

• Helps pay out-of-pocket costs due to accidents• Pays cash benefits for accidental death, dismemberment

and disability• Option for cash benefits due to critical illness

Dental-Vision Discount Plan• Provides discounts from a nationwide network of dental and

eyewear providers


SuiteSolutions plans are separate contracts. SuiteSolutions is not available in AZ, MD, NC, OR or SD. SecureSolution is only available in CA, CO, CT, FL, GA, ID, IN, KS, MN, ND, NH, OH, PA, TN, and VA. SelectSolution is not available in IN.

SuiteSolutions® • Available through membership in Health

Advocates Alliance• Accident Medical Expense (AME) and Critical

Illness benefit – $2,500– $5,000– $10,000

• Weekly Accident Indemnity Benefit– 70% of basic weekly salary to a maximum of $250 per week, for up to

52 weeks for primary insured only

• Death Benefit– $25,000 primary insured $1,000 spouse & each child

• Dismemberment – $25,000 primary insured $1,000 spouse & each child


Valuable features with all individual plans • Patient Care

– Personal assistance to help navigate through the health care system

• Retail health clinics– Convenient, cost-saving and covered as network

providers

• Health Management Team– Registered nurses on staff to help manage complex or

catastrophic diseases, injuries or conditions


Patient Care• Patient Care is a health care advocacy service

available to customers covered by Assurant Health• A Patient Care Advocate will:

– Help find network providers – Assist with billing and/or claim issues – Research cost and quality information for services and

treatments – And more…

Patient Care is an independent advocacy company and is not affiliated with Assurant Health.

See how Patient Care can help your clients save money by giving them more information about their health care options.


Patient Care cost comparison example — colonoscopy

Option 1 Option 2 Option 3

Estimated doctor cost

$1,437 $1,924 $1,290

Estimated facility cost

$3,360(hospital 1)

$4,175(hospital 2)

$1,297(outpatient

center)

Total cost $4,797 $6,099 $2,587

For illustration only. Estimated cost includes network discounts.

$3,500 inpotentialsavings!


Retail health clinics

• CVS – Minute Clinics• Walgreens – Take Care Clinics

– Convenient– Quick access and savings for common medical services

such as flu shots, strep throat, physical examinations, immunizations

– Covered the same as services performed by providers in network

Underwriting Highlights

ExpressYES — Elements

• Express Underwriting – in seconds:– 17 health questions– MIB– Rx check

• Immediate notice of approval on Confirmation screen

• Printable insurance card available upon approval• “Instant Active” indicated in Underwriting Status

04/19/23


Possible outcomes

• Instant issue — clean clients whose MIB and Rx checks pass at point of electronic submission

• Rate up — commonly for HBP, cholesterol, build (25%)

• Exclusion rider — may be time-defined or permanent

• Condition-specific deductible — unique response to minor conditions you or your clients don’t want to see excluded

• Decline — our least favorite outcome by far! Pivot to Assurant Health Access?


CSDs – Yes, please!


Pre-screens

• Available Mon-Fri, 7:30 a.m. to 6 p.m. Central Time, by telephone at:

888.575.6421

MyBook• All active policies display• Terminated policies display for 15 months• Alert History screen – displays alerts for 24

months• Alerts display:

– Renewals– Late Payments– Terminations– Rewrites– Renewed (if still active 2 months after renewal)– Paid (when payment made)– Reinstated (when reinstated)– Terminated (when terminated or lapsed)– Closed (when 2nd late payment alert occurs)

Thank you!

Product forms: Series TIM, TIM.POL.001.TX, TIM.POL.001.TX-LB

Coverage is renewable provided: eligibility and participation requirements are met, you have not moved outside the service area for a PPO plan, and there has been no discontinuation of the plan or the company’s business operations in this state. The company has the right to change premium rates upon providing appropriate notice.

For agent use only. Not for distribution to consumers.

Assurant Health is the brand name for products underwritten and issued by Time Insurance Company, Milwaukee, WI.

This plan includes limitations and exclusions, such as limitations on coverage for pre-existing conditions and exclusion of maternity care. For a complete list of limitations and exclusions, please see assuranthealth.com (major medical insurance details compare our plans).

Assurant Health No matter how the industry changes, you can rely on us to keep you selling.

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Transcript of Assurant Health No matter how the industry changes, you can rely on us to keep you selling.