Aetna Senior Supplemental Insurance

Transcription

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Senior Supplemental Insurance Includes all products underwritten by: American Continental Insurance Company (ACI) Continental Life Insurance Company of Brentwood, Tennessee (CLI) Medicare Supplement insurance underwritten by: Aetna Health and Life Insurance Company (AHLIC)

2 Why Aetna? 2

3 Why Aetna? American Continental Insurance Company (ACI) and Continental Insurance Company (CLI), both Aetna companies. Aetna Health and Life Insurance Company has not been rated by A.M. Best. 3

4 Aetna Senior Supplemental* Over 30 years specializing in the senior market Focused on being a distributor preferred company, supporting long term success for our valued producers A small company personality with big company capability Proven personalized customer service Products to cross sell that will help grow your business Attractive commissions Diverse product portfolio that meet the unique needs of your clients Qualify for sales incentives (all products help qualify - state compensation rules vary) Consumer Lead Referral Program * Includes all products underwritten by American Continental Insurance Company (ACI) and Continental Insurance Company of Brentwood, Tennessee (CLI), Aetna companies; and Medicare Supplement products underwritten by Aetna Health and Life Insurance Company (AHLIC), 4

5 Senior Supplemental Insurance Medicare Supplement A product consumers know and trust Underwritten by Aetna Health and Life Insurance Company, American Continental Insurance Company, Continental Life Insurance Company of Brentwood, Tennessee, all Aetna Companies. Final Expense (whole life) Valued protection from a trusted company Underwritten by American Continental Insurance Company, Continental Life Insurance Company of Brentwood, Tennessee.. 5

6 Complementary Health Insurance Products* Continental Care (Hospital Indemnity) Short Term Home Care Short Term Nursing Facility Care Cancer Plus (First Occurrence Cancer) *Products and benefits vary by states. Underwritten by Continental Life Insurance Company of Brentwood, Tennessee 6

7 Product Availability Based on the applicant s state of residence Launch updates available on aetnaseniorproducts.com 7

8 Medicare Supplement Products Offering Plans A, B, F, High Deductible F, G, and N Plan availability varies by state 5% Household Discount Not available in all states No pre-existing condition limitations 12-month rate guarantee Guaranteed renewable Competitive commissions Vary by state Full commission on plans issued to ages 65+ Underwritten by Aetna Health and Life Insurance Company (AHLIC), American Continental Insurance Company (ACI), Continental Life Insurance Company of Brentwood, Tennessee (CLI) 8

9 Final Expense (Whole Life) Peace of mind Provides funds when needed most Affordable coverage Rates do not increase Level, graded or modified death benefit plans Plan options vary by state Point of sale pre-approval Telephone based Jet Pre-Approval process Client applies knowing what coverage level he/she can qualify for Reduces declined applications Can expedite issuance of the policy Pre-Approval does not guarantee an application will be approved Coverage through a company with proven financial strength and commitment to the senior market Underwritten by American Continental Insurance Company (ACI) and Continental Insurance Company of Brentwood, Tennessee 9

10 Sales Tools That Help Sell Final Expense Documents Information A Family Member Will Need To Know When a Loved One Dies Record of family history Who is to be notified - Family - Attorney Where important documents are stored - Will - Insurance policies - Financial records Final arrangements - Funeral home and cemetery selection - Funeral services Included In Each Final Expense Sales Kit 10

11 Establish Client s Needs Questions to Ask The average funeral costs $10,000+. Have you considered the health costs associated with end of life health care? Are you aware that Social Security currently pays only $255 as a death benefit? Have you taken care of your final expenses? Can your family afford to bear the costs of your funeral? Have you considered other expenses that may occur? Out-of-pocket medical expenses including hospice or skilled care Estate Probate Funeral costs including grave marker, etc. Other debts Note: This is not a pre-paid funeral plan 11

12 Determine Level Of Coverage Sample Health Questions Section 3 of application Available coverage levels (and application form) vary by state If applicant can answer no to all questions in Section 3A, the client qualifies for some level of coverage Modified Coverage level Modified (where available) Graded (where available) Requires a No answer for all questions in Section 3A Sections 3A and 3B Graded Level Sections 3A, 3B and 3C Sample shown is an application when all coverage levels are available Level 12

13 Policy Benefit Plans Death Benefits Level Full Benefit Immediately Graded Modified All levels not available in all states. Accidental Death Full Benefit Immediately Non-accidental Death Policy Year 1: 40% of benefit amount Policy Year 2: 75% of benefit amount Policy Year 3: Full death benefit Accidental Death Full Benefit Immediately Non-accidental Death Years 1 and 2: ROP plus 10% Policy Year 3: full death benefit Issue Ages Maximum Benefit* $35,000 $25,000 $15,000 $10,000 $35,000 $25,000 $35,000 $25,000 Note: $3,000 minimum benefit amount for all ages 13

14 Dedicated Final Expense Toll Free Number CALL 877 JET.2759 ( ) Select menu option based on the type of Final Expense inquiry Option 1: Jet Pre-Approval Team Time Zone Monday Friday Hours Saturday Hours Eastern 8:00 a.m. 10:00 p.m. 10:00 a.m. 4:00 p.m. Central 7:00 a.m. 9:00 p.m. 9:00 a.m. 3:00 p.m. Mountain 6:00 a.m. 8:00 p.m. 8:00 a.m. 2:00 p.m. Pre-Approval is required and conducted by telephone at the point-of-sale with the client (or by 3-way conference if agent is not face-to-face with the applicant during normal hours of operation). Option 2: FE Specialist Team Time Zone Eastern Central Mountain Monday Friday Hours 8:30 a.m. 5:30 p.m. 7:30 a.m. 4:30 p.m. 6:30 a.m. 3:30 p.m. New Business Underwriting Policy status 14

15 Continental Care (Hospital Indemnity) The Opportunity Anyone concerned with paying expenses that may be incurred as a result of a hospital stay and temporary skilled nursing facility stay such as: The self employed A small business owner - list bill available A primary caregiver The primary market for Continental Care is individuals ages 30 to 64 15

16 Continental Care Can Help Policyholder has the freedom to use the benefits to: Help pay out of pocket medical expenses, related to hospital or skilled nursing confinements Help pay for travel or lodging for loved ones Offset childcare and/or family care expenses Cost of equipment or services that may or may not be medically necessary and not covered by insurance Help pay for other incidental expenses Use however they may choose! 16

17 Hospital Benefits Hospital indemnity (HI) benefits Pays a lump sum benefit for a hospital confinement of 24 hours or more Select from three benefit options $500, $750, or $1000 Payable once for each new Period of Care Additional daily benefit (an optional benefit) Pays for each day of hospital confinement Select benefit in increments of $10 From $30 to $250 per day of confinement Benefits for up to 90 days per Period of Care Private hospital room benefit Pays benefits of $25 per day (in addition to HI benefit) Pays up to 30 days for each Period of Care Private room must be medically necessary 17

18 Continental Care Also Includes Skilled Nursing Facility Indemnity Benefit* For each day of confinement in a skilled nursing facility Select in Increments of $10 From $50 to $150 per day of Confinement Elimination Period Options 0-Day, 20-Day, 100-Day Pays Benefits for up to 90 days for each Period of Care Must follow a Hospital stay of at least 3+ days* Registered Nursing Care Pays $30 per shift up to 2 shifts per day Up to a maximum of $60 per day For up to 30 days per Period of Care Periods of service within the same day which total 8 hours or less will be considered one shift Services Must Be Certified by a physician that care is medically necessary Provided by a private-duty, graduate or registered nurse * Skilled Nursing Facility Benefit not available in South Carolina 18

19 Other Policy Features Period of Care Begins the first day of confinement in a hospital due to a covered injury or sickness Ends when you have been out of the hospital or skilled nursing facility for 60 continuous days Benefits are then fully restored No lifetime maximum on the number of Periods of Care for which benefits are restored Waiver of monthly premium After 8 continuous weeks of a covered hospital or skilled nursing facility stay where Continental Care benefits are being paid Guaranteed renewable Issue age premiums Portable Benefits paid directly to policyholder Unless assigned to a healthcare provider 19

20 Agents Should Use Care *Continental Care cannot be marketed or advertised as a Replacement for a Major Medical plan Supplement to Medicare or a Medicare Supplement plan Wrap or gap-filler for a Medicare Advantage plan Continental Care is not designed to Replace the need for primary health insurance Supplement any type of insurance Pay co-payments or deductibles *When explaining the benefits of this product to a client agents should not refer to the product as a wrap, gap-filler, supplement, or imply that it functions as one. 20

21 Nursing Facility and Home Care Benefits are straightforward and easy to understand Clients can select from different benefit amounts to design coverage that suits their individual needs Pays indemnity benefits directly to the policyholder - unless they elect to assign benefits to a healthcare provider Affordable premiums Provides peace of mind Attractive Aetna branded sales materials 21

22 The Opportunity Anyone concerned about the expenses that can arise while recovering from an accident or illness. Expenses associated with short term (less than 1 yr.) confinement in a hospital, nursing facility, or nursing care provided at home For example, recovery and/or rehabilitation services following a hospital confinement (such as, care needed when recovering from a heart attack, stroke or following major surgery such as a hip replacement, bypass surgery, etc.). Other non-medical expenses that may arise should a hospital or nursing facility confinement be necessary These products should not be sold as a substitute for Long Term Care or as a supplement to Medicare Supplemental Insurance. They are designed for Short Term Recovery Care received in either a hospital, nursing facility or at-home. 22

23 Nursing Facility Care Benefits Offers coverage for medically necessary professional nursing services received while confined in a Nursing facility Hospital Pays for all levels of nursing facility care Skilled Intermediate Custodial Includes full restoration of nursing facility benefits After 180 days of non-confinement and no longer in need of medically necessary care 23

24 Nursing Facility Confinement Benefits Basic plan pays $120.00/day Any level of nursing care 24 hour in-patient stay required Must be medically necessary and doctor prescribed Choose an Elimination Period 0-Day, 20-Day, 100-Day Select a Benefit Period 90-Day, 180-Day, or 360-Day No limit on the number of Periods of Care Begins the first day of covered confinement Ends 180 consecutive days after the confinement is no longer medically required Benefits are restored automatically after the end of a Period of Care 24

25 At-Home Confinement Benefits Select a weekly benefit of $150*, $300, $450, $600 or $750 per week Up to 26 weeks per period of care Covered benefits Requires 3 or more Home Health Care (HHC) visits per week to occur on separate days Provided by Licensed HHC Provider Services must be Received at home Medically necessary and reasonable for the treatment of a covered illness or injury Full restoration of Home Care benefits After 180 days of non-confinement and no longer in need of medically necessary care 25

26 Hospital Confinement Benefit Basic coverage pays $10.00/Day * for each day of confinement Lifetime maximum of 365 days Daily base maximum benefit amounts vary by state ID $40/per day IL $30/per day Additional coverage of up to $150.00/day Available in $10 increments No elimination period required 24 hour in-patient stay required Care must be medically necessary * Minimum daily hospital benefit varies by state. In most states the minimum benefit is $10/day with additional coverage available. 26

27 Registered Nursing Care Benefits For nursing care received In a hospital (Home and NHF Care) In a nursing facility (NHF Care Only) At-Home (Home Care only) Pays Up to $30 per shift Maximum of 2 shifts per day Up to a total $60.00/day Maximum 30 days per benefit period Services must be medically necessary Services received from a private duty, graduate, or Registered Nurse are covered No prior hospital stay required 27

28 Nursing Facility Care - Affordable Rates Issue age rates vary by state Applicants ages 50-89* * Rates available for ages 18 to 89 in PA A one time non-commissionable policy fee applies. Policy fee may vary by state. 28

29 Home Care - Affordable Rates Issue age rates vary by state For Applicants ages 50-89* * Rates available for ages 18 to 89 in PA; $ Benefit Option not available in ID A one time non-commissionable policy fee applies. Policy fee may vary by state. 29

30 Home Care AND Nursing Facility Care - 30

31 Examples Of Affordable Monthly Rates Nursing Facility and Home Care Ages Nursing Facility Care 0-Day Elimination 90-Day Benefit Period $120 /Day Nursing Facility $10/ Day Hospital Benefit Home Care Weekly Indemnity Benefit $450/Week Home Care Indemnity $10/Day Hospital Benefit Total Premium 64 $12.80 $24.59 $ $21.41 $32.84 $54.25 *A $20 (one time only) policy fee will apply for each issued policy. Additional Hospital Indemnity Benefit can be added to either the Nursing Facility or the Home Care product but not both. 31

32 Underwriting Inform applicants that a telephone interview will be required Normal underwriting procedures Underwriter asks the same health questions as those shown on the application Phone Interview on all applicants age 75 or older At the underwriters discretion for applicants age 74 or younger Call home office should you have questions prior to submitting application , Option 4 (Underwriting) Do not submit applications with a yes answer to a health question policy will be declined Pre-existing conditions are not covered for the first six months the policy is in effect 32

33 Cancer Plus First Occurrence Cancer Did You Know? Cancer is the second leading cause of death in the United States Your lifetime risk of being diagnosed with cancer is significant Approximately 1 in 2 for Men and 1 in 3 for Women The risk of cancer becomes greater with age Nearly 77% of all cancers are diagnosed in persons 55+ years of age Sources: 2007 and 2008 Cancer Facts & Figures Insurance Cost Related Barriers to Cancer Care, American Cancer Society, 2008 Cancer Statistics Presentation, American Cancer Society HealthCare data presented at American Society of Clinical Oncology conference, October

34 Surviving Cancer Can Be Costly Average costs for first year cancer treatment has more than doubled since % of the treatment costs are associated with indirect medical expenses not covered by traditional health Insurance Source: HealthCare data presented at American Society of Clinical Oncology conference, October 2008; 2007 and 2008 Cancer Facts & Figures, Insurance and Cost-Related Barriers to Cancer Care American Caner Society ; 2008 Cancer Statistics Presentation, American Cancer Society 34

35 Can Provide The Funds Needed To Pay 35

36 Features Benefit paid once cancer is first diagnosed Hospitalization or other medical expense not required Benefit paid directly to the policyholder in lump sum In most situations, benefits are not included in taxable income Agents should advise applicant to consult with their Tax Advisor to determine whether the benefits would be taxable in their situation Pays regardless of other insurance, including Medicare Insurance covers most cancer types, including Leukemia and Hodgkin s Disease Skin cancer is not covered except malignant melanoma Guaranteed renewable 36

37 Affordable Coverage For Everyone! Coverage from $5,000 to $25,000 Increments of $5,000 Ages 18 to 79 Annual Rates $20 Policy Fee (first year only) - $10 in Tennessee; $6 in Mississippi; No fee in KY 37

38 Claim Filing Claim must be accompanied with a pathology report indicating that cancer is present and when it was first diagnosed No hospital or medical expenses need to be incurred to file a claim Generally, check is issued within 7-14 days of receipt of claim Policy is automatically terminated once lump sum benefit is paid 38

39 Current Cancer Plus Application* Sample *Applications vary by state 39

40 Need Assistance? Contact Agent Services , Option 3, 1 (Sales) Order supplies Assistance completing application Product availability aetnaseniorproducts.com Order supplies Track qualification for sales incentives Block of business reports News bulletins 40

41 Qualification Period: March 1, 2013 through March 31, 2014 (13 months) Destination: Barcelona, Spain Trip Dates: June 1, 2014 through June 6, 2014 Qualification Requirements: Level of Producer Minimum Production # of Qualifiers Managing General Agent $5,000,000 Top 10 Recruiting General Agent $1,000,000 Top 10 (intermediary GA) Writing Agent $ 200,000 All who qualify Qualifying Products: Medicare Supplement Complementary Products: Includes: Cancer Plus, Continental Care (hospital indemnity), Home Care and Nursing Facility Care Final Expense (whole life) Production Credit 1: 1 on production 2: 1 on production 2: 1 on production PLUS: Each of the top 5 MGAs, GAs, and Agents earn their seat at the President's Cabinet AND extra time in Barcelona. Track Your Progress: aetnaseniorproducts.com (agent side) under Promotions State compensation rules vary see program flyer available on aetnaseniorproducts.com for complete qualification rules 41

42 Question And Answer Press *1 To Ask A Question 42

43 Thank you