Health & Security Discount Plan

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Naomi Boone
5 years ago
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1 Health & Security Discount Plan

2 Disclosures This plan is NOT insurance. This plan provides discounts at certain healthcare providers for medical services. This plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount plan organization. This discount card program contains a 30-day cancellation period. FL, LA, MD, MS, ND, OK, RI, SC, SD and TX residents: Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date. AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days. MA Residents: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received. The discount medical card program makes available, before purchase and upon request, a list of program providers, including the name, city, state, and specialty of each program provider located in the cardholder s service area. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box Dallas, TX , Website to obtain participating providers: (Group #BB75070) Available only as employer-paid benefit in KS, UT, VT, WA.

4 Save Your Out of Pocket Costs Current New Insurance Insurance - OR - Out Of Pocket $ Out Of Pocket $ Save Time & Money

Family of Four: The family has high-deductible

Last year they had 13 doctor visits, but 6 of those

office visit & 1 Emergency Room visit: $272 $824 3

but saved on 3 in-network cleanings: They have no

($504 cost reduced to $311): The father s monthly

5 How Much Can You Save? Consider The Annual Healthcare Costs of a Typical Family of Four: The family has high-deductible health insurance. Last year they had 13 doctor visits, but 6 of those were handled on the phone: 4 calls with the flu, saving Urgent Care Center visits. 2 calls with ear infections, saving 1 Dr. office visit & 1 Emergency Room visit: $272 $824 3 of the family members don t have dental insurance, but saved on 3 in-network cleanings: They have no vision insurance, but needed 2 pairs of glasses ($504 cost reduced to $311): The father s monthly drug was made Non-Formulary & it now costs $62. We had it for $26. Save $36/month: TOTAL SAVINGS: $203 $193 $432 $1,924 This is an illustration of savings & does not represent an actual member experience. Savings vary by provider, service & geographical location.

Pharmacy Safe Identity Legal Care Roadside Assistance Price (Per Family per Month)

6 Benefits and Pricing Benefit Health Savings Health & Security Savings Teladoc Advocacy: Medical Health Advisor Advocacy: Medical Bill Saver TM Dental Vision Pharmacy Safe Identity Legal Care Roadside Assistance Price (Per Family per Month) $9.99 $19.99 *Plus $4.99 Application Fee, waived for 5+ employee groups that list-bill payments. 6

Teladoc Saves Unnecessary Visits & Justifies Investment Doctor visits over the phone save time & money: Emergency: $750/Visit The average American has 3.

66% are unnecessary.** Save 1 & pay for many years membership.

7 Teladoc Saves Unnecessary Visits & Justifies Investment Doctor visits over the phone save time & money: Emergency: $750/Visit The average American has 3.5 Doctor visits/year. 70% are unnecessary.* Save just 1 & pay for 1 year s membership. The average American has.4 Emergency Room visits/year. 66% are unnecessary.** Save 1 & pay for many years membership. $120/Year Doctor: $100/Visit Urgent Care: $150/Visit * 70% or more Doctor Office visits are unnecessary, The Wellness Councils of America (WELCOA), 2008 ** 66% or more of all ER visits are non-emergencies, National Ambulatory Medical Care Survey, 2006

8 Teladoc National network of U.S. board-certified physicians available 24 hours a day, 365 days a year. Never needlessly wait again! Use electronic health records, phone/video consultations to diagnose, recommend treatment & prescribe when appropriate. No consultation fee at time of call. Average call back in 22 minutes; guaranteed within 3 hours. Treat common conditions, including: Sinus / Urinary Tract Infection Poison Ivy Respiratory Conditions Bronchitis / Allergies Pink Eye Flu / Cold 2012 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Teladoc phone consultations are 8 available 24 hours, 7 days a week while video consultations are available during the hours of 7am to 9pm, 7 days a week.

9 Advocacy: Saves Time, Money & Confusion

10 Advocacy: Medical Health Advisor Your Personal Health Advocate helps resolve issues/problems Navigate complexities of healthcare & insurance Resolve insurance claims & billing issues Save time & money on healthcare bills Find the best doctors, hospitals & other providers Research current treatments & locate "best in class" medical institutions for a condition Unbiased health information to help make an informed medical decision Schedule appointments with hard to reach specialists 10

11 Advocacy: Medical Bill Saver TM Advocates work with healthcare providers in attempt to lower the balance due with medical / dental bills when member s out of pocket costs exceed $400 Negotiation can result in 25-50% savings Coordinate pre- or post-service Easy-to-read, personal Savings Result Statement Quick-Pay Fund available in applicable circumstances; Health Advocate pays provider, member reimburses Health Advocate Provider sign-off on payment terms/conditions *This does not replace health insurance, provide medical care or recommend treatment. 11

12 Dental Savings of 15% to 50%* on most dental procedures Over 92,500 participating dentists nationwide** Save on routine dental services such as x-rays and fillings Orthodontics, Periodontics & Endodontics No limit on the number of visits Simply present the card bearing the Aetna Dental Access logo, along with payment in full of the discounted fee, for immediate savings at the time services are rendered *Actual costs and savings vary by service, provider and geographical area. ** According to the Aetna Enterprise Provider Database as of November 1, The discount program provides access to the Aetna Dental Access network. This network is administered by Aetna Life Insurance Company (ALIC). Neither ALIC nor any of its affiliates offers or administers the discount program. Neither ALIC nor any of its affiliates is an affiliate, agent, representative or employee of the discount program. Dental providers are independent contractors &not employees or agents of ALIC or its affiliates. ALIC does not provide dental care or treatment &is not responsible for outcomes. 12

13 Vision 20% to 60% savings on eyewear Over 12,000 participating vision locations nationwide Most frames, lenses and specialty items are available Accepted by LensCrafters, JCPenney, EyeMasters, Pearle Vision, Sears, Sterling Optical, Target, and more 10% to 30% savings on eye exams 10% to 40% savings on mail order replacement contacts Save 40% to 50% off the overall national average on LASIK surgery 13

14 Pharmacy Save 10% to 85% on short term, acute care medications such as antibiotics & pain killers Over 60,000 chain & independent pharmacies nationwide including Wal-Mart, Rite-Aid, CVS, Walgreens, Kroger, etc. Open Formulary (includes new & experimental drugs) In 2011 members saved more than $85 million with an average savings of 37% Mail-Order program with guaranteed lowest pricing on maintenance medications (will beat AARP by 10%) Discount drug pricing tool *Discounts are Not Insurance, and are Not Intended as a Substitute for Insurance. The discount is only available at participating pharmacies. 14

15 Safe Identity Early detection/warning system scans thousands of financial & non-financial data sources to detect fraud Calculates ID Risk Score, continually updated Personal phone alerts when suspicious information indicates beginning stages of identity theft Covers pre-existing identity theft yet undiscovered Unlimited service guarantee, plus one free hour each financial coaching & legal consultation ID Theft Insurance: up to $25,000 with $0 deductible for: Lost wages related to ID theft up to $500 a week for four weeks Reimbursement for certain recovery expenses: defense costs for certain civil suits, re-filing for loans & reimbursement of fees. 15

16 Legal Care Nationwide network of 20,000 attorneys Plan attorneys charge $ per hour, or when appropriate, 40% off their usual & customary hourly rate Referred attorney will provide 9 free services*, including: Unlimited initial phone consultations for new legal matters Review independent legal documents (6 pg max per new matter) When appropriate, write letters on member s behalf When appropriate, make phone calls on member s behalf Assistance solving government problems such as welfare / INS Assistance with small claims court representation Free simple will with annual updates * Costs and filing fees additional, specific definitions apply. 16

17 Roadside Assistance Available 24 hours a day, 365 days a year Up to 15 miles towing (up to $80 retail value) per occurrence maximum for covered charges Fuel, Oil, Fluid and Water Delivery Service Lock-Out, Flat Tire, Battery & Collision Assistance Covers Member, spouse and dependent children up to age 21 permanently residing at registered address when driving any vehicles they own or lease (12 months or longer) 17

18 Product Advantages Strategic part of the Total Benefits Solution Offset growing out of pocket expenses Reduce Loss Ratio Make HSA/HRA/FSA funds go farther Don t need to leave work / home to visit a physician No limit on number of visits Benefit for insured & uninsured One price for cardholder & legal dependents 18

19 Questions?

20 Bridge the Gap of a High Deductible Plan High Deductible Health Insurance Co-Insurance Deductible Out Of Pocket $ Health Savings Account Fund $ Preventive Dr Visit

21 Proven Employer ROI Assumptions & Calculations: Members: 100 Annual Investment (100 * $9.99pmpm): $11,988 Total Members (avg. family of 2.5 members): Dr Office visits. Average cost of $ % unnecessary. 0.4 Emergency Room visits. Average cost of $1, % unnecessary. $20/hour average wage. Sick days + presenteeism + Dr visits: 2 days/year. Member Utilization 10% 20% 30% Annual Doctor Office Savings $6,125 $12,250 $18,375 Annual Emergency Room Savings $4,950 $9,900 $14,850 Productivity Add-Back $3,200 $6,400 $9,600 Total Annual Savings $14,275 $28,550 $42,850 Return On Investment 19% 138% 257% Explanation: Claims from unnecessary Doctor & Emergency Room visits are saved as a result of deploying Benefit Brainstorm s telehealth services. If only 10% of members fully engage this service, the ROI is positive; ongoing promotion will raise this to as much as 30% engagement. Removing all barriers to usage (consultation fees, lack of knowledge, complexity) is key to maximize member utilization; maximizing utilization is the key to maximizing claims savings.

A 24/7 call a doctor service, advocacy, wellness support & health discounts all in one easy-to-use card

A 24/7 call a doctor service, advocacy, wellness support & health discounts all in one easy-to-use card Disclosures This is NOT insurance. This plan provides discounts at certain healthcare providers for