Welcome to Health Saver Plus III Your Guide to the Next Generation of Affordable Health Insurance

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1 Welcome to Health Saver Plus III Your Guide to the Next Generation of Affordable Health Insurance Standard Brochure (Green) Form H-0204 Arkansas, Georgia, Brochure (Brown) Form H-0204.AR,GA, Pennsylvania Brochure (Red) Form H-0204.PA

2 HSP III Approved States WA ME MT ND OR NV ID WY SD NE MN IA WI IL MI IN OH NY PA AK CA UT CO KS MO KY WV VA NC HI AZ NM TX OK AR LA MS TN AL GA SC FL Approved States Health Choice (State Special) He Approved But Not Released - Paper Only All states listed except North Carolina has the Standalone 24HR Enhanced Accident Plan approved 2.15

3 Health Saver Plus III This is a limited-benefit fixedindemnity plan and not a major medical insurance plan. Fixed-indemnity benefits are provided for hospital confinement, specified medical, surgical and outpatient events. These benefits are paid in specific amounts and do not provide expense reimbursement for charges based on your health care provider s bill.

4 Health Saver Plus III & Minimum Essential Coverage Fixed-indemnity insurance plans do not meet the Minimum Essential Coverage requirements under the Affordable Care At and you may need to pay a tax penalty depending upon your income level and the cost of plans available

5 Health Saver Plus III is a Hospital Indemnity Plan. Since all the benefits are defined in the plan it allows the consumer to know exactly what the policy pays before accessing any health care services

6 Key Features Include $5,000,000 Lifetime Maximum Choose from three benefit options Pick your Base Plan Deductible Calendar Year Benefit Maximum Level Number of Benefit Units to fit your needs Use any Doctor or Hospital you choose..or select PPO option to take advantage..of greater savings.

7 Five Calendar Year Deductibles.\eh 1 st Choose a deductible you can afford 1) $ 100 2) $ 500 3) $ 1,000 4) $ 2,500 5) $ 5,000* * Not available in Pennsylvania

8 Medical Plan Comparison. Major Medical Hospital Indemnity Pays based on Expense Incurred Pays based on Define Benefit Schedule Deductible and Co-Payment is Applied Against Eligible Expenses Deductible is Applied Against Eligible Benefits

9 How Deductibles are applied under Hospital Indemnity Plans. The Deductible is Applied against the eligible benefits NOT the eligible expense. It s simple add up the reimbursement for all eligible benefits and subtract the selected Deductible. Eligible Benefit Based on 3 Units 3 Day Hospital Stay for Injury ($ 6,000 a day) $ 18, Surgery 4, Anesthesia (25% of Surgery Benefit) 1, Total Eligible Benefit $ 24, Deductible (Reduction of Benefits) -2, TOTAL BENEFIT PAID $ 21,693.31

10 2 nd Choose an Annual Maximum Benefit. Annual Maximum Annual Maximum Annual Maximum Maximum Covered Benefits Per Covered Person per Calendar Year $100,000 $250,000 $1,000,000 Think about the Annual Maximum Benefit as being a Bucket of Money your client purchased.

11 2 nd Choose an Annual Maximum Benefit. Annual Maximum Annual Maximum Annual Maximum Maximum Covered Benefits Per Covered Person per Calendar Year $100,000 $250,000 $1,000,000 Eligible Expense Each time they have an eligible medical expense, money comes out of the bucket to help pay for those expenses based on the Benefit Plan they selected.

12 2 nd Choose an Annual Maximum Benefit. Annual Maximum Annual Maximum Annual Maximum Maximum Covered Benefits Per Covered Person per Calendar Year $100,000 $250,000 $1,000,000 Every year Philadelphia American refills the bucket.

13 Hospital Indemnity Benefit Facility Fees.

14 PROFESSIONAL SERVICES Arkansas, Georgia, North Carolina

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16 Sponsored Benefits Sponsored Benefits are value added healthcare programs from other providers designed to enhance your healthcare experience without additional cost to your clients. TelaDoc and ScriptSave are sponsored benefits that we are making available to your clients and are not part of the Health Saver Plus policy.

17 Teladoc is a convenient alternative to urgent care or ER visits. U.S. board-certified physicians are available anytime, anywhere, and can resolve many non-emergency medical issues. They can resolve most non-emergency medical issues via phone or online video. Saving you time and money by getting no cost care in three easy steps:

18 Teladoc is a convenient alternative to urgent care or ER visits. U.S. board-certified physicians are available anytime, anywhere, and can resolve many non-emergency medical issues. They can resolve most non-emergency medical issues via phone or online video. Saving you time and money by getting no cost care in three easy steps: Step 1: Contact TelaDoc 24/7/365 Access Teladoc s network via phone, video or mobile app by going to

19 Teladoc is a convenient alternative to urgent care or ER visits. U.S. board-certified physicians are available anytime, anywhere, and can resolve many non-emergency medical issues. They can resolve most non-emergency medical issues via phone or online video. Saving you time and money by getting no cost care in three easy steps: Step 2: Talk with a Physician A physician will review your medical history and contact you with in minutes

20 Teladoc is a convenient alternative to urgent care or ER visits. U.S. board-certified physicians are available anytime, anywhere, and can resolve many non-emergency medical issues. They can resolve most non-emergency medical issues via phone or online video. Saving you time and money by getting no cost care in three easy steps: Step 3: Resolve the Issue A physician will diagnose and prescribe medication, and if medically necessary will send prescription to your pharmacy

21 Prescription Savings Card Save on Brand Name and Generic Prescriptions The ScriptSave Card is provided at NO COST to your clients as a value added feature. The card is a prescription savings card only and is NOT insurance. Easy-To Use o Simply present this card at any participation pharmacy when filling or refilling a prescription. Your card is ready to be used right away Call for help finding a pharmacy, to learn about available services and information about your medications Compare before you buy. Go to but in your group number #2242 and list your medication. It will give you prices for your medication at pharmacies near you.

22 Prescription Savings Card

23 While you can use any Doctor or Hospital you choose without Penalty. You have the option of accessing the PHCS Network to take advantage of great savings at no additional costs.

24 Go to

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26 You can do your search by several different criteria's or just put in the ZIP Code to get all listing in a particular area

27 PHCS Network Composition Summary By MSA

28 Actual Re-priced Claim

29 General Anesthesia

30 Metacarpal Fracture

31 Amputation of Finger

32 Pre-existing Conditions Explain to the applicant how we handle Pre-existing Conditions to ensure they understand how it works What is a Pre-Existing Condition? A condition for which treatment was rendered or recommended by a Physician or for which drugs or medicine was prescribed within 12 months prior to a covered Person s Effective Date and will not be covered for the following12 month period It is important to note that pre-existing conditions applies to all benefit with the exception of the Preventive Care Benefit. Re-pricing is still available through the PPO network.

33 Health Saver Plus III - Pricing (Male & Female age 35) Our most economical plans 1) Male Rate 1 Units / NTU $100 Deductible with a..$ 100,000 Annual Maximum $ ) Female Rate 1 Units / NTU $100 Deductible with a..$ 100,000 Annual Maximum $ ) Male Rate 1 Units / NTU $500 Deductible with a..$100,000 Annual Maximum $ ) Female Rate 1 Units / NTU $500 Deductible with a..$100,000 Annual Maximum $ ) Male Rate 1 Unit / NTU $1,000 Deductible with a..$100,000 Annual Maximum $ ) Female Rate 1 Units / NTU $1,000 Deductible with a..$100,000 Annual Maximum $ Rate does not include a one time $30.00 non-refundable application fee. $6.00 MS

34 Health Saver Plus III - Pricing (Male & Female age 35) Our most popular plans 1) Male Rate 2 Units / NTU $1,000 Deductible with a..$ 250,000 Annual Maximum $ ) Female Rate 2 Units / NTU $1,000 Deductible with a..$ 250,000 Annual Maximum $ ) Male Rate 2 Units / NTU $2,500 Deductible with a..$250,000 Annual Maximum $ ) Female Rate 2 Units / NTU $2,500 Deductible with a..$250,000 Annual Maximum $ ) Male Rate 3 Unit / NTU $5,000 Deductible with a..$250,000 Annual Maximum $ ) Female Rate 3 Units / NTU $5,000 Deductible with a..$250,000 Annual Maximum $ Rate does not include a one time $30.00 non-refundable application fee. $6.00 MS

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