Dallas/Fort Worth
Dallas Team Jeff Crumbaugh Sales Director Sarah Sanders Sales Support Coordinator Jake Boegemann EDC Agent Manager Daniel Miramontes EDC Agent Manager Joseph Santos EDC Agent Manager Angela Pascual EDC Agent Manager (East Texas) 2
Fort Worth Team Mike Nores Sales Director Rachel Skaggs Sales Support Coordinator Jared Pryor EDC Agent Manager J.B. Burnett EDC Agent Manager Josie Etter EDC Agent Manager Dawn Bradley ICA/EDC Agent Manager (West Texas) 3
Why Sell in Dallas/ Fort Worth? Strong brand presence 20 consecutive years Dedicated agent managers - training, business planning, demographic mapping, one-on-one field training and Retail Program opportunities (Ridgmar Mall, La Gran Plaza, Casa Linda Plaza) Unique hearing aid benefit; Hi-Health Additional benefits; including Vision, Dental, House Calls & Silver Sneakers. Strong established network of physicians (10,000+) and hospitals (48) LIFETIME renewals 4
Top 5 Compliance Points 1. OEP= AEP (Changed by CMS) 2. You MUST be certified to sell 3. AEP Material available September 15; CANNOT be used until October 1 4. You CANNOT take an AEP application before October 15 5. Shoppers will be out Pre-AEP; be sure to utilize the 2015 Hello Clarity workbooks 5
Dallas/ Fort Worth, TX Medicare Eligible Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant Market MA Enrollment UHC Members UHC Mkt Share Mkt Penetration Dallas 416,154 96,011 58,426 60.9% 23.1% Fort Worth 317,037 97,818 69,462 71.0% 30.9% Source: June 2014 CMS Market Overview MA Data 6
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Please Note: The information described in this document is pending government approval and is therefore subject to change. For producer internal use only. Distribution, directly or indirectly, to Medicare beneficiaries, other insurers, or any other person or company is strictly prohibited. Unauthorized dissemination, forwarding, or copying of this information may subject the user to disciplinary action, up to and including termination and/or civil or criminal penalties. 8
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Dallas/Fort Worth (Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant counties) 2014 2015 Plan Number H4590-012 (MA-PD) H4590-012 (MA-PD) Plan Name AARP Medicare Complete AARP Medicare Complete Product HMO HMO Premium $0 $0 PCP Copay $0 $0 Specialist Copay $25 $30 Inpatient Days 1-5 $150 / Days 6-999 $0 Days 1-5 $ 250 / Days 6-999 $0 Outpatient $150 $250 OOPM $3,900 $4,900 Rx Deductible $0 $0 Rx Tier Copays (T1/T2/T3/T4/T5) $0/$8/$45/$95/33% $0/$8/$45/$95/33% 10
Dallas/Fort Worth (Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant counties) 2014 2015 Plan Number H4590-012 (MA-PD) H4590-012 (MA-PD) Plan Name AARP MedicareComplete AARP MedicareComplete Product HMO HMO Laboratory Tests $13 $13 Routine Eye Exam $25 (1 per year) $30 (1 per year) Urgently Needed Services Skilled Nursing Facility (SNF) Care $25 In-network; $40 Non-contracted Days 1-20 $25/ Days 21-43 $152/ Days 44-100 $0 $30 In-network; $40 Non-contracted Days 1-20 $0/ Days 21-52 $155/ Days 53-100 $0 Routine Podiatry $25 (6 visits per year) $30 (6 visits per year) Physical/ Speech Therapy $25 In network $30 In network 11
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Dallas/Fort Worth (Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant counties) 2014 2015 Plan Number H4590-020 (HMO-DSNP) H4590-020 (HMO-DSNP) Plan Name UHC Dual Complete UHC Dual Complete Product HMO HMO Premium $0 $0 Foot Care $0 copay (4 visits per year) $0 copay (4 visits per year) Glaucoma Screening $0 copay $0 copay Routine Eye Exam $0 Copay (1 every 2 years) $0 Copay (1 every 2 years) Eyewear $0 Copay up to $70 $105 for Contacts (every 2 yrs.) $0 Copay up to $200 for eyewear or contacts (every 2 yrs.) Oral Exam $0 (1 every 6 months) $0 (1 every 6 months) Comprehensive Dental $0 (1 every 6 months) $0 (1 every 6 months) Dental Benefit Limit $2000.00 $2000.00 13
Dallas/Fort Worth (Collin, Dallas, Denton, Ellis, Johnson, Kaufman, Rockwall, Tarrant counties) 2014 2015 Plan Number H4590-020 (HMO-DSNP) H4590-020 (HMO-DSNP) Plan Name UHC Dual Complete UHC Dual Complete Product DSNP DSNP Premium $0 $0 Hearing Services $0 copay $0 copay Hearing Aids $2000 (every 2 years) $2000 (every 2 years) Transportation 24 one-way trips annually 24 one-way trips annually Benefit Catalog $135 quarterly credit $135 quarterly credit Prescription Drug 31-day supply from network 30-day supply from network Generic (Incl. Brands treated as generic) $0, $1.15, $2.65 copay, or 15% of the total cost $0, $1.20, $2.55 copay, or 15% of the total cost All other drugs $0, $3.50, $6.60 copay or 15% of the total cost $0, $3.50, $6.60 copay or 15% of the total cost 14 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of 14
www.uhccommunityplan.com 15 Update 2-16-12
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2015 CIP RPPO Commissionable Plans Plan Name Silver Rx + Full Dual CSNP Diabetes &/or Heart Failure Gold Rx (Hearing Aids) Diabetes &/or Heart Failure DSNP Dual Advantage + Full Dual Full dual ($0 A/B cost sharing) MA-PD Medicare Advantage (Hearing Aids) Not eligible for CSNP or DSNP 17
Dallas/Fort Worth 2014 2015 Plan Number R68010-12 (MA-PD) R68010-12 (MA-PD) Plan Name CIP (MA-PD-RPPO) CIP (MA-PD-RPPO) Product PPO PPO Premium $0 $23 PCP Copay $15 $15 Specialist Copay $45 (no referrals needed) $45 (no referrals needed) Inpatient Days 1-4 $395 / $0 copays per day after that Days 1-4 $395 / $0 copays per day after that Outpatient 20% 20% OOPM $6,700 $6,700 Rx Deductible $0 $0 Rx Tier Copays (T1/T2/T3/T4/T5) $5/ $10/ $45/$95/33% $3/ $12/ $45/$95/33% 18
Dallas/Fort Worth 2014 2015 Plan Number R68010-12 (MA-PD) R68010-12 (MA-PD) Plan Name CIP (MA-PD-RPPO) CIP (MA-PD-RPPO) Product PPO PPO Laboratory Tests $14 $13 Urgently Needed Services Skilled Nursing Facility (SNF) Care $30 In-network; $40 Non-contracted Days 1-20 $25/ Days 21-61 $152/ Days 62-100 $0 $30 In-network; $40 Non-contracted Days 1-20 $0/ Days 21-64 $155/ Days 65-100 $0 Routine Podiatry $45 (6 visits per year) $45 (6 visits per year) Physical/ Speech Therapy $45 In network $40 In network 19
Additional Offerings AARP Part D Prescription Drug Plans Two options in 2015: Saver & Preferred AARP Medicare Supplements Incredible brand recognition Market leader Low average rate increases (~5% over the last 15 years) 20
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