Individual & Family   Medical, Dental & Life Plans March 2009
PPO Plans <ul><li>SmartSense </li></ul><ul><li>Lumenos CDHPs </li></ul><ul><li>PPO Share </li></ul><ul><li>RightPlan PPO 4...
PPO Plans <ul><li>Reliable protection with some of our lowest rates </li></ul><ul><li>Choice of deductible   </li></ul><ul...
SmartSense For last 3 months of calendar year for expenses incurred in the 4 th  quarter that are less than the deductible...
PPO Plans <ul><li>Consumer-Driven Health Plans (CDHPs ) </li></ul><ul><li>HSA-compatible, HIA and HIA Plus plans </li></ul...
Lumenos Health Savings Account (HSA)-Compatible  Without Maternity   30%/30%/0% Coinsurance after deductible <ul><li>Funde...
Lumenos Health Savings Account (HSA)-Compatible  With Maternity 0% Coinsurance after deductible <ul><li>Funded by subscrib...
Lumenos Health Incentive Account (HIA)  Without Maternity   30%/30%/0% Coinsurance after deductible <ul><li>Funded through...
Lumenos Health Incentive Account (HIA) With Maternity 0% Coinsurance after deductible <ul><li>Funded through financial inc...
Lumenos Health Incentive Account Plus (HIA+) Without Maternity   30%/30%/0% Coinsurance after deductible <ul><li>Funded th...
Lumenos Health Incentive Account Plus (HIA+) With Maternity 0% Coinsurance after deductible <ul><li>Funded through health ...
PPO Plans <ul><li>Comprehensive PPO plans </li></ul><ul><li>Once deductible is met, member pays 30% co-insurance for most ...
PPO Share (5000/2500/1500) $5,000  per member 30% of negotiated fee, deductible waived $35 copay deductible waived $10 gen...
PPO Plans <ul><li>Our no-deductible PPO plan </li></ul><ul><li>No deductible </li></ul><ul><li>$40 office visit copay, 40%...
RightPlan PPO 40 Inpatient:  40% of negotiated fee plus $500 copay/day;  4-day maximum copay per admission Outpatient:  40...
PPO Plans <ul><li>HSA-Compatible plan </li></ul><ul><li>HSA-compatible </li></ul><ul><li>Most services covered at 100% aft...
PPO 3500 (HSA-Compatible) $15 generic; $35 brand copay after Medical/Pharmacy deductible met Drug Benefits  (Anthem Blue C...
PPO Plans <ul><li>Another affordable plan for individuals and families </li></ul><ul><li>Most services covered at 100% aft...
3500 Deductible PPO $15 generic; $35 brand copay after $500 brand deductible  (2-member maximum) Drug Benefits  (Anthem Bl...
PPO Plans <ul><li>Our most basic and affordable plan </li></ul><ul><li>In-hospital coverage in the event of catastrophic i...
Basic PPO   (2500/1000) HealthyCheck Centers:  $25/$75 copay for basic/ premium  screenings Routine mammogram, Pap,  PSA o...
HMO Plans <ul><li>HMO Saver </li></ul><ul><li>Individual HMO </li></ul><ul><li>Select HMO </li></ul>
HMO Plans <ul><li>First dollar coverage  on: </li></ul><ul><ul><li>Office visits </li></ul></ul><ul><ul><li>Generic drugs ...
HMO Plans See Office visits and In/Outpatient $3,000 $10 generic; $30 brand copay after $250 brand deductible  (2-member m...
Plan Options Based on Prospect’s Needs   Lumenos with maternity PPO Share HMO Maternity coverage SmartSense 5000, 3500 HSA...
Rating Methodology Summary NO YES YES YES YES YES YES Anniversary-Rated? NO CONTRACT Basic PPO CONTRACT CONTRACT MEMBER ME...
Short-Term Plans <ul><li>Coverage from 30 to 180 days </li></ul><ul><li>Choice of deductible level </li></ul><ul><li>$3 mi...
Short-Term Plans 20% of negotiated fee (Accidental injuries not subject to deductible) Ambulatory Surgical Center and ER $...
Dental Coverage Options <ul><li>Our New Dental Blue ®  PPO Plans </li></ul><ul><li>Dental SelectHMO Plans </li></ul><ul><l...
Dental Coverage Options Dental Blue PPO Plans <ul><li>Power to choose from: </li></ul><ul><ul><ul><li>Two networks (Dental...
Individual Dental – Dental Blue The deductible is waived for covered in-network Diagnostic & Preventive services 100% in-n...
Individual Dental – DHMO, SmileNet Not an insurance plan;  a very simple, low-priced discount dental program SmileNet Dent...
Dental Coverage Options What About Our Other (Previous) Dental PPO Plan? <ul><li>Sell Dental Blue 200 Essential Plan, whic...
Individual Life Insurance <ul><li>Anyone who qualifies for one of our Level 1 or  Level 1 + 25 medical plans can purchase:...
<ul><ul><li>Health  • Dental •  Life </li></ul></ul><ul><ul><li>Thank You for Selling Anthem Blue Cross! </li></ul></ul>
Upcoming SlideShare
Loading in …5
×

Indandfam Med Dent Life

706 views

Published on

Overview of what Anthem Blue Cross has to offer for CA in 2009.

Published in: Economy & Finance, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
706
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Indandfam Med Dent Life

    1. 1. Individual & Family Medical, Dental & Life Plans March 2009
    2. 2. PPO Plans <ul><li>SmartSense </li></ul><ul><li>Lumenos CDHPs </li></ul><ul><li>PPO Share </li></ul><ul><li>RightPlan PPO 40 </li></ul><ul><li>3500 Deductible PPO </li></ul><ul><li>PPO 3500 HSA-Compatible </li></ul><ul><li>Basic PPO (2500/1000) </li></ul>Benefits shown on slides that follow are in-network
    3. 3. PPO Plans <ul><li>Reliable protection with some of our lowest rates </li></ul><ul><li>Choice of deductible </li></ul><ul><li>Choice of generic or comprehensive drug coverage </li></ul><ul><li>“ Embedded” family deductible and out-of-pocket maximum </li></ul><ul><li>3 office visits before deductible </li></ul><ul><li>4 th quarter deductible carryover </li></ul><ul><li>$7 million lifetime benefits </li></ul><ul><li>No maternity coverage </li></ul><ul><li>Member-level-rated </li></ul><ul><li>2-year anniversary date rate guarantee on 5000 deductible plans </li></ul>SmartSense
    4. 4. SmartSense For last 3 months of calendar year for expenses incurred in the 4 th quarter that are less than the deductible 4 th Quarter Deductible Carryover Not covered Maternity Generic: $15 copay or 40%, whichever is greater Generic: $15 copay or 40%, whichever is greater Brand name: $500 annual brand deductible (2-member maximum), then $15 copay or 40%, whichever is greater (up to $500 maximum per prescription) — $4,500 maximum annual out-of-pocket in addition to brand deductible Drug Benefits Generic plan Comprehensive plan 30% after deductible Hospital In/Outpatient 30% after deductible HealthyCheck Centers: $25/$75 copay for basic/ premium screenings, with deductible waived Preventive Care 3 before deductible w/ $30 copay, then 30% after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum Single/Family (in addition to deductible) $500, $1,500, $2,500 or $5,000 (single) $1,000, $3,000, $5,000 or $10,000 ( family deductible can be satisfied by 2 or more members ) $2,500/$5,000 ( family out of pocket can be satisfied by 2 or more members )
    5. 5. PPO Plans <ul><li>Consumer-Driven Health Plans (CDHPs ) </li></ul><ul><li>HSA-compatible, HIA and HIA Plus plans </li></ul><ul><li>Deductible waived in-network (no cost to member) for nationally recommended preventive care services </li></ul><ul><li>Choice of no maternity plans or one maternity plan </li></ul><ul><li>After deductible, member pays 0% or 30% co-insurance (depending on plan) for most covered services </li></ul><ul><li>Generic and brand drugs – member pays 0% or 30% after annual deductible (depending on plan) </li></ul><ul><li>$7 million lifetime maximum (no maternity plans), </li></ul><ul><li>$5 million lifetime maximum (maternity plan) </li></ul><ul><li>Member-level-rated </li></ul><ul><li>Powerful online health management tools </li></ul>Lumenos ®
    6. 6. Lumenos Health Savings Account (HSA)-Compatible Without Maternity 30%/30%/0% Coinsurance after deductible <ul><li>Funded by subscriber, up to maximum limit set by U.S. Treasury </li></ul><ul><li>Unused dollars rollover year-to-year </li></ul><ul><li>Subscriber “owns” HSA </li></ul>HSA Account 30%/30%/0% after deductible Drug Benefits Not covered Maternity 30%/30%/0% after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) 30%/30%/0% after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum (in addition to deductible) $1,500/$3,000/$5,000 (single) $3,000/$6,000/$10,000 (family maximum) Single: $3,500/$2,000/$0 Family: $7,000/$4,000/$0 (aggregate)
    7. 7. Lumenos Health Savings Account (HSA)-Compatible With Maternity 0% Coinsurance after deductible <ul><li>Funded by subscriber, up to maximum limit set by U.S. Treasury </li></ul><ul><li>Unused dollars rollover year-to-year </li></ul><ul><li>Subscriber “owns” HSA </li></ul>HSA Account $0 after deductible Drug Benefits $0 after deductible Maternity $0 after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) $0 after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum/Member (in addition to deductible) $5,000 (single) $10,000 (family maximum) $0
    8. 8. Lumenos Health Incentive Account (HIA) Without Maternity 30%/30%/0% Coinsurance after deductible <ul><li>Funded through financial incentives earned through Healthy Rewards </li></ul><ul><li>Must be actively enrolled in HIA plan to access HIA account funds </li></ul>HIA Account 30%/30%/0% after deductible Drug Benefits Not covered Maternity 30%/30%/0% after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) 30%/30%/0% after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum/member (in addition to deductible) $1,500/$3,000/$5,000 (single) $3,000/$6,000/$10,000 (family maximum) Single: $3,500/$2,000/$0 Family: $7,000/$4,000/$0 (aggregate)
    9. 9. Lumenos Health Incentive Account (HIA) With Maternity 0% Coinsurance after deductible <ul><li>Funded through financial incentives earned through Healthy Rewards </li></ul><ul><li>Must be actively enrolled in HIA plan to access HIA account funds </li></ul>HIA Account $0 after deductible Drug Benefits $0 after deductible Maternity $0 after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) $0 after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum (in addition to deductible) $5,000 (single) $10,000 (family maximum) $0
    10. 10. Lumenos Health Incentive Account Plus (HIA+) Without Maternity 30%/30%/0% Coinsurance after deductible <ul><li>Funded through health plan allocation of $500/$1000 per year single/family and financial incentives earned through Healthy Rewards </li></ul><ul><li>Must be actively enrolled in HIA plan to access HIA account funds </li></ul>HIA+ Account 30%/30%/0% after deductible Drug Benefits Not covered Maternity 30%/30%/0% after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) 30%/30%/0% after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum/Member (in addition to deductible) $1,500/$3,000/$5,000 (single) $3,000/$6,000/$10,000 (family maximum) Single: $3,500/$2,000/$0 Family: $7,000/$4,000/$0 (aggregate)
    11. 11. Lumenos Health Incentive Account Plus (HIA+) With Maternity 0% Coinsurance after deductible <ul><li>Funded through health plan allocation of $500/$1000 per year single/family and financial incentives earned through Healthy Rewards </li></ul><ul><li>Must be actively enrolled in HIA+ plan to access HIA+ account funds </li></ul>HIA+ Account $0 after deductible Drug Benefits $0 after deductible Maternity $0 after deductible Hospital In/ Outpatient $0 (deductible waived) Preventive Care (nationally recommended services) $0 after deductible Office Visits Annual Deductible Annual Out-of-Pocket Maximum/Member (in addition to deductible) $5,000 (single) $10,000 (family maximum) $0
    12. 12. PPO Plans <ul><li>Comprehensive PPO plans </li></ul><ul><li>Once deductible is met, member pays 30% co-insurance for most covered services </li></ul><ul><li>Deductible waived for office visits, annual physical exam and preventive care </li></ul><ul><li>Maternity coverage </li></ul><ul><li>$5 million lifetime maximum </li></ul>PPO Share (5000/2500/1500)
    13. 13. PPO Share (5000/2500/1500) $5,000 per member 30% of negotiated fee, deductible waived $35 copay deductible waived $10 generic; $30 brand copay after $250 brand deductible $10 generic; $30 brand copay after $500 brand deductible $15 generic; $35 brand copay after $750 brand deductible Drug Benefits (Anthem Blue Cross Formulary) (2-member maximum for brand deductible) 30% of negotiated fee Maternity 30% of negotiated fee Hospital In/ Outpatient Annual physical exam: 30% of negotiated fee, or HealthyCheck Centers: $25/$75 copay for basic/premium screenings Routine mammogram, Pap, PSA ordered by physician: 30% of negotiated fee Well Child: 40% of negotiated fee Preventive Care (deductible waived) $40 copay deductible waived Office Visits $4,500 per member Annual Deductible (2-member maximum) Annual Out-of-Pocket Maximum (in addition to deductible) (2-member maximum, par/non-par) $1,500 per member $2,500 per member $5,000 per member $2,500 per member 1500 2500 5000
    14. 14. PPO Plans <ul><li>Our no-deductible PPO plan </li></ul><ul><li>No deductible </li></ul><ul><li>$40 office visit copay, 40% share of costs </li></ul><ul><li>3 prescription drug options: </li></ul><ul><ul><li>None </li></ul></ul><ul><ul><li>Generic only </li></ul></ul><ul><ul><li>Comprehensive (generic and brand) </li></ul></ul><ul><li>Single policy coverage (each family member gets their own policy) </li></ul><ul><li>No maternity </li></ul><ul><li>$5 million lifetime maximum </li></ul>RightPlan PPO 40
    15. 15. RightPlan PPO 40 Inpatient: 40% of negotiated fee plus $500 copay/day; 4-day maximum copay per admission Outpatient: 40% of negotiated fee plus $500 copay per outpatient surgery admission Hospital In/Outpatient No coverage (P958), or Generic coverage (PE48) - $15 generic, or Comprehensive coverage (PE49) - $15 generic, $35 brand copay after $500 brand deductible Drug Benefits (Anthem Blue Cross Formulary) Not covered Maternity HealthyCheck Centers: $25/$75 copay for basic/ premium screenings Routine mammogram, Pap, PSA ordered by a physician: $40 office visit plus 40% of negotiated fee Well Child: $40 office visit plus 40% of negotiated fee Preventive Care $40 copay Office Visits No deductible Annual Deductible $7500/subscriber Annual Out-of-Pocket Maximum (par/non-par)
    16. 16. PPO Plans <ul><li>HSA-Compatible plan </li></ul><ul><li>HSA-compatible </li></ul><ul><li>Most services covered at 100% after deductible is met ($100 copay for emergency services after deductible; waived if admitted) </li></ul><ul><li>Deductible waived for HealthyCheck screenings </li></ul><ul><li>No maternity </li></ul><ul><li>Generic and brand drug coverage after annual deductible is met </li></ul><ul><li>Member-level-rated </li></ul><ul><li>$5 million lifetime maximum </li></ul><ul><li>2-year anniversary date rate guarantee </li></ul>PPO 3500 (HSA-Compatible)
    17. 17. PPO 3500 (HSA-Compatible) $15 generic; $35 brand copay after Medical/Pharmacy deductible met Drug Benefits (Anthem Blue Cross Formulary) Not covered Maternity HealthyCheck Centers: $25/$75 copay for basic/ premium screenings, deductible waived Routine mammogram, Pap, PSA ordered by physician: $0 after deductible Well Child: $0 after deductible Preventive Care $0 after deductible Hospital In/Outpatient $0 after deductible Office Visits $3500/member, $7,000/family (aggregate) Annual Deductible (Medical/Pharmacy combined, par/non-par) $1500/member, $3,000/family (aggregate) Annual Out-of-Pocket Maximum (in addition to deductible) (Medical/Pharmacy combined, par/non-par)
    18. 18. PPO Plans <ul><li>Another affordable plan for individuals and families </li></ul><ul><li>Most services covered at 100% after deductible is met ($100 copay for emergency services after deductible; waived if admitted) </li></ul><ul><li>Out-of-pocket maximum met in-network when deductible is met </li></ul><ul><li>Deductible waived for HealthyCheck screenings </li></ul><ul><li>No maternity </li></ul><ul><li>Member-level-rated </li></ul><ul><li>Generic and brand drug coverage </li></ul><ul><li>$5 million lifetime maximum </li></ul><ul><li>2-year anniversary date rate guarantee </li></ul>3500 Deductible PPO
    19. 19. 3500 Deductible PPO $15 generic; $35 brand copay after $500 brand deductible (2-member maximum) Drug Benefits (Anthem Blue Cross Formulary) Not covered Maternity HealthyCheck Centers: $25/$75 copay for basic/premium screenings, deductible waived Routine mammogram, Pap, PSA ordered by physician: $0 after deductible Well Child: $0 after deductible Preventive Care $0 after deductible Hospital In/Outpatient $0 after deductible Office Visits $3500/member Annual Deductible (2-member maximum) Satisfied in-network once annual deductible is met Annual Out-of- Pocket Maximum (in addition to deductible) (2-member maximum, par/non-par)
    20. 20. PPO Plans <ul><li>Our most basic and affordable plan </li></ul><ul><li>In-hospital coverage in the event of catastrophic illness or injury </li></ul><ul><li>Office visit only after out-of-pocket maximum is met </li></ul><ul><li>Prescription drugs in the hospital only </li></ul><ul><li>Available with or without $1,000 Term Life </li></ul><ul><li>No maternity </li></ul><ul><li>$5 million lifetime maximum </li></ul>Basic PPO (2500/1000)
    21. 21. Basic PPO (2500/1000) HealthyCheck Centers: $25/$75 copay for basic/ premium screenings Routine mammogram, Pap, PSA ordered by physician: 20% of negotiated fee Preventive Care (deductible waived) Not covered Maternity Not covered Drug Benefits 20% of negotiated fee Hospital In/Outpatient $1000/member $2500/member $2500 No office visit benefits until out-of-pocket maximum is met, then plan pays 100% of negotiated fee Office Visits Annual Deductible (2-member maximum) $2500 Annual Out-of-Pocket Maximum (in addition to deductible) (2-member maximum, par/non-par)
    22. 22. HMO Plans <ul><li>HMO Saver </li></ul><ul><li>Individual HMO </li></ul><ul><li>Select HMO </li></ul>
    23. 23. HMO Plans <ul><li>First dollar coverage on: </li></ul><ul><ul><li>Office visits </li></ul></ul><ul><ul><li>Generic drugs </li></ul></ul><ul><ul><li>Preventive care </li></ul></ul><ul><li>Unlimited office visits with set copays </li></ul><ul><li>Coverage for services from doctors and hospitals in HMO network </li></ul><ul><li>Comprehensive drug plan </li></ul><ul><li>Maternity coverage </li></ul><ul><li>Lifetime maximum - unlimited </li></ul>HMO Saver, Individual HMO, Select HMO
    24. 24. HMO Plans See Office visits and In/Outpatient $3,000 $10 generic; $30 brand copay after $250 brand deductible (2-member maximum) Drug Benefits (Anthem Blue Cross formulary) Office visits: $10 copay Inpatient: no charge Outpatient: 20% of negotiated fee See Office visits and In/Outpatient ( subject to deductible) Maternity Inpatient: 20% of negotiated fee Outpatient: 20% of negotiated fee Inpatient: $250 copay/day first 4 days; then covered at 100% Outpatient: 20% of negotiated fee, $250/surgery $1,500 deductible, then: Inpatient: 20% of negotiated fee Outpatient: 20% of negotiated fee (emergency & non-emergency services subject to deductible) Hospital In/Outpatient $25 copay $10 copay Preventive Care (specific services) $25 copay/visit $10 copay/visit Office Visits (unlimited) No deductible $1,500/member for Inpatient, Outpatient and ASCs only Annual Deductible $1500/member Annual Out-of-Pocket Maximum (in addition to deductible) (2-member maximum) Select HMO Individual HMO HMO Saver
    25. 25. Plan Options Based on Prospect’s Needs Lumenos with maternity PPO Share HMO Maternity coverage SmartSense 5000, 3500 HSA, 3500 PPO 2-year anniversary date rate lock Lumenos PPO 3500 (HSA-Compatible) Control over finances, including health care expenses Lumenos HSA/HIA/HIA+ (0% coinsurance plans) 3500 Deductible PPO or PPO 3500 (HSA-Compatible) 100% coverage of most services after deductible RightPlan PPO 40 Individual HMO or Select HMO No deductible PPO Share and HMO (unlimited) SmartSense (up to three) Immediate coverage for office visits before deductible Basic PPO, SmartSense Budget Recommended Plans: If Main Need Is:
    26. 26. Rating Methodology Summary NO YES YES YES YES YES YES Anniversary-Rated? NO CONTRACT Basic PPO CONTRACT CONTRACT MEMBER MEMBER MEMBER MEMBER Member-Level or Contract Rated? NO HMO NO PPO Share YES RightPlan YES 3500 HSA, 3500 PPO YES Lumenos YES SmartSense Gender-Rated? Plan
    27. 27. Short-Term Plans <ul><li>Coverage from 30 to 180 days </li></ul><ul><li>Choice of deductible level </li></ul><ul><li>$3 million lifetime maximum </li></ul><ul><li>Easy application process </li></ul><ul><li>Streamlined underwriting </li></ul><ul><li>No maternity </li></ul><ul><li>Member-level-rated </li></ul>Short-Term Plans
    28. 28. Short-Term Plans 20% of negotiated fee (Accidental injuries not subject to deductible) Ambulatory Surgical Center and ER $10 generic; $30 brand name Brand name maximum $500 Drug Benefits (Anthem Blue Cross Formulary) Not covered Maternity 20% of negotiated fee Hospital In/Outpatient $250, $500, $1,000, $2,000 Deductible $1,000 per member plus deductible Out-of-Pocket Maximum
    29. 29. Dental Coverage Options <ul><li>Our New Dental Blue ® PPO Plans </li></ul><ul><li>Dental SelectHMO Plans </li></ul><ul><li>SmileNet Dental Discount Program </li></ul>
    30. 30. Dental Coverage Options Dental Blue PPO Plans <ul><li>Power to choose from: </li></ul><ul><ul><ul><li>Two networks (Dental Blue 100 or 200) </li></ul></ul></ul><ul><ul><ul><ul><li>Can even go to a dentist in DB 300 network and still be “in-network” </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Best to choose 200 Essential or 200 Plus plan if dentist is in DB 300 network </li></ul></ul></ul></ul><ul><ul><ul><li>Four plans </li></ul></ul></ul><ul><ul><li>Key benefits: </li></ul></ul><ul><ul><ul><li>Negotiated discounts during waiting periods </li></ul></ul></ul><ul><ul><ul><li>One of the largest PPO dental network in CA </li></ul></ul></ul><ul><ul><ul><li>Negotiated discounts after exceeding the plan maximum </li></ul></ul></ul><ul><ul><ul><li>Discounts on non-covered dental work such as teeth whitening, implants and orthodontics </li></ul></ul></ul>
    31. 31. Individual Dental – Dental Blue The deductible is waived for covered in-network Diagnostic & Preventive services 100% in-network (80% out-of-network) 50% (in-network and OON) Fee schedule (e.g., $57 for stainless steel crown) Not covered Major Services 80% (60% OON) Basic services: 0 Major services: 6 Basic services: 3 Major services: 12 200 Plus 100 Plus 100% in-network (fee schedule out-of-network) Diagnostic Care (cleanings, exams, X-rays) Not covered Orthodontia Fee schedule (e.g., $42 for filling) 80% fillings; 50% stainless steel crowns (fee schedule OON) Basic Services Basic services: 3 Major services: 12 0 Waiting Periods (months) $1000/person/yr $500/person/yr Maximum Benefit $50 single/$150 family $25/person (no family maximum) Deductible 200 Essential 100 Basic
    32. 32. Individual Dental – DHMO, SmileNet Not an insurance plan; a very simple, low-priced discount dental program SmileNet Dental Discount Program $5 Office Visits $0 Routine Cleanings Yes Orthodontia Coverage $0 Diagnostic Care (oral exams, X-rays) None for most services Waiting Periods Unlimited Maximum Benefit None Deductible (3) DHMO Plans
    33. 33. Dental Coverage Options What About Our Other (Previous) Dental PPO Plan? <ul><li>Sell Dental Blue 200 Essential Plan, which offers: </li></ul><ul><ul><li>Identical benefits to previous Dental PPO plan </li></ul></ul><ul><ul><li>Access to much larger network </li></ul></ul><ul><ul><li>Discounts during waiting periods and after exceed plan maximum </li></ul></ul><ul><ul><li>Discounts on non-covered dental work such as teeth whitening, implants and orthodontics </li></ul></ul>
    34. 34. Individual Life Insurance <ul><li>Anyone who qualifies for one of our Level 1 or Level 1 + 25 medical plans can purchase: </li></ul><ul><ul><li>$15,000, $30,000, $50,000, $75,000 or $100,000 (if over age 19) </li></ul></ul><ul><ul><li>$15,000 or $30,000 (ages 1-19) </li></ul></ul><ul><li>Basic PPO and PPO Saver plans include $1,000 of Term Life insurance for: </li></ul><ul><ul><li>An additional $1 per month through age 49, or </li></ul></ul><ul><ul><li>An additional $2 per month for ages 50-64 </li></ul></ul>Term Life Insurance
    35. 35. <ul><ul><li>Health • Dental • Life </li></ul></ul><ul><ul><li>Thank You for Selling Anthem Blue Cross! </li></ul></ul>

    ×