Health slideshow smc


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Understand how health insurance actually works and then visit us at to compare quotes from all the various carriers and even apply online. Should you need assistance, please contact our office. Thanks for checking us out!

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Health slideshow smc

  1. 1. Family & Business
  2. 2. QUESTIONS YOU MAY HAVE <ul><li>Who am I? </li></ul><ul><li>Why Custom Select Insurance Services? </li></ul><ul><li>How are doctor visits and prescriptions be covered? </li></ul><ul><li>Are annual exams covered? </li></ul><ul><li>How much will it cost? </li></ul><ul><li>When will my coverage begin? </li></ul><ul><li>How long will this take today? </li></ul>
  3. 3. <ul><li>Custom Select Insurance Services strives to provide quality products and superior customer service to individuals, families and businesses. Offering support for most personal and business needs. Continuously building and maintaining long term relationships with our clients and our community. </li></ul>
  4. 4. <ul><li>Discuss concerns and obtain brief health history </li></ul><ul><li>Help you understand how insurance works </li></ul><ul><ul><li>Identify available industry options </li></ul></ul><ul><ul><li>Review what your money actually pays for </li></ul></ul><ul><ul><li>The difference between a copay plan and a health savings account </li></ul></ul><ul><ul><ul><li>Determine which is the right type of plan for your needs </li></ul></ul></ul><ul><li>Review quotes from carriers </li></ul><ul><ul><li>We run quotes with most if not all carriers in your state to ensure you are getting the right plan at the best available price </li></ul></ul><ul><ul><li>Options to cover your deductible will also be discussed </li></ul></ul><ul><li>Answer questions </li></ul><ul><li>Complete application </li></ul><ul><ul><li>Submit with initial premium </li></ul></ul><ul><ul><ul><li>Adjust premiums based on your health qualifications </li></ul></ul></ul>
  5. 5. <ul><li>Insurance costs the same no matter where you buy it. All insurance is regulated by your State. </li></ul><ul><ul><li>Advantages of working with an agent: </li></ul></ul><ul><ul><ul><li>Helps you identify the right product for your particular needs and get the best price available. </li></ul></ul></ul><ul><ul><ul><li>You have an advocate on your side should you have issues with an insurance company </li></ul></ul></ul><ul><li>Custom Select is the only company with agents that has the largest selection of insurance carriers in your State. </li></ul>
  6. 6. <ul><li>Individual Health Insurance </li></ul><ul><ul><li>Aetna </li></ul></ul><ul><ul><li>Atlantis </li></ul></ul><ul><ul><li>American Community </li></ul></ul><ul><ul><li>American Medical Security </li></ul></ul><ul><ul><li>American National </li></ul></ul><ul><ul><li>AmeriHealth </li></ul></ul><ul><ul><li>ANTEX </li></ul></ul><ul><ul><li>Anthem </li></ul></ul><ul><ul><li>Assurant </li></ul></ul><ul><ul><li>Avalon </li></ul></ul><ul><ul><li>Blue Cross Blue Shield </li></ul></ul><ul><ul><li>Carefirst </li></ul></ul><ul><ul><li>Celtic </li></ul></ul><ul><ul><li>Cigna </li></ul></ul><ul><ul><li>Coventry </li></ul></ul><ul><ul><li>Excellus BCBS </li></ul></ul><ul><ul><li>Golden Rule </li></ul></ul><ul><ul><li>Health Partners </li></ul></ul><ul><ul><li>Humana </li></ul></ul><ul><ul><li>IAC </li></ul></ul><ul><ul><li>IHC </li></ul></ul><ul><ul><li>Imerica </li></ul></ul><ul><ul><li>Kaiser Permanente </li></ul></ul><ul><ul><li>Optima Health </li></ul></ul><ul><ul><li>Pacificare </li></ul></ul><ul><li>Individual Health (Cont.) </li></ul><ul><ul><li>Southern Health </li></ul></ul><ul><ul><li>UnitedOne </li></ul></ul><ul><ul><li>USHealth </li></ul></ul><ul><ul><li>Unicare </li></ul></ul><ul><ul><li>Vista Health </li></ul></ul><ul><ul><li>Wellpath </li></ul></ul><ul><ul><li>World </li></ul></ul><ul><li>Group Health Insurance </li></ul><ul><ul><li>Aetna </li></ul></ul><ul><ul><li>AmeriHealth </li></ul></ul><ul><ul><li>Atlantis </li></ul></ul><ul><ul><li>CDPHP </li></ul></ul><ul><ul><li>Cigna </li></ul></ul><ul><ul><li>Coventry </li></ul></ul><ul><ul><li>Emblem </li></ul></ul><ul><ul><li>Empire BCBS </li></ul></ul><ul><ul><li>Excellus BCBS </li></ul></ul><ul><ul><li>GHI </li></ul></ul><ul><ul><li>HealthNet </li></ul></ul><ul><ul><li>Health Partners </li></ul></ul><ul><ul><li>Horizon BCBS </li></ul></ul><ul><ul><li>Kaiser Permanente </li></ul></ul><ul><ul><li>Medica </li></ul></ul><ul><ul><li>Optima Health </li></ul></ul><ul><ul><li>Oxford </li></ul></ul><ul><li>Group Health (Cont.) </li></ul><ul><ul><li>Pacificare </li></ul></ul><ul><ul><li>United Healthcare </li></ul></ul><ul><ul><li>Unicare </li></ul></ul><ul><ul><li>Wellpath </li></ul></ul><ul><ul><li>World </li></ul></ul><ul><li>Supplemental Plan Carriers </li></ul><ul><ul><li>AFLAC </li></ul></ul><ul><ul><li>Delta Dental </li></ul></ul><ul><ul><li>Guaranteed Trust Life </li></ul></ul><ul><ul><li>National States </li></ul></ul><ul><ul><li>Patriot Health </li></ul></ul><ul><ul><li>Solera Dental </li></ul></ul><ul><ul><li>Value Benefits of America </li></ul></ul><ul><li>Life Insurance Carriers </li></ul><ul><ul><li>AIG Banner </li></ul></ul><ul><ul><li>Chesapeake Life </li></ul></ul><ul><ul><li>Forester’s </li></ul></ul><ul><ul><li>ING </li></ul></ul><ul><ul><li>John Hancock </li></ul></ul><ul><ul><li>Lincoln Financial </li></ul></ul><ul><ul><li>RBC </li></ul></ul><ul><ul><li>Standard Life </li></ul></ul><ul><ul><li>Security Mutual </li></ul></ul><ul><ul><li>United Home </li></ul></ul><ul><ul><li>William Penn </li></ul></ul>
  7. 7. <ul><li>Replacing Coverage: </li></ul><ul><ul><li>Do not cancel your existing coverage until you have your new plan in your hands, have read it, and are satisfied with it. </li></ul></ul><ul><li>Temporary Insurance: </li></ul><ul><ul><li>If you are just in between jobs or do not have insurance now, you may want to consider a Short Term medical plan. </li></ul></ul><ul><ul><li>Plans are meant to cover temporary needs and can protect you during underwriting. </li></ul></ul><ul><li>Pre-Existing Conditions/ Waiting periods: </li></ul><ul><ul><li>Pre-existing conditions are injuries or illnesses that begin prior to the effective date of the new insurance. Pre-existing conditions may not be covered. There may be a waiting period for well care visits and some procedures may not be covered. </li></ul></ul><ul><li>Underwriting Process: </li></ul><ul><ul><li>This process can take anywhere from 24 hours up to 5 weeks or longer. It depends on whether or not medical records are required. You may be asked to call your doctor to assist in releasing your medical records. </li></ul></ul>
  8. 8. <ul><li>Group Coverage </li></ul><ul><ul><li>Group of one, 2-50, 51+ </li></ul></ul><ul><ul><li>No Health Restrictions (HIPPA) </li></ul></ul><ul><ul><ul><li>Reason why group insurance is usually very expensive </li></ul></ul></ul><ul><ul><li>Option for COBRA </li></ul></ul><ul><li>Individual Coverage </li></ul><ul><ul><li>Any individual or family </li></ul></ul><ul><ul><li>Individual health qualifications </li></ul></ul><ul><ul><ul><li>Reason why individual plans can be less expensive </li></ul></ul></ul><ul><ul><li>Always owned by Insured </li></ul></ul>*These options apply to all Major Medical plans
  9. 9. <ul><li>HMO (Health Maintenance Organization) </li></ul><ul><ul><li>Insurance company determines care provided </li></ul></ul><ul><ul><li>May be limited with coverage area or available doctors </li></ul></ul><ul><ul><li>Limited number of specialists </li></ul></ul><ul><ul><li>Typically limited care options </li></ul></ul><ul><li>PPO (Preferred Provider Organization) </li></ul><ul><ul><li>Insured determines care provided </li></ul></ul><ul><ul><li>Typically national coverage </li></ul></ul><ul><ul><li>Options for any specialist </li></ul></ul><ul><ul><li>Options for best available care </li></ul></ul>
  10. 10. <ul><li>Copay Plans </li></ul><ul><ul><li>Set copays for doctor visits and prescriptions </li></ul></ul><ul><ul><li>Most expensive plan option </li></ul></ul><ul><ul><li>Individual deductibles and coinsurance </li></ul></ul><ul><li>Deductible 1 st Plans </li></ul><ul><ul><li>Negotiated or insurance rates for doctor visits </li></ul></ul><ul><ul><li>Discounts for prescriptions </li></ul></ul><ul><ul><li>Least expensive option </li></ul></ul><ul><ul><li>Individual deductibles and coinsurance </li></ul></ul><ul><li>Health Savings Account Plans </li></ul><ul><ul><li>Negotiated or insurance rates for doctor visits. </li></ul></ul><ul><ul><ul><li>Some carriers offer copay options for wellness exams </li></ul></ul></ul><ul><ul><li>Discounts for prescriptions; </li></ul></ul><ul><ul><li>Tax benefits </li></ul></ul><ul><ul><li>Family deductibles and coinsurance </li></ul></ul>
  11. 11. <ul><li>When you… </li></ul><ul><li>Go see a Doctor </li></ul><ul><li>Get a Prescription </li></ul><ul><li>Go to the ER </li></ul><ul><li>Stay in a Hospital </li></ul><ul><li>You create a bill. </li></ul>Doctors & Hospitals -------------------------------- Network or “ Re-pricing House” Insurance Carrier receives Bill Guaranteed Prices Carrier’s members use network of doctors
  12. 12. DEDUCTIBLE Paid Annually Per Person or Per Family * All Covered Expenses apply towards the deductible first INSURANCE CARRIER Pays 100% for Covered Expenses COINSURANCE Paid Annually Per Person or Per Family 50/50 60/40 70/30 80/20 90/10 100% (% of next $5,000 - $20,000 after deductible) *Most are an additional $2,000
  13. 13. The Unknown Factor: Doctor Visits and Prescriptions <ul><li>Standard Copay Plans </li></ul><ul><li>Individual Deductibles </li></ul><ul><li>Individual Coinsurance </li></ul><ul><li>(Typically 80/20) </li></ul><ul><li>Copays for doctor visits </li></ul><ul><li>Copays for prescriptions </li></ul><ul><li>* Do Not count towards deductible & are Continuous after deductible </li></ul><ul><li>HSA Plans </li></ul><ul><li>Family (Shared) Deductible </li></ul><ul><li>Family Coinsurance </li></ul><ul><li>(Typically 100%) </li></ul><ul><li>Negotiated rates for doctor visits </li></ul><ul><li>Discounts for prescriptions </li></ul><ul><li>* Counts towards deductible & </li></ul><ul><li>there’s No Cost after deductible </li></ul>Lower Premiums Higher Premiums
  14. 14. <ul><li>Family deductible and coinsurance </li></ul><ul><ul><li>Coinsurance usually 100% versus 80/20 like copay plans </li></ul></ul><ul><li>Lower premiums </li></ul><ul><ul><li>Copay plan with an individual $500 deductible and 80/20 coinsurance </li></ul></ul><ul><ul><ul><ul><li>Total annual Risk for a couple equals $5,000 </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>$500 deductible x 2 = $1,000 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>$2,000 coinsurance x 2 = $4,000 </li></ul></ul></ul></ul></ul><ul><ul><li>HSA plan with a family $5,000 deductible and 100% coinsurance </li></ul></ul><ul><ul><ul><ul><li>Total annual risk for a couple equals $5,000 </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Family deductible of $5,000 x1 = $5,000 </li></ul></ul></ul></ul></ul><ul><li>Saved premiums can be tax deferred </li></ul><ul><ul><li>Set aside up to the amount of your deductible in a savings account that can be used for medical expenses </li></ul></ul><ul><ul><ul><li>Not limited to just doctor visits, prescriptions or your deductible </li></ul></ul></ul><ul><ul><ul><li>May also be used for dental and vision expenses, over-the-counter medications, vitamins, alternative and elective procedures and even to pay for long term care premiums </li></ul></ul></ul><ul><ul><li>Account earns you interest </li></ul></ul><ul><ul><li>You never lose it like group Flexible Spending plans </li></ul></ul><ul><ul><ul><li>It’s there for whenever you may need it </li></ul></ul></ul>
  15. 15. 5 things that vary with Major Medical plans: After meeting the deductible and coinsurance, all plans virtually work the same. What you need to know is… <ul><li>How doctor visits & annual exams are covered </li></ul><ul><li>Prescription options and deductibles </li></ul><ul><li>Notable limitations or “hidden copays” </li></ul><ul><li>Maximum out-of-pocket by insured (you) </li></ul><ul><li>Maximum insurance company will pay </li></ul>
  16. 16. <ul><li>What We Know: </li></ul><ul><ul><li>Insurance generally covers your medical bills… </li></ul></ul><ul><ul><ul><li>Who is going to cover your loss of income or your deductibles? </li></ul></ul></ul><ul><ul><li>Over 80% of why health insurance is used is accident related and have an expense under $3,000 annually </li></ul></ul><ul><li>Illness and Accident Supplemental Plans </li></ul><ul><ul><li>Benefits pay to you </li></ul></ul><ul><ul><ul><li>Depending on what you choose, benefits pay in a lump sum upon diagnosis or based on treatment received. </li></ul></ul></ul><ul><ul><li>Reduces your out-of-pocket expenses </li></ul></ul><ul><ul><ul><li>Use them to pay your deductible </li></ul></ul></ul><ul><ul><ul><li>Cover non-insurance services like a chiropractor or simply to offset your loss of income…you decide, it is your money . </li></ul></ul></ul>
  17. 17. <ul><li>Accident Benefits (Per incident) </li></ul><ul><ul><li>Medical Expenses Benefit </li></ul></ul><ul><ul><ul><li>Pays you $2,500 - $10,000 per person </li></ul></ul></ul><ul><ul><li>Emergency Air Ambulance </li></ul></ul><ul><ul><ul><li>Pays you $4,000 </li></ul></ul></ul><ul><ul><li>Accidental Death & Dismemberment </li></ul></ul><ul><ul><ul><li>Pays your family $5,000 - $10,000 </li></ul></ul></ul><ul><li>Illness Benefits That Pay to You </li></ul><ul><ul><li>Stroke, Cancer, Heart Attack, Coronary Bypass, Kidney Failure, Organ Transplant, Any Terminal Illness, Nursing Home Confinement </li></ul></ul><ul><ul><li>Benefits pay in a lump sum upon diagnosis </li></ul></ul>
  18. 18. <ul><li>Choose Best plan for your concerns (Review Premium Options) </li></ul><ul><li>Complete Application Today (Submit with initial premium for review) </li></ul><ul><ul><li>Underwriting will generally take 24 hours up to 5 weeks </li></ul></ul><ul><ul><li>Do not cancel other coverage until underwriting is completed </li></ul></ul><ul><ul><ul><li>Need coverage today? </li></ul></ul></ul><ul><ul><ul><ul><li>Ask about starting a short term policy TODAY! </li></ul></ul></ul></ul><ul><li>Underwriting Process </li></ul><ul><ul><li>Telephone Interview </li></ul></ul><ul><ul><li>Medical Records </li></ul></ul><ul><ul><li>Physical Exam </li></ul></ul><ul><ul><li>Is Money an issue? </li></ul></ul><ul><ul><ul><li>Consider lower premiums with a Health Savings Account </li></ul></ul></ul><ul><ul><ul><li>Take advantage of a Low Cost Illness & Accident Indemnity plan </li></ul></ul></ul>
  19. 19. <ul><li>Do you have enough life insurance? </li></ul><ul><ul><li>We can review several options to ensure you are properly covered. </li></ul></ul><ul><ul><ul><li>Policies we can offer you… </li></ul></ul></ul><ul><ul><ul><ul><li>Term insurance </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Annuities </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Universal life </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Whole life </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Final Expense Coverage </li></ul></ul></ul></ul><ul><ul><li>Typical areas to be concerned about protecting: </li></ul></ul><ul><ul><ul><li>Burial (Even after typical need for insurance has expired) </li></ul></ul></ul><ul><ul><ul><li>10+ years of income (if still working) </li></ul></ul></ul><ul><ul><ul><li>Mortgage paid off </li></ul></ul></ul><ul><ul><ul><li>Kids can attend college </li></ul></ul></ul><ul><ul><ul><li>Support for a local non profit or religious cause </li></ul></ul></ul>
  20. 20. <ul><li>Issue and Effective Dates - The Issue Date is the date the insurance company makes you an offer. The Effective Date is the date the policy begins coverage: If you requested an Effective Date that was earlier than the Issue Date, the coverage will go into effect retro-actively or you may request to change the date up to 60 days after the date that you applied for coverage. </li></ul><ul><li>Standard - This means your policy was issued as it was discussed. </li></ul><ul><li>Rated - Due to your specific health, an increase in premium was placed on the policy to cover the additional risk factors. </li></ul>
  21. 21. <ul><li>Exclusion / Waiver - Due to health risk, a condition or person may be completely excluded from coverage or may be temporarily excluded; generally 6 or 12 months. </li></ul><ul><li>Declined - In this situation coverage was unable to be offered. This is where CSS excels above the competition! Get together with your agent to discuss other options that may be available, we are here to help, not just to sell you a policy. </li></ul><ul><li>Renewals or Changes - Changes occur and as they do, Custom Select will be there to help. Remember, we represent several carriers with all lines of insurance. So if one company isn’t working for you, we can get you on with another; allowing you to keep the same customer support (Custom Select) under one roof for all of your insurance needs! </li></ul>
  22. 22. We appreciate you letting others know how we helped with your concerns today! *Make sure to ask your agent about our referral program