Listening, Learning, Responding and Caring
AlwaysCare Benefits, Inc. Home office based in Baton Rouge, LA Dental, Vision, Hearing, Life & Disability 400,000+ covered members Privately owned and operated Recognized by Inc Magazine as one of the fastest growing privately owned companies Customer first culture Confidential
Our goals Customer-first culture based on exceptional technology, service, flexibility, competitive plans and rates. Best in class provider of ancillary benefits. Single source for dental and vision benefits. Confidential
Strong membership growth  (primary insureds) Confidential
Our metrics 92%+ group retention 99%+ claims processing accuracy 95% of inquiries resolved on first contact New groups implemented in 5 days (avg.) 95% overall Customer satisfaction rate 90%+ of survey respondents will recommend AlwaysCare to a family member or friend Claim processing time: 4-5 business days Confidential
The AlwaysCare Target Market Group Dental and Vision Available for groups of 2 or more Strong Niche: Blue collar and service type industries  2-9 shelf plans and rates Average case size for block is 78 employees Largest case 30,000 eligible
The AlwaysCare Difference Makers Online Services Website AlwaysAssist Consumerism & Transparency Account Management Services Enrollment assistance Welcome calls/letters
The AlwaysCare Difference Makers Consumer Driven Dental and Vision leader Dental Dual Choice (high/low offerings) – min. of 5 enrolled per plan Carryover Benefit Rider – dental’s version of the HRA Consumerism & Transparency via the web Vision Members drive their decisions of cost, convenience or choice Online access for purchasing of contacts
Difference-Makers: Group Dental Plan Design Flexibility Choice of deductible options including $100 lifetime Cosmetic Riders – bleaching, porcelain crowns Endosteal Implants Covered under major services Available on all plans and case sizes Carryover Benefit  Carrying over benefit dollars for future needs One preventive visit per year required Available for all group sizes Ease of Administration Employer determines contribution level Paperless enrollment available
Dental Details Optional Benefits Orthodontia Available for groups over 10 enrolled lives Standard benefit includes an annual maximum as well as a lifetime maximum $7-9 added to the EE+Child(ren) and Family Rate Up to age 19 Higher Annual Maximums   Available for groups over 10 enrolled lives - $1500 and $2000
Dental Details DenteMax network 80,000 providers nationwide  Passive/blind PPO model Active PPO options available Participation guidelines 2-9 75% of eligibles  10+ greater of 5 or 20% of eligibles Rate bands 20-49%; 50-79% and 80% or higher Periodontics & endodontics Basic or major services Annual maximums $500, $750, $1000, $1200, $1500 and $2000
AlwaysDental – FAQ Waiting Periods No waiting period options available and standard for groups with 25 or more and 75% participation 12 month waits on major services only Takeover credit available at the group level Missing Tooth Clause Prior like coverage covered if tooth extracted within the last 36 months  Or, covered after 36 months with AlwaysCare Usual & Customary 70 th , 80 th  or 90 th   Network or No Network Passive model using the DenteMax network
Dental Product Updates   Wellness Benefit Enhancements Additional Cleaning for pregnant women in their 2nd or 3rd trimesters  (Standard Benefit) Members 40+ years of age who demonstrate risk factors for oral cancer or suspicious lesions are entitled to one adjunctive, pre-diagnostic test per year  (Standard Benefit) Members diagnosed with diabetes are eligible for 2 extra cleanings every twelve months (Optional Benefit)
Dental Questions to Ask When and what age limits have you recently changed to your contract? Have you made any changes to benefit frequencies? Do you split up simple vs. complex periodontic/ endodontic procedures? How do you handle UCR? Can you provide me your top 10 ADA codes?
Difference-Makers: Group Vision Two and Three Tier Network Plans Standard in and out-of-network plan with copay flexibility Three tier Wal-Mart vision plan option  Mail Order contact lenses via the web Use their contact benefit Great discounts Materials-Only Plan Options with hearing rider Great add-on for medical plan that covers annual vision exam High value and low cost
Vision Details NVA and proprietary network 22,000+ providers nationwide Retail and independent practitioners  Prescription fulfillment flexibility Site of annual exam does not have to dictate where prescription is filled Consumer drives decision  Contacts in lieu of lenses and frames Member receiving contacts must wait 12 months to receive lens or frame benefit and vice versa  Benefit frequencies   12/12/12/12; 12/12/24/12 and 12/12/24/24 Date of service not policy or calendar  year
Vision Product Updates   Simply need 5 enrolled if packaging with dental 3 year rate guarantees for 50+ enrolled 5% load  Costco added to the network Member will need to file claim on their own behalf Specialty lenses and material upgrades only for First Look Network  Provides identified as Value Add (VA) or Service Plus (SP) on website Lens Options: UV, scratch resistance  and anti-reflective coating, tinting, polarized, polycarbonate, etc. Second pair of glasses or contact lenses with preferred pricing
Return On Investment Annual premium $83.76  With Section 125 $71.20 Copays: exam $10 and materials $10 Total annual cost: $91.20 Annual benefit In-network: $50 annual exam + $50 lenses + $120 frames = $220 Out-of-network: $35 annual exam + $50 lenses + $50 frames = $135 ROI In-network: Pay in $91.20 get $220 of benefit (save $128.80) Out-of-network: Pay in $71.20 get $135 of benefit (save $63.80)
AlwaysHearing – Delivering Value Hearing Model Traditional PPO plans – in and out-of-network benefits Optional rider to dental and/or vision Benefit Highlights Covers hearing diagnostics Allowance toward the cost of hearing aids Free hearing diagnostics for Children Significant discounts on hearing aids – 40%+ There is a need Affects 31.5 million Americans; 68% under 65 iPod generation aging
New Products   Life/AD&D, STD and LTD  Partnering with GroupRe Plus (a The Hartford company) Combined billing and package discounts will be available Great addition to our Dental and Vision products
Group Life Insurance   Basic Life Available for 10+ enrolled Choice of coverage amounts Flat amount, % of earnings or combination benefit schedule available Voluntary Life Available for 10+ enrolled  Increments of $10,000  Guaranteed issue for greater of 10+ enrolled or 25% of eligibles (benefits based on size and participation)
Short Term Disability   STD Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) First Day Hospital Benefit Benefits commence on first day of hospital confinement or date of Outpatient Surgical procedure Elimination Period  Accident as short as 0 Illness 7 or higher  Maximum Benefit Periods 13, 26 or 52 weeks Weekly Benefit Amounts 50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $2500  Min Benefit $25
Long Term Disability   LTD Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) EAP service included  Up to 5 visits per policyholder Elimination Period  90 or 180 days (other options available) Definition of Disability Options 2 year ‘own’ occ and ‘any’ occ thereafter (other options available) Monthly Benefit Amounts 50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $6000 (other amounts available)  Min Benefit: amount is greater of 10% of group’s monthly benefit or $50
Difference-Makers: Individual Dental True Dental Insurance Group-like features Fee schedule plan design Available for ages 19-64 Enroll Online Freedom of Choice Select any dentist or one of our network dentist Access to web-based tool with additional certified dentists Vision Benefit $35 allowance for annual vision exam Mail order contact lenses via the web Discounts on materials with Outlook Vision Network (10,000 vision centers)
Difference-Makers: Web-Based Tools AlwaysAssist - Online Group Administration Adds and deletes of employees View bills AlwaysAssist - Member Access Claims status Print temporary and request additional ID cards Dental Cost Estimator  Change of address Track annual maximum and deductible levels AlwaysAssist - Providers Check eligibility  Verify benefits Dental Health Center - Consumerism Tools Provider locator of in-network and extended network certified providers Frequently Asked Questions of Dentists and ‘Ask A Dentist’
www.alwayscarebenefits.com Web Demo www.alwayscarebenefits.com
Difference-Maker: Quality Service Genuine caring people Extended hours M-F 7:30 a.m. to 8:30 p.m. (CST) Sat. 9:00 a.m. to 3:00 p.m. (CST) Customer first mentality Numbers speak for themselves Average group stays with AlwaysCare for over 5 years Persistency over 90%
Questions & Answers Thank You

Always Care Introduction Presentation 2009

  • 1.
  • 2.
    AlwaysCare Benefits, Inc.Home office based in Baton Rouge, LA Dental, Vision, Hearing, Life & Disability 400,000+ covered members Privately owned and operated Recognized by Inc Magazine as one of the fastest growing privately owned companies Customer first culture Confidential
  • 3.
    Our goals Customer-firstculture based on exceptional technology, service, flexibility, competitive plans and rates. Best in class provider of ancillary benefits. Single source for dental and vision benefits. Confidential
  • 4.
    Strong membership growth (primary insureds) Confidential
  • 5.
    Our metrics 92%+group retention 99%+ claims processing accuracy 95% of inquiries resolved on first contact New groups implemented in 5 days (avg.) 95% overall Customer satisfaction rate 90%+ of survey respondents will recommend AlwaysCare to a family member or friend Claim processing time: 4-5 business days Confidential
  • 6.
    The AlwaysCare TargetMarket Group Dental and Vision Available for groups of 2 or more Strong Niche: Blue collar and service type industries 2-9 shelf plans and rates Average case size for block is 78 employees Largest case 30,000 eligible
  • 7.
    The AlwaysCare DifferenceMakers Online Services Website AlwaysAssist Consumerism & Transparency Account Management Services Enrollment assistance Welcome calls/letters
  • 8.
    The AlwaysCare DifferenceMakers Consumer Driven Dental and Vision leader Dental Dual Choice (high/low offerings) – min. of 5 enrolled per plan Carryover Benefit Rider – dental’s version of the HRA Consumerism & Transparency via the web Vision Members drive their decisions of cost, convenience or choice Online access for purchasing of contacts
  • 9.
    Difference-Makers: Group DentalPlan Design Flexibility Choice of deductible options including $100 lifetime Cosmetic Riders – bleaching, porcelain crowns Endosteal Implants Covered under major services Available on all plans and case sizes Carryover Benefit Carrying over benefit dollars for future needs One preventive visit per year required Available for all group sizes Ease of Administration Employer determines contribution level Paperless enrollment available
  • 10.
    Dental Details OptionalBenefits Orthodontia Available for groups over 10 enrolled lives Standard benefit includes an annual maximum as well as a lifetime maximum $7-9 added to the EE+Child(ren) and Family Rate Up to age 19 Higher Annual Maximums Available for groups over 10 enrolled lives - $1500 and $2000
  • 11.
    Dental Details DenteMaxnetwork 80,000 providers nationwide Passive/blind PPO model Active PPO options available Participation guidelines 2-9 75% of eligibles 10+ greater of 5 or 20% of eligibles Rate bands 20-49%; 50-79% and 80% or higher Periodontics & endodontics Basic or major services Annual maximums $500, $750, $1000, $1200, $1500 and $2000
  • 12.
    AlwaysDental – FAQWaiting Periods No waiting period options available and standard for groups with 25 or more and 75% participation 12 month waits on major services only Takeover credit available at the group level Missing Tooth Clause Prior like coverage covered if tooth extracted within the last 36 months Or, covered after 36 months with AlwaysCare Usual & Customary 70 th , 80 th or 90 th Network or No Network Passive model using the DenteMax network
  • 13.
    Dental Product Updates Wellness Benefit Enhancements Additional Cleaning for pregnant women in their 2nd or 3rd trimesters (Standard Benefit) Members 40+ years of age who demonstrate risk factors for oral cancer or suspicious lesions are entitled to one adjunctive, pre-diagnostic test per year (Standard Benefit) Members diagnosed with diabetes are eligible for 2 extra cleanings every twelve months (Optional Benefit)
  • 14.
    Dental Questions toAsk When and what age limits have you recently changed to your contract? Have you made any changes to benefit frequencies? Do you split up simple vs. complex periodontic/ endodontic procedures? How do you handle UCR? Can you provide me your top 10 ADA codes?
  • 15.
    Difference-Makers: Group VisionTwo and Three Tier Network Plans Standard in and out-of-network plan with copay flexibility Three tier Wal-Mart vision plan option Mail Order contact lenses via the web Use their contact benefit Great discounts Materials-Only Plan Options with hearing rider Great add-on for medical plan that covers annual vision exam High value and low cost
  • 16.
    Vision Details NVAand proprietary network 22,000+ providers nationwide Retail and independent practitioners Prescription fulfillment flexibility Site of annual exam does not have to dictate where prescription is filled Consumer drives decision Contacts in lieu of lenses and frames Member receiving contacts must wait 12 months to receive lens or frame benefit and vice versa Benefit frequencies 12/12/12/12; 12/12/24/12 and 12/12/24/24 Date of service not policy or calendar year
  • 17.
    Vision Product Updates Simply need 5 enrolled if packaging with dental 3 year rate guarantees for 50+ enrolled 5% load Costco added to the network Member will need to file claim on their own behalf Specialty lenses and material upgrades only for First Look Network Provides identified as Value Add (VA) or Service Plus (SP) on website Lens Options: UV, scratch resistance and anti-reflective coating, tinting, polarized, polycarbonate, etc. Second pair of glasses or contact lenses with preferred pricing
  • 18.
    Return On InvestmentAnnual premium $83.76 With Section 125 $71.20 Copays: exam $10 and materials $10 Total annual cost: $91.20 Annual benefit In-network: $50 annual exam + $50 lenses + $120 frames = $220 Out-of-network: $35 annual exam + $50 lenses + $50 frames = $135 ROI In-network: Pay in $91.20 get $220 of benefit (save $128.80) Out-of-network: Pay in $71.20 get $135 of benefit (save $63.80)
  • 19.
    AlwaysHearing – DeliveringValue Hearing Model Traditional PPO plans – in and out-of-network benefits Optional rider to dental and/or vision Benefit Highlights Covers hearing diagnostics Allowance toward the cost of hearing aids Free hearing diagnostics for Children Significant discounts on hearing aids – 40%+ There is a need Affects 31.5 million Americans; 68% under 65 iPod generation aging
  • 20.
    New Products Life/AD&D, STD and LTD Partnering with GroupRe Plus (a The Hartford company) Combined billing and package discounts will be available Great addition to our Dental and Vision products
  • 21.
    Group Life Insurance Basic Life Available for 10+ enrolled Choice of coverage amounts Flat amount, % of earnings or combination benefit schedule available Voluntary Life Available for 10+ enrolled Increments of $10,000 Guaranteed issue for greater of 10+ enrolled or 25% of eligibles (benefits based on size and participation)
  • 22.
    Short Term Disability STD Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) First Day Hospital Benefit Benefits commence on first day of hospital confinement or date of Outpatient Surgical procedure Elimination Period Accident as short as 0 Illness 7 or higher Maximum Benefit Periods 13, 26 or 52 weeks Weekly Benefit Amounts 50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $2500 Min Benefit $25
  • 23.
    Long Term Disability LTD Available for 10+ enrolled Employer Paid, Contributory or Voluntary (10+ enrolled or 25%) EAP service included Up to 5 visits per policyholder Elimination Period 90 or 180 days (other options available) Definition of Disability Options 2 year ‘own’ occ and ‘any’ occ thereafter (other options available) Monthly Benefit Amounts 50%, 60%, 66 2/3% or flat amount not to exceed 66 2/3% Max Benefit up to $6000 (other amounts available) Min Benefit: amount is greater of 10% of group’s monthly benefit or $50
  • 24.
    Difference-Makers: Individual DentalTrue Dental Insurance Group-like features Fee schedule plan design Available for ages 19-64 Enroll Online Freedom of Choice Select any dentist or one of our network dentist Access to web-based tool with additional certified dentists Vision Benefit $35 allowance for annual vision exam Mail order contact lenses via the web Discounts on materials with Outlook Vision Network (10,000 vision centers)
  • 25.
    Difference-Makers: Web-Based ToolsAlwaysAssist - Online Group Administration Adds and deletes of employees View bills AlwaysAssist - Member Access Claims status Print temporary and request additional ID cards Dental Cost Estimator Change of address Track annual maximum and deductible levels AlwaysAssist - Providers Check eligibility Verify benefits Dental Health Center - Consumerism Tools Provider locator of in-network and extended network certified providers Frequently Asked Questions of Dentists and ‘Ask A Dentist’
  • 26.
    www.alwayscarebenefits.com Web Demowww.alwayscarebenefits.com
  • 27.
    Difference-Maker: Quality ServiceGenuine caring people Extended hours M-F 7:30 a.m. to 8:30 p.m. (CST) Sat. 9:00 a.m. to 3:00 p.m. (CST) Customer first mentality Numbers speak for themselves Average group stays with AlwaysCare for over 5 years Persistency over 90%
  • 28.