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Protection For Life
- 1. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Protection for Life Helping to protect your health, income and family
- 2. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 About Me ► 7 years insurance experience ► Licensed with the following insurance companies: – Health: United Healthcare, Humana, Assurant – Life: Minnesota Life, Voya, Surebridge – Medicare: Humana, United Healthcare, Aetna ► Life Style, Health History and Budget – My commitment is to design a strategy and solution with these variables in mind. 2
- 3. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 We are one of the largest insurance distribution companies in America with more than 3,000 agents nationwide. HealthMarkets Insurance Agency 3 HealthMarkets provides solutions that meet the health and financial protection needs of individuals and families.
- 4. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Health Care Reform 4 HealthMarkets provides guidance to help you understand your options under health care reform. Subsidy On Exchange Off Exchange
- 5. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Portfolio of Insurance Companies 5 Our broad portfolio of recognized and trusted national and regional insurance companies. UnitedHealthOne is the brand name for UnitedHealthcare family of companies that offer personal health insurance products. Products are marketed through independent agents. For costs, benefits, limitations and exclusions of UnitedHealthOne plans. Please see the product brochure. Not all agents are licensed to sell all products. Availability of carriers and products may vary by state.
- 6. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Best For Your Budget 6 Understanding the needs of you and your family Combining the products to give you the best level of coverage for your budget Health Medicare Health & Wellness Supplemental Long-Term Care Association Life Retirement
- 7. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Life is Full of Milestones and Surprises Along the way we can help you with Protection for Life 7 Protect Your Health, Your Income, Your Family
- 8. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 The Protection You Need at 30 … … is different at 45 or 65 YOUNG FAMILY (Age 30 – 40) On Your Mind: Planning ahead to protect you family, your income and your future ► Health Insurance ► Supplemental Insurance ► Life Insurance 8 These recommendations are general guidelines based on commonalities we notice among our customers. The information and product listed are not meant to be interpreted as appropriate for everyone, as each individual has unique needs and circumstances. NEARING EMPTY NEST (Age 40 – 55) On Your Mind: Planning ahead to protect you family, your future long-term care needs and protect your assets for retirement ► Health Insurance ► Supplemental Insurance ► Life Insurance ► Retirement Income ► College Funding RETIREMENT (Age 65+) On Your Mind: Protecting and managing your assets for financial stability ► Medicare Plan & Supplements ► Retirement Income ► Life or Final Expense Insurance CLOSE TO RETIREMENT (Age 55 – 64) On Your Mind: Planning for retirement by protecting the assets you’ve accumulated over the years ► Health Insurance ► Supplemental Insurance ► Life Insurance ► Retirement Income ► Long-Term Care Insurance
- 9. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Protection for Life has Three Primary Components 9 Your family has hopes and dreams for the future—life insurance can help protect them Expecting the unexpected is one thing, paying for it can be quite another. Supplemental insurance can pay you a direct cash benefit to help with expenses A good health policy is indispensable and can also be surprisingly affordable
- 10. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 The Affordable Care Act Protections under Health Reform: ► Lifetime limits are prohibited and annual limits are restricted ► You can't be refused insurance or charged more because of a pre-existing condition ► Children up to age 26 may remain on a parent’s policy ► Preventive services must be covered and cannot have cost-sharing ► Many people are now eligible for a break on health insurance costs through tax credits called subsidies ► All individual and small group health policies are required to include certain “essential health benefits.” – Those benefits include coverage on ambulatory patient services; emergency services; hospitalization; maternity and newborn care; and more. 10
- 11. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 The Metal Plans (On Exchange) 11 Bronze Level Plan covers approximately 60% of expected costs Silver Level Plan covers approximately 70% of expected costs Gold Level Plan covers approximately 80% of expected costs Platinum Level Plan covers approximately 90% of expected costs Lowest Premiums Highest Premiums
- 12. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 What is a Qualifying Event? 12
- 13. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Fact Finder 13
- 14. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Fact Finding: Health 14 1 in 8 persons seek medical attention from an injury each year 67% of all Emergency Room visits are injury related The average hospital stay is 4.9 days The average cost of a hospital stay has doubled The Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality (AHRQ). Statistical Brief 146, Costs for Hospital Stays in the United States, 2010, Anne Pfuntner, Lauren M. Wier, M.P.H., and Claudia Steiner, M.D., M.P.H. | FaceTheFactsUSA.org | National Safety Council, Injury Facts, 2012 | CDC National Hospital Ambulatory Medical Care Survey, 2009
- 15. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Supplemental Insurance 42% of Americans say they live paycheck to paycheck 15 How will we cover our day-to-day expenses if one of us is sick or injured? How long can we afford for one of us to be out of work? Supplemental insurance can pay a cash benefit to you and can help protect you financially Can we pay our health insurance deductible without using our savings or going into debt? 2010 CareerBuilder survey
- 16. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 High Cost of Health Care & Bankruptcy 16 Illness and medical bills contributed to more than 62% of all bankruptcies. (1) Statistics from a Harvard University report “Medical Bankruptcy in the United States, 2007” published in The American Journal of Medicine® And of those filing bankruptcy, almost 78% had health insurance.1
- 17. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 17 Fact Finding: Supplemental www.StatisticBrain.com/corrective-lenses-statistics | American Heart Association | American Association for Critical Illness, September 2010 | National Safety Council, Injury Facts, 2010 Edition | Council for Disability Awareness, Long-Term Disability Claims Review, 2012 With 75% of people needing some type of vision correction, a vision plan is a good value Critical Illness costs cause more than 60% of all bankruptcies. 78% had health insurance. The average amount for medical bankruptcy is under $15,000. Health discount Cards can help you receive discounts on quality health-related dental & vision services for an affordable price. Researchers have found that people with gum disease are two time more likely to suffer from coronary heart disease Telemedicine Services give you access to diagnostic consultations when you need more than basic medical advice 95% of disabling injuries occurred off the job which means Worker’s Compensation does not cover them. 1 in 4 Americans in the workforce today will suffer a disabling injury before they retire.
- 18. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 In households with children under the age of 18, if the primary breadwinner died today … Why Life Insurance is Important 18 4 in 10 … say they would have immediate trouble meeting everyday expenses 7 in 10 … say they would have trouble meeting everyday expenses within 90 days LIMRA International, Inc.
- 19. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 19 Fact Finding: Life LIMRA International, Inc. In households with children under the age of 18, if the primary breadwinner died today, 4 in 10 say they would have immediate trouble meeting everyday expenses and 7 in 10 say they would have trouble meeting everyday expenses within 90 days. 93% of people think life insurance is necessary but …5 in 10 households feel they don’t have enough The top reason people don’t buy life insurance is because they believe they can’t afford it. REALITYPERCEPTION
- 20. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Customized Protection for Life Solution 20 Creating your Customized Protection for Life Solution includes:
- 21. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 21
- 22. ©2014 HealthMarkets InsuranceAgency | Proprietary and Confidential. | HMIA000003 Legal use The following is a customer presentation prepared for agents of HealthMarkets Insurance Agency. This presentation and its materials are the property of HealthMarkets and are to be used only for the purpose intended. Any unauthorized dissemination or online posting of these materials, or excerpts of these materials, through other methods is strictly prohibited. HealthMarkets Insurance Agency is the d/b/a, or assumed name of Inshpere Insurance Solutions, Inc. which is licensed as an insurance agency in all 50 states and the District of Columbia. Not all agents are licensed to sell all products. Service and product availability varies by state. 22
Editor's Notes
- #2 Title Slide: Thank you for taking the time to meet with me today. I look forward to discussing your health care needs and feel confident that I can help you identify a solution that gives you the protection you need — and at a price that is within your budget. You probably have several questions including why you should listen to my advice as opposed to obtaining coverage directly through the Exchange, or another health insurance broker. Let me propose an outline to follow during our discussion today that will hopefully address that question — as well as any others you might have. Does that sound fair? NOTE: Wait for customer response First, I would like to take a few minutes to introduce myself and HealthMarkets Insurance Agency, the company I represent. Then I would like to go over a series of questions with you in order to better identify your health insurance needs. From there we can look at a variety of plans that will help you understand the options that are available to you. Before we begin, I want to emphasize that there is no additional cost to work with me to get any of the plans you might choose, including the plans you can purchase on the Exchange. Each carrier sets their premium and that price is the same, regardless of how you obtain it. As an added value to you, I can help you apply for any coverage you choose and then monitor the applications as they go through the approval process. Of course, as part of this process, I will help you determine whether or not you qualify for a healthcare subsidy from the government and assist you in obtaining that benefit if you qualify.
- #3 This slide will be used to provide background/experience/personal information about the agent. Each agent wishing to use this slide will need to fill it in as desired and obtain compliance approval
- #4 SLIDE 4: HealthMarkets Insurance Agency The company I represent is called HealthMarkets Insurance Agency and we are licensed to do business in all 50 states and the District of Columbia. We are unique in the health insurance marketplace because we don’t represent just one carrier. We can help you consider products from a number of recognized and trusted carriers. In many cases we find that a combination of products, from different companies provides the best solution to fit individual needs.
- #5 SLIDE 5: Health Care Reform One of the primary services I provide is to help my clients better understand the Affordable Care Act and what it means to them. As I mentioned earlier, if you are eligible for a health insurance subsidy, I can show you the product options available through the [federal or state] Exchange and assist you in obtaining a subsidy and the coverage best suited for you and your family.
- #6 SLIDE 6: Portfolio of Carriers Most people like to have choices when they shop for insurance. As I mentioned earlier, we have a large portfolio of products from many of the most recognized and trusted companies in the industry. It is important to note that not every carrier shown here offers products on the Exchanges or offers the type of insurance product that you may be interested in. But because of HealthMarkets’ unique approach, you can see that I can provide you with many solutions from numerous well-known companies.
- #7 SLIDE 7: Best for Your Budget You invited me here to help you examine health care options. And that will be the focus of our discussion today. Once I have an understanding of your family’s needs and budget, I can show you different options that can give you the protection you need at a price you can work within your budget. It’s likely that we’ll combine different insurance products for a solution that best fits your needs. In many situations the use of complimentary products can offer more affordable options. Just like gears in a machine turning together to make the machine work, we often find that the combination of insurance products may provide a better solution. As we begin looking at solutions, I’ll explain why that works so well.
- #8 SLIDE 8: Life is Full of Milestones and Surprises Life is full of changes, special events and surprises. There are special events like marriage or the birth of a child. And sometimes there are surprises, like an unexpected injury or accident. At HealthMarkets, we do more than simply sell health insurance. We help people get the protection they need to keep pace with life’s changes. We want to help you protect your health, but we also want to help protect your income and your family. We call this comprehensive approach Protection for Life. We work to find solutions that protect your health, your income and family — come what may.
- #9 SLIDE 9: The Protection You Need at 30… Would you agree that our insurance needs change over time? What we need at 30 will be different than what we need at 45 and at 65? One of my goals is to make you a long-term client, not just a customer for today. After we determine the best solution for you today, I would like to meet with you on a regular basis to make sure that your coverage stays consistent with your needs as they change. And finally, if I’ve done a good job meeting your needs, I hope you’ll personally recommend both the HealthMarkets approach and me to others you think would benefit from the products and service I offer.
- #10 SLIDE 10: Protection for Life — 3 Primary Components Protection for Life is a comprehensive approach to insurance and the cornerstone is always a solid health insurance policy. A good major medical policy covers the cost of doctor visits, hospitalizations and prescription drugs. Major medical insurance pays the bill for those who provide care to you and your family. However, our Protection for Life approach is designed to include protection that can help cover lost income and out of pocket expenses and even 24/7 access to healthcare professionals over the phone or internet. By supplementing your health insurance, you can get coverage that pays cash benefits directly to you for covered illnesses and injuries. Knowing that you have money you can use to help pay your mortgage, your car payment and other bills is a major relief when you’re faced with unexpected health issues. Even though you might be sick or injured, you won’t need to worry about how you’ll be able to put food on the table. The final piece to Protection for Life is to help cover you if the unthinkable happens. If you don’t survive an accident or illness, your family needs additional protection. Our Protection for Life approach is designed to include at least a $50,000 term life insurance policy. You can choose to upgrade this policy to $100,000 or even more if you wish. I want to help you protect your health, your income and your family. As I get to know your needs better, we can develop a Protection for Life plan that fits within your budget, but gives you much wider coverage than just health insurance alone. Do you have any questions at this time? If not, let’s take a few minutes to learn a little more about The Affordable Care Act.
- #11 SLIDE 11: Affordable Care Act The new health care law, sometimes called “ObamaCare” was passed by Congress in 2010. There are several protections under Health Reform you should be aware of: • Lifetime limits are prohibited and annual limits are restricted on most covered benefits • You can't be refused insurance or charged more because of a pre-existing condition • Children up to age 26 may remain on a parent’s policy • Preventive services must be covered and cannot have cost-sharing • Many people are now eligible for help with their health insurance premiums through tax credits called subsidies • All individual and small group health plans are required to include certain “essential health benefits.” Those benefits include coverage on ambulatory patient services; emergency services; hospitalization; maternity and newborn care; and more. The Health Insurance Marketplace (federal and state-operated insurance exchanges) opened on October 1, 2013. The federal or state exchange is the official website for people to purchase qualified health insurance policies. You should note that the ACA does not require anyone to purchase health insurance through an Exchange, although subsidies will only be available for plans sold there. We can talk about plans that are available both on an Exchange and off an Exchange when I explain a little more about the subsidies or tax credits.
- #12 SLIDE 12: The Metal Plans (On Exchange) To help with out-of-pocket costs, which have been a big issue in health care, the ACA set new limits for 2014 [2015]. These limits help cap exposure for consumers to approximately [$6,000 for an individual and $12,000 for families.] (This is going to change slightly for 2015. 6,600 individual / 13,2000 family) These limits will be indexed to average premium growth in future years. The ACA now also requires that all plans on an Exchange must design their cost-sharing (deductibles, copays, coinsurance) to fit into specific levels of coverage. This is where the term “Metal Plans” comes from as the government created several levels based on metals. They are: Bronze Level – Plan covers approximately 60% of expected costs Silver Level – Plan covers approximately 70% of expected costs Gold Level – Plan covers approximately 80% of expected costs Platinum Level – Plan covers approximately 90% of expected costs A Bronze plan generally has the lowest monthly premium but the highest out-of –pocket expenses up to the annual maximum. We will use these levels to help us compare your options and choices today.
- #13 Open enrollment for 20XX coverage is over but you may be eligible for a Special Enrollment Period that allows you to buy a private health plan through the Marketplace if you have a Qualifying Event. Some examples of qualifying events include: Marriage or divorce Having a baby or adopting a child Moving your residence, gaining citizenship, leaving incarceration Losing other health coverage due to losing job-based coverage, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances.
- #14 SLIDE 13: Fact Finder With some Health Reform discussion as background, and as your licensed agent, I want to give you a good Protection for Life plan as we work towards your decision. [I like to refer to myself as a benefits advisor because I can guide you through the many benefit options available as we build this Protection for Life plan.] NOTE: Fill out HealthMarkets Fact Finder with the client
- #15 SLIDE 14: Fact Finding Let’s spend a few minutes determining the type of health insurance benefits you are looking for. Remember, the Exchanges were created to help individuals and small businesses purchase health insurance coverage in an online retail setting. However, the ACA does not require anyone to purchase health insurance through an Exchange, however subsidies are only available there. We’ll also determine if you are eligible for a subsidy as subsidies are even available to people with higher incomes — for example, tax credits are available for a four-person family whose income is up to $94,200. But that amount may be fairly small. We’ll also discuss other options besides health insurance alone that can offer greater financial protection. NOTE: Fill out HealthMarkets Fact Finder with client. Based on the preferences discuss with your client, take them through the “If This, Then That” decision tree that you learned during Sales Training. This exercise will help your client see more clearly why their decisions lead them to a specific metal level plan. Now that I have a better understanding of your specific needs, let’s take a few minutes to see if we can find a plan that can help with out of pocket expenses associated with an illness or accident.
- #16 SLIDE 15: Supplemental Insurance When I first introduced the idea of Protection for Life I said that we wanted to help you obtain a plan that would protect your health, your income and your family. Even with health insurance an accident or illness can still create financial burdens. If wondering where the money will come from to pay the deductible, the co-insurance or simply replace your income could keep you up at night, supplemental plans can help. Supplemental plans can pay cash benefits directly to you if you are sick or injured. Let’s take a few minutes to see if any of these plans fit your Protection for Life needs.
- #17 SLIDE 16: High Cost of Health Care & Bankruptcy A significant medical event can create financial problems that go beyond paying your doctor or hospital. Did you know that a previous study showed that illness and medical bills contribute to more than 62% of all bankruptcies. And of those filing, almost 78% had health insurance. Even outside of bankruptcy, it’s been estimated that about 56 million adults — that’s more than 20 percent of the population between the ages of 19 and 64 — will still struggle with health-care-related bills this year*. Having health insurance doesn't buffer you against potential financial problems. In addition to health insurance, you need other forms of insurance coverage in order to help with out of pocket expenses. *NOTE: For reference on the above statistic — Medical Bills Are the Biggest Cause of US Bankruptcies: Study; CNBC June 25, 2013.
- #18 SLIDE 17: Fact Finding -Supplemental NOTE: Ask Supplemental questions. Based on their responses, take your client through the “If This, Then That” decision tree that you learned during Sales Training. This exercise will help your client see more clearly why their decisions lead them to specific supplemental coverage to fulfill their needs.
- #19 SLIDE 18: Life Insurance The last component I recommend for a comprehensive Protection for Life approach is Life Insurance. Would it surprise you to learn that 70% of Americans with dependent children would have trouble paying their bills within 3 months if the bread-winner died? And, 40% of them would be immediately in jeopardy. How long could your family pay the bills if something happened to you?
- #20 SLIDE 19: Fact Finding — Life Insurance I mentioned earlier that a Protection for Life solution is designed to include a term life insurance policy for at least $50,000. Is that going to be enough to protect your family? If not, I can quickly help you determine the amount of life insurance someone in your situation should have. Remember, even if you decide to apply for a higher amount of life insurance, your overall solution will still be designed to fit within your budget. Use the “Multiple of Income” or the “D.I.M.E.” needs analysis to determine the amount of Life Insurance required
- #21 SLIDE 20: Customized Protection for Life Solution Thank you for working with me through all of these recent questions. It helps me understand your unique situation and will allow me to design some alternatives that will give you the protection you need at a price you can afford.. Give me few minutes to pull some comparison quotes together. Next I will show you two or three different solutions that will not only give you the health care coverage you are looking for, they will give you what we call Protection for Life…covering your health, your income and your family.
- #22 End of Mandatory NOTE: The slides beyond this point are to be used for support only and are not intended to be used in the Protection for Life standard presentation.
- #23 SLIDE 2: Legal Use