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It’s time for a change…. The company behind the change…. Philadelphia American Life Insurance Company (PALIC) has a history dating back to 1904 and is now part of the New Era Life family of insurance companies Over $300,000,000 of annually premium income. - PowerPoint PPT Presentation

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Slide 1

Its time for a change

1 Add NotesThe company behind the change

Philadelphia American Life Insurance Company (PALIC) has a history dating back to 1904 and is now part of the New Era Life family of insurance companies

Over $300,000,000 of annually premium income.

Over $120,000,000 of Health Premium annually

Philadelphia American Life Company is licensed in 47 .states.

2 Add NotesThe man behind the company

Dr. Bill Chen, our president, and CEO, earned his doctorate in theoretical statistics from Purdue University in 1970 and became a Fellow in the Society of Actuaries in 1978. He has spent nearly 30 years in the life and health. insurance industry. He has been honored by numerous organizations including Ernst and Young, Merrill Lynch Regional and was recognized as Entrepreneur of the Year in 1994 by Inc. Magazine. 3 Add NotesIts time for a changeRETHINK the way you view healthcare

4 Add NotesEmpowered healthcare is the Mission..

Think PreventionSmart and healthy lifestyle choicesThink ControlTake control over personal healthcare decisions

Its a new world of Defined Benefit plans and supplemental benefits.

Now, WE are required to be more pro-active in controlling our medical expenses AND be equally pro-active in the management of our personal health.For a growing number of American's, the days of $20 co-pays are coming to an end.

6The Key to Controlling Healthcare Costs is More Than Co-Pays and Deductibles Its about providing the right plan at the right time to help guide personal decisions.

Welcome to Health Saver Plus! Your Guide to the Next Generation of Affordable Health Insurance

In todays market where health insurance is often unavailable or unaffordable, Health Savers Plus can help provide you and your family with peace of mind by proving health insurance benefits you can afford.

The idea is that affordable, quality healthcare is achievable if you the consumer, have the basic knowledge and willingness to make informed decisions by discussing your treatment plan and costs with the healthcare professional of your choice. 8

Welcome to Health Saver Plus! Your Guide to the Next Generation of Affordable Health Insurance

Key Features Include $5,000,000 Lifetime Maximum Choose from three benefit options .Pick your Base Plan Deductible Number of Benefit Units to fit your needs Calendar Year Benefit Maximum Use any Doctor or Hospital you choose Without PenaltyThree Calendar Year Deductibles To Choose From.Maximum of three Deductibles per policy$ 1,000 $ 2,500 $ 5,000

11Maximum Covered Benefits Per Covered Person per Calendar Year$100,000$250,000$1,000,000

Maximum Number of Days Per Covered Persons3060180Choose Your Maximum Benefit Level.

12Hospital Indemnity Benefits Facility Fees .

Select The Number of Benefit Units To Fit Your Needs1 Unit2 Units3 UnitsDaily Indemnity Benefit For Hospital Confinement $1,000$2,000$3,000Confinement in a Hospital Intensive Care Unit (ICU) (Up to 20 days per Calendar Year$1,500$3,000$4,500Daily Indemnity Benefit For Hospital Confinement For Mental Illness, Alcohol and/or Substance Abuse$ 500$1,000$1,500Daily Indemnity Benefit For Hospital Confinement in a Rehabilitation Facility or Skilled Nursing Facility$ 500$1,000$1,500Daily Indemnity Benefit For Outpatient Radiation or Chemotherapy $ 500$1,000$1,500Inpatient Physician Hospital Visit per visit$ 50$ 100$ 150Daily Indemnity Benefit for Outpatient Hospital or Ambulatory Surgical Center services when surgery is performed$1,000$2,000$3,000Emergency Ambulance for each trip due to a covered injury or Sickness that results in a hospital confinement. $250per trip13Professional Services.

* The reimbursement schedule for 1 unit is similar to what is payable under Medicares Physician ..fee schedule for surgeries. You may acquire up to three units based on plan selected Assistant Surgical Services We will pay 20% of the amount listed in the fee scheduleAnesthesia Benefit for covered servicesWe will pay 25% of the amount listed in the fee schedule1 Unit2 Units3 UnitsSurgical Procedure:* The plan will pay this benefit if any Covered Person undergoes a surgical procedure when performed in a Hospital or in an Ambulatory Surgical Center due to a eligible Accident or Sickness. 1 X the Policy fee schedule2 X the Policy fee schedule3 X the Policy fee schedule

Inpatient Pathologist / Radiologist:* The plan will pay this benefit if any Covered Person undergoes an Inpatient Pathologist / Radiologist procedure as a result of a Covered Accident or Sickness. 1 X the Policy fee schedule2 X the Policy fee schedule3 X the Policy fee schedule14Sample of Common Surgeries .

CPTDESCRIPTION19307mastectomy, modified radical 27130total hip arthroplasty29881knee arthroscopy/surgery33533coronary artery bypass, arterial, single93510left heart catheterization 45380 colonoscopy and biopsy 47562 laparoscopic cholecystectomy 50590 lithotripsy, fragmenting of kidney stone 58150 total hysterectomy 66984 cataract surg w/intraocular lens, 1 stage15 Sample Fee Schedule Comparisonby State Policy Fee Schedule (1 Unit)100.00%Alabama87.00%Arkansas 85.00%Arizona 93.68%Colorado93.59%Georgia - Atlanta97.03%Iowa86.41%Illinois - Chicago105.66%Illinois - Rest of the state92.96%Indiana 90.50%Louisiana - New Orleans97.82%Michigan - Detroit107.11%Michigan - Rest of the state94.80%Missouri - St. Louis94.78%Mississippi88.18%Nebraska85.49%Ohio95.76%Oklahoma86.99%Pennsylvania - Philadelphia106.03%Pennsylvania - Rest of the state94.60%South Carolina88.38%Tennessee 89.06%Wisconsin 89.36%16 Outpatient Benefits .

CALENDAR YEAR DEDUCTIBLE$500 per insuredCalendar Year Maximum$2,000Units 1 Unit2 Units3 UnitsOutpatient Office Visit $ 25$ 50$ 75Other Outpatient Services (per test) MRI, CAT Scan or Nuclear testing Other diagnostic testing or X-rays Laboratory testing Injections$ 17540105

$ 350802010$ 5251203015 Generic Prescription (per prescription filled)$ 5$ 10$ 15Brand Name Prescription (per prescription filled)

$ 10$ 20$ 30Well Care Maximum$ 50 per visit up to $150 per calendar year17 Receive Benefits From Three Pools .

Patient Protection and Affordable Care Act

18 Medical Plan Comparison .

19Inpatient Hospital 6 daysEligible Benefit DeductiblePayableOut of PocketHospital Bill $25,469.71$18,000.00$1,000.00 $17,000.00$8,469.71Pathology Bills81003$9.00$9.66$9.66-$0.6680053$33.00$45.42$45.42-$12.4285025$9.00$33.42$33.42-$24.4284132$11.25$19.74$19.74-$8.4980053$33.00$45.42$45.42-$12.4280074$25.00$204.63$204.63-$179.6382247$10.00$21.57$21.57-$11.5782248$10.00$21.57$21.57-$11.5785651$8.00$15.24$15.24-$7.2485025$9.00$33.42$33.42-$24.4284132$11.25$19.74$19.74-$8.4980053$33.00$45.42$45.42-$12.4285025$9.00$33.42$33.42-$24.42Radiology Bills 71020$47.00$26.91$26.91$20.0972193$255.00$141.36$141.36$113.6474160$270.00$154.26$154.26$115.7474020$57.00$32.91$32.91$24.0976705$130.00$70.98$70.98$59.02Hospital Visits $286.00$150.00$150.00$136.00$225.00$150.00$150.00$75.00$225.00$150.00$150.00$75.00$210.00$150.00$150.00$60.00$210.00$150.00$150.00$60.00$175.00$150.00$150.00$25.00Totals$27,770.21$19,875.09$1,000.00$18,875.09$8,895.12Health Saver Plus Diverticulitis6 day stay$1,000 Deductible3 Units20PricingOur most economical plans (Male/Female age 40 with 2 children)

1) Family Rate 1 Unit / NTU $1,000 Deductible with a ..$100,000 Annual Maximum$ 196.022) Family Rate 2 Units / NTU $2,500 Deductible with a ..$250,000 Annual Maximum$ 317.99Our most popular plan (Male/Female age 40 with 2 children)

4) Family Rate 2 Units / NTU $1,000 Deductible with a ..$1,000,000 Annual Maximum$ 500.96Rate does not include a one time $30.00 non-refundable application fee3) Family Rate 2 Units / NTU $1,000 Deductible with a ..$250,000 Annual Maximum$ 435.6221Enhanced 24 Hour Accident Expense Insurance PlanwithAccident Disability Income Benefit

22 Add NotesEnhanced Accident Expense Plan .

BENEFIT SUMMARY1 Unit2 UnitsAccidental Injury Benefit$ 2,000.00$ 4,000.00Accidental Death Benefit$ 50,000.00$ 100,000.00Ground or Air Ambulance$ 5,000.00$ 10,000.00Hospital Income Benefit$ 150.00$300.00Dismemberment Benefits Loss of Finger or Toe Single Loss Benefit Multiple Loss Benefit$ 500.00$ 1,000.00$ 1,000.00$ 2,000.00 Loss of Hand, Arm, Foot, Leg Single Loss Benefit Multiple Loss Benefit$ 5000.00$ 10,000.00$ 10,000.00$ 20,000.00 Loss of Site Single Loss Benefit (One Eye) Multiple Loss Benefit (Both Eyes)$ 5000.00$ 10,000.00$ 10,000.00$ 20,000.0023 Enhanced Accident Expense Plan .

Optional Accident Disability Income Benefit 1 Unit2 UnitsMonthly Benefit $ 1,000.00$ 2,000.0012 Months 24 MonthsTwo Benefit Period To Choose FromType 1Type 2Only Two Occupational Classes24 Monthly Bank Draft Rates Issue Ages for Accident Plan 0-75Issue Ages for Accident Disability Rider 18-64

ACCIDENT PLAN1 Unit 2 UnitsInsured$23.00$31.05Insured & Spouse$44.28$56.93Insured & Children$53.48$69.00Family$74.75$94.88Child Only$16.10$20.13ACCIDENT DISABILTY INCOME RIDER1 Unit 2 UnitsType 1 - 12 months$10.35$20.70Type 1 - 24 months$13.23$26.45Type 2 - 12 months$19.55$39.10Type 2 - 24 months$26.45$52.9025Its time for a changeUnderwriting

Simplified Issue Application

26 Add NotesSimplified Issue Application .

27 Simplified Issue Application .

28 Simplified Issue Application .

29 Its time for a changeUnderwriting

Made Easy

30 Add NotesIts time for a changeUnderwriting Tip -1

To help you ensure we are receiving accurate information from the applicant, you might let them know that a representative from the home office will call and review the application and their prescription history that you are about to review with them. You might tell them as your agent you are going to:

Ask them a series of questions about their medical history and ask them what medications they have taken in the last 12 months. These will be the same questions that the Company will ask you on a recorded phone call when they process your application.

Please be as thorough as possible to ensure consistency between their application and the recorded quality assurance call. This will help in getting their application processed in a timely manner.

31 Add NotesExplain to the applicant how we handle Pre-existing Conditions to ensure they understand how it works What is a Pre-Existing Condition? A condition for which treatment was rendered or recommended by a Physician or for which drugs or medicine was prescribed within 12 months prior to a covered Persons Effective Date.

Underwriting Tip - 2

32 Add NotesNew BusinessFlow Chart

33 Add NotesIts time for a changeFaxApplicationPaperApplicationLSPPolicy SystemReviewed ForProcessingMissingFormsContactAgentAll FormsChecked forLegibilityAsk Foranother FaxorOriginalApp To BeMailedNoYESYesManually KeyInto SystemE-APP

34 Add NotesUnderwriterReviewAPS orOtherRequirementConditionalOfferNo Requirements orAfter Review of newinformationDeclineYESNO + Issue Policy + Draft PremiumPre-ScreenQACIntelliScriptUnderwriters Desk

35 Add Notes IntelliScript

Prior200720082009201036 Add Notes Quality Assurance Call

The Quality Assurance Desks will be open from 8:00 am to 5:00 pm CST Monday thru Friday.The purpose of this call is to allow the applicant to add any information that may have forgotten to disclose to the agentA Thank You email is sent from the home office upon receipt of the application to let the applicant know that we will be calling them and if they have not heard from us we invite them to call the toll free number to complete the call. 37 Add Notes Let them know about the Quality Assurance Call and how important it is.

Let them know that we will be ordering an RX history showing prescriptions they have had filled and the doctors name.

Make sure you charge the correct rate ups. If they are not on the application, you will find them located in the Underwriting Guide This relates specifically to question 13!

How Do I Get Quick Issue

Let your client know what underwriting will be expecting38 Add NotesIn the last 12 months, other than conditions listed on the application, has any applicant had any medical or surgical advice or treatment or including prescriptions or operations or been advised to have medical tests or surgery that has not yet been performed, or is awaiting medical tests? If YES-you will need to refer to the Underwriting guide to determine if any action is necessary.

How Do I Get Quick Issue

Stress The Importance of Question #1339 Add NotesWHAT ABOUT CONDITIONS NOT ON THE APPLICATION?The application ask about common conditions, but not all medical conditions! Please use the UW Manual if conditions are disclosed but not asked on the application. Question 13 ask about Other conditions. ANEMIA- Within 2 Years since recovery = 2 Points Between 2-5 years since recovery = 1 Point More than 5 years = STD Otherwise = DEC

GASTRIC BYPASS SURGERY- Within the last 12 months = 2 Points 1 Year-3 Years-full recovery = 1 Point More than 3 years, full recovery = STD With Complications = DEC40 Add Notes If the Rx history and the Quality Assurance Call are ...consistent with the information on the application-you ..can expect QUICK turnaround

If information is developed through any of these ..sources that is not consistent with the application, an ..APS may be ordered which may delay issue several .weeks.

Getting complete information, avoids underwriting requiring the agent to go back later which may cause you to have to Resale the program

How Do I Get Quick Issue

Get complete information41 Add NotesUnderwriting Made Easy

[email protected]

Tobacco RateMy client stopped smoking five years ago. He smoked 2 packs a day but now only smokes an occasional cigar once or twice a week, can I quote him the non-tobacco rate?

ThanksSuccessful Agent

Get quick answers to your Underwriting Questions?42 Add NotesUnderwriting Made Easy

In Summary-Explain to the client How Pre-Existing Conditions are applied

How the surgical schedule works with the based on the number of units they selected

The application process including the Quality Assurance ...... Call

How important complete medical and prescription history is in completing the application.

Underwriting is always available to help at [email protected] Add Notes

Online ServicesHow to register Online as a new agent Access to Downloading the eAppCheck the status of your pending businessDownload a copy of your applicationGet a copy of your commission statementSee your latest commission check

The following slides will provide you with the following information

Register Today Atwww.neweralife.com

Download The eApp

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Select either the Health Saver Plus or theEnhanced 24 Hour Accident Expense Plan

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Now You Can Login To Online Agent Service Atwww.neweralife.com

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Dave CollettDownload a copy of your completed Application

Manage Your Agent Profile

SalesForms

Online Applications

CommissionStatement

Pending BusinessOnline Applications

Medicare Supplement

Health Saver Plus

Use 60000Demo as your agent number while you are familiarizing yourself with the eApp otherwise it will assume a life application

65 Add Notes