Disability Products Services Life and Disability products are
Disability Products & Services Life and Disability products are underwritten by Anthem Life Insurance Company. Independent licensee of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered mark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
The Anthem Life Disability Philosophy • Create optimal disability outcomes for both the employee and the employer while providing a positive member experience. • Customized care • We evaluate a member’s functional ability based on clinical and vocational information—not just statistics and norms. • The team intervenes early and stays with the case, continuously working with the employee, provider and employer to develop an action plan designed to achieve the best possible outcome. 10/7/2020 2
Our Advantage • • • Strength & Stability Broad Product Offerings with Added Value Benefit Features That Make The Difference Flexible Reporting Superior Customer Service Our strength, innovation and dedication makes us the right solution to your needs. 10/7/2020 3
Life & Disability’s Strength and Stability • A. M. Best: A (Excellent) agency rating • Parent company ranked 38 th on the Fortune 500 list • Parent company named Most Admired Health Insurance Company by Fortune Magazine • Parent company ranked 2 nd on 2006 Business Week’s Top 50 Performing Companies • More than 96, 000 group customers and 5. 8 million members* • Large Case/National Accounts Expertise • More than 50 years of experience* Each affiliated life company is a separate, independent legal entity for financial purposes and is solely responsible for its own contractual obligations and liabilities. *Anthem Life internal data 2006 10/7/2020 4
Broad Product Offerings Disability Product Portfolio Voluntary STD and LTD (Insured) Short-Term Disability (STD) (Insured & ASO) 25% participation required Long-Term Disability (LTD) (Insured & ASO) 10/7/2020 5
Features That Make A Difference Behavioral Health RN Review Flexible Reporting Disability Resources Dedicated Disability Case Manager Vocational Rehabilitation Social Security Advocacy 10/7/2020 6
Features That Make A Difference • Short-Term Disability (STD) • ASO case management models - Levels 1, 2, 3 • Flexible Advice to Pay services • Behavioral Health Disability Program • Resource Advisor Program • Return to Work Assistance (Vocational Rehabilitation) • Social Security Advocacy • Optional paperless claims intake process • W-2 reporting and employer FICA matching services available 10/7/2020 7
Features That Make A Difference STD Case Management Models Level 1 Level 2 Level 3 Least intensive management More proactive management Most proactive management ASO Only Fully Insured & ASO = Administrative Service Only 10/7/2020 8
Features That Make A Difference Short Term Disability Case Management Models Level One (ASO only) • Disability approval based on attending physician statement • Payment continues until notification from client of return to work • Desirable option when governed by management request, labor restriction or company culture Level Two (ASO only) • Disability payments begin based on initial attending physician statement • Estimated time off work compared to optimal duration guidelines for given diagnosis or procedure • Disability leave beyond normal duration requires periodic medical updates for continued benefits 10/7/2020 9
Features That Make A Difference Short Term Disability Case Management Models Level Three (Fully Insured or ASO) • Objective medical documentation required to support disability • Claimant’s job description evaluated to determine functional impairment • Clinical information and functional requirements assessed in conjunction with duration guidelines • Full vocational rehabilitation services included • 100% review of all behavioral health claims by staff psychologist • Registered Nurses assist in case management • Independent Medical Examinations available for use when appropriate 10/7/2020 10
Features That Make A Difference Flexible Advice to Pay Services • Full range of case management options available • Reporting frequency based on client need to meet payroll requirements • Disability claim reporting can be tailored for customer absence tracking 10/7/2020 11
Features That Make A Difference Behavioral Health Program • In-house Behavioral Health professionals • All claims reviewed • For appropriate diagnosis, treatment and disability determination • For early identification of depression in chronic and acute medical conditions • Ongoing behavioral health training for disability case managers 10/7/2020 12
Life & Disability Insurance Products Innovative Supplemental Programs Resource Advisor • Included with group Disability plans at no additional cost • Provides employees and family members with resources that may help them achieve a healthier balance including: • 24 hour toll-free telephone counseling • Legal/Financial Counseling for employees • Face to face counseling sessions for beneficiaries and for employees who become disabled • Access to Online Resources: resources and providers for child care and elder care, legal and financial resource center, excellent articles and links to a myriad of helpful resources • Online will preparation and identity theft information 10/7/2020 13
Features That Make A Difference Return To Work Assistance • Certified Vocational Rehabilitation Consultants on staff • Vocational rehabilitation assistance • Return-to-work assistance (STD and LTD) • In-house transferable skills analyses • Internet access for rehabilitation opportunities 10/7/2020 14
Disability Products and Services Social Security Advocacy • In-house Social Security Consultants with years of experience working for Social Security Administration • Immediate involvement in claims with catastrophic/terminal conditions • Award activity • 67% within 12 months* • 86% over 24 months* • Saved an average of 15% in attorneys’ fees during each of the past 5 years • Highly successful overpayment recovery program *Anthem Life internal data 2006 10/7/2020 15
Flexible Reporting • Frequency based on client need • Daily or weekly authorization reports available for Advice to Pay customers or upon client request • Quarterly and annual reporting on closed cases • Financial data • Gross and net benefit, withholdings, tax reporting, W-2 issuance • Report elements • Data for International Classification of Diseases (ICD), Major Diagnostic Categories (MDC), age/gender, tenure and alternate duty programs • Trends • Client data sorting • Comparative reporting • Claims costs 10/7/2020 16
Superior Customer Service • Dedicated Service Center • Over 98. 1% financial accuracy in 2006* • 93% of calls answered in <30 seconds in 2006* Average speed to answer - 8 seconds • Call abandonment rate - 1. 5%* • Busy Rate - 0%* *Anthem Life internal data 2006 10/7/2020 17
Legal Disclaimer Life and Disability products are underwritten by Anthem Life Insurance Company. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In most of Missouri: Right. CHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. (serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123. ). In Wisconsin: Blue Cross Blue Shield of Wisconsin (" BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (" Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ® ANTHEM is a registered trademark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. 10/7/2020 18
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