For Agent use only Not for distribution to
For Agent use only. Not for distribution to Consumers. National General Accident and Health markets products underwritten by National Health Insurance Company, Time Insurance Company, Integon National Insurance Company, and Integon Indemnity Corporation. National General Foundation Health
Why a fixed-benefit indemnity plan Plan design & how it works State availability & eligibility Post-sale administration National General Foundation Health
Why fixed-benefit indemnity plans • 2017 ACA plans’ premiums rose by 25% on average 1 • 2017: There was an average of 3. 9 insurers on the Health Insurance Marketplace (down from 5. 4 in 2016)2 • Approximately 62% of Americans have less then $1, 000 in savings 3 1 Retrieved 11/29/2016 from http: //fortune. com/2016/10/25/obamacare-insurance-premiums-2017 -healthcare/ 2 Retrieved 11/29/2016 from http: //kff. org/health-reform/issue-brief/2017 -premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/ 3 Retrieved 11/29/2016 from http: //www. marketwatch. com/story/most-americans-have-less-than-1000 -in-savings-2015 -10 -06 National General Foundation Health
Why fixed-benefit indemnity plans A fixed-benefit indemnity plan is great for clients who: – Don’t have the budget for major medical plans – Don’t want to pay for benefits they don’t use – Missed Open Enrollment and still need help paying for health care expenses THESE PLANS PROVIDE LIMITED BENEFITS. Make sure your clients know this is not a major medical plan and does not satisfy the requirements of minimum essential coverage under the Affordable Care Act. They may be subject to a tax penalty. National General Foundation Health
National General Foundation Health overview • Benefits start right away – no waiting period • First-dollar benefits – no deductibles or copays • Access to the Multi. Plan Network of doctors and hospitals for added savings • Includes a L. I. F. E. Association membership National General Foundation Health
Why National General Foundation Health Offers predictable and affordable access to health care • Clients can go to any doctor or hospital they want • They save more when they use Multi. Plan Network providers • Benefits for office visits, lab and x-rays, surgeon costs, and more • Benefits are paid on top of other coverage • No coordination of benefits • Automatic renewals National General Foundation Health
Office visits & lab work Plan Details: Benefits for office visits and lab work Level 1 Level 2 Level 3 Doctor’s Office Visit $50/day 2 days per year $70 /day 2 days per year $90 /day 2 days per year Diagnostic Tests $100/day 1 day per year $200/day 2 days per year $300/day 2 days per year X-Ray Benefits $100/day 1 day per year $100/day 2 days per year $100/day 3 days per year Laboratory Benefit $50/day 1 day per year $75/day 2 days per year $100/day 3 days per year Ex: MRI, Mammogram Ex: Cholesterol, A 1 C National General Foundation Health
Plan Details: Hospital and Ambulance benefits Level 1 Level 2 Level 3 $1, 000 per day Up to 31 days per year $2, 000 per day Up to 60 days per year $3, 000 per day Up to 90 days year $250 $500 $1, 000 $100 per day 1 day per year $200 per day 2 days per year $300 per day 2 days per year Ground $300 $400 $500 Air $1, 000 $2, 000 $3, 000 Ambulance Hospital Charges Confinement Benefit Requires a stay for more than 24 hours Hospital Admission Limited to one admissions per year Emergency Room Visit 1 time per year National General Foundation Health
Surgeon Benefit Plan Details: Surgeon Benefits Inpatient Admitted for no less than 24 hours Level 1 Level 2 Level 3 $1, 000/per day $2, 000/per day $3, 000/per day $500/per day $1, 000/per day $1, 500/per day Outpatient Admitted and released in a period less than 24 hours Maximum days per policy year: 3 (combined inpatient and outpatient benefits) Benefits are paid per covered person, per policy year. Benefits and product availability may vary by state National General Foundation Health
Plan Details: Network Multi. Plan Network • Over 4, 800 hospitals Average 42% discount for Physicians and Specialists! • 100, 000 ancillary facilities • 800, 000 health care professionals • Assignment of benefits – we pay providers directly www. multiplan. com National General Foundation Health
How the plan works Like other insurance plans, customers should: ü Use the network website to search for network providers: www. multiplan. com ü Set an appointment with the provider ü Present his/her ID Card when checking in ü After receiving treatment(s), ü The EOB will show the network discount and the plan benefit paid ü The insured is responsible for paying any remaining balance after the plan benefit is paid The plan benefit your client receives is the same regardless of where they receive care or how much the provider charges. National General Foundation Health
How the plan works: National General Foundation Health Level 2 plan Office visit for illness Office visit Chest x-ray Total charges $2001 $3702 Network discount 3 $239 $570 Office visit/ X-ray benefits $70/$100 Total out-of-pocket: $161 That’s about a 70% savings when you add the network discount and plan benefits Not an actual case. For Illustration purposes only. 1. http: //www. jhsph. edu/news-releases/2015/primary-care-visits-availableto-most-uninsured-but-at-a-high-price. html 2. http: //health. costhelper. com/chest-x-rays. html 3. Multiplan discounts average 42% for physicians and specialists National General Foundation Health
How the plan works: National General Foundation Health plan – level 2 Overnight stay for an Appendectomy 1 Hospital stay charge $5, 784 Surgeon fee $1, 586 Anesthesia fee 2 $908 Network discount 3 $1, 453 Cost after network discount $6, 825 Surgeon benefit $2, 000 Hospital admission benefit (1 st visit) $500 Hospital confinement benefit $2, 000 Total out-of-pocket: $2, 325 That’s big savings when you add the network discount and plan benefits Not an actual case. For Illustration purposes only 1. https: //www. healthcarebluebook. com/page_Procedure. Details. aspx? id =69&dataset=MD&g=Appendectomy 2. Anesthesia not covered under plan 3. Multiplan network discount for acute inpatient average 19. 72% National General Foundation Health
NG Foundation Health Plan Sample Rates Sample rates for primary age 50 - 54 Sample rates for primary age 18 - 49 Family Composition Plan Level 1 Plan Level 2 Plan Level 3 Individual $87. 46 $169. 96 $252. 96 Individual $120. 48 $235. 00 $350. 11 Couple $174. 93 $339. 92 $505. 93 Couple $240. 96 $470. 01 $700. 22 1 Parent Family $202. 04 $391. 12 $581. 59 1 Parent Family $221. 49 $429. 97 $639. 90 2 Parent Family $289. 51 $561. 08 $834. 55 2 Parent Family $341. 98 $664. 97 $990. 01 Rates shown are representative of rates in most states, however, rates may vary by state and age. Always refer to the quoting tool for specific rates for your clients. National General Foundation Health
Bundle with our supplemental plans for even more coverage We have many coverage options to choose from Add more financial protection • • • Trio. Med: AME, Critical Illness, and AD & D Cancer and Heart/Stroke Term Life – Critical Illness Acci. Med: AME and AD & D Plan Enhancer: AME with optional CHS and SIP riders* Dental PPO or Dental Indemnity plans also make a great add-on *Riders not available in all states National General Foundation Health
Added value with membership in the L. I. F. E. Association Health Care Family Benefits Entertainment • Telemedicine • Well. Card savings: • Fitness program savings • Identity theft protection discounts • Auto service discounts Discounts on • Travel services • Retail stores • Dining & entertainment discounts on vitamins, prescriptions, and more • Direct Labs • Senior Medical Alert *If sold with the National General STM or Trio. MED, client would receive only one L. I. F. E. Association Membership National General Foundation Health
National General Foundation Health State availability AL AR AZ DC FL GA ID IL IN LA MI MO MS NC NM* NV OH OK PA RI SC TN TX VA WI** WV WY *In New Mexico, any person applying for coverage that has prior health insurance with any carrier, including a National General Foundation Health plan, must have at least a 95 -day gap before applying for a National General Foundation Health plan. **L. I. F. E. Association not available in WI National General Foundation Health
Eligible Ages Primary applicant – Age 18 – 64 at time of application • Children up to age 26 – No child only • Requires a Health Questionnaire National General Foundation Health
Who it’s good for A fixed-benefit indemnity plan is good for clients who: – Don’t have the budget for major medical plans – Don’t want to pay for benefits they don’t use – Missed Open Enrollment and still need help paying for health care expenses These plans are not suitable for clients who: - Utilize a lot of medical services - Want comprehensive medical coverage and don’t mind paying higher premiums - Have a serious illnesses or chronic condition National General Foundation Health
Example of exclusions • Pre-existing conditions • Pregnancy • Dental procedures • Workers compensation • Elective or cosmetic surgery • Hazardous activities • Prescriptions and • Mental disability and chemical medications abuse *Not a comprehensive list of exclusions. Please refer to the policy of the marketing product brochure for a complete list. National General Foundation Health
Enrollment – 1 st or 15 th – Must apply by 25 th for 1 st – Must apply by 9 th for 15 th Initial Payment Drawn at time of application Reoccurring Payment 5 days before the monthly anniversary of start date (monthiversary) Form of Payment EFT Visa, Master. Card, or Discover National General Foundation Health
Product Enrollment – E-Signature • www. vipmemberbenefits. com • Login to e-sign their application • Easiest Method – Voice Signature • 3 -way call with insured on the line • Dial 210 -835 -9969 • Instructions present on each application National General Foundation Health
Post Sale: Instant Access Electronic policy fulfillment • Customers can view all policy documents at www. NGAHDocuments. com ID card(s) will arrive separately in the mail. Customers can manage their policies at www. VIPmemberbenefits. com • Change payment types • Change of address National General Foundation Health
Post Sale: Member Services 888 -781 -0585 • Cancellations National General Accident & Health PO BOX 1070 Winston Salem, NC 27102 -1070 888 -344 -3232 – Plan cancellations received 10 days prior to the monthiversary date will stop payment for the next months premium withdrawal National General Foundation Health
Field Training available so take advantage and get your agent training sessions set up with Dan Giancola! You can email him at: Training@NGISAdmin. com Your Sales Team is also available to help: Lori Bartoshevich - Lori. bartoshevich@ngic. com 414 -231 -4500 Karen Papp- Karen. Papp@ngic. com 414 -604 -5481 National General Foundation Health
Thank You! National General Foundation Health
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