United Healthcare Underwritten By Golden Rule Strengthen your
United. Healthcare ® Underwritten By Golden Rule Strengthen your product portfolio with affordable health insurance plans This presentation currently excludes the marketing states of: CT, DE, GA, KS, KY, LA Not For Consumer Use 36256 -0606 All Gen 21 States and Georgia Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Today’s Agenda q Evolution of Golden Rule, A United Healthcare Company q Product Portfolio and Competitive Rate Comparisons q Network Size and Strength q Ease of Doing Business q Value Added Benefits q Setting Ourselves Apart From the Rest q E-Store: Online Quoting and Application Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 2
Why Golden Rule? 3 q Leader in the individual and family market q Experience and expertise spans 60 years q Pioneer of consumer driven health care solutions q Strong financial ratings* § Rated A by A. M. Best § Rated A+ by Standard & Poor *These ratings are an indication of financial strength and stability Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 3
Resolving Claims 4 Over 3. 5 million claims processed in 2006! Over 14, 000 claims processed per work day Over 2. 2 million dollars paid out per work day! 90% are processed in 10 working days or less! 99% benefit accuracy rate! Actual health claims results 2006 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 4
Rate Reduction for New Business 5 % Population >= 5% rate decrease 93. 47% % Population >= 10% rate decrease 35. 49% % Population >= 15% rate decrease 15. 23% Pennsylvania 5% - 23% Oklahoma 5% - 12% Michigan Up to 19% South Carolina Up to 7% Illinois 5% – 15% Texas 5% – 20% Indiana 5% - 14% Tennessee 14% - 15% Maryland 10% Nebraska Missouri 5% Arizona 5% - 19% Ohio 5% - 18% Iowa 5% - 7% Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 5%
Top States By 2007 Production 1 FL 2 GA 3 TX 4 OH 5 MI 6 MO 7 AZ 8 CO 9 PA 10 WI 11 MD 12 CT 13 VA 14 SC 15 NC 16 AL 17 LA 18 IL 19 TN 20 OK Most Competitive Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 6
Product Portfolio 7 United. Healthcare, Underwritten by Golden Rule Our goal is to provide you with a choice Today we’re positioned to be your of health plans designed to fit your go-to-carrier for all plan types in clients’ needs at a price they can afford. the individual health market! Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 7
Health Savings Accounts (HSA) Qualified HSA Plans give clients the option to establish a Health savings Account: q HSA 100® – Our comprehensive HSA q HSA Saver – More limited benefits and priced 2040% less ® Optional Benefits Available with HSA Plans $5 Million Lifetime Maximum Benefit Term Life Benefit Enhanced Preventive Care Benefits Package HSA Hospital Indemnity Rider Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 8
HSA 100 Who does the HSA 100® fit? ü Those who are willing to trade low deductible health insurance for higher deductible plans ü Those interested in saving money on premium ü Those who prefer comprehensive coverage Comprehensive Coverage • 100% after the deductible for all covered expenses including: § Doctor office visits § Rx coverage § In hospital patient services § Out patient services § Preventive mammogram, Pap Smear, PSA Testing Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 9
HSA Saver ® 10 HSA Saver – our most affordable HSA plan § Priced 20 -40% less than HSA 100® § Limited Coverage • Outpatient doctor visits - not covered • Outpatient Rx – not covered • Outpatient X-ray and lab – Same deductible choices as HSA 100 (covered if within 14 days of surgery or confinement) § Coverage provided for the more costly expenses • Inpatient hospital • Inpatient Rx • Outpatient surgery, MRI, CAT Scan, chemotherapy, radiation treatment, hemodialysis § Coverage provided for Preventive • Mammogram, Pap Smear, PSA Testing Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Monthly Base Premium Comparison 11 ® HSA Saver (catastrophic) vs. ® HSA 100 (comprehensive) Golden Rule HSA 100 Dublin, OH 430 ® Husband & Wife, aged 40 Golden Rule HSA Saver ® $5, 800 Ded; 100% $156. 86 $122. 55 Premium based on preferred health status, Rx copay. Premium based on January 07 effective date. Each plan has its own benefit design and other characteristics not presented here. Not For Consumer Use Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 21% Savings
Exante Bank • • • 12 Wholly owned subsidiary of United. Health Group Crediting 4% interest rate* FDIC insured account balances Investment opportunities HSA pre-paid debit card or checkbook Easy online account management Prompt customer service Exante Bank 866 -234 -8913 * Rate as of 6/1/06; subject to change Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 12
High Deductible Plans • High Deductible Plans (non-HSA qualified) § Plan 100® – our simplest plan § Plan 80 SM – similar to Plan 100 but with 80/20 coinsurance SM § Saver 80 – our most affordable plan Optional Benefits Available with High Deductible Plans $5 Million Lifetime Maximum Benefit Term Life Benefit Prescription Drug Card Benefit First-Dollar Accident Benefit Enhanced Preventive Care Benefits Package Maternity Benefit Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 13
High Deductible Plans ® • Plan 100 * - our simplest plan § Choose a Plan Deductible • 1, 500, $2, 500, $3, 500, $5, 000 § 100% after the deductible • Doctor office visits • Rx coverage • Preventive care • In hospital patient services • Out patient services § Max of two deductibles per family, per calendar year Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 14
High Deductible Plans • Plan 80 SM* - similar to Plan 100® but with 80/20 coinsurance § 15 - 25% less premium than Plan 100 § 80/20 to $15, 000 coinsurance, then 100% § Same deductibles as Plan 100 • Saver 80 SM – our most affordable plan § 30 - 40% less premium than Plan 100 § 80/20 to 15, 000 coinsurance, then 100% § Limited Coverage • Outpatient doctor visits - not covered • Outpatient Rx – not covered § Coverage provided for the major (catastrophic) expenses ØHemodialysis, radiation, chemotherapy, and organ transplant drugs ØSurgeon, assistant surgeon and facility fees ØCAT Scans, MRIs ØEmergency room fees Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 15 Plan 80 Deductibles $1500 $2500 $3500 $5000 Saver 80 Deductibles $500 $1000 $1500 $2500 $3500 $5000
Monthly Base Premium Comparison 16 Husband & Wife, aged 35 with two children Sarasota, FL 342 Golden Rule Plan 100 Plan 80 Saver 80 $2500 Deduct 100% 80 / 20% $262. 79 $228. 39 $175. 97 $1500 Deduct 100% 80 / 20% $323. 39 $279. 17 $213. 65 Premium based on preferred health status, Rx copay. Premium based on January 08 effective date. Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 33% Savings 34% Savings
Copay Plans 17 • Copay Plans § Copay Select. SM – our most benefit rich plan with excellent preventive care benefits § Copay Saver. SM – our most affordable copay plan Optional Benefits Available with Copay Plans $5 Million Lifetime Maximum Benefit Term Life Benefit Prescription Drug Card Benefit Buy-Up (Copay Select only) Two Additional Doctor Office Visits (Copay Saver only) Maternity Benefit First-Dollar Accident Benefit Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Copay Select SM 18 SM Copay Select - Our benefit-rich copay plan with excellent preventive care § $35 doctor office copays regardless of deductible! • Copay is unlimited • General practitioner, specialist, urgent care • Covers history and exam § Core plan benefits remain the same regardless of deductible! § Includes Rx copays regardless of deductible! Copay Select SM Deductibles $500 $1000 $1500 $2500 $5000 • Generic - $15 copay (no deductible) • Name Brand - $100 person deductible § $30 preferred § $60 non-preferred • Annual maximum of $3, 000 per insured (Optional Prescription Drug Benefit Buy-Up) § Preventive care not subject to the plan deductible! Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 18
Copay Select Preventive Care SM 19 • Preventive Care Doctor Office Visit • History and exam - $35 copay • X-ray and Lab - 80% / 20% (not subject to deductible) • $300 annual maximum person • Child Immunizations (ages 0 -18) • Vaccine - 80% / 20% (not subject to deductible) • Separate $300 annual maximum person • Preventive mammogram, pap smear, PSA testing • 80% / 20% (not subject to deductible) Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 19
Copay Saver SM Copay Saver. SM – our most affordable copay plan § Priced 20 -30% less § $35 doctor office copay • Limited to 2 person, per calendar year • Optional buy-up to total of 4 visits § $15 copay for Generic Rx (Brand name drugs not covered) § Preventive Mammogram, pap smear, PSA testing: 80 / 20% § X-ray and lab are covered if performed within 14 days of a surgery or confinement Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 20
Monthly Base Premium Comparison 21 Copay Select. SM (comprehensive) vs. Copay Saver. SM (catastrophic) Husband & Wife, aged 35 with two children Golden Rule Copay Select Austin, TX 787 Golden Rule SM Copay Saver SM $5, 000 Ded; 80 / 20% $5, 000 Ded; 80 / 20 % $351. 26 $273. 69 Premium based on preferred health status, Rx copay. Premium based on January 08 effective date. Each plan has its own benefit design and other characteristics not presented here. Not For Consumer Use Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 22% Savings
Optional Benefits 22 To Enhance Plans Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 22
Enhanced Preventive Care Benefits Package 23 This optional benefit is available with all plans except Copay Select. SM. No waiting period $300 annual max on covered expenses PSA testing, pap smear, mammography max l a u n An $35 copay per doctor office visit ry ca a m i r P Doctor office x-ray and lab covered at 100% Plan d tc. N, e Y G B , O re ed aiv w s i e l uctib ed Well care visits Child (0 -18) immunizations d ply ot ap n s e o te $ Separa Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. ax m l a u n 300 an 23
Prescription Drug Card Benefits Prescription Drug Card Benefit: 24 SM This optional benefit is available only with Plan 100® and Plan 80 ü Generic: $15 copay ü Name-Brand Preferred: $30 copay ü Name-Brand non-preferred: $60 copay • Name brand copay is after a $100 person, calendar year deductible • $3, 000 annual maximum (If generic is available, name brand is reimbursed at generic price) Prescription Drug Card Benefit Buy-Up SM This optional benefit is available only with Copay Select. ü Eliminates the $3, 000 annual drug maximum Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 24
Maternity Benefit 25 This optional benefit is available with all plans except HSA plans This benefit helps cover the costs for routine pregnancy or delivery: • Client pays 20% • Golden Rule pays 80% • Graded benefit with a maximum of $7500 Years Covered Annual Maximum 1&2 $2, 500 3&4 $5, 000 5+ $7, 500 *Not available in AR, MD, NC, VA Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 25
Optional Benefits 26 $5 Million Lifetime Maximum Benefit* Available with all plans • Upgrades coverage to $5, 000 person Term Life Benefit** Available with all plans • Decreasing term life benefit • Benefit payout based on primary insured’s age at the time of death Two Additional Doctor Office Visits This optional benefit is available only with Copay Saver. SM • Increases the number of copay doctor office visits from 2 to 4 person, per year Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 26
Optional Benefits 27 First Dollar Accident Benefit This optional benefit is available will all plans except HSA plans. • Upfront coverage for unexpected injuries • Treatment of an injury within 90 days of an accident • Benefit choice of $500 or $1, 000 • Plan deductible must be greater or equal to the benefit amount selected *Not available in VA **Not available in NC Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 27
Preferred Network 28 United. Healthcare Choice. Plus Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 28
United. Healthcare Choice Plus 29 §Expansive national network* §Owned by United. Health Group §Choice of network providers at all times §Offers significant provider discounts** üAverage network discount of 45% üLeverage strength of United. Health Group üStrength in numbers *United. Healthcare Choice Plus Network is not offered with Golden Rule Health plans in all states. **Discounts vary by provider, geographic location, and service provided Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 29
Preferred Network Discounts* 30 Sample doctor visit EOB 45% Discount* $125. 00 $68. 69 . . *Discounts vary by provider, geographic location, and service provided Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 30
Preferred Network Discounts* 31 Sample lab work EOB 90% Discount* $34. 39 $357. 75. . *Discounts vary by provider, geographic location, and service provided Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 31
Update: Network 32 32 Top 10 Health Plans Accepted by Office-Based Physicians Health Plan Physicians Accepting United. Health 64. 8% Blue Cross Blue Shield 64. 3% Humana 52. 3% Aetna 43. 4% Cigna 39. 6% Wellpoint 38. 3% Wellcare 37. 7% Medicare 27. 3% Healthnet 17. 8% Sierra 10. 5% Source: SK&A Information Services, October 2007 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Golden Rule 33 Eligibility and Underwriting Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 33
Underwriting 34 • It’s a new day – the United. Healthcare way! • Sound pricing data from actuaries on treatment and prescription costs ü Opportunity to issue apps with fewer riders ü Looking closely at plan design and deductible size • Initiated auto-issue through E-Store* ü Issue applications in 48 hours or less ü Application matches certain underwriting criteria *Actual health underwriting results February 2006 - not all applicants qualify Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 34
Rate Classes 35 (Broker Guide page 24) • Preferred . 90 = 61% § Preferred H&W chart (Broker Guide page 25) § No history of high blood pressure § No medical exclusionary riders longer than one year • Standard I 1. 00 = 35% • Standard II 1. 25 = 4% § Expanded height and weight table, to help accept more cases (Broker Guide page 25) Guidelines button § Male 6’ 0” aged 45 max considered weight • Was 257 lbs • Now 279 lbs § Female 5’ 6” aged 45 max considered weight • Was 205 lbs • Now 228 lbs Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. on the rating software will help determine which health class status to quote
Rate Classes 36 (Broker Guide page 24) § Elimination of the Tobacco Rate Class • Relative tobacco surcharge based on Issue Age & Rate Class Issue Age Preferred Standard II Under 40 1. 20 1. 35 1. 60 40 -54 1. 30 1. 55 1. 80 55+ 1. 50 1. 65 1. 90 § Elimination of Motorcycle Exclusion • 20% individual rating in lieu of an exclusion rider will be applied during underwriting • Added in underwriting if applicant has driven a motorcycle in the past 24 months Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Clearance Periods • • Atrial fibrillation – 2 years Cancer – depends on type Colon cancer – 5 years Prostate cancer – 2 years Epilepsy – 1 year since last seizure Hyperthyroid – 6 months Gastric Bypass – 5 years and stable weight for at least 12 months Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 37
Riders Increased deductible rider § Example: Controlled hypertension § Increase overall deductible by $400 § Premium remains the same § Hypertension is considered a covered expense Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 38
Riders Option Two: Temporary Rider § Placed on a condition for a specific period § Usually one to two years § Premium remains the same § Condition is not covered during rider period Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 39
Preliminary Evaluation* Broker Service Center: 800 -474 -4467 Select prompt 1 for underwriting assistance • Necessary information needed to effectively prescreen § Age and gender § Diagnosis and date § Prescribed treatment, medications, and dosages • Quick Response Prescreen • Specialty Team § Refer to underwriting manual § Confer with underwriter § Advise of underwriting opinion *No guarantee of coverage. Final decision is up to underwriting at time of submission Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 40
Service Standards 41 • We issue 83% of all applications* • 61% of applicants receive preferred rating class* • We handle all underwriting requirements § Amendments § HBQ questionnaires § APS (when medical histories are unclear or complex) § MIB reports • Underwrite at time of application / telephone • Certificates are mailed to you / I. D. cards are mailed to your client Actual 2006 health underwriting results Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 41
What Your Clients Can Expect • Each individual listed on the application is underwritten separately • Effective date of choice • Premium modes: § Monthly bank draft (EFT) § Direct quarterly billing • Submit premium at time of application § Premium is refunded if non-issue • 12 -month initial rate guarantee* • I. D. cards for certificates or policies are mailed directly to client *Subject to benefit or location change Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 42
Golden Rule E-Store 43 ESTORE Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 43
E-Store Overview 44 § Available to all appointed brokers § Offers convenient online access § Creates a professional web presence § Can reduce operating expenses § Fast and efficient § Can help grow your business Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 44
E-Store Features 45 § Online quoting and application submission § Quote archiving and application tracking § Simple navigation to support your Golden Rule business üPrint all forms and brochures needed to write Golden Rule plans üCheck correspondence for lapses and re-rate notification üStatus of pending applications üDownload quoting software üNetwork link for checking doctors and hospitals Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 45
E-Store Online Quoting 46 q. E-mail customized quote directly to client • View quote • Complete app and apply online q. Broker Assisted Application • Assist client in completing majority of the app • E-mail completed app to client for review and electronic signature • Client submits to Golden Rule Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 46
47 On E-Store’s “My New Business” and “My Block of Business” sections you’ll find: Ø Tracking by app number, name, paid to date, plan name, current billed premium, and more. Ø Information on health class, ratings, riders, and premium. Ø Details on dependents. Visit www. goldenrulehealth. com/broker for full details. Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
48 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Update: E-Store improvements • My Book of Business Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 49 49
50 50 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
51 51 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
52 52 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
53 53 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Golden Rule 54 Resources & Training Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 54
Resources • Broker Service Center § (800) 474 -4467 § keybroker@goldenrule. com • E-Store § www. goldenrule. com • National Key Broker Sales Manager § Annette Dahlke • (800) 232 -5432 Ext. 12312 • (920) 661 -2312 Direct line • Annette. Dahlke@eams. com • Webinars § https: //goldenrule. webex. com (no WWWs) § www. goldenrule. com/On. Demand. shtml Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 55
56 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
57 Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group.
Why Choose Golden Rule? 58 1. Our commitment to YOU… and the individual health insurance market 2. Best in Class Broker support 3. United. Healthcare brand recognition and leadership 4. Full range of health plans to fit your clients’ needs and budgets 5. Ease of doing business 6. Competitive rates! 7. Strength of network for claims repricing 8. Fast and flexible underwriting 9. E-Store technology 10. Continued training opportunities Confidential property of United. Health Group. Do not distribute or reproduce without the express permission of United. Health Group. 58
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