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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
UnitedHealthcare®Underwritten By Golden Rule
This presentation currently excludes the marketing states of: CT, DE, GA, KS, KY, LA
Not For Consumer Use36256-0606 All Gen 21 States and Georgia
Strengthen your product portfolio with affordable health insurance plans
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Today’s Agenda
Evolution of Golden Rule, A United Healthcare Company
Product Portfolio and Competitive Rate Comparisons
Network Size and Strength
Ease of Doing Business
Value Added Benefits
Setting Ourselves Apart From the Rest
E-Store: Online Quoting and Application Submission
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.3
Why Golden Rule?
Leader in the individual and family market Experience and expertise spans 60 years Pioneer of consumer driven health care solutions Strong financial ratings*
Rated A by A.M. Best Rated A+ by Standard & Poor
*These ratings are an indication of financial strength and stability
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.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
Resolving Claims
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Rate Reduction for New Business
% Population >= 5% rate decrease 93.47%
% Population >= 10% rate decrease 35.49%
% Population >= 15% rate decrease 15.23%
Pennsylvania 5% - 23%
Michigan Up to 19%
Illinois 5% – 15%
Indiana 5% - 14%
Maryland 10%
Missouri 5%
Iowa 5% - 7%
Oklahoma 5% - 12%
South Carolina Up to 7%
Texas 5% – 20%
Tennessee 14% - 15%
Nebraska 5%
Arizona 5% - 19%
Ohio 5% - 18%
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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
Top States By 2007 Production
Most Competitive
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.7
Our goal is to provide you with a choice of health plans designed to fit your
clients’ needs at a price they can afford.
UnitedHealthcare, Underwritten by Golden Rule
Today we’re positioned to be your
go-to-carrier for all plan types in
the individual health market!
Product Portfolio
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
HSA 100® – Our comprehensive HSA HSA Saver® – More limited benefits and priced
20-40% less
Qualified HSA Plans give clients the option to establish a Health savings Account:
Optional Benefits Available with HSA Plans
$5 Million Lifetime Maximum Benefit Term Life Benefit
Enhanced Preventive Care Benefits Package
HSA Hospital Indemnity Rider
Health Savings Accounts (HSA)
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
HSA 100
Who does the HSA 100® fit?
Those who are willing to trade low deductible health insurance for higher deductible plans Those interested in saving money on premium 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
HSA Saver®
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 – (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
Same deductible
choices as HSA 100
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Monthly Base Premium Comparison
Golden Rule Golden Rule
HSA 100® HSA Saver®
$5,800 Ded; 100%
$5,800 Ded; 100%
$156.86 $122.55
HSA Saver® (catastrophic)
vs.
HSA 100® (comprehensive)
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
Dublin, OH 430 21% Savings
Husband & Wife, aged 40
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.12
Exante Bank
• Wholly owned subsidiary of UnitedHealth Group• Crediting 4% interest rate*• FDIC insured account balances• Investment opportunities • HSA pre-paid debit card or checkbook• Easy online account management
* Rate as of 6/1/06; subject to change
Prompt customer service
Exante Bank
866-234-8913
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
High Deductible Plans
• High Deductible Plans (non-HSA qualified)
Plan 100® – our simplest plan
Plan 80SM – similar to Plan 100 but with 80/20 coinsurance
Saver 80SM – 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
High Deductible Plans
• Plan 80SM* - 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 80SM – 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
Hemodialysis, radiation, chemotherapy, and organ transplant drugsSurgeon, assistant surgeon and facility feesCAT Scans, MRIsEmergency room fees
Saver 80 Deductibles
$500
$1000
$1500
$2500
$3500
$5000
Plan 80 Deductibles
$1500
$2500
$3500
$5000
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Monthly Base Premium Comparison
Premium based on preferred health status, Rx copay. Premium based on January 08 effective date.
Sarasota, FL - 342
33% Savings
Husband & Wife, aged 35 with two children
Golden Rule
Plan 100 Plan 80 Saver 80
$2500 Deduct
100%
$2500 Deduct
80 / 20%
$2500 Deduct
80 / 20%
$262.79 $228.39 $175.97
$1500 Deduct 100%
$1500 Deduct
80 / 20%
$1500 Deduct
80 / 20%
$323.39 $279.17 $213.65 34% Savings
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Copay Plans
• Copay Plans Copay SelectSM – our most benefit rich plan with excellent preventive care
benefits
Copay SaverSM – 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.18
Copay SelectSM
$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!• Generic - $15 copay (no deductible)• Name Brand - $100 per 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!
Copay SelectSM
Deductibles
$500
$1000
$1500
$2500
$5000
Copay SelectSM
- Our benefit-rich copay plan with excellent preventive care
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Copay SelectSM Preventive Care
• Preventive Care Doctor Office Visit
• History and exam - $35 copay
• X-ray and Lab - 80% / 20% (not subject to deductible)
• $300 annual maximum per person
• Child Immunizations (ages 0-18)
• Vaccine - 80% / 20% (not subject to deductible)
• Separate $300 annual maximum per person
• Preventive mammogram, pap smear, PSA testing
• 80% / 20% (not subject to deductible)
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Copay SaverSM
Copay SaverSM – our most affordable copay plan
Priced 20-30% less
$35 doctor office copay • Limited to 2 per 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Monthly Base Premium Comparison
Golden Rule Golden Rule
Copay SelectSMCopay Saver
SM
$5,000 Ded; 80 / 20%
$5,000 Ded; 80 / 20 %
$351.26 $273.69
Copay SelectSM (comprehensive) vs. Copay SaverSM (catastrophic)
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
Austin, TX - 787 22% Savings
Husband & Wife, aged 35 with two children
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Optional Benefits
To Enhance Plans
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Enhanced Preventive Care Benefits Package
No waiting period
$300 annual max on covered expenses
PSA testing, pap smear, mammography
$35 copay per doctor office visit
Doctor office x-ray and lab covered at 100%
Well care visits
Child (0-18) immunizations Separate $300 annual max
Annual max does not apply
Primary care, OBGYN, etc.
Plan deductible is waived
This optional benefit is available with all plans except Copay SelectThis optional benefit is available with all plans except Copay SelectSM..
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Prescription Drug Card Benefits
Prescription Drug Card Benefit:This optional benefit is available only with Plan 100® and Plan 80
SM
Generic: $15 copay Name-Brand Preferred: $30 copay Name-Brand non-preferred: $60 copay
• Name brand copay is after a $100 per person, calendar year deductible• $3,000 annual maximum
(If generic is available, name brand is reimbursed at generic price)
Prescription Drug Card Benefit Buy-UpThis optional benefit is available only with Copay Select
SM.
Eliminates the $3,000 annual drug maximum
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Maternity Benefit
• Client pays 20%• Golden Rule pays 80%• Graded benefit with a maximum of $7500
This optional benefit is available with all plans except HSA plansThis optional benefit is available with all plans except HSA plans
*Not available in AR, MD, NC, VA
This benefit helps cover the costs for routine pregnancy or delivery:
Years Covered Annual Maximum
1 & 2 $2,500
3 & 4 $5,000
5+ $7,500
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Optional Benefits
$5 Million Lifetime Maximum Benefit$5 Million Lifetime Maximum Benefit**Available with all plans
•Upgrades coverage to $5,000,000 per person
Term Life Benefit**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 VisitsTwo Additional Doctor Office VisitsThis optional benefit is available only with Copay SaverThis optional benefit is available only with Copay SaverSM
• Increases the number of copay doctor office visits from 2 to 4 per person, per year
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Optional Benefits
*Not available in VA
**Not available in NC
First Dollar Accident BenefitFirst Dollar Accident BenefitThis optional benefit is available will all plans except HSA plans.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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.28
Preferred Network
UnitedHealthcare
ChoicePlus
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.29
Expansive national network*Owned by UnitedHealth GroupChoice of network providers at all timesOffers significant provider discounts**
Average network discount of 45%Leverage strength of UnitedHealth GroupStrength in numbers
UnitedHealthcare Choice Plus
*UnitedHealthcare Choice Plus Network is not offered with Golden Rule Health plans in all states.**Discounts vary by provider, geographic location, and service provided
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.30
Preferred Network Discounts*
*Discounts vary by provider, geographic location, and service provided
Sample doctor visit EOB
$125.00$68.6945%
Discount*
.
.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.31
. .
Preferred Network Discounts*
*Discounts vary by provider, geographic location, and service provided
Sample lab work EOB
$357.75$34.39
90%
Discount*
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
32Update: Network
Top 10 Health Plans Accepted by Office-Based Physicians
Health Plan Physicians Accepting
UnitedHealth 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.33
Golden Rule
Eligibility and Underwriting
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.34
Underwriting
• It’s a new day – the UnitedHealthcare way!
• Sound pricing data from actuaries on treatment and prescription costsOpportunity to issue apps with fewer ridersLooking closely at plan design and deductible size
• Initiated auto-issue through E-Store* Issue applications in 48 hours or lessApplication matches certain underwriting criteria
*Actual health underwriting results February 2006 - not all applicants qualify
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Rate Classes (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) Male 6’0” aged 45 max considered weight
• Was 257lbs• Now 279lbs
Female 5’6” aged 45 max considered weight• Was 205lbs• Now 228lbs
Guidelines button on the rating software will help determine which health class status to quote
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Rate Classes (Broker Guide page 24)
Elimination of the Tobacco Rate Class• Relative tobacco surcharge based on Issue Age & Rate Class
Issue Age Preferred Standard I 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Riders
Increased deductible rider
Example: Controlled hypertension Increase overall deductible by $400 Premium remains the same Hypertension is considered a covered expense
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Preliminary Evaluation*
• 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*No guarantee of coverage. Final decision is up to underwriting at time of submission
Broker Service CenterBroker Service Center: 800-474-4467: 800-474-4467Select prompt 1 for underwriting assistanceSelect prompt 1 for underwriting assistance
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.41
Service Standards
• 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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.43
Golden Rule E-Store
ESTORE
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.44
E-Store Overview
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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.45
E-Store Features
Online quoting and application submission Quote archiving and application tracking Simple navigation to support your Golden Rule business
Print all forms and brochures needed to write Golden Rule plans
Check correspondence for lapses and re-rate notification
Status of pending applicationsDownload quoting softwareNetwork link for checking doctors and hospitals
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.46
E-Store Online Quoting
E-mail customized quote directly to client • View quote• Complete app and apply online
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
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
On E-Store’s “My New Business” and “My Block of Business” sections you’ll find: Tracking by app number, name, paid to date, plan name, current billed premium, and more.
Information on health class, ratings, riders, and premium.
Details on dependents.
Visit www.goldenrulehealth.com/broker for full details.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
49Update: E-Store improvements
• My Book of Business
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.54
Golden Rule
Resources & Training
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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/OnDemand/OnDemand.shtml
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.58
Why Choose Golden Rule?
1. Our commitment to YOU… and the individual health insurance market
2. Best in Class Broker support 3. UnitedHealthcare brand recognition and leadership 4. Full range of health plans to fit your clients’ needs and budgets5. Ease of doing business 6. Competitive rates! 7. Strength of network for claims repricing8. Fast and flexible underwriting9. E-Store technology10. Continued training opportunities
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