unicare start. unicare is part of wellpoint health networks, inc., one of the largest health care...

UNICAREUNICARE

Start

UNICARE is part of WellPoint Health Networks, Inc., one of the largest

health care companies in the nation!

WellPoint is a Fortune 500 company, and has been recognized as Fortune’s “Most Admired”health care company for the last two years

UNICARE is reinventing

the Individual and Small Group

insurance market!

Public versus corporate points of view...

Assumed Assumed PricePrice

Willing To Pay

19-29 30-39 40-49 50-59

INDIVIDUALS INDIVIDUALS (non-Poor)(non-Poor)

Range of existing

Plans

50%

50%

Source: California Healthcare

Foundation - 1999

Physician

Hospital

Pharmacy

Pharmacy

Hospital

Physician

$200

$300

$400

$500

$600

1993 1995 1997 1999 2001 2003 2005

Ho

spit

al P

hys

icia

n

Source: Health Care Financing Administration, 1999, Scott-Levin, 1999

$45

$85

$125

$165

$205

Ph

armacy

$150 68% 7%PRICE

Average Annual Usage

% of Americans

% of Total Dollars

$1,200 24% 23%

$12,000 8% 70%

Source: Watson Wyatt Worldwide

Opportunity is knocking!Opportunity is knocking!

• Lifetime maximum of up to $5 million

• Wide choice of plans

• Preventive Care

• Out-of-Pocket Maximums provide protection against catastrophic expenses

• MedCall® 24-hour nurse hotline

• No claim forms with network providers

Our Individual Medical Plans Offer

• UNICARE Saver 2000 Plan• High Deductible for Medical Savings Accounts

(MSAs)• UNICARE Plans offer several deductibles:

– $2,000– $1,500– $1,000– $500

• UNICARE Premier No Deductible Plan• Term Life Coverage

Individual Plan Choices

We offerLOW-MEDIUM-HIGHplan options based on

plan design and premium!

Please note: New sales brochures present benefits and share of costs in a “you pay (this)” format

• Saver 2000 Plan provides in-hospital coverage with $2,000 deductible

• Deductible plans with choice of 5 deductibles!

• Premier No Deductible Plan (with NO Annual Deductible!)

• $30 Co-Pays for in-network physician office visits on all plans!

• Office visit co-pay excludes lab and x-rays

Individual & FamilyMedical Plans Features

• Covers hospitalization and provides some limited benefits• 2 office visits to participating providers per member, per year

(adult) before deductible is met for a $30 Copay• No preventive care benefit

(except for babies and children through age 6)• Employment-related accidental injury or illness covered

(unless covered by Worker’s Compensation Insurance or Employer liability laws)

• No Maternity

Individual UNICARESaver 2000 Plan Features

• $2,000 medical deductible

• UNICARE pays 70%, you pay 30% for inpatient facility and eligible professional charges

• $200 Brand Name drug deductible

• $500 Drug Maximum, per member per year (in- and out- of network)

Drug Co-pays:Drug Co-pays:

Retail (30 days):$10 for Generic$25 for Brand Name

Mail order (up to 60 days):$20 for Generic$50 for Brand

Individual UNICARESaver 2000 Plan Share of Costs

• Four separate plans with a choice of deductibles and in-network coinsurance levels

• Up to 4 office visits to participating providers per member (adult) before deductible is met for a $30 copay

• $200 worth of covered charges for Preventive Care for children and adults *(subject to deductible and coinsurance)

• Employment-related accidental injury or illness covered

(Unless covered by Worker’s Compensation Insurance or Employer liability laws)

Individual UNICARE Deductible Plans

* Other than mandated benefits

• 5 Deductible plans:– $2,000– $1,500– $1,000– $500

Individual UNICARE Deductible Plans Share of Costs

• 80/20 to $3,000 in-network out-of-pocket max.* on the $500 and $1,000 plans

• 70/30 to $3,000 in-network out-of-pocket max.* on the $1,500 and $2,000 plans

* Must also meet deductible

Individual UNICARE Deductible PlansPrescription Drug Share of Costs

Brand Name Drug Deductibles

According to Plan:

Plan Deductible

UNICARE 500 $50

UNICARE 1,000 $100

UNICARE 1,500 $150

UNICARE 2,000 $200

Drug Co-Paysfor all plans

Retail (30 days):

$10 for Generic $25 for Brand Name

Mail order (up to 60 days):

$20 for Generic $50 for Brand Name

Individual UNICAREPremier No-Deductible Plan Features

• Rich benefits and no annual deductible

• Unlimited office visits

• $200 worth of covered charges for preventive care for adults*(subject to any coinsurance or copay)

• Employment-related accidental injury or illness covered (Unless covered by Worker’s Compensation Insurance or Employer Liability Laws)

* Other than mandated benefits

Individual UNICAREPremier No-Deductible Plan Share of Costs

• $30 Copay

• 80/20 to $3,000 in-network out-of-pocket maximum*

• No brand name drug deductible

• No drug maximum limitation

Drug Co-pays:Retail (30 days):

$10 for Generic$25 for Brand Name

Mail order (up to 60 days):$20 for Generic$50 for Brand

* Must also meet deductible

*Must also meet deductible

Office Visits$30 office visit copay excludes lab and x-rays

Other Common Elements

Annual Out-of-Pocket Maximum*

Individual•$3,000* on all plans for in-network charges!•$10,000* on all plans for out-of-network charges!

Family•$6,000* on all plans for in-network charges!•$20,000* for out-of-network charges on all plans!

Affordable Term Life Insurance

• Individual Term Life insurance is available to anyone who qualifies for one of our medical plans

• Easy to apply for: Have applicant check the box on application form and complete the Term Life Insurance Application Addendum

Marketing Strategies

• 70% of those in the market don’t have a Life insurance agent

• Window of opportunity: people don’t buy Term Life insurance unless YOU sell them Term Life insurance

• Sound financial planning; Term Life is a “financial safety net” for your clients and those who depend on them

Key Features to Look For in an Agent Agreement

Future renewals based on commission schedule in force when case was written.

Renewals paid for as long as case is in force.

Ownership and assignment provisions.

Our Commitment to You:Your UNICARE Agent Agreement

• Ownership contract

(six cases issued)

• Corporations can be licensed

• No limitations on renewals

• Do not accept agent of record on individual business

UNICARE CompetitorPlans Plans

• First Year Commission 20% ?

• Contract Ownership Yes! ?

• Free Quoting Software Yes! ?

• Access to Underwriters Yes! ?

• AgentOnline/AgentConnect Coming ?

UNICARE: Compare the difference!

Example of individual production at one case perweek. Average premium of $150 per case, 20%commission first year-accruing scale.

Month 1 $120Month 2 $240Month 3 $360Month 4 $480Month 5 $600

Supplemental Income