for financial professional use only- not for public distribution aig accident & health product...
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FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
AIG Accident & Health Product Solutions
September 28,2015
Paul GonzalesDirector, National Sales SupportAIG Life Brokerage | Accident & Health | AIG Life and Retirement 713 - 831 - 6208 [email protected]
Policies issued by American General Life Insurance Company and The United States Life Insurance Company in the City of New York, members of American International Group, Inc. (AIG)
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FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
Accidents aren’t planned, but happen all the time. Financial impact can be devastating
About 60% of bankruptcies are medically related(Medical Bankruptcy in the US, 2007. Results of a National Study, the American Journal of Medicine, August 2009)
About 1 in 9 Americans seek medical attention for an injury each year.(National Safety Council, Injury Facts – 2011 Edition. Not all injuries will result in a benefit payment)
The economic impact of unintentional injuries in 2009 amounted to about $2,300 per person.
(National Safety Council, Injury Facts – 2011 Edition. Not all injuries would result in a benefit payment)
Over 26 million people were treated in hospital emergency rooms for injuries.
(National Safety Council, Injury Facts – 2011 Edition. Not all injuries would result in benefit payments.)
Approximately 49.2 million visits to physician offices were due to unintentional injuries.
(National Safety Council, Injury Facts – 2010 Edition. Not all injuries would result in benefit payments.)
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“No one can predict when or where an accident will happen — or what the related costs will be.”
There were 133 million emergency room visits in 20131
Injuries that occur every2…
• 7 seconds at work
• 2 seconds for workers off the job
• 2 seconds at home
• 3 seconds via non-motor vehicle
57.1% of US bankruptcies are due to medical expenses 2
1 2013 Fast Facts on US Hospitals, Health Forum, an affiliate of the American Hospital Association2 National Safety Council, Injury Facts, 2015 Edition
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What is an Accidental Injury?
Activity Non accidental injury Accidental injury
Shoveling snow
Straining back or herniating disk from weight of snow
Slipping on ice breaking arm
Playing baseball
Tearing rotator cuff from wear and tear of repetitive pitching
Getting hit on the wrist by a ball, resulting in a fracture
Jogging Straining or tearing ligament from regular running routine
Misstepping, having a fall and fracturing an ankle
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AG Accident Choice Plus® – Why is this an Opportunity? Stay tuned to learn more!
Accident Expense Plus® – Customized coverage for individuals and families
EmergencyCare Plus® - Innovative Solution for Accidental Injuries
Accidents may happen but Now you have Several Solutions at your Fingertips!
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Before we Begin, What is Available for You to Sell?
FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
AG Accident Choice Plus®
Supplemental Accidental Injury Insurance
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Key Features of AG Accident Choice Plus
AG Accident Choice
PlusAccidental benefit amounts of $5,000, $10,000, $15,000, $20,000, $25,000
3 deductible options: $100, $300, $500
Three riders available: Critical Illness: Accidental Death & Dismemberment: Accidental Disability Income:
Individual or family coverage available (children covered through age 25)
Issue age 0 – 64, Guaranteed renewable to age 65
Unisex rates with 5 age bands
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Benefits for both You and Your Clients
Benefits to the You
Guaranteed issue – no underwriting, no medical exam required
Customizable policy – critical illness and other riders available (varies by
state)
Multiple payment options - including recurring credit card and EFT
Benefits to your Clients
Dollar-for-dollar reimbursement - up to the calendar year maximum
No coordination with major medical – pays benefits related to accidents regardless of
other health coverage
No network restrictions – access any hospital, physician or medical facility
Pays money directly to clients – not medical providers
No waiting period to use benefits – submit claims immediately
No lifetime limit – no matter how many accidents client has
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AG Accident Choice Plus
Calendar year deductible, not per claim Must seek care within 72 hours of accident Covered accident expenses up to 45 days after accident include but are not
limited to:– Emergency Room
– Hospital
– Urgent Care Center
– Surgery
– Major Diagnostic Exams
– X-Rays
– Physical Therapy
– Physician Charges
Benefits do not coordinate with client’s major medical coverage
No occupational exclusions except professional athletes
24 hour coverage
Benefit Payment Information
Coverage is available for spouse and/or children under same policy if primary insured is covered. Spouse and children may have different benefit amounts for critical illness rider provided coverage for each does not exceed coverage of primary insured.
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AG Accident Choice Plus Riders
Critical Illness
None. If you are diagnosed with a critical illness, you
receive a lump sum benefit.
Heart attack, invasive cancer, stroke
Spouse and children may be included if they are covered under the base policy AND if primary insured has opted for
this rider
One time lump sum payout of $5,000 - $50,000 in $5,000
increments
6 simple questions on the application
No coordination with other insurance coverage. Benefits are paid in addition to those received from other health
insurance policies
None.
N/A
Spouse and children may be included if they are covered under
the base policy AND if primary insured has opted for this rider
One time lump sum payout of up to $50,000 (per unit) for primary$25,000 (per unit) for spouse, and $12,500 (per unit) for children. Units or spouse and/or children must be same as primary’s units (max of 5 units)
Automatic - no questions, no underwriting
No coordination with other insurance coverage. Benefits are paid in addition to those received
from other health insurance policies
Accidental Death & Dismemberment
Accidental Disability Income
None.
Accident as defined/covered in base policy which causes insured to become totally disabled and unable to work. Doesn’t cover disabilities due to sickness.
Primary insured only – must be 18+ years or older and work ≥ 30 hours
a week
Benefit amount is based on income. Minimum monthly benefit available is $500.
Simple – two questions to qualify on the application
No coordination with other disability insurance coverage such as workers compensation or social security. Benefits are paid in addition to those received from other disability insurance policies.
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AG Accident Choice Plus Price Comparison
Male, age 30, no nicotine, a price comparison of an all base policy versus adding on the Critical Illness Rider benefit. State of Illinois.
Benefit Deductible Annual Premium Critical Illness
$10,000 $500 $342 $0
$10,000 $500 $393 $10,000
$10,000 $500 $418 $15,000
Benefit Deductible Annual Premium Accident Only DI
$10,000 $500 $342 $0
$10,000 $500 $519 $1,000/monthly
$10,000 $500 $608 $1,500/monthly
Male, age 30, no nicotine, earning $35,000 annually, comparing an all base approach versus adding on the Accident Only Disability Rider benefit. State of Illinois.
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Case Study
How it works:
Lisa’s fall = head injury + broken leg in 2 places
Injury services = ambulance, ER visit, x-rays, medication, CT Scan, physician charges, surgery, cast, & PT
Injury bills = $9,500
Total out- of- pocket expense = $500
Not an actual case, and is a hypothetical representation for illustrative purposes only.
Client Profile: Lisa 33 years old, self employed web developer
Problem Expensive medical insurance for self employed individuals
Lisa purchased health insurance policy with a low premium and $10,000 deductible
Lisa supplemented major medical with AG Accident Choice Plus for $10,000 per calendar year accident benefit with a $500 deductible. Her premium is less then $33 a month for the base contract.
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AG Accident Choice Plus – A Solution to the Realities of Today
Dollar-for-dollar reimbursement
No coordination with major medical
No network restrictions
Customizable riders
Pays money directly to clients
No waiting period to use benefits
No lifetime limit
Guaranteed issue
FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
Accident Expense Plus®
Supplemental Accidental Injury Insurance
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Imagine an economical and intelligent way to protect against health care costs related to accidents
That’s Accident Expense Plus
Rapid reimbursement for a wide variety of costs related to covered accidents
Can help cover deductibles, co-pays and other expenses not covered by primary major medical plan
Pays benefits regardless of other coverage in place
Can also provide a one time lump sum payout if diagnosed with any of three major critical illnesses1,2
Accident Expense Plus can provide benefits for a wide range of accident-related costs, from emergency room visits to physical therapy to diagnostic exams — even surgery.
The “plus” is an optional Critical Illness Rider that can pay a lump sum benefit if you’re diagnosed with invasive cancer, heart attack or stroke.
1.There will be a charge for each rider selected. See the rider for details regarding the benefit descriptions, limitations and exclusions.
2.The Critical Illness Rider is not available in all states. Please consult your agent or review the policy and outline of coverage for your state.
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Accident Expense Plus Policy Highlights
* The Critical Illness Rider is not available in all states. The minimum benefit is $25,000 in the following states: DE, IA, KS, OK, SC, TX, VT and WV.
Accident Expense Plus - A customizable and flexible policy with…
Accident benefit
amounts from $1,000 to $15,000
4 deductible options: $0, $100, $250,
$500
Critical illness rider
benefits from $5,000 to $25,000*
Individual or family
coverage available
Issue ages 0 to 64 and
Guaranteed renewable to
age 65
Benefits do not
coordinate with major medical
coverage
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How Easy is it to Qualify? Easier than you Think!
Accident coverage is guarantee issue
– There are no medical qualifications for accident coverage
– Individuals up to age 64 are eligible for this plan
Critical Illness Rider is simplified issue
– Accept/reject based on 4 application questions
Children are eligible for critical illness benefits*
Critical illness benefit amount is not tied to the accident benefit amount in the base policy
* Dependent child coverage not available in UT.
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Critical Illness Rider
None - If you’re diagnosed with a covered critical illness, you receive a lump sum benefit. It’s that simple.
Heart attack, stroke, invasive cancer
One time lump sum payout of $5,000, $10,000, $15,000, $20,000 or $25,000
Spouse and children may be included in the rider
Four simple questions on the application
The rider does not coordinate with other insurance coverage. Benefits are paid in addition to those received from other health insurance policies.
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FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
Two Powerful Benefits, One Low-cost Solution
Accidental Injury Insurance
Critical Illness Insurance
Accident Expense
Plus
Dollar-for-dollar reimbursement :
■ Emergency Room
■ Hospital
■ Urgent Care Center
■ Surgery
■ Diagnostic Exams
■ X-rays
■ Physical Therapy
Lump sum benefit paid after
initial diagnosis for these
major critical illnesses:
■ Invasive Cancer
■ Heart Attack
■ Stroke
An affordable supplement to
major medical insurance
■ Pays benefits regardless of other coverage
■ Makes payments directly to your client
■ An ideal supplement for high-deductible major medical plans
+ =
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Accident Expense Plus Price Comparison
Male age 30, no nicotine, a price comparison of an all base approach versus adding on the Critical Illness Rider benefit. State of Arizona.
Benefit Deductible Annual Premium Critical Illness
$10,000 $500 $255 $0
$10,000 $500 $315 $10,000
$10,000 $500 $404 $25,000
$15,000 $500 $264 $0
$15,000 $500 $324 $10,000
$15,000 $500 $413 $25,000
Something to Consider - Adding $5,000 (a 50% increase) of base benefit results in an increase of only 2.5% - 3.5% to the annual premium.
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Accident Expense Plus – A Case Study
The Problem
Jack, 16, rising basketball star who needed an out-of-network specialist of their major medical plan
John and Samantha are proud parents — their son Jack is an
outstanding student who is also becoming a highly recruited basketball
star. When he fractured his wrist taking a hard foul in the playoffs last
year, the family’s doctor referred him to a specialist outside their major
medical carrier’s network.
The Solution
Thanks to the family’s Accident Expense Plus policy, John and Samantha were promptly reimbursed
for their out-of-network expenses and received additional benefits for the treatment and physical
therapy. Jack made a full recovery and is back on the court this season. His bank shot — and his
parents’ bank accounts — are as strong as ever.
Not an actual case, and is a hypothetical representation for illustrative purposes only.
FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
EmergencyCare Plus®
Supplemental Emergency Injury Expense Insurance
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EmergencyCare Plus – A Cost Effective Alternative
Even with all the precautions we take to keep ourselves and our families safe, accidents sometimes happen. And, in addition to physical challenges, accidents can lead to financial difficulties as well.
EmergencyCare Plus is designed to provide benefits for a wide range of accident-related costs — from emergency room visits to physical therapy to family lodging.
EmergencyCare Plus helps protect your family against many of the unexpected financial burdens that an accidental injury can bring about, allowing you to better manage the costs and focus on getting your life back to normal.
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FOR FINANCIAL PROFESSIONAL USE ONLY- NOT FOR PUBLIC DISTRIBUTION
Benefits of EmergencyCare Plus
Delivers benefits for the injuries clients are most likely to need coverage for injuries caused by accidents while playing sports
Provides a death benefit if death occurs within 90 days of a covered accidental injury
Pays all benefits directly to you (unless payment is assigned to a healthcare provider), regardless of what is covered by major medical health plans
Issue ages 18 to 64 and Renewable to age 75
No APS, parameds, or exams
Spouse and child(ren) coverage available
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Why EmergencyCare Plus?
EmergencyCare Plus pays benefits for the injuries you’re likely to need coverage for, including children’s sports injuries
Supplements existing coverage – benefits paid directly to the insured – regardless of what’s covered by other sources
Hospital Cash Rider
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EmergencyCare Plus Base Benefits
Accidental Death: $25,000 Primary; $5,000 Spouse; $1,000 Children
Dismemberment: up to $15,000 Primary; $7,500 Spouse; $2,500 Children
Emergency Treatment: $50
Accident Follow-up: $15 per treatment
– 3 treatments per accident
Burns: up to $2,500 for burns to 30% of the body, or more
Ambulance: $75 Ground; $500 Air
Dislocation: up to $1,700 for open reduction; $450 for closed
Family Lodging: $50 per day
– 30 days maximum
Fracture: up to $2,000 for open/compound fracture; $1,000 closed
Lacerations: $50
Diagnostic Exams: $75
Paralysis: $2,500 Quadriplegia, $1,500 Hemiplegia; $1,000 Paraplegia
Physical Therapy: $10/Treatment
– maximum of 10 treatments
Prosthesis: $250
Surgery: up to $400
Transportation: $150 Round Trip
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EmergencyCare Plus Basics
Coverage Options
– EmergencyCare Plus Family
– EmergencyCare Plus Individual
– EmergencyCare Plus Individual/Spouse
– EmergencyCare Plus Individual/Children
Hospital Cash Benefit Rider
– Pays insured funds towards hospital admission, confinement, intensive care, and rehabilitation.
EmergencyCare Plus
Rider
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EmergencyCare Plus Plan Package Options*
All three plans include:
*Packages different in the state of Florida, see ECP Florida Client Guide for more details
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EmergencyCare Plus Package RatesIncludes Base Policy & Hospital Cash Rider
Anticipating the unexpected with EmergencyCare Plus
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As a Reminder,
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Questions?
Thank You!
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Disclosure Information
IMPORTANT NOTE: All benefits payable are subject to the terms and conditions of the policy,
including benefit durations, limitations and exclusions. Not all benefits and exclusions apply in
every state. Please consult the policy form and outline of coverage for details. There will be a
charge for each rider selected. See the rider for details regarding the benefit descriptions,
limitations and exclusions. Guarantees are backed by the claims-paying ability of the issuing
insurance company. Comprehensive medical coverage may be required in some states in order to
apply for or maintain this coverage.
Policies issued by: American General Life Insurance Company (AGL), Policy Form Number 04120, 11125, Rider Form Number 04025, 11125, 11126, 11127 except in New York, where issued by The United States Life Insurance Company in the City of New York (US Life), Policy Form Number 07120N. Issuing companies AGL and US Life are responsible for financial obligations of insurance products and are members of American International Group, Inc. (AIG). Products may not be available in all states and product features may vary by state.