Family & Business

QUESTIONS YOU MAY HAVE

Who am I? Why Custom Select Insurance Services? How are doctor visits and prescriptions

be covered? Are annual exams covered? How much will it cost? When will my coverage begin? How long will this take today?

Custom Select Insurance Services strives to provide quality products and superior customer service to individuals, families and businesses. Offering support for most personal and business needs. Continuously building and maintaining long term relationships with our clients and our community.

Discuss concerns and obtain brief health historyDiscuss concerns and obtain brief health history Help you understand how insurance worksHelp you understand how insurance works

Identify available industry options Review what your money actually pays for The difference between a copay plan and a health savings account

Determine which is the right type of plan for your needs

Review quotes from carriersReview quotes from carriers We run quotes with most if not all carriers in your state to ensure

you are getting the right plan at the best available price Options to cover your deductible will also be discussed

Answer questionsAnswer questions Complete applicationComplete application

Submit with initial premium Adjust premiums based on your health qualifications

Insurance costs the same no matter Insurance costs the same no matter where you buy it. All insurance is where you buy it. All insurance is regulated by your State.regulated by your State. Advantages of working with an agent:

Helps you identify the right product for your particular needs and get the best price available.

You have an advocate on your side should you have issues with an insurance company

Custom Select is the only company with Custom Select is the only company with agents that has the largest selection of agents that has the largest selection of insurance carriers in your State.insurance carriers in your State.

Individual Health Insurance

Aetna Atlantis American Community American Medical Security American National AmeriHealth ANTEX Anthem Assurant Avalon Blue Cross Blue Shield Carefirst Celtic Cigna Coventry Excellus BCBS Golden Rule Health Partners Humana IAC IHC Imerica Kaiser Permanente Optima Health Pacificare

Individual Health (Cont.)

Southern Health UnitedOne USHealth Unicare Vista Health Wellpath World

Group Health Insurance

Aetna AmeriHealth Atlantis CDPHP Cigna Coventry Emblem Empire BCBS Excellus BCBS GHI HealthNet Health Partners Horizon BCBS Kaiser Permanente Medica Optima Health Oxford

Group Health (Cont.) Pacificare United Healthcare Unicare Wellpath World

Supplemental Plan Carriers

AFLAC Delta Dental Guaranteed Trust Life National States Patriot Health Solera Dental Value Benefits of America

Life Insurance Carriers AIG Banner Chesapeake Life Forester’s ING John Hancock Lincoln Financial RBC Standard Life Security Mutual United Home William Penn

Replacing Coverage: Replacing Coverage: Do not cancel your existing coverage until you have your new plan in your hands,

have read it, and are satisfied with it.

Temporary Insurance: Temporary Insurance: If you are just in between jobs or do not have insurance now, you may want to

consider a Short Term medical plan. Plans are meant to cover temporary needs and can protect you during

underwriting.

Pre-Existing Conditions/ Waiting periods: Pre-Existing Conditions/ Waiting periods: Pre-existing conditions are injuries or illnesses that begin prior to the effective

date of the new insurance. Pre-existing conditions may not be covered. There may be a waiting period for well care visits and some procedures may not be covered.

Underwriting Process: Underwriting Process: This process can take anywhere from 24 hours up to 5 weeks or longer. It depends

on whether or not medical records are required. You may be asked to call your doctor to assist in releasing your medical records.

Group CoverageGroup Coverage Group of one, 2-50, 51+ No Health Restrictions (HIPPA)

Reason why group insurance is usually very expensive

Option for COBRA

Individual CoverageIndividual Coverage Any individual or family Individual health qualifications

Reason why individual plans can be less expensive Always owned by Insured

*These options apply to all Major Medical plans

HMOHMO (Health Maintenance Organization)

Insurance company determines care provided May be limited with coverage area or available

doctors Limited number of specialists Typically limited care options

PPO PPO (Preferred Provider Organization)

Insured determines care provided Typically national coverage Options for any specialist Options for best available care

Copay PlansCopay Plans Set copays for doctor visits and prescriptions Most expensive plan option Individual deductibles and coinsurance

Deductible 1Deductible 1stst Plans Plans Negotiated or insurance rates for doctor visits Discounts for prescriptions Least expensive option Individual deductibles and coinsurance

Health Savings Account PlansHealth Savings Account Plans Negotiated or insurance rates for doctor visits.

Some carriers offer copay options for wellness exams Discounts for prescriptions; Tax benefits Family deductibles and coinsurance

When you… • Go see a Doctor• Get a Prescription• Go to the ER• Stay in a Hospital

You create a bill.

Doctors& Hospitals

--------------------------------

Network Network or or “Re-pricing House”

Insurance Carrier receives Bill

Guaranteed Prices

Carrier’s members usenetwork of doctors

DEDUCTIBLEDEDUCTIBLEPaid Annually

Per Person or Per Family

*All Covered Expenses apply towards the

deductible first

INSURANCEINSURANCECARRIERCARRIERPays 100% for Covered Expenses

COINSURANCECOINSURANCEPaid Annually

Per Person or Per Family

50/50 60/40 70/30 80/20 90/10 100%

(% of next $5,000 - $20,000 after deductible)

*Most are an additional $2,000

The Unknown Factor:

Doctor Visits and Prescriptio

ns

Standard Copay Plans

Individual DeductiblesIndividual Coinsurance

(Typically 80/20)

•Copays for doctor visits

•Copays for prescriptions

*Do Not count towards deductible & are Continuous after

deductible

HSA Plans

Family (Shared) DeductibleFamily Coinsurance

(Typically 100%)

•Negotiated rates for doctor visits

•Discounts for prescriptions

*Counts towards deductible &

there’s No Cost after deductible

Family deductible and coinsurance Coinsurance usually 100% versus 80/20 like copay plans

Lower premiums Copay plan with an individual $500 deductible and 80/20

coinsurance Total annual Risk for a couple equals $5,000

$500 deductible x 2 = $1,000 $2,000 coinsurance x 2 = $4,000

HSA plan with a family $5,000 deductible and 100% coinsurance Total annual risk for a couple equals $5,000

Family deductible of $5,000 x1 = $5,000 Saved premiums can be tax deferred

Set aside up to the amount of your deductible in a savings account that can be used for medical expenses

Not limited to just doctor visits, prescriptions or your deductible May also be used for dental and vision expenses, over-the-

counter medications, vitamins, alternative and elective procedures and even to pay for long term care premiums

Account earns you interest You never lose it like group Flexible Spending plans

It’s there for whenever you may need it

5 things that vary with 5 things that vary with Major MedicalMajor Medical plans:plans:

After meeting the deductible and coinsurance, all plans virtually work the same.

What you need to know is… 1. How doctor visits & annual exams are

covered

2. Prescription options and deductibles

3. Notable limitations or “hidden copays”

4. Maximum out-of-pocket by insured (you)

5. Maximum insurance company will pay

What We Know: Insurance generally covers your medical bills…

Who is going to cover your loss of income or your deductibles?

Over 80% of why health insurance is used is accident related and have an expense under $3,000 annually

Illness and Accident Supplemental Plans Benefits pay to you

Depending on what you choose, benefits pay in a lump sum upon diagnosis or based on treatment received.

Reduces your out-of-pocket expenses Use them to pay your deductible Cover non-insurance services like a chiropractor or simply to offset

your loss of income…you decide, it is your money.

Accident Benefits Accident Benefits (Per incident) Medical Expenses Benefit

Pays you $2,500 - $10,000 per person Emergency Air Ambulance

Pays you $4,000 Accidental Death & Dismemberment

Pays your family $5,000 - $10,000

Illness Benefits That Pay to YouIllness Benefits That Pay to You Stroke, Cancer, Heart Attack, Coronary Bypass,

Kidney Failure, Organ Transplant, Any Terminal Illness, Nursing Home Confinement

Benefits pay in a lump sum upon diagnosis

Choose Best plan for your concerns (Review Premium Options)

Complete Application Today (Submit with initial premium for review)

Underwriting will generally take 24 hours up to 5 weeks Do not cancel other coverage until underwriting is completed

Need coverage today? Ask about starting a short term policy TODAY!

Underwriting Process Telephone Interview Medical Records Physical Exam Is Money an issue?

Consider lower premiums with a Health Savings Account Take advantage of a Low Cost Illness & Accident Indemnity plan

Do you have enough life insurance?Do you have enough life insurance? We can review several options to ensure you are properly

covered. Policies we can offer you…

Term insurance Annuities Universal life Whole life Final Expense Coverage

Typical areas to be concerned about protecting:Typical areas to be concerned about protecting: Burial (Even after typical need for insurance has expired) 10+ years of income (if still working) Mortgage paid off Kids can attend college Support for a local non profit or religious cause

Issue and Effective Dates Issue and Effective Dates -- The Issue Date is the date the insurance company makes you an offer. The Effective Date is the date the policy begins coverage: If you requested an Effective Date that was earlier than the Issue Date, the coverage will go into effect retro-actively or you may request to change the date up to 60 days after the date that you applied for coverage.

Standard Standard -- This means your policy was issued as it was discussed.

Rated Rated -- Due to your specific health, an increase in premium was placed on the policy to cover the additional risk factors.

Exclusion / Waiver Exclusion / Waiver -- Due to health risk, a condition or person may be completely excluded from coverage or may be temporarily excluded; generally 6 or 12 months.

Declined Declined -- In this situation coverage was unable to be offered. This is where CSS excels above the competition! Get together with your agent to discuss other options that may be available, we are here to help, not just to sell you a policy.

Renewals or Changes - Renewals or Changes - Changes occur and as they do, Custom Select will be there to help. Remember, we represent several carriers with all lines of insurance. So if one company isn’t working for you, we can get you on with another; allowing you to keep the same customer support (Custom Select) under one roof for all of your insurance needs!

We appreciate you letting others knowhow we helped with your concerns today!

*Make sure to ask your agent about our referral program