time insurance company the assurant self-funded program provides tools for small-business employers...
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Time Insurance CompanyThe Assurant Self-Funded Program provides tools for small-business employers to establish a self-funded health benefit plan for their employees. The benefit plan is established by the employer and is not an insurance product. Stop-loss insurance for the self-funded plan is underwritten and issued by Time Insurance Company. For agent use only.
Assurant Self-Funded ProgramA health care financing solution
Joe Simpson-Sales Representative
Today’s Goal
• Why Assurant Self Funded?
• Assurant’s partnership with Health Plan Services
• State of the Organization-Assurant to National General
• Underwriting
• Give you a differentiator in the market
• Help you prospect for leads
• Continual Innovation in the group space
Assurant Health and Health Plan Services • Health Plan Services has their own quoting ability
• Preferred Underwriting
• Licensed Sales Consultants
• Access to their product line plus our small group level funded product
• Access to an Assurant Rep
Backed by experience and strength
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• Assurant Health-Sold to National General in Principal
• Fortune 500 Company with an A.M Best rating of A- (Excellent)
• Bought the rights to use Time Insurance Paper• More than 120 years of experience• In the small group self-funded market since
2002
Level Funded Overview
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• Feels like a fully insured plan – Employee– Deductible
– Coinsurance
– OOP Max
– Doctor Office and Rx Copays
– HSA/ HRA
– Compliant with HHS Requirements regarding preventive benefits, life time maximums and pre-existing conditions.
• Feels like a fully insured plan -- Employer– Pay one monthly premium
– Design your plan
Level Funded Overview
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• What makes the plan self funded?
• Still an underwritten product
• Premium Breakdown– Stop-loss Insurance
• Specific Deductible
• Aggregate Deductible
– Administration, sales, general expenses
– Claim prefunding • Potential Refund!
Common Misconceptions of Level Funded Plan
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• You cannot write this product on groups under 100-FALSE-our product is filed for groups 2-99
• There is a risk for the employer with level funded-FALSE-Assurant has removed all the risk associated with self insured plans so the product looks and feels like a fully insured plan
• Due to ACA, you cannot underwrite a group under 100. This is only true for the fully insured market. ACA allows underwriting on level funded plans.
The QuoteStop Loss Insurance Limits
Annual Specific Deductible $25,000.00
Annual Aggregate Limit $37,106.64
Monthly Bill
Employee 5 $210.32
Employee + Spouse 4 $567.87
Employee + Child 1 $420.64
Family 7 $715.09
Stop Loss Premium $3,875.89
Admin. Sales and General Expenses $1,781.24
Claim Pre- Funding $3,092.22
Total $8,749.35
Stop-loss insurance protects employers
Specific stop-loss limit
(Individual)
Aggregate stop-loss limit
(Group)
Protects against higher-than-expected claims by individual member
Protects against higher-than-expected claims incurred by the group as a whole
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Employers will receive a refund if the plan year ends with claims below the expected amounts — or the aggregate limit — and there is money left in the employer’s claims fund.
* Assurant Self-Funded Program customer experience, 2013
Refund of unused claims fund dollars
More than 50% of
our self-fundingemployers receivea refund at the end of their plan year*
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There is a 6- or 12-month runout period that begins at the end of each plan year to allow for claims from that plan year to be processed. The refund is paid at the end of the runout period
More special features
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Employer-funded health plan templates
Office visit and prescription copays, deductibles and coinsurance apply to the total out-of-pocket maximums.12
Assurant Health is not engaged in rendering legal or tax advice. Please see a qualified tax professional for help.
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• Group Size 2-24 Employees – 6.5 % Total Monthly Premium
• Group Size 25-50 Employees – 6.0 % Total Monthly Premium
• Group Size 51-99 Employees – 5.0 % Total Monthly Premium
Agent Compensation
Assurant Health is not engaged in rendering legal or tax advice. Please see a qualified tax professional for help.
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• Health Saving Accounts (HSAs):
−Contributions are tax deductible or can be made with pretax dollars
−Both the employer and employee can contribute
• Health Reimbursement Accounts (HRAs):
−Deductible and/or Coinsurance reimbursments
−Reimbursements can go to EE or directly to Provider
Tax-advantaged opportunities
Plan administration you can trust
Allied Benefit Systems, Inc. (Allied)
Allied Member Service Team888.292.0272 Monday—Thursday: 7:30 a.m. to 7:00 p.m.Friday: 8:00 a.m. to 5:00 p.m.Saturday: 9:00 a.m. to 12:00 p.m.Central timeEmployer/Employee websiteassurantselffunded.com
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A national health solutions company
Support that leaves employers time to focus on their businesses
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Comprehensive Web-based plan management
Thank You!
Joe Simpson(414)299-8375
For agent use only. Not for distribution to consumers. The Assurant Self-Funded Program provides tools for small-business employers to establish a self-funded health benefit plan for their employees. The benefit plan is established by the employer and is not an insurance product. Stop-loss insurance for the self-funded plan is underwritten and issued by Time Insurance Company.
J-71968 (Rev. 11/2014) © 2014 Assurant, Inc. All rights reserved.
This presentation provides summary information for the health benefit plan templates and Assurant Health stop-loss coverage. Please refer to the Summary Plan Description or stop-loss policy for a complete listing of the benefits, exclusions and terms of coverage. In the event that there are discrepancies with the information in this presentation, the terms and conditions of the Summary Plan Description, stop-loss policy and other plan documents will govern.