FIRSTChoice “ Guaranteed Issue ” Health Insurance Plans Underwritten by: Central United Life...

FIRSTChoice “Guaranteed Issue”

Health Insurance Plans

Underwritten by:

Central United Life Insurance Company

Marketed by:

BMC Agency, Inc.

This PowerPoint presentation is intended strictly as a training tool for licensed FIRSTChoice agents, as well as an information source for

prospective agents to evaluate the product. It is expressly forbidden to

be used in any sales situation or public venue, in whole or in part.

BMC Agency, Inc. has a “ZERO TOLERANCE” policy in which any

violation of this “Agent Eyes Only” rule by any FIRSTChoice

representative may result in their

immediate termination

WITH CAUSE!

FIRSTChoice Guaranteed Issue Health Plans

Central United Life is a member of the Manhattan Insurance Group, whose Worksite strategy is to offer sound, affordable products that meet the

demands of even the most sophisticated of Policyholders. CUL has focused on the

acquisition of life, accident and health insurance for

more than 20 years.

Since the introduction of the first “Guaranteed Issue” Health Insurance

supplement for individuals in 2003, BMC Agency, Inc. has remained committed to

refining and revolutionizing the individual health insurance marketplace.

This is why CUL chose BMC to assist in the development and promotion of their

incredible FIRSTChoice series.



Who qualifies for “Guaranteed Issue” Consideration?

Individuals age 18-64 who work an average of 30+ hours

per week, their spouse ( if 18-64 ) and their children.


Once issued, the plans are GUARANTEED RENEWABLE to age 65, so long as premiums are paid when due. It is not necessary to maintain ‘full time’ employment

status once a FIRSTChoice plan is issued!


How are Pre Existing Conditions treated?Conditions for which an insured sought or

received medical treatment in the 12 months prior to application date, or which

manifest symptoms that would have caused an ordinarily prudent person (a

person of average intelligence) to have done so will not be covered for 12 months after the

effective date, whether or not they are disclosed on the application.


Are there any Ineligible Conditions or Ineligible Occupations with FIRSTChoice?

NO!Individuals 18-64 working an average of 30+ hours per week may apply regardless of their

Occupation or Pre-Existing conditions!


Most FIRSTChoice plan designs include a unique combination of features that provide significant “front loaded” benefits when they are needed the most. There are three separate benefits

designed to provide cash for the expense of the hospital room when confined.

1) The Daily Room Benefit2) The Indemnity Benefit3) The First Hospital Confinement Benefit


The Daily Room Benefit is paid for up to 365 days per period

of confinement, currently much longer than any competitor.

( Others are usually 30 or 31 days maximum )


The Indemnity Benefit is

paid on the first day of hospital confinement in any calendar year.


The First Hospital Confinement Benefit is paid during the first

period of hospital confinement of any calendar year. Depending on

the plan selected, it can be as much as $10,000 over the first 6 days,

in addition to any and all other benefits!

The First Hospital Confinement Benefit in both the GOLD and PLATINUM plan designs pays as follows:


Day 1: $1,000Day 2: $1,000Day 3: $2,000Day 4: $2,000Day 5: $2,000Day 6: $2,000TOTAL: $10,000

If a period of confinement lasts less than 6 days, the balance of the benefit is

available for a subsequent confinement for the same

condition, provided it occurs within 6 months.


There are THREE important areas that must be considered when

selecting which Guaranteed Issue plans to market. We feel that the

FIRSTChoice Plan Series is superior to the competition in all three!

1) PLAN DE$IGN2) PREMIUM$3) COMPEN$ATION

FIRSTChoice Plan Design

The FIRSTChoice PLATINUM Plan has

9 separate benefits, including the 4 most significant, that

are equal to or superior to ANY OTHER GUARANTEED ISSUE plan currently available!

As of 7/27/10 FIRSTChoice PLATINUM PLAN

USA+ Secure Advantage 2000

Core Value 1000 MAX eHealthStarr GetMed 360 AIM Health Max Plus

Daily RoomBenefit

$2,500 days 1,3, 4, 5,& 6$1,500 day two

$500 days 7 - 365

$2,000/dayUp to 31 days/yr

$1,000/dayUp to 30 days/yr.

$1,000/dayUp to 30 days/yr. Then 3x

$500/day

$1,000/day x 31 $2,000 first day +$1,000/day for 100 days

per yearIntensive

Care$2,000/day

Up to 20 days/yr.IN ADDITION to DRB

$2,000 days 2-31IN LIEU of DRB

$1,000/day up to 5 days/yr., IN ADDITION to

DRB

X $2,000/dayUp to 15 days/yr.


Surgery $10,000 ScheduleUnlimited Times

$100% of Medicare RBRVS

100% of RBRVS not to exceed charges

$100% of Medicare RBRVS $10,000 ScheduleMax of 2 Times/yr.

$100% of Medicare RBRVS

Anesthesia 25% of Surgical benefit 25% of Surgical benefit 20% of Surgery benefit 20% of Surgery benefit 25% of Surgical benefit 25% of Surgical benefitWellness $400 mammogram,

$200 PSA, $100 PAP $30 X 1 visit/yr or $20

Copay "in network"1 X $150/yr. $100 x one visit/yr. $20 Copay X 5 in network

$40 X 5 out of network$150 x 1 per year

X-Ray /Labs

X 1 X CWE at DirectLabs $75 X 5/yr. 3 visits/yr 100% coins. to $1,000 annual max, shared

with Dr. Office benefit

Up to $100 x 3/yr. $400 x 5/yr.

Maternity Covered as any illness10 month wait

X X X X Covered as any illness12 month wait

OP Sickness( Doctor's Office )

4 X $100 per insured category+

5 X $30 or $20 Copay "in network"

$75 X 5/yr. 5 X $30 Copay, 100% coins. to $1,000 annual max

$20 copay X 5 in network$40 X 5 out of network

$100 x 7 per year

Emergency Room Increases OP Sick. benefit to $150

1 per year up to $100 X $100 per visit,1 visit per year

Max of 2 visits to receive Max of $1,000.yr.

$100 ded. per visit

X

Prescription Medicine

X Companion Life RX benefit

4-Tiered RxDiscount Rx

Discount Program X Generic Copay + Brand Name discount card

CriticalIllness

X X X X $10,000 $5,000

Private Duty Nursing

$250/day for20 days/yr.

X X X X X

AD&D $30,000 $10,000 X X $15,000 XAccident % of $1,800 schedule +

4 X $200 per accident1 per year. $5000 -

$200 ded.$5,000 annual max$100 ded, then 80%

X $5,000 less $100 ded. All other benefits pay first.

X

Mental Health X X 60 x $500/day Inpatient10 x $25 Outpatient

60 x $500/day Inpatient40 x $50 -75% Coins.

Outpatient

X X

Substance AbuseX X 60X $500/day inpatient

20 x $25 outpatient( Combined with Mental Health benefit above )

X X

Ambulance $300/trip, one trip/yr. 1 x up to $100/yr. XPRICE $241.00/mo. $370/mo. $282.72/mo. $334/mo. $329.90 $349/mo.

As of 7/27/10 FIRSTChoice GOLD PLAN

USA+ Essential Health 1000

Core Value 1000 eHealthStarrStarr 500

GetMed 360Platinum 250

Value Health Plan Diamond Plan

Daily RoomBenefit

$2,100 days 1,3, 4, 5,& 6$1,400 day two

$400 days 7 - 365

$1,000/dayUp to 31 days/yr


$500/dayUp to 30 days/yr.

$250/day x 31 $1,000/day Up to 30 days/yr.

IntensiveCare


IN ADDITION to DRB

$2,000 days 2-31IN LIEU of DRB!

X X $1,000/dayUp to 15 days/yr.

$3,000/day Up to 14 days/yr. IN LEU of DRB!

Surgery $5,000 ScheduleUnlimited Times

$100% of Medicare RBRVS 80% of RBRVS not to exceed charges

$80% of Medicare RBRVS $10,000 ScheduleMax of 2 Times/yr.

$8,000 Schedule

Anesthesia 25% of Surgical benefit 25% of Surgical benefit, Max of $500

20% of Surgery benefit 20% of Surgery benefit 25% of Surgical benefit 20% of Surgical benefit

Wellness $200 mammogram,$100 PSA, $50 PAP

$30 X 1 visit/yr or $20 Copay "in network"

1 X $150/yr. $100 x one visit/yr. $20 Copay X 5 in network$40 X 5 out of network

X

X-Ray /Labs

X 1 X CWE at DirectLabs $75 X 3/yr. 3 visits/yr 80% coins. to $1,000 annual max, shared with Dr.

Office benefit

X Discount

Maternity Covered as any illness10 month wait

X X X X X

OP Sickness( Doctor's Office )

4 X $75 per insured category+ 5 X $30 or $20 Copay "in network"

$75 X 3/yr. 5 X $30 Copay, 100% coins. to $1,000 annual max

$20 copay X 5 in network$40 X 5 out of network

$75 X 5/yr.

Emergency Room Increases OP Sick. benefit to $112.50

1 per year up to $100 X $75 per visit,1 visit per year

Max of 2 visits to receive Max of $1,000.yr. $100 ded.

per visit

X

Prescription Medicine X X 4-Tiered RxDiscount Rx

Discount Program X Discount

CriticalIllness

X X X X X X

Private Duty Nursing $150/day for20 days/yr.

X X X X X

AD&D $20,000 $10,000 X X $15,000 X

Accident % of $1,800 schedule + 4 X $150 per accident

1 per year. $5000 - $200 ded.

$5,000 annual max$100 ded, then 80%

X $5,000 less $100 ded. All other benefits pay first.

$75/visit X 2 visits/yr.

Mental Health X X 60 x $500/day Inpatient10 x $25 Outpatient

60 x $250/day Inpatient40 x $50 -75% Coins. Outpatient

X X

Substance Abuse X X 60X $500/day inpatient20 x $25 outpatient

( Combined with Mental Health benefit above )

X X

Ambulance 300/ trip, max of 1 trip/yr. X $100/trip X 2 trips/yr.

PRICE $156/mo. $245/mo. $282.72/mo. $241/mo. $199.90 18-39= $85/mo * 40-49=$180/mo.

50-59=$266/mo. * 60-64=$288/mo.


Remember that all FIRSTChoice plans are GUARANTEED

RENEWABLE POLICIES, not certificates of some Group Master

policy or Association Plan. This provides much greater protection for the insureds!


FIRST Choice Plans are true “Defined Benefit” plans. As

such, the stipulated benefit is always paid in full, regardless of the billed amount. There is no “pays UP TO $$$” language

in FIRST Choice policies!


Unlike the competition, many of which have no benefit for Intensive Care, or pay it “in lieu” ( instead of! ) the DRB, FIRSTChoice policies pay all Intensive

Care benefits IN ADDITION TO any and all other benefits of the policy,

including the DRB. This is a HUGE advantage to the policyholder!


Virtually ALL Guaranteed Issue Plans address

SURGERY in one of two ways. Many pay a percentage, often 100%, of the Medicare

reimbursement rate ( RBRVS, or Resource Based Relative Value Scale ). What many agents and

most clients do not realize is that this amount IS NOT based upon the total cost of the procedure,

but simply on the amount charged by the PRIMARY SURGEON ONLY! This does not include the Operating Room, Suture Kits, dressings, etc.!

Another problem is this; at a time when an estimated 46% of doctors

are threatening to boycott Medicare over what they feel is inadequate compensation, how will a client

under age 65, and not covered by Medicare, compel their doctor to accept this discounted amount?



The rest address Surgery with an established Surgical Schedule,

usually with a maximum benefit of $10,000. Often, the benefit from a $10,000 Surgical Schedule will be

more than for the identical procedure under a 100% RBRVS Medicare Reimbursement rate!


One drawback to most plans with Surgical Schedules is

that they tend to limit coverage to one or two

surgical procedures per year, maximum!


FIRSTChoice incorporates the best of both, with a

$10,000 Surgical Schedule that can be accessed an UNLIMITED number of times each year, for either inpatient or outpatient

procedures!

The FIRSTChoice benefit for Anesthesia is the highest

percentage paid, 25% of the amount paid for Surgery. Since our Surgical Schedule will deliver more benefits

and do it more often than other plans, the Anesthesia Benefit is correspondingly higher as well!



Unlike the vast majority of competitors, FIRSTChoice plans

provide benefits for MATERNITY, both Natural Delivery as well as Caesarian Section, effective 10

months after the policy effective date!!


FIRSTChoice plans are the only “Guaranteed Issue” plans currently known to include

Private Duty Nursing benefits. The Platinum Plan also has the

highest levels of AD&D protection, $30,000!


The total paid for an Accident will come from several different plan

benefits. They are:1) Accident Rider2) Specific Injury Rider3) Surgery Schedule, with

Anesthesia


Accident Rider: Pays a (first dollar) benefit for each accident.

Specific Injury Rider: Pays as much as $1,800 per accident from a (first dollar) schedule of procedures.

Surgery Schedule: Pays a (first dollar) percentage of the Surgery Schedule, plus 25%+ for anesthesia!


There are benefits absent from FIRSTChoice that appear with other Guaranteed Issue plans.

They include Prescription Drugs, Outpatient Labs & X-Rays, Critical

Illness, and “Association Junk”


Prescription Drugs tend to fall into one of two

categories, Maintenance Drugs and

Occasional Drugs.Let’s consider each!


Maintenance Drugs are taken regularly, and are often available in

generic or generic equivalents. Literally hundreds are available at

discount chains, often for $4.00 each, or less! These are less

expensive than when using a discount drug card!

Maintenance Drugs can also be very expensive. For that reason, ALL BMC Agents are provided access to

a quality PPO repricing and Discount Medical benefits card.

This optional benefit can reduce the cost of procedures by 30%

and more!


Occasional Drugs are most commonly Antibiotics, used

infrequently, and Pain Medication, usually very inexpensive. We

believe it is less costly over time for the client to ‘pay as you need’

these, as opposed to building in costs that drive up plan premiums.



X-Rays and Lab tests are legitimate medical procedures, but have

become abused as doctors increasingly practice ‘defensive

medicine.’ We have chosen to avoid coverage for these elements in favor of additional coverage for expensive

confinements/procedures.


Critical Illness plans normally require even more scrutiny in underwriting than Major Medical. To include CI

benefits within a Guaranteed Issue program adds a disproportionately high premium cost that we feel is

an ineffective use of our clients premium dollars.

Prior to 2003, the only option for “Uninsurable” clients was an expensive ‘state pool’ or an

“Association Package” that featured “discounts” on some medical services, but mostly benefits

unrelated to Health Insurance.



Today, even though numerous “Guaranteed Issue” plans exist that

feature solid Health Insurance benefits, most plans are still littered

with movie tickets, rental cars, Disney discounts, and vitamins.

With FIRSTChoice, you get quality INSURANCE BENEFITS, period.


By limiting eligibility to employees who work an average of 30+

hours/week, and avoiding marginal benefits subject to abuse, we are able to provide what we believe to be the

strongest package of “Guaranteed Issue” benefits available in our

industry today!

FIRSTChoice Premiums

Ranging from the HSA Supplement for less than a dollar a day, to the

PLATINUM plan design with the richest benefits available in any Guaranteed

Issue chassis, FIRSTChoice plan designs are available in a variety of

configurations, all of which are lower in price than competitor plans with fewer

and smaller benefits!

FIRSTChoice COMPEN$ATION

Almost all “Guaranteed Issue” plans today pay a ‘levelized’ commission, and

very few offer annualization.

FIRSTChoice plans provide ‘heaped’ first year commission with 6 months advanced commissions available to

agents that qualify!

The highest commission levels available from competitors for top

IMO/FMO contracts is 30% First Year Commission.

*********************************************************************************************************************

This same 30%, (with 8% renewals), is what we pay

AGENTS with FIRSTChoice!



Higher Contracts can be earned by General Agencies and

Managers with active production teams.

Details are available from the BMC Marketing Partner

that provided you with this PowerPoint presentation!

BMC Agency, Inc. and CUL FIRSTChoice

STRONG BENEFITS!************************************************************************************************************

Low Premiums!***********************************************************************************************************

High Compensation!**************************************************************************************************************

“The FIRSTChoice in Guaranteed Issue Health Plans!”

FIRSTChoice “ Guaranteed Issue ” Health Insurance Plans Underwritten by: Central United Life...

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