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Product and Services Overview

Product and Services Overview. Who founded A&M International Health Plans (AMIHP)?.

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Product and Services Overview

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  1. Product and Services Overview

  2. Who founded A&M International Health Plans (AMIHP)? William G. McKelvey President of AMF Risk Management Solutions, A managing General Underwriter for Great West and Canada Life, and Mr. Joseph Antonell, President of Asert Benefit Services, a successful managed care company in Miami, Florida. Together they have formed A & M International Health Plans (AMIHP). AMIHP will now have the experience and expertise to offer employers substantial cost savings on their self funded employee benefit plans through the combination of each companies strengths. AMIHP is on the leading edge of innovative group medical cost containment and control.

  3. AMF Risk Management Solutions (AMF) • AMF was established by William G. McKelvey in 1976. • AMF is a Managing General Underwriter (MGU) for Great West Life, The Canada Life Insurance company, and American Fidelity Assurance Companies. • All of these insurers enjoy an A M Best Rating of A+. • AMF underwrites group medical stop loss insurance over employer sponsored self insured group medical and dental programs.

  4. AMIHP Mission To provide a real cost savings alternative to self funded employer group medical programs. AMIHP plans will provide financial incentives for plan participants to seek care abroad where cost reductions of 50-75% are possible. AMIHP will assist and guide plan participants through the process, with it’s unique concierge services, to assure successful medical outcomes by board Certified Physicians in accredited international hospital facilities.

  5. Who Our Products Help! AMIHP will be providing services to: • Self Funded Group Medical Plans • AMIHP plans provide participant incentives to receive affordable health care abroad. • Net Savings of up to 60 – 75%.

  6. Who Our Products Help! AMIHP will be providing services to: • Mini Med Plans • A great alternative coverage for non-catastrophic expenses. • Maximum benefits, however, are typically limited from $10,000 to$25,000. • AMIHP can be superimposed on top of mini-med plans to accommodate catastrophic claim coverage or simply used as a PPO with savings of up to 60-75%. • These cost savings will ease the financial burden on plan participants, by maximizing available benefit dollars.

  7. Who Our Products Help! AMIHP will be providing services to: • Healthcare Savings Account Benefit dollars buy more services when they cost 60 – 75% less, when performed at AMIHP qualified International facilities. • An AMIHP PPO plan offering, alongside and HSA/HRA is a smart choice! • Self Pay Individuals benefit as in (3) above. • Over 500,000 U.S. citizens received medical care abroad in 2005.

  8. Medical Travel Today! • Mostly cosmetic and elective surgery. • Primarily self-pay or under-insured patients. • Motivation is mostly low cost.

  9. Problems with International Health Care • Identifying high quality Physicians and Hospitals. • The uncertainty of International Travel (many people have never left the US) • Language barriers. • Liability for Medical Mal Practice. • What if the surgical procedure is unsuccessful?

  10. AMIHP Solutions for International Health Travel • AMIHP has established a network of board Certified Physicians, and accredited hospitals to choose from. • AMIHP handles all the details of International Travel – “we will be with the patient from start to finish”. • AMIHP Physicians are Multilingual, enabling clear and concise communication. • International Mal Practice Insurance can be made available at extra cost but may not be needed due to below. • If a surgical procedure is unsuccessful at an International location AMIHP plans offer two options: (1) Return to the International location for correction or (2) Elect to have the procedure completed in the US at a network facility.

  11. Medical Travel With AMIHP for Most Elective Surgical Procedures • AMIHP Certifies All In-patient Admissions. • In-expensive procedures will be certified for domestic care. • Physically unfit for travel patients will be certified for domestic care. • Procedures and care which cannot reasonably be done internationally will be certified for domestic care. • All other eligible care will be certified at international facilities. • AMIHP International Care Services. • Work with patient to assemble enough health data to enable international physicians to evaluate the suitability of international care and the anticipated procedure. • Provide a checklist of necessary documents for international travel including an updated passport.

  12. Medical Travel With AMIHP for Most Elective Surgical Procedures Cont… • Obtain airline reservations for patient and companion to destination city. • Meet patient and companion at airport of destination city & transport to four star recovery center. • Accompany the patient and companion to initial physician consultation and later to the hospital where surgery is to be performed. • Pick up patient and companion after surgery and deliver to recovery center. • Deliver patient and companion to airport following recovery. • Follow up with patient after return to U.S. for satisfaction survey. Note: Expenses for Airline travel for both the patient and companion, recovery facility charges for room and board, as well as transportation costs in the foreign country will be paid as a medical expense of the plan.

  13. Sample Benefit PlansDesigned • Jet Set Plan 1 • 100/50 PPO with modifications for international medical care. • Jet Set Plan 2 • 90/50 PPO with modifications for international medical care. • Jet Set Plan 3 • Compliments existing self-insured programs with stop-loss and administration provided by AMIHP.

  14. Costs of Surgeries in Costa Rica VS US Medical ProceduresUSACosta Rica Heart Bypass $130,000 $24,000 Heart Valve 160,000 15,000 Angioplasty 57,000 9,000 Hip Replacement 43,000 12,000 Hysterectomy 20,000 4,000 Knee Replacement 40,000 11,000 Spinal Fusion 62,000 25,000

  15. Boston Office • Insurance Plan Development • Insurance Administration • Underwriting • Marketing and Sales • Risk Assessment

  16. Miami Office • Operations Center • Bi-lingual Staff (Spanish/English) • Health Advocate Call Center • Case Management • Triage Medical Services Needed • Doctor to Doctor Communication of patient history and proposed medical services • Provider Relations • Bill and Payment Processing

  17. Medical Providers Qualification Criteria • US Accreditation (preferred) • Extensive Work Experience • Reputation/ Success Rate • Licenses/ Certificates • Education • Medical Schools • Recurrent Training

  18. Our Vision First Two Years of Operation (2008-2009) • 100,000 employee lives covered. • Leader in Southeast United States employer market. • Product offering of primary medical and dental procedures. • Medical procedure volume of $85 million.

  19. Our Vision Next Five Years (by 2013) • 1 million employee lives covered. • Leader in US employer market. • Annual growth of 20% in covered lives. • Product offering covering all medical services. • Medical procedure volume of $850 million.

  20. AMIHP Summary • Substantial cost savings for employer self funded plans. • Employers may pass along some savings to employees. • No disruption of services for most low use of services by employees/dependents. • No sacrifice of quality care. • AMIHP international plan can be offered as an option alongside current plan. • AMIHP coordinates all aspects for a turn key solution through employers, brokers and AMF approved TPA’s.

  21. Website Address WWW.AMIHPLANS.COM

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