Medical GAP Coverage

1. PLEASE MUTE YOUR PHONE THANK YOU! Oberlin Marketing Fort Wayne, IN (260) 486-9739 Medical GAP Coverage

3. What is GAP and where did it come from?

4. Why Now? The following slides give a great visual effect of the direction our group health market is headed. In order continue positive growth, agents and their clients must be willing to adapt to the changes.

5. This slide shows how in just over 10 years, the cost of healthcare has risen almost 175%, with a good portion of that increase coming in the last 5 years.

7. Benefit Features and Options • Inpatient Hospital Benefit • $500 - $10,000 annual maximum per insured person. • The max for an insured’s family is 3x the above coverage. • * This coverage is for inpatient stays, inpatient surgery, in-hospital physician charges, and emergency room treatment if admitted to hospital. • Outpatient Hospital Benefit • 40%-70% of the inpatient hospital benefit per insured. • The family benefit is 3x this coverage as well. • * This coverage is for services rendered in hospital emergency room, hospital outpatient facility, outpatient surgical facility, or MRI facility. Physician Office Visit - $10-$50 per visit per insured person; 1-3 visits per year. Ambulance Benefit (Accident Only) - $50-$350 per person. 3x the benefit per family.

8. How does this help you? • Retention – When renewal cases have increases, GAP gives the agent another option to help renew the case. • New Business – When an agent can bring a fresh idea to a prospect that they have never seen before, it differentiates that agent from the competition. If the agent can show the employer a savings and keep the out of pocket expenses down, the odds of winning that case are much higher. • Commission – Agents and agencies will earn commissions when a GAP is sold. This is a way to earn additional money on top of the commission earned in the sale of the group case itself.

9. Annual Commisions: Major Medical: $7,560 (based on $30 per head) CMB Gap: $3,631 (48% extra commission)

10. Pros and Cons Against the Competition • No deductible with our gap plan • Outpatient benefit can go all the way up to $7,000 • Rates are extremely competitive. • Will pay benefits for deductibles, coinsurance AND copayments covered by the health benefit plan. • Family limit is 3x the insured benefit. (Opposed to 2x) • Guaranteed Issue with no pre-ex.

12. This group switched to a $10,000 deductible plan with copays and per occurrence deductibles . They implemented a very common HRA plan that will pay a max of $8,500. The employees have to satisfy a $1,500 deductible before any benefit is paid out. The below chart shows why switching to a Crescent Medical Bridge Gap Plan may be a better option. Claim example using a typical shoulder injury followed by an MRI and surgery.

13. Quoting Procedure Gena Gilleo – (800) 486-9739 • Name and brief description of group. • Census with name, birthdate, and coverage level. • Copy of current and renewal plan including rates. • List of several alternate plans with higher deductibles and lower premiums. • We also need to know what state the business is headquartered in.

14. For more information:

15. Sources: • Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005-2001 • Sally Pipes, President of the Pacific Research Institute. “Forbes Magazine” 10-10-2011