Interim Coverage Presentation Title Sales Training · 2018. 12. 19. · Data iSight will negotiate discounts on covered services. 5 Proprietary & Confidential For training purposes

Proprietary & Confidential For training purposes only. Not for public distribution or solicitation. PPT Interim Coverage AZBlue 1118

Presentation TitleInterim Coverage

Sales Training

For training purposes only. Not for public distribution or solicitation.

Proprietary & Confidential For training purposes only. Not for public distribution or solicitation. PPT Interim Coverage AZBlue 1118 2 Proprietary & Confidential For training purposes only. Not for public distribution or solicitation. PPT Interim Coverage AZBlue 1218

Why Sell Interim Coverage?

Need: Product for individuals and families:

Who won’t receive a subsidy or cannot afford an Affordable Care Act (ACA)

compliant plan

Who missed open enrollment

For whom high deductibles or narrow networks are a significant problem

Who have limited alternative options due to availability

Compensation: Great income potential both during and outside open

enrollment - the Interim Coverage selling season starts now!


Interim Coverage Plans

Interim Coverage Interim Coverage Plus

Office Visit Copay

Once the visit limit is exceeded, additional

covered office visits are subject to plan

deductible and coinsurance

$50 copay per person per visit, subject to limits below:

• 30-90 day coverage period: not to exceed one visit

Deductible Options

(maximum three per family)

$2,500

$5,000

$10,000

Coinsurance Options 80% 70% 50% 70% 50%

Out of Pocket Maximum

(Does not include the plan deductible,

precertification penalties or expenses not

covered)

$4,000 $6,000

$5,000

$6,000 $10,000

$10,000

Pre-existing conditions covered? NO

Up to $25,000 of billed charges per

person per policy period for certain

pre-existing conditions.

Policy Maximum $2 million


Interim Coverage Overview

Interim Coverage and Interim Coverage Plus are short term medical

insurance plans which provide coverage during life transitions

These plans do not qualify as Minimum Essential Coverage under the ACA

Premiums may be lower than ACA plans as these plans require medical

underwriting, provide more limited benefits and do not cover expenses

related to pre-existing conditions

Coverage Plus provides limited benefits for certain pre-existing

conditions

Interim Coverage and Interim Coverage Plus are medically underwritten.

Policy issuance is not guaranteed

Use any provider in the United States for covered services

Data iSight will negotiate discounts on covered services


Coverage Age Eligibility

At time of application:

Primary insured up to age 65

Must apply before age 64 and 11 months

A spouse between the ages of 18 up to age 65

Must apply before age 64 and 11 months

Dependent children under the age of 26

Child-only plans are available for children ages 2-17


Coverage Duration

Coverage can be purchased in durations of 30-90 days

May cancel at any time

Payment Methods

Monthly pay via credit card

Coverage may be rewritten – If the customer reapplies, new pre-

existing condition limitations and deductibles/out-of-pocket will apply.


Underwriting Guidelines

Not eligible for coverage if:

Eligible for Medicare or Medicaid

Applicant or any immediate family member, whether or not applying for coverage, who is pregnant,

an expectant parent, in the process of adopting a child or undergoing fertility treatment.

Over 300 pounds (male) or 250 pounds (female) or undergone weight loss or bariatric surgery

Has been diagnosed or treated for Acquired Immune Deficiency Syndrome (AIDS) or other Immune

Disorders

Within the last 5 years if an applicant or any person applying for coverage received an abnormal test

report, medical advice, or diagnosis, care or treatment recommended or received for:

– Stem cell transplant

– Heart disorder, heart attack, coronary artery disease or circulatory system disorder (includes by-

pass or stent surgery or carotid artery disease/surgery

– Stroke, seizures disorder or other neurological disorder

– Cancer or tumor OR taking medication to prevent recurrence of cancer or tumorous growth

– Paraplegia, quadriplegia or multiple sclerosis

– Emphysema, chronic bronchitis or COPD (chronic obstructive pulmonary disease)

– Interim coverage – Insulin Dependent Diabetes; Interim Plus - Diabetes

– Kidney disorder other than stones and/or liver disease

– Degenerative arthritis (degenerative disc disease, herniated disc, rheumatoid or psoriatic

arthritis or degenerative joint disease)

– Alcohol or drug abuse or dependency OR chemical dependency


Expenses Not Covered (partial listing)

Pre-existing conditions

A pre-existing condition is defined as any medical condition or sickness for which medical advice, care, diagnosis,

treatment, consultation or medication was recommended or received from a doctor within twelve months immediately

preceding the covered persons’ effective date of coverage; or symptoms within the twelve months immediately prior to

the coverage that would cause a reasonable person to seek diagnosis, care or treatment will not be a covered benefit.

Consultation means evaluation, diagnosis, or medical advice was given with or without the necessity of a personal

examination or visit.

Outpatient prescription drugs

Exception: drugs administered during a covered inpatient confinement are covered

Pregnancy or childbirth except for the complications of pregnancy

Expenses for the treatment of mental illness or nervous disorders, alcoholism or drug

addiction or chemical dependency

Expenses paid under workers’ compensation insurance or automobile insurance

Expenses resulting from participation in interscholastic or collegiate sports

Claims arising from participation in school or organized competitive sports or any high-

risk sport, including riding an all-terrain vehicle, snowmobile or go-cart are not covered

Note: This is a partial listing only. Refer to the policy for complete provisions, exclusions and details.


Accessing the Producer Portal

Access the IHC website:

https://www.myihcgroup.com/

Click on Producers at the top of the page

to get to the producer portal account login

Information found on the producer portal:

Quoting and Enrollment

Agent Connectivity Tools (ACT)

Sales Dashboard

Marketing Materials

Message Center

Contact Information

Go directly to the portal by clicking here:

IHC Marketplace Account Login

https://www.myihcgroup.com/

https://producers.ihcmarketplace.com/Account/Login


Quoting and Application

www.myihcgroup.com

Quote and assist customers online through the application process

Email proposals with application links for clients to complete

application on their own

E-signatures are acceptable

View brochures

View product information

http://www.myihcgroup.com/


After Application Submission

Access your activity reports in broker portal

Case Status

Lapsed Cases

Quoting Activity

View Customer ID cards and applications

Customer can download through customer portal at

http://www.loomisco.com/healthxgateway/member/ within 24-48 hours of

application submission

Welcome kit, including policy and durable ID card are sent to the

policyholder via regular mail to the customer within 7-10 days of

application submission

http://www.loomisco.com/healthxgateway/member/


You must be contracted with IHC Carrier Solutions (IHCCS) through the BCBSAZ

relationship in order to sell Interim Coverage and Interim Coverage Plus

• Contracting is available at the Resource Center

www.ihcspecialty.com/azblue/

• Click “Get Contracted”

You must have an active Health license in AZ and be contracted with IHCCS

Appointment is completed after the first application submission

Getting Started


Once contracted, agents receive two emails from IHC:

A welcome email with the assigned agent number (BCBSAZ agent ID

numbers start with the numbers 05)

An email from “[email protected]” with the subject line, “New

Account Created.” This email contains instructions on how to log in,

activate an account and set a unique password

If account is not set up within 48 hours, the password will need to be

reset. This can be done via the login page.

New agents to IHC or BCBSAZ, or agents who are currently contracted

with IHC (but not BCBSAZ) and wish to market and sell these offerings

must complete the contracting process

The IHC assigned producer ID # determines the products available to be

marketed and sold

Getting Contracted


Once Contracted with IHCCS

Your welcome email will also provide you with a unique link to quote and

enroll your clients.

Bookmark your link for easy continued access

This personalized link will ensure that you receive credit for your

sales; do not share it with other agents.

Publish and access your link with the “Link Creation Tool” at any time

Post your link on your website

Place a banner in your email signature

Send an email to a client which enables self-enrollment


Important Information

This training presentation is for agents only, and not intended for client solicitation. It provides a

brief description of the important features of Interim Coverage and Interim Coverage Plus.

Brochures are available and may be provided as a supplement to this training presentation. This

presentation and the provided brochures are not a policy and only the actual policy provisions

will control. The policy itself sets forth in detail the rights and obligations of both the policyholder

and the insurance company. It is, therefore, important that policyholders READ THE POLICY

CAREFULLY.

This coverage is not required to comply with certain federal market requirements for health

insurance, principally those contained in the Affordable Care Act. Be sure to check your policy

carefully to make sure you are aware of any exclusions or limitations regarding coverage of pre-

existing conditions or health benefits (such as hospitalization, emergency services, maternity

care, preventive care, prescription drugs, and mental health and substance use disorder

services). Your policy might also have lifetime and/or annual dollar limits on health benefits. If

this coverage expires or you lose eligibility for this coverage, you might have to wait until an

open enrollment period to get other health insurance coverage. Also, this coverage is not

“minimum essential coverage.” If you don’t have minimum essential coverage for any month in

2018, you may have to make a payment when you file your tax return unless you qualify for an

exemption from the requirement that you have health coverage for that month.


About Blue Cross and Blue Shield of Arizona

Blue Cross and Blue Shield of Arizona does not underwrite, insure or administer the insurance plans described on this site. The insurance plans

described on this site are underwritten by Independence American Insurance Company, a member of The IHC Group. There is no ownership affiliation

between Independence American Insurance Company, The IHC Group or Blue Cross and Blue Shield of Arizona. Independence American Insurance

Company and The IHC Group are independent companies that underwrite, insure and/or administer the insurance plans described on this site. Blue

Cross and Blue Shield of Arizona contracts with The IHC Group to make the insurance plans described on this site available to customers who wish to

purchase a short term medical product.

About Independence American Insurance Company

Independence American Insurance Company is domiciled in Delaware and licensed to write property and/or casualty insurance in all 50 states and the

District of Columbia. Its products include short-term medical, hospital indemnity, fixed indemnity limited benefit, group and individual dental, and pet

insurance. Independence American is rated A- (Excellent) for financial strength by A.M. Best, a widely recognized rating agency that rates insurance

companies on their relative financial strength and ability to meet policyholder obligations (an A++ rating from A.M. Best is its highest rating).

About The IHC Group

Independence Holding Company (NYSE: IHC), formed in 1980, is a holding company that is principally engaged in underwriting, administering and/or

distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries

(Independence Holding Company and its subsidiaries collectively referred to as “The IHC Group”). The IHC Group includes three insurance companies

(Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance

Company), and IHC Specialty Benefits, Inc., a technology-driven full-service marketing and distribution company that focuses on small employer and

individual consumer products through general agents, telebrokerage, call centers, advisors, private label arrangements, independent agents, and through

the following brands: www.HealtheDeals.com; Health eDeals Advisors; Aspira A Mas; www.PetPartners.com; and www.PetPlace.com.

About The Loomis Company

The Loomis Company (Loomis), founded in 1955, has been a leading Third Party Administrator (TPA) since 1978. Loomis has strategically invested in

industry leading ERP platforms, and partnered with well-respected companies to enhance and grow product offerings. Loomis supports a wide spectrum

of clients from self-funded municipalities, school districts and employer groups, to large fully insured health plans who operate on and off state and

federal marketplaces. Through innovation and a progressive business model, Loomis is able to fully support and interface with its clients and carriers to

drive maximum efficiencies required in the ever evolving healthcare environment

About the Companies

http://www.petplace.com/


Please visit

www.ihcspecialty.com/azblue/

to get contracted

Thank You!

Documents

Interim Coverage Presentation Title Sales Training · 2018. 12. 19. · Data iSight will negotiate discounts on covered services. 5 Proprietary & Confidential For training purposes