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Comprehensive benefits at Affordable prices...
What a Smart Solution!
New and Improved Product!
Lower Competitive Retail Pricing
New Plan Names- Three accident medical amounts to choose from: $2500, $5000 or $10,000
Two Tiered Pricing- Individual and Family
Individual Agent Enrollment Links
$100 deductible
Available in 32 states
Entire retail price is commissionable (no non-commissionable association fees)
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Client
◦ Complement major medical coverage
◦ Fill the need for Accident Medical Expense insurance
◦ Covers the deductible
◦ Provide deep discounts for health related and everyday services
The Smart Solution Plus was designed to:
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Agent ◦ Fill the commission gap created by healthcare reform
This series offers an amazing opportunity for you, including:
◦ Best in the industry first and renewal commissions!◦ 100% of the monthly membership fee is commissionable!◦ Commissions paid weekly!◦ Online member enrollment!◦ Now with individual agent enrollment links!◦ No appointment fees or cost to sell it! ◦ Live and webinar trainings available!
The Smart Solution Plus was designed to:
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State Approval Map
MT
WY
ID
WA
OR
NV
UT
CA
AZ
ND
SD
NE
CO
NM
TX
OK
KS
AR
LA
MO
IA
MN
WI
IL IN
KY
TN
MS AL GA
FL
SC
NC
VAWV
OH
MI
NY
PA
MD
DE
NJ
CTRI
MA
ME
VT
NH
AK
Revised 2-1-2012
HI
MI
DC
Plan Overview www.SmartSolutionPlus.com
Entire monthly fee commissionable!!
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Accident Medical Expense
Accidental Death and Dismemberment
Insurance Benefits
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Rating of A+ (Superior)
$2,500/$5,000 /$10,000 Accidental Medical Expense
Underwritten by Zurich –A+ rated carrier
Must receive treatment within 90 days of the covered accident◦ All eligible medical expenses must occur within 52 weeks of the covered accident.
Eligible medical expenses are those related to hospital room and board, general nursing care, surgery under general anesthetic, laboratory tests, x-rays, anesthesia, prescription drugs, therapeutic services and supplies, hospital emergency care, doctor’s visits (inpatient and outpatient), and dental treatment for injury to natural teeth.
Subject to a $100 deductible - Benefits and deductible apply per incident per covered person
In all states the Accident Medical Expense benefit is payable on an excess basis. The payable amount will be reduced by amounts already paid or payable by any Other Plan. It will pay the resulting amount less the Deductible.
FOR EXAMPLE: You have a major medical health insurance policy with a $5000 deductible and you have purchased the 5000 Family plan for $54.95.
You or your dependent were injured in a covered accident and your bills totaled $6,000 dollars.
Your Health Insurance should cover $1000 and charge $5000 towards your deductible.
Your Smart Solution Plus plan would pay you $4,900. ($5000 minus your $100 deductible per incident)
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Benefit Summary
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$5,000/$10,000/$20,000 Accidental Death and Dismemberment
Underwritten by Zurich A+ rated carrier
Death or dismemberment must occur within 365 days of the covered accident
If you, or a family member, are involved in a covered accident and sustain a covered injury which causes death or dismemberment, member/ or beneficiary is eligible for the Principle Sum Payment.
As of 2-1-2012 Spouse and dependents are covered at a the full elected benefit amount. (until now they were covered at a reduced amount)
To view Zurich Certificate of Coverage (listed in the member guide):◦ Go to www.DownloadCertOnline.com◦ State: Select the state in which you purchased coverage.◦ Group Code: CAUSA◦ Certificate Number: MCB 4380415◦ Security Number: 3914724
Benefit Summary
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Primary member must be at least 18 years old◦ No maximum age limit
Reduction Schedule begins at age 70
There is NOT an exclusion or limitation for:◦ Organized Sports◦ ATV ◦ Skiing / Snowboarding◦ Deep sea diving accident◦
Additional info- AME/ADD
The Principal Sum will be reduced based on the Covered Person's previous Principal Sum per the following schedule shown below for
Your attained age: Age at Date of Loss
Percent of Original Principal Sum
Age 70-74 65%
Age 75-79 45%
Age 80-84 30%
Age 85 or over 15%
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24 Hour Nurse Line
24 Hour Physician Access – AmeriDoc
Medical Discounts:◦ Dental ◦ Vision◦ Prescription◦ Hearing
Health Related Benefits
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24-Hour Nurseline
Call the 24-Hour Nurse Line 24 hours a day, 7 days a week whenever you want, as often as you want. It’s fast, it’s convenient, and it’s always confidential.
You can get information about:◦ Symptoms◦ Treatment Options◦ Medical Terms◦ Procedures◦ Disease◦ Medications◦ Referrals to support groups or other organizations
Listen to Audio Messages◦ By simply calling the toll-free number you can listen to the health
information library’s recorded messages on a wide variety of health and well-being issues.
Benefit Summary
Benefit Summary
AmeriDoc – 24-Hour Physician Access
AmeriDoc is an affordable solution to the challenge of healthcare access. We provide you and your family with round-the-clock access to U.S.-based, licensed physicians for telephone, video and email medical consultations.
Regardless of the time or your location, you can connect with a physician in real-time for general information, review your medical records, answer questions, diagnosis of common conditions, recommend treatment plans, and prescribe non-controlled medications when appropriate.
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* in Oklahoma, Informational Consultations are available by Medical Doctors (M.D.s) and Doctors of Osteopathy (D.O.s); and Diagnostic Consultations are
available only by Doctors of Osteopathy (D.O.s).
Benefit Summary
AmeriDoc – 24-Hour Physician Access
AmeriDoc Services include:
Information Consultation: If you have a medical question that only a doctor can answer, physicians are available for unlimited general advice and recommendations regarding a range of routine medical conditions.
Diagnostic Consultations: When you need more than basic medical advice and require a
thorough examination, including prescription medication when necessary, diagnostic consultations are always available to you.
Electronic Medical Records: A personal health profile that stores your medical history, consultations, doctor’s notes and follow up discussions. The information submitted is secure and confidential, and is available at any time. This record can also be shared with your primary care physician for continued care.
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Benefit SummaryAmeriDoc – 24-Hour Physician Access - Continued
It’s like having a doctor in the family. AmeriDoc provide members with:
◦ Physicians provide specific answers to medical questions, discuss symptoms, recommend treatment options, diagnose many common conditions, and prescribe medication when appropriate.
◦ Save time and money by eliminating unnecessary trips to the doctor’s office, improving access to preventative care.
◦ 100% secure and HIPPA compliant
◦ Reduced absenteeism, fewer sick days by eliminating unnecessary office visits
◦ Everyone is accepted- No denials based on pre-existing conditions.
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Dental Savings
Members and their immediate family receive reduced costs on their dental needs.
Members can save 15% to 50% on dental care through our Dental network of over 60,000 dental practice locations, including both general dentists and specialists.
Members choose any dentist they want within the network of participating dentists across America. You can also change dentists within the network at any time for any reason.
Members have immediate access within the network.
There is no limit to the number of visits a member and their immediate family can have!
Benefit Summary
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Dental Savings ExamplesBenefit Summary
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Sample Plan Savings for ZIP code IL 60173 (savings can vary by zip code)
ADA Code Procedure Description Usual Fee 1Discounted Fee (for
Plan Members) 2 Member SavingsSavings
Percentage
D0120 Routine 6 Month Check-Up $57 $21 $36 63%
D0150 In Depth Check-Up $99 $31 $68 69%
D0210 Full Mouth X-Rays $144 $60 $84 58%
D0274 Four Bitewing X-Rays $70 $27 $43 61%
D0330 Panoramic Film $122 $47 $75 61%
D1110 Adult Teeth Cleaning $102 $47 $55 54%
D1120 Child Teeth Cleaning $75 $32 $43 57%
D1351 Protective Sealant / Tooth $61 $27 $34 56%
D2330 1 Surface White Filling for U or L Front Tooth $175 $61 $114 65%
D2752 Single Crown - Porcelain on Noble Metal $1,162 $531 $631 54%
D2950 Core Build-Up With Pins $296 $96 $200 68%
D3310 Root Canal Treatment - Front Tooth $826 $316 $510 62%
D4341 Perio Scaling and Root Planing (Per Quadrant) $271 $101 $170 63%
D5110 Full Upper Denture $1,855 $759 $1,096 59%
D6210 Tooth Replacement Part of Permanent Bridge $1,197 $546 $651 54%
D7140 Single Tooth Removal - Simple Extraction $197 $56 $141 72%
Vision Savings
Save 35% off normal retail prices on frames (complete pair) and 20% off lenses and lens add-ons. Visit participating retailers such as LensCrafters, EyeMasters, Pearle Vision and other independent vision providers! In all, there are more than 45,000 providers in over 21,000 locations to choose from.
Benefit Summary
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Prescription Savings
You will now save an average of 31% off the retail price of generic drugs and 15% off the retail price on brand name drugs at retail pharmacies.
The retail pharmacy network includes more than 60,000 national and regional chain pharmacies such as CVS, RiteAid, Walgreens, Albertsons, Kroger, Wal-Mart, Target, Safeway and more!
Mail Order Direct- Save an average of 50% on select generic medication when ordering through the mail. The Mail Order Direct program lets you purchase a 90-day supply of select medications for a low, fixed price through CVS Caremark Mail Service Pharmacy. Plus, enjoy free standard shipping and handling!
Studies show that 25% of prescribed prescriptions are not filled because of the cost.
Benefit Summary
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Hearing
Newport Audiology Centers is one of the nation’s leading providers of audiological and hearing-aid services with a network of more than 2,500 full service centers. All of the latest digital technologies and models are available through this program, including Completely-In-the-Canal, In-the Ear and Behind-the-Ear models.
In order for members to receive their savings benefits, they must call 877-412-1384 to schedule an appointment. Members will then be directed to the closest location for their complimentary audiological (hearing) evaluation.
Highlights◦ 35% discount off Newport Audiology’s hearing aid prices ◦ Two year supply of hearing aid batteries with purchase ◦ Complimentary initial audiological (hearing) evaluation ◦ Two year manufacturer’s warranty, including a one-time replacement for loss or damage ◦ Unlimited follow-up visits during the useful life of the hearing aid for cleaning and check ups ◦ 100% Service Satisfaction Guarantee during the first 60 days ◦ A complimentary audiological (hearing) evaluation every two years
Benefit Summary
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Roadside Assistance
Dining, Shopping and Entertainment
Lifestyle Benefits
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Benefits can be used by any family member
Roadside Assistance
Whether you have a flat tire, dead battery or you lock your keys in the car, emergency roadside assistance is just a phone call away. Members simply call the toll-free dispatch number for discounted roadside assistance.
Members can call Member Services, 24-hours a day, seven days a week anywhere in the United States and Canada in the event they have car trouble. Spanish speaking representative always available.
Qualified service assistants will be immediately dispatched to the member.
Members save money on the service because they pay the special commercially negotiated rates for the service performed.
Members will have the following services with this benefit:◦ Towing◦ Flat-Tire Change◦ Fuel/Fluid Delivery◦ Jump Start◦ Lock-out Assistance
Benefit Summary
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Everyday Savings – Online Dining and Shopping Discounts
Save up to 50% off on things you need everyday at thousands of merchants nationwide!
Grocery : Save on the things you buy most! Simply print coupons to save at your favorite grocery stores!
Shopping: Enjoy online savings at more than 30,000 retailers!
Dining: Save on fast food, casual dining, and fine dining at over 60,000 participating restaurants!
Movies: Discover great deals on DVD rentals and movie passes!
Auto Services: Save up to 50% on auto services and repair including oil changes, routine maintenance and bodywork, and emergency repairs!
Rental Cars: Members-only savings are available at over 8,000 car rental locations!
Recreation: Enjoy your favorite activities and save money! Members enjoy savings at sporting events, amusement parks, and more!
Benefit Summary
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Everyday Savings – Samples Dining only:
Benefit Summary
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Everyday Savings ExamplesBenefit Summary
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One time non commissionable $5.00 Enrollment Fee
Client credit card will be charged for the 1st month + Enrollment fee within 48 hours of signing up
Going forward the client is charge on their Insurance effective date (either the 1st or 15th)
Members who sign up between:◦ the 1st and 14th , the insurance is effective on the 15th ◦ the 15th to end of month, the insurance is effective on the 1st
◦ All other benefits can be used 3 days after signing up
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Additional Information
Importance of entering the members email address during the enrollment process.
The member is immediately emailed a temporary member ID card which allows them to use their plan prior to receiving their member guide.
Member guides are taking right at two weeks to be delivered.
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Additional Information
Website◦ www.SmartSolutionPlus.com
Member Services in Irving, TX◦ (866) 726-9673◦ Monday – Friday ◦ 7am to 7pm CST◦ 75% Bilingual – English and Spanish
Information and Assistance
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Melissa HopkinsAssistant Vice President, National Sales
Access Plans USA4929 W. Royal Lane, Suite 200
Irving, Texas 75063972-915-3238 office972-322-5767 cell
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