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Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on...

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Signature Gap Insurance Product Training
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Page 1: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

Signature Gap Insurance

Product Training

Page 2: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

CurrentHealthcareLandscape

Page 3: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

3 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Risinghealthcarecostsandhealthinsurancereformshaveshakenthingsupforemployers.Asaresult,manyofyourclientsareraisingtheiremployees’out-of-pocketcostsbymovingtohighdeduc7blehealthplans(HDHPs).

Changesinthemarket

Source: PwC 2015 Health and Well-being Touchstone survey

Page 4: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

4 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Risingcontribu7ontocoverage

1 The Kaiser Family Foundation and Health Research & Educational Institute, Employer Health Benefits 2014 Annual Survey

This cost-shi7ing trend has lowered employer costs, but employees are now le7 open to greater financial risks.

Page 5: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

5 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Due to the increases in the cost of care, more and more employees may be skipping or waiCng to seek treatment. When employees do so, they might risk long-term health issues that could cost more over Cme.

Risingcostsmeangreaterliabilityforemployees

Page 6: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

6 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Percentage of consumers with employer-based insurance who took the following acCons in the last 12 months due to cost of care.

Theeffectsofcost-shiGingonemployeehealthcarechoices

Source: PwC Health Research Institute 2015 consumer survey

Page 7: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

WhyyourclientsneedGapinsurance

Page 8: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

8 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Your clients are faced with difficult decisions each year on how to offer affordable healthcare coverage, without subjecting their employees to financial risk. What are the most common ways you reduce your employer costs? • Raising deductibles • Offering higher co-pays • Increasing employee out-of-pocket maximums

ClientChallenges

Page 9: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

9 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

How do employers keep the negative results of deductibles, offering higher co-pays or increasing OOP maximums from impacting their employees? Further, if employees delay seeking appropriate medical care due to the cost, this may negatively impact productivity and ultimately the company’s bottom line.

Howtopreventemployeefinancialrisk

Page 10: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

10 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

The Kemper Benefits Signature Gap insurance plan works with an employer’s current medical coverage to help fill the gaps in their existing primary coverage, while maintaining employee benefits. Address your clients’ needs by offering them the option to enhance their protection and increase their peace of mind.

Whatisagapplan?

Page 11: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

SignatureGapInsurance:AbePersolu7on

Page 12: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

12 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Ournew,enhancedKemperBenefitsSignatureGapsolu7onhelpsfillintheholesleGbehindbyyourclients’primarycoveragewhenhospitalconfinedwithflexiblebenefits:

KemperBenefitsSignatureGapInsurance

•  AbroadrangeofInpa7entHospitalConfinementBenefitamounts

•  Moreoutpa7entcoverageamountop7ons

•  Flexiblebenefitmaximumscombinedwithdeduc7blechoices

•  Physicianofficevisitbenefitrideravailable

•  Guaranteedissue

•  Canbeofferedasvoluntaryoremployer-paid

•  5enrolledlivepar7cipa7onrequirement*

*Varies by state

Page 13: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

13 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

BroadRangeofInpa.entHospitalConfinementbenefitannualmaximumamounts

•  In-pa7entHospitalConfinementBenefit1$1,000-$7,000perperson

1ThemaximumInpa7entHospitalBenefitplusdeduc7bleselectedmaynotexceedtheInsuredPerson’stotalIn-Networkout-of-pocketexposureundertheemployer’smedicalplan.Inmostinstances,theemployerwillselectaGapbenefitmaximumthatislessthanthattotalexposure.

Benefitsataglance

Page 14: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

14 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Outpa.entCoverageAnnualMaximum

•  Outpa7entcoveragebenefit2 PerPerson: 20%-70%oftheInpa7entmaximum

PerFamily: Upto2xtheperpersonmaximum

2TheperpersonOutpa7entBenefitPeriodMaximumselectedbytheemployermaynotexceed50%oftheIn-HospitalBenefitPeriodMaximum.PlansissuedwithanOutpa7entBenefitMaximumgreaterthan$2,500mustincludeaminimumGapBenefitPeriodDeduc7blethatmeetstheCompany’scurrentunderwri7ngguidelines.

Benefitsataglance

Page 15: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

15 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

PhysicianOfficeVisitBenefitRider

PhysicianOfficeVisitBenefitAnnualMaximum

•  PhysicianOfficeVisit(POV)Benefit3PerVisit:$10-$50($10increments)

PerFamily:8,10or12visits

3.PhysicianOfficeVisit(POV)BenefitnotavailablewithHSAcompa7bleplans.

Page 16: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

16 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

FlexibleAnnualBenefitMaximumsCombinedwithDeduc.bleChoices

•  Tradi7onalBenefitPeriodDeduc7bles

Perinsuredperson: None,$250,$500,$750,$1,000 or$1,250

AppliestoInpa7ent&Outpa7entBenefitRiderbenefits

•  Plantailoredtofitemployerneeds

Benefitsataglance

Page 17: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

17 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

HSACompa.bleBenefitPeriodDeduc.bleMinimum4

•  Individual Coverage (Employee only) $1,350

•  Family Coverage $2,700

Benefitsataglance

4TobeHSACompa7ble,theminimumIndividualandFamilyDeduc7blesrequiredbytheIRSmustbeissued.The2016and2017minimumrequireddeduc7bleis$1,300/$2,600.TheDeduc7blemustapplytoboththeInpa7entandOutpa7entBenefitsandmaynotbewaivedforAccidents.ThePhysicianOfficeVisitBenefitRidermaynotbeincluded.

Page 18: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

Plan Details

Page 19: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

19 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

KemperBenefitsSignatureGapInsurance

ProductDescrip7on

Thisisanrenewable,limitedbenefit,groupmedicalexpenseGapproductthatprovidesbenefitsthatsupplementexis7ngemployergroupmedicalplans.Itcoverscertainpor7onsoftheout-of-pocketexpensesthatemployeesandtheirfamiliesincurundertheirMedicalPlan(coinsurance,copays,deduc7bles)uptothemaximumannualbenefitselectedbytheemployer.Itisdesignedtohelpfillgapsinprimarycoverage,suchascopays,coinsuranceordeduc7bles.Thisproductdoesnotpay100%ofout-of-pocketexpenses.Expensesmustbecoveredbytheinsuredperson’smedicalplantobecoveredunderthisproduct.

Page 20: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

20 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

ProductFeatures

•  Benefitsarepayablefor“CoveredCharges,”whicharedefinedastheinsuredperson’smedicalplandeduc7ble,copaymentsorcoinsurance.

•  Allplansincludeinpa7entandoutpa7entbenefits•  Pregnancyiscoveredsameasanysickness•  Usestheprimarymedicalplan’sEOB(explana7onofbenefits)asabasisfordeterminingwhatiscovered

•  PlansmayincludeaGapdeduc7bleop7onifelectedbythegroup•  Designedtobeexemptfromthehealthcareaccess,portabilityandrenewabilityrequirementsofTitleI(HIPAA)relatedtoemployergrouphealthplans

•  IncludesHSAcompa7bleop7ons

•  Guaranteedissue(subjecttoeligibilityrequirements)

•  Par7cipa7onrequirementof5enrolledlives

Page 21: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

21 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

ProductFeaturesandBenefitsAllbenefitop7onsareelectedattheemployergrouplevel.Benefitsarepayableiftheinsuredpersoniscoveredbyamedicalplanandcoveredchargesareincurred.Coveredchargesarethededuc7bles,copaymentsandcoinsuranceamountsthattheinsuredpersonisrequiredtopayunderhisorhermedicalplan.Eachbenefitissubjecttotheterms,condi7ons,limita7ons,exclusions,benefitperiodmaximumsandbenefitperioddeduc7bleincludedinthepolicy. Benefit BenefitOp.on BenefitPeriodMaximums

Inpa.entHospitalBenefit PerPerson $1,000-$7,000

Outpa.entBenefitRider PerPersonPerFamily

20%-70%oftheInpa7entmaxUpto2Xtheperpersonmax

PhysicianOfficeVisit(POV)Benefit

PerVisitPerFamily

$10-$50($10increments)8,10or12visits

Tradi.onalBenefitPeriodDeduc.ble

PerInsuredPerson

None,$250,$500,$750,$1,000or$1,250

Deduc.bleOp.ons(onlyavailablewithTradi7onalDeduc7bleplans)

NoDeduc7ble;appliestoInpa7ent&Outpa7entBenefitRiderbenefits

HSACompa.bleBenefitPeriodDeduc.bleMinimum

IndividualCoverage(Employeeonly)Familycoverage

$1,350$2,700

Page 22: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

22 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Inpa7entHospitalBenefit

BenefitsarepayableiftheinsuredpersonishospitalconfinedundertheregularcareandaPendanceofaphysicianforatleast15hoursduetosicknessorinjuryandtheexpensesarecoveredbyandappliedtotheinsuredperson’smedicalplandeduc7ble,copaymentsorcoinsurance(coveredcharges).Coveredchargesfortreatmentinahospitalemergencyroomandtransporta7onbyambulancetoahospitalduetosicknessorinjuryarealsocoveredunderthisbenefitiftheinsuredpersonishospitalconfinedwithin24hoursofthetreatmentortransport.

Coveredchargesforhospitalconfinementoftheinsuredperson’snewbornchildrenarepayablefromthemomentofbirthun7ldischargedfromthehospital.BenefitsaresubjecttotheIn-HospitalMaximumBenefitshownintheScheduleofBenefits.ThehospitalconfinementmustbeginaGertheinsuredperson’seffec7vedate.In-HospitalMaximumBenefit

•  $2,000-$7,000perinsuredperson,perBenefitPeriodHSAInpa.entMaximumBenefit

•  $2,000-$5,000perinsuredperson,perBenefitPeriodNote:TheIn-HospitalBenefitMaximumplusdeduc7bleselectedmaynotexceedtheinsuredperson’stotalin-networkout-of-pocketexposureundertheemployer’smedicalplan(deduc7ble+coinsuranceandco-pays).Inmostinstances,theemployerwillselectaGapbenefitmaximumthatislessthanthattotalexposure.

Page 23: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

23 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Outpa7entBenefitRider

Benefitsarepayableforcoveredchargesforoutpa7enttreatmentduetoaninjuryorsickness.CoveredchargesaresubjecttotheOutpa7entMaximumBenefitshownintheScheduleofBenefits.CoveredchargesmustbeginaGertheinsuredperson’seffec7vedate.

Thisbenefitincludescoveredchargesfortreatmentinahospitalemergencyroomandtransporta7onbyambulancetoahospitalduetosicknessorinjuryiftheinsuredpersonisnothospitalconfinedwithin24hoursofthetreatmentortransport.Italsoincludescoveredchargesforoutpa7entdurablemedicalequipmentreceivedbytheinsuredperson.

Thisbenefitdoesnotincludeanyexpensesincurredforoutpa7entprescrip7ondrugsoranexamina7onofaninsuredpersonbyaphysicianinthephysician’sofficeorurgentcarefacility.

Outpa.entMaximumBenefit•  PerInsuredPerson:20%-70%ofselectedIn-HospitalMaximumBenefitper

BenefitPeriod•  PerFamily:27mesthePerInsuredPersonOutpa7entMaximumBenefitNote:TheperpersonOutpa7entBenefitPeriodMaximumselectedbytheemployermaynotexceed50%oftheIn-HospitalBenefitPeriodMaximum.PoliciesprovidingOutpa7entBenefitMaximumsinexcessof$2,500mustincludeaGapplandeduc7ble.Theoutpa7entbenefitsareinlieuofanyinpa7entbenefit.Theoutpa7entbenefitdoesnotincludecoverageforanyexpensesincurredforanexamina7on.TheintentoftheOutpa7entBenefitRideristocovertreatment,suppliesandothernon-physicianrelatedoutpa7entcharges,whiletheOutpa7entPhysicianOfficeVisitBenefitRidercoversthephysician’sservicesfortheexamina7onoftheinsuredperson(officevisit).

Page 24: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

24 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Outpa7entPhysicianOfficeVisit(POV)BenefitRider*

Benefitsarepayableforcoveredchargesforaninjuryorsicknessforanexamina7onof

theinsuredpersonbyaphysicianinthephysician’sofficeorurgentcarefacility.CoveredchargesaresubjecttotheOutpa7entPhysicianOfficeVisitMaximumBenefitshownintheScheduleofBenefits.Benefitsarenotpayableforanyotherserviceorsupplyprovidedinthephysician’sofficeorurgentcarefacility,includingbutnotlimitedto,chargesforx-raysandlaboratoryservices.

Outpa.entPhysicianOfficeVisitMaximum•  PerInsuredPerson:$10,$20,$30,$40or$50perphysicianofficevisit•  PerFamily:Uptwoamaximumof8,10,or12visitsperfamilyperbenefitperiodNote:TheintentofPhysicianOfficeVisitBenefitRideristocoverthephysician’sservicesfortheexamina7onoftheinsuredperson(officevisit),whiletheOutpa7entBenefitRidercoverstreatment,suppliesandothernon-physicianrelatedoutpa7entcharges.Benefitsarenotpayableforanyotherserviceorsupplyprovidedinthephysician’sofficeorUrgentCareFacility,including,butnotlimitedto,chargesforx-raysandlaboratoryservicesundertheOutpa7entPhysicianBenefitRider.BenefitPerioddeduc7blesdonotapplytothisRider.ThisriderisnotavailablewithGapplansissuedtosupplementaHighDeduc7bleHealthPlanthatrequiresHSAcompa7bility.

*POVRidernotavailablewithHSAcompa7bleplans

Page 25: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

25 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

Deduc7bleOp7ons

Tradi.onalPerPersonBenefitPeriodDeduc.ble•  PerInsuredPersonperBenefitPeriod:None,$250,$500,$750,$1,000or$1,250

Note:BenefitsarepayableforanInsuredPersonaGertheyhavesa7sfiedthe“perInsuredPerson”deduc7ble

HSACompa.bleIndividualCoverage/FamilyCoverageBenefitPeriodDeduc.ble

•  IndividualCoverage(EmployeeOnly):$1,350•  FamilyCoverage:$2,700 Note:Ifoneormoredependentsarecoveredundertheemployee’scer7ficateofinsurance,theen7reFamilyCoverageDeduc7blemustfirstbemetbeforeanybenefitswillbepaidforanyinsuredperson.TheFamilyDeduc7blemaybesa7sfiedbyoneormoreinsuredpersons.Thistypeofdeduc7bleisrequiredforHighDeduc7bleHealthPlans(HDHP)thatareHSAcompa7ble.TobeHSAcompa7ble,theminimumIndividualandFamilyDeduc7blesrequiredbytheIRSmustbeissued.Thededuc7blemustapplytoboththeInpa7entandOutpa7entBenefits.

Deduc.blesapplyto:•  BoththeInpa7entHospitalBenefitandtheOutpa7entBenefitRider

Deduc.blesdonotapplyto:•  Outpa7entPhysicianOfficeVisitBenefitRiderBenefits

Page 26: Signature Gap Insurance - Kemper Health Gap PowerPoint.pdfSignature Gap Insurance Product Descrip7on This is an renewable, limited benefit, group medical expense Gap product that

26 Thisdocumentisprovidedforinforma7onalpurposesonlyanditscontentsarenotintendedtosupersedeprimarysourcematerials.

PoliciesmarketedbyReserveNa.onalInsuranceCompany,aLifeandHealthCompany.PoliciesIssuedbyFidelitySecurityLifeInsuranceCompany(FSL)notaffiliatedwithKemperCorpora7on.FSListheinsurancecompanyunderwri7ngtheKemperBenefitsSignatureGapplan.FSLislocatedinKansasCity,Missouri,andhasbeenrated“A-”(Excellent)basedonananalysisoffinancialposi7onandopera7ngperformancebyA.M.BestCompany,anindependentanalystoftheinsuranceindustry.Forthelatestra7ng,accesswww.ambest.com.Incaseofconflictbetweenthispresenta7on,thecer7ficateofinsuranceandtheMasterPolicy,thelanguageoftheMasterPolicyisoverriding.AsampleMasterPolicyisavailableuponrequest.Pleaseverifystateavailabilityatthe7meofsale.GroupMasterPolicyNo.MG-158/MG-159/MG-160,PolicyFormNo:M-9134Formnumbersmayvarybystate.KemperBenefits,kemperbenefits.com,ispartofKemperCorpora7on(NYSE:KMPR),adiversifiedinsuranceholdingcompany,withsubsidiariesthatprovideanarrayofproductstotheindividualandbusinessmarkets.TheKemperBenefitsSignatureGapinsuranceplanisnot“minimumessen7alcoverage”underthefederalAffordableCareAct.NeitherReserveNa7onalInsuranceCompany,FSLnortheiragents,representa7ves,associatesoremployeesrenderlegalortaxadvice.Theemployershouldseektheexpertassistanceofitsownlegalortaxadviser.ThisisonlyasummaryofproductsandservicesofferedbyFSL.Actualofferingsmayvarybygroupsizeandotherunderwri7ngconsidera7ons,andaresubjecttostateinsurancelaw,andthebenefits/provisionsasdescribedmayvaryduetosuchlaw.Allproductsaresubjecttotheterms,condi7ons,limita7onsandexclusionsofthespecificpolicy.Pleaseseethespecificpolicyandcer7ficatesfordetails.Policiesarenotavailableinallstates.©2016.Allrightsreserved.

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