confidential property of unitedhealth group. do not distribute or reproduce without the express...

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.

UnitedHealthcare®Underwritten By Golden Rule

This presentation currently excludes the marketing states of: CT, DE, GA, KS, KY, LA

Not For Consumer Use36256-0606 All Gen 21 States and Georgia

Strengthen your product portfolio with affordable health insurance plans

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Today’s Agenda

Evolution of Golden Rule, A United Healthcare Company

Product Portfolio and Competitive Rate Comparisons

Network Size and Strength

Ease of Doing Business

Value Added Benefits

Setting Ourselves Apart From the Rest

E-Store: Online Quoting and Application Submission

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Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.3

Why Golden Rule?

Leader in the individual and family market Experience and expertise spans 60 years Pioneer of consumer driven health care solutions Strong financial ratings*

Rated A by A.M. Best Rated A+ by Standard & Poor

*These ratings are an indication of financial strength and stability

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Over 3.5 million claims processed in 2006!

Over 14,000 claims processed per work day

Over 2.2 million dollars paid out per work day!

90% are processed in 10 working days or less!99% benefit accuracy rate!

Actual health claims results 2006

Resolving Claims

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Rate Reduction for New Business

% Population >= 5% rate decrease 93.47%



Pennsylvania 5% - 23%

Michigan Up to 19%

Illinois 5% – 15%

Indiana 5% - 14%

Maryland 10%

Missouri 5%

Iowa 5% - 7%

Oklahoma 5% - 12%

South Carolina Up to 7%

Texas 5% – 20%

Tennessee 14% - 15%

Nebraska 5%

Arizona 5% - 19%

Ohio 5% - 18%

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1 FL

2 GA

3 TX

4 OH

5 MI

6 MO

7 AZ

8 CO

9 PA

10 WI

11 MD

12 CT

13 VA

14 SC

15 NC

16 AL

17 LA

18 IL

19 TN

20 OK

Top States By 2007 Production

Most Competitive

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Our goal is to provide you with a choice of health plans designed to fit your

clients’ needs at a price they can afford.

UnitedHealthcare, Underwritten by Golden Rule

Today we’re positioned to be your

go-to-carrier for all plan types in

the individual health market!

Product Portfolio

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HSA 100® – Our comprehensive HSA HSA Saver® – More limited benefits and priced

20-40% less

Qualified HSA Plans give clients the option to establish a Health savings Account:

Optional Benefits Available with HSA Plans

$5 Million Lifetime Maximum Benefit Term Life Benefit

Enhanced Preventive Care Benefits Package

HSA Hospital Indemnity Rider

Health Savings Accounts (HSA)

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HSA 100

Who does the HSA 100® fit?

Those who are willing to trade low deductible health insurance for higher deductible plans Those interested in saving money on premium Those who prefer comprehensive coverage

Comprehensive Coverage• 100% after the deductible for all covered expenses including:

Doctor office visits Rx coverage In hospital patient services Out patient services Preventive mammogram, Pap Smear, PSA Testing

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HSA Saver®

HSA Saver – our most affordable HSA plan

Priced 20-40% less than HSA 100®

Limited Coverage• Outpatient doctor visits - not covered• Outpatient Rx – not covered• Outpatient X-ray and lab – (covered if within 14 days of surgery or confinement)

Coverage provided for the more costly expenses• Inpatient hospital• Inpatient Rx• Outpatient surgery, MRI, CAT Scan, chemotherapy, radiation treatment,

hemodialysis

Coverage provided for Preventive • Mammogram, Pap Smear, PSA Testing

Same deductible

choices as HSA 100

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Monthly Base Premium Comparison

Golden Rule Golden Rule

HSA 100® HSA Saver®

$5,800 Ded; 100%

$5,800 Ded; 100%

$156.86 $122.55

HSA Saver® (catastrophic)

vs.

HSA 100® (comprehensive)

Premium based on preferred health status, Rx copay. Premium based on January 07 effective date. Each plan has its own benefit design and other characteristics not presented here.Not For Consumer Use

Dublin, OH 430 21% Savings

Husband & Wife, aged 40

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Exante Bank

• Wholly owned subsidiary of UnitedHealth Group• Crediting 4% interest rate*• FDIC insured account balances• Investment opportunities • HSA pre-paid debit card or checkbook• Easy online account management

* Rate as of 6/1/06; subject to change

Prompt customer service

Exante Bank

866-234-8913

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High Deductible Plans

• High Deductible Plans (non-HSA qualified)

Plan 100® – our simplest plan

Plan 80SM – similar to Plan 100 but with 80/20 coinsurance

Saver 80SM – our most affordable plan

Optional Benefits Available with High Deductible Plans


Prescription Drug Card Benefit First-Dollar Accident Benefit


Maternity Benefit

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• Plan 100® * - our simplest plan

Choose a Plan Deductible

• 1,500, $2,500, $3,500, $5,000

100% after the deductible

• Doctor office visits

• Rx coverage

• Preventive care

• In hospital patient services

• Out patient services

Max of two deductibles per family, per calendar year

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• Plan 80SM* - similar to Plan 100® but with 80/20 coinsurance 15 - 25% less premium than Plan 100 80/20 to $15,000 coinsurance, then 100% Same deductibles as Plan 100

• Saver 80SM – our most affordable plan 30 - 40% less premium than Plan 100 80/20 to 15,000 coinsurance, then 100%

Limited Coverage• Outpatient doctor visits - not covered• Outpatient Rx – not covered

Coverage provided for the major (catastrophic) expenses

Hemodialysis, radiation, chemotherapy, and organ transplant drugsSurgeon, assistant surgeon and facility feesCAT Scans, MRIsEmergency room fees

Saver 80 Deductibles

$500

$1000

$1500

$2500

$3500

$5000

Plan 80 Deductibles

$1500

$2500

$3500

$5000

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Premium based on preferred health status, Rx copay. Premium based on January 08 effective date.

Sarasota, FL - 342

33% Savings

Husband & Wife, aged 35 with two children

Golden Rule

Plan 100 Plan 80 Saver 80

$2500 Deduct

100%

$2500 Deduct

80 / 20%

$2500 Deduct

80 / 20%

$262.79 $228.39 $175.97

$1500 Deduct 100%

$1500 Deduct

80 / 20%

$1500 Deduct

80 / 20%

$323.39 $279.17 $213.65 34% Savings

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Copay Plans

• Copay Plans Copay SelectSM – our most benefit rich plan with excellent preventive care

benefits

Copay SaverSM – our most affordable copay plan

Optional Benefits Available with Copay Plans


Prescription Drug Card Benefit Buy-Up (Copay Select only)

Two Additional Doctor Office Visits (Copay Saver only)

Maternity Benefit First-Dollar Accident Benefit

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Copay SelectSM

$35 doctor office copays regardless of deductible!• Copay is unlimited• General practitioner, specialist, urgent care• Covers history and exam

Core plan benefits remain the same regardless of deductible!

Includes Rx copays regardless of deductible!• Generic - $15 copay (no deductible)• Name Brand - $100 per person deductible

$30 preferred $60 non-preferred

• Annual maximum of $3,000 per insured (Optional Prescription Drug Benefit Buy-Up)

Preventive care not subject to the plan deductible!

Copay SelectSM

Deductibles

$500

$1000

$1500

$2500

$5000

Copay SelectSM

- Our benefit-rich copay plan with excellent preventive care

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Copay SelectSM Preventive Care

• Preventive Care Doctor Office Visit

• History and exam - $35 copay

• X-ray and Lab - 80% / 20% (not subject to deductible)

• $300 annual maximum per person

• Child Immunizations (ages 0-18)

• Vaccine - 80% / 20% (not subject to deductible)

• Separate $300 annual maximum per person

• Preventive mammogram, pap smear, PSA testing

• 80% / 20% (not subject to deductible)

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Copay SaverSM

Copay SaverSM – our most affordable copay plan

Priced 20-30% less

$35 doctor office copay • Limited to 2 per person, per calendar year • Optional buy-up to total of 4 visits

$15 copay for Generic Rx (Brand name drugs not covered)

Preventive Mammogram, pap smear, PSA testing: 80 / 20%

X-ray and lab are covered if performed within 14 days of a surgery or confinement

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Golden Rule Golden Rule

Copay SelectSMCopay Saver

SM

$5,000 Ded; 80 / 20%

$5,000 Ded; 80 / 20 %

$351.26 $273.69

Copay SelectSM (comprehensive) vs. Copay SaverSM (catastrophic)

Premium based on preferred health status, Rx copay. Premium based on January 08 effective date. Each plan has its own benefit design and other characteristics not presented here.Not For Consumer Use

Austin, TX - 787 22% Savings

Husband & Wife, aged 35 with two children

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Optional Benefits

To Enhance Plans

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No waiting period

$300 annual max on covered expenses

PSA testing, pap smear, mammography

$35 copay per doctor office visit

Doctor office x-ray and lab covered at 100%

Well care visits

Child (0-18) immunizations Separate $300 annual max

Annual max does not apply

Primary care, OBGYN, etc.

Plan deductible is waived

This optional benefit is available with all plans except Copay SelectThis optional benefit is available with all plans except Copay SelectSM..

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Prescription Drug Card Benefits

Prescription Drug Card Benefit:This optional benefit is available only with Plan 100® and Plan 80

SM

Generic: $15 copay Name-Brand Preferred: $30 copay Name-Brand non-preferred: $60 copay

• Name brand copay is after a $100 per person, calendar year deductible• $3,000 annual maximum

(If generic is available, name brand is reimbursed at generic price)

Prescription Drug Card Benefit Buy-UpThis optional benefit is available only with Copay Select

SM.

Eliminates the $3,000 annual drug maximum

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Maternity Benefit

• Client pays 20%• Golden Rule pays 80%• Graded benefit with a maximum of $7500

This optional benefit is available with all plans except HSA plansThis optional benefit is available with all plans except HSA plans

*Not available in AR, MD, NC, VA

This benefit helps cover the costs for routine pregnancy or delivery:

Years Covered Annual Maximum

1 & 2 $2,500

3 & 4 $5,000

5+ $7,500

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Optional Benefits

$5 Million Lifetime Maximum Benefit$5 Million Lifetime Maximum Benefit**Available with all plans

•Upgrades coverage to $5,000,000 per person

Term Life Benefit**Term Life Benefit**Available with all plans

•Decreasing term life benefit •Benefit payout based on primary insured’s age at the time of death

Two Additional Doctor Office VisitsTwo Additional Doctor Office VisitsThis optional benefit is available only with Copay SaverThis optional benefit is available only with Copay SaverSM

• Increases the number of copay doctor office visits from 2 to 4 per person, per year

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Optional Benefits

*Not available in VA

**Not available in NC

First Dollar Accident BenefitFirst Dollar Accident BenefitThis optional benefit is available will all plans except HSA plans.This optional benefit is available will all plans except HSA plans.

• Upfront coverage for unexpected injuries• Treatment of an injury within 90 days of an accident• Benefit choice of $500 or $1,000 • Plan deductible must be greater or equal to the

benefit amount selected

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Preferred Network

UnitedHealthcare

ChoicePlus

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Expansive national network*Owned by UnitedHealth GroupChoice of network providers at all timesOffers significant provider discounts**

Average network discount of 45%Leverage strength of UnitedHealth GroupStrength in numbers

UnitedHealthcare Choice Plus

*UnitedHealthcare Choice Plus Network is not offered with Golden Rule Health plans in all states.**Discounts vary by provider, geographic location, and service provided

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Preferred Network Discounts*

*Discounts vary by provider, geographic location, and service provided

Sample doctor visit EOB

$125.00$68.6945%

Discount*

.

.

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. .

Preferred Network Discounts*

*Discounts vary by provider, geographic location, and service provided

Sample lab work EOB

$357.75$34.39

90%

Discount*

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32Update: Network

Top 10 Health Plans Accepted by Office-Based Physicians

Health Plan Physicians Accepting

UnitedHealth 64.8%

Blue Cross Blue Shield 64.3%

Humana 52.3%

Aetna 43.4%

Cigna 39.6%

Wellpoint 38.3%

Wellcare 37.7%

Medicare 27.3%

Healthnet 17.8%

Sierra 10.5%Source: SK&A Information Services, October 2007

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Golden Rule

Eligibility and Underwriting

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Underwriting

• It’s a new day – the UnitedHealthcare way!

• Sound pricing data from actuaries on treatment and prescription costsOpportunity to issue apps with fewer ridersLooking closely at plan design and deductible size

• Initiated auto-issue through E-Store* Issue applications in 48 hours or lessApplication matches certain underwriting criteria

*Actual health underwriting results February 2006 - not all applicants qualify

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Rate Classes (Broker Guide page 24)

• Preferred .90 = 61% Preferred H&W chart (Broker Guide page 25) No history of high blood pressure No medical exclusionary riders longer than one year

• Standard I 1.00 = 35%

• Standard II 1.25 = 4% Expanded height and weight table, to help accept more

cases (Broker Guide page 25) Male 6’0” aged 45 max considered weight

• Was 257lbs• Now 279lbs

Female 5’6” aged 45 max considered weight• Was 205lbs• Now 228lbs

Guidelines button on the rating software will help determine which health class status to quote

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Rate Classes (Broker Guide page 24)

Elimination of the Tobacco Rate Class• Relative tobacco surcharge based on Issue Age & Rate Class

Issue Age Preferred Standard I Standard II

Under 40 1.20 1.35 1.60

40-54 1.30 1.55 1.80

55+ 1.50 1.65 1.90

Elimination of Motorcycle Exclusion• 20% individual rating in lieu of an exclusion rider will be applied

during underwriting

• Added in underwriting if applicant has driven a motorcycle in the past 24 months

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Clearance Periods

• Atrial fibrillation – 2 years • Cancer – depends on type• Colon cancer – 5 years• Prostate cancer – 2 years• Epilepsy – 1 year since last seizure• Hyperthyroid –6 months • Gastric Bypass – 5 years and stable weight for at least

12 months

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Riders

Increased deductible rider

Example: Controlled hypertension Increase overall deductible by $400 Premium remains the same Hypertension is considered a covered expense

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Riders

Option Two: Temporary Rider

Placed on a condition for a specific period Usually one to two years Premium remains the same Condition is not covered during rider period

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Preliminary Evaluation*

• Necessary information needed to effectively prescreen Age and gender Diagnosis and date Prescribed treatment, medications, and dosages

• Quick Response Prescreen

• Specialty Team Refer to underwriting manual Confer with underwriter Advise of underwriting opinion

*No guarantee of coverage. Final decision is up to underwriting at time of submission*No guarantee of coverage. Final decision is up to underwriting at time of submission

Broker Service CenterBroker Service Center: 800-474-4467: 800-474-4467Select prompt 1 for underwriting assistanceSelect prompt 1 for underwriting assistance

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Service Standards

• We issue 83% of all applications*

• 61% of applicants receive preferred rating class*

• We handle all underwriting requirements Amendments HBQ questionnaires APS (when medical histories are unclear or complex) MIB reports

• Underwrite at time of application / telephone • Certificates are mailed to you / I.D. cards are mailed to your client

Actual 2006 health underwriting results

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What Your Clients Can Expect

• Each individual listed on the application is underwritten separately

• Effective date of choice• Premium modes:

Monthly bank draft (EFT) Direct quarterly billing

• Submit premium at time of application Premium is refunded if non-issue

• 12-month initial rate guarantee*• I.D. cards for certificates or policies are mailed directly to client

*Subject to benefit or location change

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Golden Rule E-Store

ESTORE

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E-Store Overview

Available to all appointed brokers

Offers convenient online access

Creates a professional web presence

Can reduce operating expenses

Fast and efficient

Can help grow your business

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E-Store Features

Online quoting and application submission Quote archiving and application tracking Simple navigation to support your Golden Rule business

Print all forms and brochures needed to write Golden Rule plans

Check correspondence for lapses and re-rate notification

Status of pending applicationsDownload quoting softwareNetwork link for checking doctors and hospitals

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E-Store Online Quoting

E-mail customized quote directly to client • View quote• Complete app and apply online

Broker Assisted Application• Assist client in completing majority of the app• E-mail completed app to client for review and electronic

signature• Client submits to Golden Rule

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On E-Store’s “My New Business” and “My Block of Business” sections you’ll find: Tracking by app number, name, paid to date, plan name, current billed premium, and more.

Information on health class, ratings, riders, and premium.

Details on dependents.

Visit www.goldenrulehealth.com/broker for full details.

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49Update: E-Store improvements

• My Book of Business

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Golden Rule

Resources & Training

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Resources

• Broker Service Center (800) 474-4467 [email protected]

• E-Store www.goldenrule.com

• National Key Broker Sales Manager Annette Dahlke

• (800) 232-5432 Ext. 12312• (920) 661-2312 Direct line• [email protected]

• Webinars https://goldenrule.webex.com (no WWWs) www.goldenrule.com/OnDemand/OnDemand.shtml

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Why Choose Golden Rule?

1. Our commitment to YOU… and the individual health insurance market

2. Best in Class Broker support 3. UnitedHealthcare brand recognition and leadership 4. Full range of health plans to fit your clients’ needs and budgets5. Ease of doing business 6. Competitive rates! 7. Strength of network for claims repricing8. Fast and flexible underwriting9. E-Store technology10. Continued training opportunities

confidential property of unitedhealth group. do not distribute or reproduce without the express...

Documents

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competitive slide

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