FIRSTChoice *Guaranteed Issue* Health Insurance

Guaranteed Issue”
Health Insurance Plans
Marketed by Licensed Representatives of
GoHealth VMO
Agents, please understand that
any prospect who can afford
and qualify for a Major Medical
plan should be encouraged to
purchase one. We do not
endorse agents utilizing our
plan if it is possible for the
prospect to purchase coverage
that is more comprehensive
than our plan.
With that said, also understand that we have
two excellent plan designs, Traditional and
Super Supp, that are specifically designed to
reduce or eliminate the out of
pocket costs left over by Major
Medical for an average period of
hospital confinement.
This is one of the reasons that a high
percentage of all FirstChoice applicants are in
perfect or near perfect health, which also
contributes to the success and longevity of
our program.
Central United Life is a member of
the Manhattan Insurance Group.
Manhattan Life ( Est 1850 ) was the first
insurance company to issue a life
insurance policy on the life of a female.
They also earned the nickname “Old
Reliable” pay paying claims on the lives
of deceased Confederate soldiers during
the Civil War.
Best Benefits
The Best Price
The Most Secure Policy
The Highest Commissions
Fantastic Incentive Trips
FirstChoice Plan Design
FirstChoice Plans are true
“Defined Benefit” plans. As
such, the stipulated benefit
is always paid in full,
regardless of the billed
amount. There is no “pays
UP TO $$$” language in
FirstChoice policies!
Who qualifies for “Guaranteed
Issue” Consideration?
Individuals (W-2 or 1099)
age 18-65 who work an
average of 30+ hours per
week, their spouse ( if 1865 )
and their children.
FirstChoice Plan Design
By limiting eligibility to employees
who work an average of 30+
hours/week, and avoiding
marginal benefits subject to abuse,
we are able to provide what we
believe to be the strongest package
of “Guaranteed Issue” benefits
available in our industry today!
FirstChoice Plan Design
Remember that all FirstChoice
POLICIES, not certificates of a
Group Master policy or
Association Plan.
This provides much greater
protection for the insured's!
If the policy holder is still actively at
work on the policy anniversary date
after age 65, and they desire to
continue the coverage, they may
keep the policy by maintaining
employment and renewing at policy
anniversary dates until age 70!
Are there any Ineligible Conditions or
Ineligible Occupations with FirstChoice?
Individuals 18-65 working an average of 30+
hours per week may apply regardless of their
Occupation or
Pre-Existing Conditions!
How are Pre Existing Conditions treated?
Conditions for which an insured sought
or received medical treatment in the 12
months prior to application date, or
which manifest symptoms that would
have caused an ordinarily prudent person
(a person of average intelligence) to have
done so will not be covered for 12
months after the effective date, whether
or not they are disclosed on the
FirstChoice Guaranteed Issue Health Plans
There are THREE important areas
that must be considered when
selecting which Guaranteed Issue
plans to market. We feel that the
FirstChoice Plan Series is superior
to the competition in all three!
FirstChoice Plan Design
The FirstChoice PLATINUM Plan
has 6 separate benefits,
including the 4 most significant,
that are equal to or superior to
currently being sold!
Get a FirstChoice Brochure & Note These Benefits:
Hospital Benefits, Up to $4500 per day!
($2500 day 1, & days 3 – 6, $1500 for day 2) $500 per day for days
7 – 365. Then, ICU pays an additional $2000 for up to 20 days/yr!)
Surgical Schedule of $10,000 per occurrence + 25% to the
Accidental Injury scheduled benefits up to $1800, plus $200 per
injury, plus any applicable surgical/anesthesiology benefits.
Maternity as any other illness
Wellness ($400 MAM, $100 PAP)
Doctor’s Office $100 x 4 (or $150 per visit if ER for Sickness)
( SIR rider not available in NC & GA, HII not available in GA, Surgery
Rider is available in PA instead of Surgery + Rider. )
FirstChoice Guaranteed Issue Health Plans
Most FirstChoice plan designs include a
unique combination of features that provide
significant “front loaded” benefits when they
are needed the most. There are three
separate benefits designed to provide cash
when hospital confined.
1) The Daily Room Benefit
2) The Indemnity Benefit
3) The First Hospital
Confinement Benefit
FirstChoice Guaranteed Issue Health Plans
The Daily Room Benefit is
paid for up to 365 days per
period of confinement,
much longer than
any competitor.
( Others are usually 30 or 31
days maximum )
FirstChoice Guaranteed Issue Health Plans
Indemnity Benefit
is paid on the first day
of hospital
in any calendar year.
FirstChoice Guaranteed Issue Health Plans
The First Hospital
Confinement Benefit is paid
during the first period of
hospital confinement of any
calendar year. Depending on
the plan selected, it can be as
much as $10,000 over the first
6 days.
FirstChoice Guaranteed Issue Health Plans
The First Hospital Confinement Benefit in
both the GOLD and PLATINUM plan designs
pays as follows:
Day 1: $1,000
Day 2: $1,000
Day 3: $2,000
Day 4: $2,000
Day 5: $2,000
Day 6: $2,000
TOTAL: $10,000
If a period of confinement
lasts less than 6 days, the
balance of the benefit is
available for a subsequent
confinement for the same
condition, provided it
occurs within 90 days.
FirstChoice Plan Design
Unlike the competition, some of
which have no benefit for Intensive
Care, or pay it “in lieu” ( instead of! )
the DRB, FirstChoice policies pay all
benefits IN ADDITION TO any
and all other benefits of the policy,
including the DRB. This is a HUGE
advantage to the policyholder!
FirstChoice Plan Design
Virtually ALL Guaranteed Issue Plans
in one of two ways.
Many pay a percentage, often 100%, of the
Medicare reimbursement rate ( RBRVS, or
Resource Based Relative Value Scale ). What
many agents and most clients do not realize is
that this amount IS NOT based upon the total
cost of the procedure, but simply on the
amount charged by the PRIMARY SURGEON
ONLY! This does not include the Operating
Room, Suture Kits, dressings, etc.!
FirstChoice Plan Design
Some GI plans pay based upon
the RBRVS, or Resource Based
Relative Value Scale, also referred to
as the Medicare Discount Rate. The
rest address Surgery with an
established Surgical Schedule,
usually with a maximum benefit
of $10,000.
FirstChoice Plan Design
Often, since the RBRVS is
applied to the charges of the
SURGEON ONLY, the benefit from
a $10,000 Surgical Schedule will
be more than for the identical
procedure under a 100% RBRVS
Medicare Reimbursement
FirstChoice Plan Design
One drawback to many
plans with Surgical
Schedules is that they tend
to limit coverage to one or
two surgical procedures per
year, maximum!
FirstChoice Plan Design
FirstChoice incorporates the
best of both, with a
$10,000 Surgical Schedule that
can be accessed an
UNLIMITED number of times
each year, for either inpatient
or outpatient procedures!
FirstChoice Indemnity Insurance CULBMCFC 001 (08/10)
FOR AGENT USE ONLY Central United Life Insurance Company
Page 37, HEART
Heart Transplant
Catheterization of Heart
Suture of Heart wound or
Valvotomy, aortic and
pulmonic valve
Valvotomy, mitral valve
Valvuloplasty or Replacement,
aortic and mitral valve
Coronary Bypass, single or
Repair of Myocardinal
Repair of Septal Defect
Angioplasty, percutaneous
These are
just a few
of the
FirstChoice Plan Design
The FirstChoice benefit for
Anesthesia is the highest
percentage paid, 25% of the
amount paid for Surgery. Since our
Surgical Schedule will often deliver
more benefits and for more times
than other plans, the Anesthesia
Benefit is usually correspondingly
higher as well!
For example, with a Platinum Plan $10,000 Surgical Schedule,
the following would be provided for Anesthesia
( 25% of Surgery Benefit provided for Anesthesia )
Surgical Event
Surgical Schedule
Dollar Amount
for Anesthesia
Heart Bypass
100% / $10,000
30% / $3,000
50% / $5,000
20% / 2,000
A complete surgical schedule can be seen in the FirstChoice Product
Guide on the FirstChoice Website:
FirstChoice Plan Design
Unlike the vast majority of
competitors, FirstChoice plans
provide benefits for
MATERNITY, both Natural
Delivery as well as Caesarian
Section, effective 10 months
after the policy effective date!!
FirstChoice Plan Design
FirstChoice plans are among
the few “Guaranteed Issue”
plans currently known to
include Private Duty Nursing
FirstChoice Plan Design
The total paid for an Accident will
come from several different plan
benefits. They are:
Accident Rider
Specific Injury Rider
Surgery Schedule
( Not available in
NC and GA )
FirstChoice Plan Design
Accident Rider:
Pays a (first
dollar) benefit for each accident.
Specific Injury Rider:
Pays as
much as $1,800 per accident from a
(first dollar) schedule of procedures.
Surgery Schedule: Pays a (first
dollar) percentage of the Surgery
Schedule, plus 25%+ for anesthesia!
FirstChoice Plan Design
There are benefits absent from
FirstChoice that appear with
other Guaranteed Issue plans.
They include Prescription
Drugs, Outpatient Labs & XRays, Critical Illness, and
“Association Junk”
FirstChoice Plan Design
Occasional Drugs are most
commonly Antibiotics, used
infrequently, and Pain Medication,
usually very inexpensive. It is
usually less costly over time for
the client to ‘pay as you need’
these, as opposed to building in
costs that drive up plan
FirstChoice Plan Design
X-Rays and Lab tests are legitimate
medical procedures, but have become
abused as doctors increasingly practice
‘defensive medicine.’ We have chosen
to avoid coverage for these elements in
favor of additional coverage for
expensive confinements/procedures.
Yet, you’ll still have access to HUGE
PPO discounts through Beechstreet
FirstChoice Plan Design
Today, even though numerous
“Guaranteed Issue” plans exist that
feature solid Health Insurance
benefits, most plans are still littered
with movie tickets, rental cars,
Disney discounts, and vitamins.
With FirstChoice, you get quality
Beechstreet now offered with Platinum and Gold plans!
Clients are provided access to a quality
PPO repricing and Discount Medical
benefits relationship through
Beechstreet Network.
This plan costs NOTHING to the
(This is a stand alone program, provided as a courtesy,
and is not otherwise affiliated with CUL)
Ranging from the “Super
Supplement” to the “PLATINUM”
plan design with the richest
benefits we have seen in any
Guaranteed Issue chassis, FirstChoice
plan designs are available in a variety of
configurations, all of which are lower in
price than competitor plans with fewer
and smaller benefits!
Almost all “Guaranteed Issue” plans
today pay a ‘levelized’ commission,
and very few offer annualization.
FirstChoice plans provide ‘heaped’ first
year commission with
6 months advanced commissions
available to agents that qualify!
BMC Agency, Inc. and CUL FirstChoice
Low Premiums!
High Compensation!
“The FirstChoice in
Guaranteed Issue Health
In our opinion, this is what
makes FirstChoice the finest
Guaranteed Issue program in
How can we be of immense
value to folks who qualify for
and can afford Major Med?
Traditional Supplement
and Super Supplement
may be even better
values than our
incredible Platinum and
Gold plan designs!
When used in conjunction with
Major Medical plans for “an average
period of hospital confinement”*,
our Traditional Supp and Super
Supp plans will often deliver
sufficient funds to “reduce or
eliminate the Out-of-Pocket
charges associated with the
confinement.” * According to the Statistical
Abstract of the U.S. the average period of
confinement in 2009 was 4.83 days.
One way to use the FirstChoice supplements
is simply purchase them in addition to
existing Major Med plans to “fill the gaps.”
For an ‘average’ confinement ( 5 days )
our Super Supp plan would pay, for a
qualified stay, $5,000!
$100 per day X 5 days = $500
$500 on day one
= $500
5 days of FHC
= $4,000
------------------------------Total = $5,000
For an ‘average’ confinement ( 5 days )
our Traditional Supp plan would pay,
for a qualified stay, $5,000
$100 per day X 5 days = $500
$500 on day one
= $500
5 days of FHC
= $4,000
------------------------------Total = $5,000
Plus, Up to $5,000 more for
Surgery & $1,250 for Anesthesia!
The Super Supp would deliver very
similar benefits to the Traditional
Supp plan, with the exception of
Surgical and OP Sickness, for an even
lower premium cost.
In addition, the Super Supp complies
with IRS section 223, and would not
restrict an insured from making a tax
free deposit into an HSA account if
they so desired.
Let’s take a 5 minute break, and then reconvene to discuss CUL’s
excellent suite of Ancillary Cancer and Accident products that let you
Stand out from the Worksite competition!
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