Insurance Carrier
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Guarantee Trust Life Insurance Company
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Founded in 1936
Headquartered in Glenview, Illinois
Mutual legal reserve company with over $2 billion
life insurance in force
Rated B+ (Very Good) by A.M. Best
1.2 million insureds
Licensed in 49 states
Visit www.realfastservice.com to learn more
Reinsurance
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Munich Re Group
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2nd Largest Reinsurance Company
Founded in 1880
Headquartered in Munich, Germany
5,000 insurance companies in 150 countries rely on
Munich Re's expertise and financial strength
Affiliated companies in 23 countries
Visit www.munichre.com to learn more
Individual Major Medical – A
Growing Market
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45 million uninsureds
15 million uninsureds with an annual household
income of $50,000 and above
Medical inflation has driven premiums out of the
reach of many – increasing the number of
uninsureds
Smaller and larger companies are dropping their
group coverage and encouraging employees to
purchase insurance on their own
The growth and opportunities in this market
is enormous
Assur-Care Series
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Comprehensive major medical
coverage for individuals and
families
Choice of 2 major medical plans
Flexibility (choices in deductibles
and coinsurance)
Assur-Care Series
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Advantage
Benefits are
richer
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Cost is higher
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Complete
Benefits are very
attractive, and
very affordable
•Coverage is available for eligible individuals, families and even
children alone.
•Substandard cases may be issued with rate ups or riders.
Additional Features on Both Plans
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The policy will pay 100% of covered
expenses up to the Lifetime
Maximum after the out-of-pocket
maximum expenses are met by the
insured
Additional Features on Both Plans
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Rx Discount Card
On the Advantage Plan, while you are meeting
your Rx Co-pay Drug Card deductible, if
applicable, and, on both plans, for drugs not
covered under the Rx benefit rider, simply present
your Rx Discount Card at an affiliated network
pharmacy to receive a discount on drug
purchases.
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The Rx discount is not an insurance benefit. The
Rx discount is not available for drugs purchased
at pharmacies not affiliated with Express Scripts.
Additional Features on Both Plans
Routine
Physical Exams
Advantage Plan - Covered after insured 90 days; up to $150
maximum benefit per examination per covered member/spouse per
benefit period (every two years), including lab tests (blood/urine)
associated with the same routine physical exam. Subject to
coinsurance only.
Complete Plan - Covered after insured 12 months; up to $100
maximum benefit per examination per covered member/spouse per
benefit period (every two years), including lab tests (blood/urine)
associated with the same routine physical exam. Subject to
coinsurance only.
Example: Cost of physical is $200. Insured has Advantage Plan at
80/20 to $10,000 coinsurance. In this case, carrier will pay 80% of
the $200 only up to $150. The actual 80% of the $200 comes to
$160, so the insured is responsible for the additional $50, which
does not go toward any deductible or coinsurance stop-loss.
Additional Features on Both Plans
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Child Health Supervision
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Pap Smear
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One baseline ages 35-39. Age 40 and over covered yearly
Prostate Cancer Screening (PSA) Tests
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One screening per calendar year
Mammograms
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Includes immunization. Specific age intervals from birth to 6 years
One per calendar year for males age 40 and over
Colorectal Cancer Screenings*
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One screening, including sigmoidoscopies or fecal occult blood testing,
every 3 years for persons at least 50 years old.
*excluding Colorado
All above covered subject to deductible, service deductibles, copayments and coinsurance (unless rider selected).
Optional Enhanced Routine Preventive Care Benefits Rider:
Covers above benefits subject to coinsurance only, with no
waiting periods! Subject to age intervals as outlined above.
Additional Features on Both Plans
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LabOne
LabOne* is another cost containment program. It does not replace
existing lab benefits. LabOne is a fully accredited and certified
laboratory which offers significant savings over other labs. At the time
of service, simply request that lab work be sent to LabOne for
processing. There will be a LabOne card sent with each insured’s
policy/certificate.
LabOne will submit claims for services directly to Guarantee Trust Life
or the plan administrator. If a provider is unable to collect the
specimen, LabOne has contracted draw sites
available.
You will receive LabOne discounts when your lab specimens are sent
to LabOne for testing. Covered expenses are subject to calendar year
deductible, coinsurance and any applicable service deductibles.
Client Services: 1-800-750-1253 www.laboneselect.com
*Not available in all states.
Additional Features on Both Plans
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Initial 12 Month Rate Guarantee
Initial premium rates, excluding fees, are
guaranteed for 12 months. Initial premium rates
may change if you move, change your plan or
add/delete covered dependents
Additional Features on Both Plans
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24-Hour Occupational Coverage
To be eligible for this optional Rider, the applicant and/or spouse must be:
(1) A sole proprietor, partner, owner or other individual gainfully
employed in an occupation eligible for the Rider; and
(2) Eligible to opt out of Workers’ Compensation by their state
law and have done so.
This optional Rider provides benefits for injuries or sicknesses, that arise out of
or in the course of employment, on the same basis as any other
covered illness.
Benefits are payable provided the covered person is not insured or required
to be covered under any Workers’ Compensation or similar law, the expenses
are incurred while the Rider is inforce and the covered person's occupation and
employment status as listed on the application for this benefit has
not changed after the covered person's effective date under the Rider.
Additional Features on Both Plans
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Family Premium Discount
Preferred Health Discount
Family premium discount of 5% applies
when a certificate is issued with
two or more eligible family members
applying together.
Preferred health discount of 20% applies
to qualified individuals ages 18 through
39.
Additional Features on Both Plans
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Calendar Year Deductible Carryover
Covered expenses incurred during the last
three months of a calendar year that are
applied to the medical plan’s calendar
year deductible will also apply toward
the following year’s calendar year
deductible. This does not apply to the
separate Rx Drug Card deductible.
Additional Features on Both Plans
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Common Accident Deductible
If two or more covered persons
sustain an injury in the same
accident, only one calendar
year deductible will be applied to all
covered medical expenses arising
out of that accident.
Additional Features on Both Plans
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Medical Emergencies
Medical benefits for emergency services (as
defined in the policy) will be considered for
payment at participating provider benefit level,
limited to the usual, reasonable and customary
charge. Emergency services must be provided
within 72 hours following the onset of the injury
or illness.
Medically Necessary Covered Services Not
Available From A PPO Provider - and referred to a
Non-PPO provider will be considered for payment
at PPO level, limited to the usual, reasonable and
customary charge.
Pre-Existing Conditions Limitation
An illness or injury of a covered person for which the covered person has
received medical advice, treatment, services, diagnostic tests, consultation
or medication during the twelve (12) months prior to the covered person’s
effective date of coverage under the policy. Benefits will be payable for a
pre-existing condition, unless the condition is specifically excluded under
the policy or excluded by endorsement or rider attached to the policy or
certificate, if at the end of a continuous 12-month period commencing
on or after the effective date of the covered person’s coverage, the person
has not received medical advice, treatment, services, diagnostic tests,
consultation or medication in connection with such illness or injury; or, at
the end of the two (2) year period commencing on the effective date of
the covered person’s coverage, the person has been covered under the
policy.
Health conditions duly disclosed in the application for coverage of
the covered person and otherwise covered by this policy, unless the
condition is specifically excluded by endorsement or rider attached
to the policy or certificate, are covered from the effective date of
coverage under the policy.
Preferred Provider Organization (PPO)
Networks
The Most Extensive PPO
Networks Available in the
Industry:
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Features National and Popular Regional
Networks
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www.gtlplans.com now displays the
available PPO networks by state
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Each network has a link to their website,
phone number and also displays
Network Factor
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This makes it as easy as a click of your
mouse to find out if your client’s
physician is participating in one of the
available networks
AmeriBenefit Plan
AmeriBenefit Plan
16476 Chesterfield Airport Rd
2nd Floor
Chesterfield, MO 63017
Email: info@ameribenefitplan.com
Phone: (888) 416-2815
AmeriBenefit Plan
Membership* benefits include:
*ABP Membership is optional in CO/GA. The above benefits, including the Accident Medical
Expense Benefit, are only available to members of AmeriBenefit Plan.
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Accident Medical Insurance – Choice of $1,000 coverage with
a $100 deductible or $5,000 coverage with a $250 deductible
GymAmerica.com – On-line interactive exercise and
diet program
Vitamin and Nutritional Supplement Discounts
– 15% discount on a wide range of products
HopTheShops.com – Cybermall featuring over 100 high quality
e-tailers and stores with special discounts and features.
Pre-Employment Background Reports/Investigative
Services – Special discounts on these services provided by an
internationally renowned investigative and consulting agency
Powernet Global – Long distance rate of 4.9 cents per minute
state to state, twenty-four hours a day, seven days a week
Emergency Medical Info Card – Wallet-size card provides
personal medical profile in case of emergency
Penny Wise Office Supplies Discounts – Up to 36% off
already discounted prices on a large selection of items
ITC-50 Hotel Discounts – A network of over 4,000 hotels that
offer a 50% discount
Theme Park Discounts – Provides members access to discounts
at theme parks
Major Competitive Advantages in Plan
Benefits
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Physical, Respiratory and Speech Therapy for
Rehabilitative Treatment – no limits
Transplants – no separate maximum benefit
Rx Benefit – no limits
Home Health Care (in lieu of a covered hospital confinement)
Up to 40 visits per person per calendar year
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Spinal Manipulation and other Manipulative Therapy - Up
to $500 maximum benefit per covered person per
calendar year
Covers Emergency Care received outside the U.S. – no
time limits or maximums
24 Hour Occupational Coverage – no charge for those
who qualify
Who are your Prospects?
•Uninsureds
•Offer them affordable health insurance
•Insureds
•Save them money
•Younger ages
•Affordable and comprehensive coverage
•Families
•Affordable for the family
•Doctor office visits and Rx benefits
Field Tools To Assist You
Reference Guide
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Quick Reference Guide:
Height and Weight Chart
 Ineligible Occupations
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New Business Guidelines
 Administrative Guidelines
 Customer Service Information
 Claims Information
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Underwriting
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Reviews the enrollment application.
Based on answers, additional
information, telephone verification
or medical records may be ordered.
All underwriting notes on a case are
available on line so you can easily
see what the case status is.
Underwriting
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Depending on the condition of the
applicant, several things can happen:
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Case
Case
Case
Case
Case
issued standard
issued with rate up
issued with exclusionary rider*
pended for medical records
declined
* Note: Consumers can call into underwriting to
verbally accept exclusionary riders and/or rateups!
Effective Date and Billing Information
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1st and 15th of the month
Monthly Bank Draft (automated checking
debit)
Monthly Credit Card (Visa or MasterCard) $7 billing fee
Monthly Direct - $7 billing fee
Quarterly - $7 billing fee
Semiannual - $7 billing fee
List Bill (except in these states):
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CO, MI, MO, TN, VA, WI
What happens after the application
is submitted?
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After online application is submitted, the consumer is
emailed a confirmation with a link to their
application.
The agent will be sent an email confirming we
received the application, date, confirmation #, plan
selected, premium amount and link to web site.
The consumer email will tell them to call the 800# for
the telephone verification
The underwriter will automatically call the applicant
for the TI if the applicant has not already called in. (5
times)
Policy Fulfillment and Issue
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Once the case is issued, an approval
letter is sent from underwriting to the
insured.
The agent can check on case issuance
and the date the kit was mailed via the
web site.
A fulfillment kit with certificate/policy, ID
card, ABP brochure, welcome letter, etc.
is mailed within 24-48 hours.
On Line Tools for Submitting and
Managing Business
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Prepare a quote proposal
(view, save,
print, email)
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Apply on line (easy process)
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A confirmation email is sent to the agent and
the applicant
Look up your application status on line
Status, notes, letters and
correspondence associated with your
applications are at your fingertips
Doing Business with Insurance Benefit
Group is Easy
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On line-applications (or paper).
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Quick turnaround time in underwriting.
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Innovative web site for agents to track and
manage their business.
Sales tools to support your marketing
efforts.
Summary
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Comprehensive Coverage
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Flexibility of Benefits
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Competitive Rates
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Easy enrollment
GTL - 4 Pillars
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Doc CoPay
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$40 CoPay
Unlimited Visits
Wellness
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5 Benefits
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Mammogram, Pap Smear, PSA Test, Colorectal Cancer
Screening; Child Immunization
No Deductible (Coinsurance Only)
No Waiting Period
Organ Transplants – no separate maximum benefit
Physical, Respiratory and Speech Therapy for
Rehabilitative Treatment – no separate maximum benefit