1. Supplemental
Medical Expense
Plan
“PremierCare”
Host
Rodney Mattos
Director of Sales

2. Agenda
 Purpose of PremierCare Supplement Plan
 Key Advantages
 Explanation of the Benefits
 How to Use the Quote Sheet
 Commonly Ask Question

3. Purpose of PremierCare*
 To offer an employer lower monthly
premiums without reducing the
employees overall medical benefits.
 To simplify the explanation of the Gap
Plan to your clients.
Simple and Easy
*Available January 1, 2013, pending CA DOI approval.

4. Our Product
 Paysa percentage of the members
medical deductible and/or coinsurance,
(or copays over $100) up to a calendar
year amount. Similar to our dental plans.
50% 60% 70% 80% 90% 100%
$500 to $500 to $500 to $500 to $500 to $500 to
$10,000 $10,000 $10,000 $10,000 $10,000 $10,000

5. Key Advantages
 Single Point of Contact: (Your Account Manager)
 Supplemental Medical
 Dental
 Vision
 Easy Billing Reconciliation
 RX Rider
 Pays the deductible on the RX plan
 Separate benefit and maximum
 Percentage must match Supplement Plan
 Not available if 100% benefit is purchased.
50% 60% 70% 80% 90%
$150 up $150 up $150 up $150 up $150 up
to $2,000 to $2,000 to $2,000 to $2,000 to $2,000

6. Key Advantages
 Package Discounts
 New Business(all products new to Premier)
 5% off Dental Manual Rate (And)
 5% off Supplemental Medical
 Currently a Premier Dental Customer
 5% of Supplemental Medical
 No Limitations on Outpatient
 The maximum applies for both inpatient and
outpatient services

7. Key Advantages
 No Exclusions*
 If the illness or injury is covered by the
underlying medical plan, then it is a
covered benefit with PremierCare. In
regards to PPO plans, PremierCare only
pays for In-Network Providers.
*See brochure for complete details of coverage limitations

8. Sample Benefit Summary Example of ABC Company
Carrier Type PPO PremierCare Employee Out-of- Pocket
90%* to $7,000
Annual Deductible IN-Network Only IN-Network Only IN-Network Only
Individual $5,000 90% $500
Family $10,000 90% $1,000
Outpatient/Prof Services
Physician Office Visit $45 Copay $0 $45 Copay
Preventative Care No Charge N/A $0
Rehabilitative Services 45% (after ded.) 90% of Charges 10%
Lab, X-ray, other Test 45% (after ded.) 90% of Charges 10%
Hospital Services
Inpatient Hospital 45% (after ded) 90% of Charges 10%
Outpatient Surgery 45% (after ded) 90% of Charges 10%
Emergency Room 45% (after ded) 90% of Charges 10%
Mental Health
Inpatient 45% (after ded) 90% of Charges 10%
Prescription Drugs
Tier 1 $10 Copay N/A $10 Copay
Tier 2 $45 (after RX Ded) 90% of Ded $45 copay + 10% Ded.
Tier 3 $65 (after RX Ded) 90% of Ded $65 + 10% of Ded
RX Deductible $500 90% 10%
Max Out of Pocket $8,000 $1,000
$16,000 $2,000
* 90% of the Patients Responsibility

9. How to Use the Quoting Sheet

10. Enrollment Materials
 Employer Application
 Employee App
 PremierCare Rate Sheet .PDF
 Underlying Medical Plan Benefit Sheet
 First Months Investment

11. Collateral Material
 Benefit
Summary Brochure
 Employee Explanation Brochure

12. Underwriting Guidelines
 Minimum of 5 employees or 20% whichever is greater
 Plan supplements fully insured HMO and PPO
medical plans
 Age and dependent status are need to quote
 Plans are sold on an employer sponsored or
voluntary basis
 Rates are guaranteed for 12 months
 PremierCare's annual maximum benefit must be less
than or equal to the Out of Pocket Limit of the
underlying major medical plan.
 Ineligible Groups/Industries: Legal services with less
than 25 enrolled employees, associations and
multiple employer trusts.

13. Our Biggest Question?
 MedicalCarriers won’t allow me to sell a
medical gap plan next to their core plan?

14. Our Suggestion
 If the medical carriers says you can not sell a
medical gap plan next to their plan, we suggest
the following:
 Agree with them
 Request a copy of the letter from the Department
of Insurance stating that they can prohibit gap
plans for their products.
 You need this letter to protect yourself from brokers
who may try to sell your clients gap plans in the
future.
 Thank them for their assistance
 If you receive a letter from the Department of
Insurance agreeing with their statement, please
forward to us. We would love to share this with
other partners in the business.

15. Key Advantages
(continued)
 Profit Sharing
 PremierCare is offering up to 15% of the
profits to their brokers. This benefit is
available for our medical and dental
products. Please requests our Profit Sharing
brochure for complete details.

16. For Additional Information
Please contact your
Local Account Executive
or call
Premier Access Insurance Company
P: (888) 326-3210
E: Sales@Premierlife.com
www.premierlife.com