HEA/HES
If you get a fracture, casted for 2 weeks how much of a claim could you recieve on a plan 2 HEA?
2,100
What are the issue ages for the IEA, and IES?
And what is the last age you are able to qualify for the return of premium benefit?
Ages 16 to 69
Last age to qualify for return of premium is 54
What are the two product selection options available for the outpatient essential policies?
Individual coverage
Family coverage
Susie was playing at the park with Charlie. Charlie fell off the top of the jungle gym and was given three stitches That remained in for two full weeks.
Susie currently Has two family plans a plan 3 HEA, and a plan 2 OEA, How much of a claim with Susie receives for Charlie’s injury?
$4,950
4200 from the HEA , $750 from the OEA
If you were hospitalized for 1 night due to a stroke what policy would pay?
And, how much would you be able to claim on a plan 3 family plan?
3,300 , HES
What is the maximum number of exclusion writers an applicant can obtain on their policy for IES policy?
3 pre-existing conditions riders
What are the three coverage amounts available for the outpatient surgery portion of this policy?
And is there a max number of claims that can be made per year?
Plan 1= $500, plan 2= $750, plan 3=$1000
Yes,You are limited 4 occurrences per year.
He was diagnosed with lung cancer. How much would he be paid out if he survived cancer for 14 days.
What are the four features on the accidental death essentials policy?
Accidental death benefit common carrier
Accidental death benefit all other causes
Single dismemberment benefit
Multiple dismemberment benefit
John had a car accident on his way home. His wife, and 2 children were in the vehicle. They had a plan 1 HEA/HES family plan.
John was in the hospital one night, his son had a broken arm, his daughter had stiches (in for 10 days), and his wife received no major injury.
The whole family was taken to the hospital in ambulance. How much of a claim could they recieve?
$2,625 plus up to 600 Ambulance Reimbursement
(John 825 + up 150 Ambulance,son 1,050 out patient + 150 Ambulance, daughter 750 + 150 ambulance, wife 150 ambulance)
Chris would like to purchase an IEA/IES policy. He is 25 years old and makes a gross annual income of $35,000.Chris would like to apply for 100% return of premium rider on the sickness portion.
Given his gross annual income, what is the max amount of benefit we could qualify him for? And what would his monthly premium be if he bought the policy today?
Chris would qualify for $1750 each month.
His monthly premium would be $322 a month for $1,750 accident and sickness policy with 100% return of premium on the sickness portion
What are the three features available on the outpatient essential policies?
Outpatient surgery benefit
Rehabilitative therapy benefit
Medical appliance reimbursement benefit
Stage A prostate cancer
It pays 25% of face amount. Leaving remaining 75% for a life threatening condition.
Tom and his wife Karen were in an accident while travelling by Greyhound to a football game. They had an accidental death essentials family plan 2.
Unfortunately John passed away, and caring lost her right arm. How much money would care and receive on her claim?
$250,000
$200,000 death by common carrier, $50,000 single dismemberment
Family plan 3 HES was purchased when wife was 19 weeks pregnant with twins, babies spent 2 weeks in ICU after birth. How much could there claim pay out( if they qualify for full recovery amount)?
67,200
ICU 2 weeks = 1,500x14= 21,000 x 2 = 42,000 for both babies
Recovery 2x3= 6 weeks, 6x7x300= 12,600x2= 25,200 for both babies
42,000+25,200= 67,200
What are the four features of the income essentials policies?
1. Total disability benefit 100% up to six months
2.Partial disability benefit 100% for 30 days
3.Return to work benefit 50% for 30 days must follow total disability
4.Accumulation, one additional month each year the policy is in force to the maximum of 24 months
Tanya and Paul would like to purchase the plan 3 outpatient essentials accident policy for their family,
How much would the premium be? And Until what age are the children covered?
$56, children are covered till age 25 at which time they can Continue coverage by purchasing a new policy.
Amounts 10,000, 15,000, 25,000, 50,000, 100,000
Osman Was in a car accident that resulted to him being hospitalized for 7 days, and totally disabled for 5 months, And return to work part time for one month Due to partial disability.He also received 5 stitches in his hand.
He has full accident benefits with us. plan 3 HEA,plan 3 OEA, and 2,000/m IEA.
How much would he claim?
$20,400
$8400 HEA + $1000 OEA + $11,000 IEA (Five months total disability, 1 month return to work benefit)
Brady got into a bar fight for hitting on the bouncers girlfriend he received a concussion and was Totally disabled and unable to work for four months. Following total disability he returned to work part time for one month.
Thankfully Brady had an IEA what’s the benefit amount of $1500 a month. How much could he claim on this policy?
Brady would claim $1500 a month for the first four months and $750 for the return of work benefit totalling $6,750.
Derrick would like to purchase an outpatient accident and sickness policy for his family. His main priority being accidents. He is 32 years old and his maximum budget is $112 a month. What combo plan would you put together to accommodate his budget?
Plan 2 OES (55.50), and plan 3 OEA (56)
Total premium $111.50
Colton and Cindy have a plan to HEA/HES family plan. Prior to giving birth to their son Cindy spent 10 days in the hospital, and then delivered their son who upon birth spent 2 weeks in the ICU.
Which policy will pay and how much was your claim Be?
The HES will pay under the hospitalization and recovery benefit portions. Total claim $22,800
(Cindy= 10 days in hospital +30 days recovery at 150 a day= $6,000
Baby 14 days at $750 +21 days recovery at $150 =$16,800)