Contact Cate Holtman for information:
800-269-8879 or
[email protected]
(MA Sample Version)
Specially Designed Programs for
Commonwealth Purchasing Group
Who We Are
Digital Benefit Advisors delivers a powerful new approach to employee benefits by combining the commitment of experienced, local market advisors with the sophisticated technology and innovative resources of a respected national firm.
Client Advantages
Our employer clients benefit from enhanced carrier leverage through aggregate case volume and access to proprietary products. They also experience tremendous efficiencies created by a cutting-edge technology platform. Our award winning program to help clients navigate health care reform is also part of the exceptional value we deliver to our clients.
Digital Advantage Suite
The Digital Advantage suite is our “best of breed” employee benefits offerings. These are
proprietary products available through Digital Benefit Advisors.
Key Features
Designed to complement and enhance the benefits program you currently offer. No underwriting. Those who enroll in the
coverage will receive it.
Can be funded by any combination of employer or employee funds.
Simplified enrollment, billing and plan administration.
Who We Are
Digital Benefit Advisors delivers a powerful new approach to employee benefits by combining the commitment of experienced, local market advisors with the sophisticated technology and innovative resources of a respected national firm.
Client Advantages
Our employer clients benefit from enhanced carrier leverage through aggregate case volume and access to proprietary products. They also experience tremendous efficiencies created by a cutting-edge technology platform. Our award winning program to help clients navigate health care reform is also part of the exceptional value we deliver to our clients.
Digital Advantage Suite
The Digital Advantage suite is our “best of breed” employee benefits offerings. These are
proprietary products available through Digital Benefit Advisors.
Key Features
Designed to complement and enhance the benefits program you currently offer. No underwriting. Those who enroll in the
coverage will receive it.
Can be funded by any combination of employer or employee funds.
Simplified enrollment, billing and plan administration.
We are pleased to offer you a complete suite of
innovative products and services not available
elsewhere.
When it comes to selecting a benefits program for your
employees, it’s not just about choosing a health plan – it’s about the efficiency, services and delivery of a competitive program. We understand the challenges employers face in today’s marketplace, and we have designed a customized benefits package to help you save money, make your job easier, keep you in compliance with numerous laws and regulations and help you attract and retain qualified talent.
This guide is designed to provide a menu of employee benefits solutions to choose from. You may elect to offer any
combination of the products listed or allow your employees to design their own benefits solution.
We have created an
innovative approach to
provide competitively
priced employee benefits
coverage.
The nature of employee benefits programs is changing rapidly. In our efforts to offer you the most complete and innovative products and services, we’ve partnered with a specialist in creative solutions, Digital Benefit Advisors. The benefits products described in this guide were selected specifically with you and your employees in mind.
As the nature of how employee benefits programs are selected and communicated continues to change, a new category of benefits has evolved … we call these new benefits, Integrated Benefits. With this approach, you can offer your employees choices and the ability to select a benefits program that best meets their needs. At the same time, your company gains greater control of the cost and complexities associated with offering a benefits program.
The Digital Benefit Advisors Advantage
The following descriptions of available benefits are purely informational and have been provided to you for illustrative purposes only. Payment of benefits will vary from claim to claim within a particular benefit option and will be paid at the sole discretion of the applicable insurance provider for each benefit option. The terms and conditions of each applicable policy or certificate of coverage will provide specific details and will govern in all matters relating to each particular benefit option described in this summary. In no case will any information in this summary amend, modify, expand, enhance, improve or otherwise change any term, condition or element of the policies or certificates of coverage that govern the benefit options described in this summary.Digital Benefit Advisors is not responsible for paying or providing, nor shall it be obligated to pay for or provide benefits under any of the benefit options described in this guide.
Why Consider Dental Insurance?
Providing comprehensive, quality benefits to your employees for the best value is especially difficult in
today's economic environment. Make a smart investment while promoting overall wellness by offering dental
coverage – a desirable employee benefit.
Dental insurance is unique from other types of insurance in that it is purchased with the intent to use it. It is a valuable supplement to any employee benefits program. As employers and employees continue to place more emphasis on wellness, dental care is another means of early detection of other potentially serious
(and expensive) health concerns, including heart disease, diabetes and cancer.
Our Digital Advantage Dental plan includes features that provide traditional dental care, as well as overall
wellness-related exams.
Key Features of Digital Advantage Dental
Can be funded by any combination of employer or employee funds Access to any dentists or access in network providers
Average network discounts = 32 percent Premium discounts through Digital Insurance
Unique combination of dental care and disease detection benefits
Your Digital Advantage agent will help you select the plan design and benefit features that best fit the needs and affordability objectives of your group.
Your Monthly
Premium;
Employee -
$43.90
Emp & 1 Dep - $85.80
Family
-$141.70
This is a brief summary of Dental Insuranceunderwritten by Metropolitan Life Insurance,New York, NY. Not all plans or plan features are available in all jurisdictions. Please refer to materials provided by the insurance carrier, including proposals and brochures, for a complete description including plan limits and exclusions.
Coverage Type PDP In-Network Out-of-Network
Preventive Care-Cleanings, exams,
x-rays 100% of PDP Fee 100% of R & C Fee Basic-Fillings, repairs, endodontics/root
canal, periodontics, simple extractions 80% of PDP Fee 80% of R & C Fee Major-Bridges and dentures,
Inlays/onlays, implants, crowns, oral surgery
50% of PDP Fee 50% of R & C Fee
Orthodontia-Dependent children are
covered until age 19 50% of PDP Fee 50% of R & C Fee Deductible:
Individual Family
In-Network $50.00 $100.00
Out-of-Network $50.00 $100.00
Annual Maximum Benefit $1,750 $1,750
Orthodontia Lifetime Maximum
Choose the benefits options that are the right fit for your group.
Not all insurance policies or plan features are available in all jurisdictions. Please refer to materials provided by the insurance carrier, including proposals and brochures, for a complete description including policy limitations and exclusions.
BENEFITS
RATES/PLANS
GUARANTEED
PARTICIPATION
FUNDING
Off-the-Job Accident
Insurance Standard Guaranteed Issue 2 Enrolled Lives – Per Plan(Target is 20%) Employer and/orEmployee Paid
Critical Illness
Insurance Standard Guaranteed IssueUp to $20,000 2 Enrolled Lives(Target is 20%) Employer and/orEmployee Paid
Cancer Standard Guaranteed Issue 5 Enrolled Lives(Target is 20%) Employer and/orEmployee Paid
Dental Quoted Guaranteed Issue As Required by Carrier As Required by Carrier
Whole Life Insurance Standard Guaranteed IssueUp to $75,000 5 Enrolled Lives(Target is 20%) Employer and/orEmployee Paid
Fixed Term Life
Insurance Standard Guaranteed IssueUp to $75,000 5 Enrolled Lives(Target is 20%) Employer and/orEmployee Paid
Disability Standard Up to $3,500 MonthlyGuaranteed Issue 5 Enrolled Lives Employer and/orEmployee Paid
Why Consider Accident Insurance?
Accidents and injuries can happen at any place or at any time and the results can be costly. This
policy also pays benefits even if you don’t have an accident.
As one of your most important assets, it is important to help protect your employees and ensure they bounce back from whatever life throws at them.
The Accident policy offers off-the-job benefits for accidents. Coverage cannot be denied due to past medical history, and there are no medical
questions to answer.
Hearing the word “ouch” is
never a good thing
An affordable option…
SAMPLE DESCRIPTION OF BENEFITS
PLAN
Hospital Admission $1,000
Accident Emergency Treatment $50
Major Diagnostic Examination Benefits $150
Accident Follow-up Treatment Benefits $40
Physical Therapy Benefits $25
Dislocation Benefits $200-$8,000
Fracture Benefits $100 -$10,000
Ambulance Benefits Up to $500
Accidental Death and Dismemberment Up to $10,000
Accident Hospital Income Benefits (up to 365 days per accident) $250 Accident Hospital ICU (up to 30 days per covered accident) $500
Burns $750-$10,000
SAMPLE WEEKLY PREMIUM
PLAN
Employee Only $3.11
Employee & Child(ren) $6.31
Employee & Spouse $4.67
Employee & Family (including spouse and children) $7.87
Accident Insurance policy is designed to provide benefit payments to help protect against the high cost of accidents. Why do your employees need it? Because it pays benefits regardless of any other insurance they might have. Plus, you’ll have the comfort of knowing that your employees will still be covered even if their medical insurance doesn’t pay. Payments are made through convenient payroll deductions.
This is a brief summary of Accident Insurance underwritten by Boston Mutual Life Insurance Company. Forms and form numbers may vary and this coverage may not be available in all jurisdictions. This presentation is not complete without the product brochure that includes the full list of limitations and exclusions. Refer to the policy, certificate and riders for complete details.
75%
of healthy individuals
over the age of 40 will
become critically ill.
Source: 2009 Heart and Stroke Statistical Update, AmericanHeart Association.
Use of statistics does not imply endorsement
Why Consider Critical Illness Insurance?
A major cause of personal bankruptcy in the United States is expenses and loss of income due to health care-related treatments.
With advances in medicine, many people are now surviving treatment of a critical illness. Unfortunately, surviving the financial impact of treatment and loss of income is another story. Critical Illness insurance is designed to help address the cost not covered by medical insurance.
Coverage is available on a Guarantee Issue basis. Applicants will receive coverage regardless of personal or family medical history.
Sample Weekly Rates for $10,000 (Non-Tobacco User)
Age Employee Only25 $1.66
35 $2.68
45 $4.57
55 $7.48
65 $12.42
The policy pays a lump sum benefit directly to the insured upon the initial diagnosis of a covered critical illness.
This lump-sum payment provides employees the flexibility to spend the money on whatever makes sense for them and their family, which might include basic monthly expenses like mortgage payments, car insurance, groceries and childcare.
This is a brief summary of Critical Illness Insurance underwritten by Boston Mutual Life Insurance Company. Forms and form numbers may vary and this coverage may not be available in all jurisdictions. This presentation is not complete without the product brochure that includes the full list of limitations and exclusions. Refer to the policy, certificate and riders for complete details.
Plan Benefit
% of Benefit
Cancer 100%
Stroke 100%
End Stage Renal Disease 100%
Coma 100%
Paralysis 100%
Severe Burns 100%
Loss of Sight, Speech, Hearing 100%
Alzheimer’s Disease 100%
Amyotrophic Lateral Sclerosis (ALS) 100%
Benign Brain Tumor 100%
Coronary Artery Bypass 30%
Angioplasty and Stent Insertion 30%
1
out of
3
people
will face a cancer
diagnosis in their
lifetime.
Source: American Cancer Society. Cancer Facts & Figures 2013. Use of statistics does not imply endorsement
This is a brief summary of Cancer Insuranceunderwritten by Transamerica Life Insurance Company,Cedar Rapids, IA. Policy Form Series CPCAN200 and CCCAN200. Forms and form numbers may vary and this coverage may not be available in all jurisdictions. This presentation is not complete without the product brochure that includes the full list of limitations and exclusions. Refer to the policy, certificate and riders for complete details. EBD TTDBABRO 0213-25989954
While some individuals diagnosed with cancer have meaningful and adequate health Insurance to cover most of the cost of treatment, an increasing number of privately insured workers face the prospect of crippling out-of-pocket costs, according to updated information for the National Cancer Institute. Those rising costs often leave both uninsured and individuals with insurance without the coverage they need.
CancerSelect®Plus plan highlights include: Guaranteed Issue underwriting, simplified group participation
requirements, affordable pricing and a substantialcancer screening wellness benefitto help promote regular exams for early detection.
Benefit Category
Description of Benefits
Policy Pays
Hospital Benefits
Hospital Confinement $200
Ambulance Benefits $200
Private-Duty Nurse $200
Hospice Care $100 Surgery Benefits
Inpatient $1,000
Outpatient $1,500
Prosthesis $50-$500
Reconstructive Surgery $120-$250 Radiation &
Chemotherapy Benefits
Radiation and Chemotherapy $150
Associated Radiation and Chemotherapy Expenses $25
Blood, Plasma, Blood Components, Bone Marrow
and Stem Cell Transplant $150
New or Experimental Treatment $150 Wellness &
Non-Medical Benefits
Magnetic Resonance Imaging (MRI) Scans $150
Family Member Lodging $150
At Home Nursing $150
Out Patient Lodging $150
Calendar Year Cancer Screening Benefit Per Covered Person $150
Cancer Maintenance Therapy Benefit $25
Benefits are paid directly to the insured and can be used to offset costs associated with major medical coverage, including deductibles, co-payments and co-insurance. Benefit amounts are paid per covered year and reset at each policy anniversary date … even for the same diagnosis!
MA Sample Weekly Premium
Rate
Employee Only $3.33
Employee & Child(ren) $3.91
Employee & Spouse and Child(ren) $6.08
Why Consider Cancer Insurance?
50%
of U.S. households
(58 million) say
they need more
life insurance
Source: LIMRA Facts About Life 2013 Use of statistics does not imply endorsement.
Why Consider Interest Sensitive Whole Life Insurance?
Interest sensitive whole life insurance can provide an additional source of financial protection for
employees and provide additional options for their retirement.
Without a medical exam, interest sensitive whole life insurance coverage can be purchased and will build cash value with a guaranteed 4 percent interest rate. Individuals can help protect themselves and eligible members of their family, all with the convenience of payroll deduction. Employees can also keep their coverage and take it with them if they ever leave the company.
Sample Benefits and Values Non-Tobacco
$10/week
Issue Age Face Amount Cash Valueat Age 65 Paid Up at Age65 25 $68,455 $28,876 $56,689 35 $45,048 $17,050 $33,472 45 $28,124 $8,580 $16,843 55 $16,790 $2,812 $5,951
Key Product Features
Guaranteed issue to $13/week of employee coverage Aggregate participation – minimum enrolled is 5 lives Cash value accumulates with guaranteed interest rate
of 4 percent
Policy loan provision
Coverage available for employee, spouse, children and grandchildren
Rates never change
Coverage amounts available from $2 to $30 per week for employees ages 18 - 72. Employees can purchase whole life policies for their spouse and each eligible child and grandchild. They can also choose to attach term life insurance protection to their policy or their spouse’s to add extra coverage for their children. With the convenience of payroll deductions and a range of policy choices, this is a great benefit.
*In using the term “permanent”, it is important to note that coverage could lapse prior to the maturity for non-payment of premiums. This is a brief summary of ELOPSM, Interest Sensitive Whole Life Insurance Policyunderwritten by Boston Mutual Life Insurance Company,Canton, MA. Policy form series ICC13 END-95(ESO) 3/13 and END-95 (ESO) 3/13. Forms and form numbers may vary and this coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. 335-1651 9/13
30%
of U.S. households have
no life insurance at all.
Source: LIMRA Facts About Life 2013. Use of statistics does not imply endorsement.
Why Consider Group Term Life Insurance?
Group term life insurance helps offer your employees and their families the added security needed to
remain financially secure in the event of an unforeseen death.
The working years are some of the most crucial times for families to find security. Group term life insurance is an ideal way for employees to help protect and provide for their families during these important years. Employers can offer pure term life insurance protection at cost-effective group rates.
There is no way to know what will happen tomorrow, but there is a way to help protect families against the unexpected. Trans SelectSM5 is Transamerica’s new term life insurance product to meet life’s changes — today
and tomorrow.
Trans SelectSM5 Helps Provide Financial Support for Your Family in Times of Need
Recent studies show one in four U.S. households relies only on group life insurance to provide financial protection if a wage-earner dies.
Other findings from the study show:
Half of U.S. households (58 million) say they need more life insurance – the highest level ever. Among households with children under 18, 11 million have no life insurance coverage.
With Trans SelectSM5, you can help to secure your employees’ future if something happens to them or their loved
ones. Buying life insurance is a decision that should not be put off. Prudent financial planning with Transamerica term life can help protect your employees’ future and give them peace of mind.
Trans SelectSM5 Benefits Are Easy to Understand
Trans SelectSM5 offers guaranteed level premiums for the term period of 5 years. Employees can pay these
premiums through the convenience of payroll deduction.
Trans SelectSM 5 Group Term Life Insuranceunderwritten by Transamerica Life Insurance Company,Cedar Rapids, Iowa 52499.Premiums are guaranteed level for 5 years, then may increase annually starting in year 6.Policy form series CPVTL200 and CCVTL200. Rider form series CRTIVT00 and CRWPL200. Forms and form numbers may vary, and this coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details. EBD TTDBABRO 0213-25989954
Why Consider Short-Term Disability Insurance?
Disabilities happen. If employees miss work due to an injury or illness, short-term disability insurance can
help replace a portion of their lost wages while recovering.
Innovative employers understand that disability
insurance is both a benefit and a health and
productivity tool.
Most injuries and illnesses are not long-lasting, andemployees will likely be back at work quickly. In the meantime, their regular paychecks could stop. If that happens, the replacement income from disability insurance will be a big help. Some conditions that could lead to a disability claim include illness, childbirth, injury and surgery.
Key Product Features
Employees choose a benefits amount up to 66 2/3 percent of their income
Benefits are in $50 increments up to a max of $1,250 per week
Benefits are tax-free
Age Freeze – Rates based on issue age
Partial Disability Benefit
If you’re only able to do part of your job or work part-time, you can receive partial benefits. With your part-time earnings and your partial disability benefit, you could receive up to 99 percent of your pre-disability earnings.
Rehabilitation Assistance Benefit
While you are participating in an approved rehabilitation program, we can pay an increased benefit to you. You don’t have to pay premiums while you are disabled.
Other Important Product Information
Pre-existing condition limitations – 12-month sickness, 12-month accident Pregnancy is treated as any other illness after 10 months of being covered Guaranteed Issue – no health underwriting
Benefits coordinate with any sick leave or worker’s compensation payments received from the employer
Weekly Benefits Amount Annual Income Required for 60% Benefits Amount Hourly Wage Based on 40
Hour Work Week
18-29 Weekly Premium
30 - 44 Weekly Premium 45-49 Weekly Premium 50-54 Weekly Premium 55-59 Weekly Premium 60-64 Weekly Premium
$300 $23,400 $11.25 $ 5.48 $ 5.71 $ 6.55 $ 7.84 $ 9.29 $10.89 $400 $31,200 $15.00 $ 7.31 $ 7.62 $ 8.73 $10.46 $12.39 $14.52 $500 $39,000 $18.75 $ 9.14 $ 9.52 $ 10.92 $13.07 $15.48 $18.15 $600 $46,800 $22.50 $10.97 $ 11.42 $13.10 $15.69 $18.58 $21.78 $700 $54,600 $26.25 $12.79 $ 13.33 $15.28 $18.30 $21.68 $25.41
Sample Plan Design and Rates – 15 Day
Elimination Period, 1 Year Benefit Period
Creative Worksite Short-Term Disability,underwritten by Companion Life Insurance Company. Not all plans or plan features are available in all jurisdictions. Please refer to materials provided by the insurance carrier, including proposals and brochures, for a complete description including plan limits and exclusions.
Why Long-Term Care Insurance?
More and more employees realize that the biggest threat to their family’s retirement income is if the
need for long-term care insurance should arise.
This important coverage is a vital part of financial planning as it is designed to protect employees’ retirement income and personal lifestyles. Long-term care insurance pays for the expenses associated with needing care for an extended period of time at home or even a stay in a long-term facility.
Long-term care is defined as the type of care needed as the result of:
An inability to perform every day activities such as eating, dressing, bathing, toileting, transferring, and continence for a period of at least 90 days; or A severe cognitive impairment requiring substantial
supervision to protect your health and safety.
The need for care can arise at any age. A long-term care situation can come about as the result of an accident or it can be needed temporarily due to a long recovery period after a significant illness such as cancer.
Key Product Features
Cash Benefit – In lieu of being reimbursed for covered costs, elect to receive 10 times the daily benefit as cash to use as the employee sees fit.
Return of Premium to Age 67 – If an employee dies before the age of 67, the premiums paid for the policy will be refunded to your estate or a named beneficiary (less any claims paid).
Double Coverage for Accident Benefit to Age 67 – If an employee needs care due to an accident before the age of 67, expenses will be reimbursed up to twice the amount the employee is insured. Extra reimbursement does not reduce the pool of money.
Policy Portability – Coverage will be issued as a policy in the name of the employee. Coverage is portable and employee premium will not change as the result of leaving employment.
Key Product Components:
Maximum Daily Benefit - The maximum amount the employee will be reimbursed for eligible care expenses on a daily basis.
Pool of Money – The total amount available over the lifetime of the policy to cover eligible expenses.
Benefit Increase Options (BIO) – Deferred Bio, 3% Compound, and 5% Compound. Benefits increase automatically 3-5% on an annual basis.
Elimination Period (Deductible) – The number of care-days the employee pays for care out of pocket before reimbursement from policy start date. This deductible may only pertain to facility care. The employee may not satisfy any elimination period for home health care reimbursement.
Using Long-Term Care Insurance
Coinciding with the baby-boomer generation approaching retirement, employees may find themselves in the situation where the cost associated with needing long-term care could be one of the largest unfunded liabilities in the country today. As the nation ages, the segment of the population at risk of needing long-term care is increasing rapidly – more rapidly than the number of individuals with any private pay solution such as insurance.
Not all plans or plan features are available in all jurisdictions. Please refer to materials provided by the insurance carrier, including proposals and brochures, for a complete description including plan limits and exclusions.
3 in 4 Americans over age 65 will need some
type of long-term care services.
(Core + Elective) x
Communication =
Integrated Benefits
An employer’s benefit program is an investment
designed to recruit and retain their most important
asset, employees! Despite this large investment,
many employers miss the opportunity to assure their
ROI by not developing an effective communication
and enrollment strategy.
Let Digital Insurance assist in an effective
communication and enrollment strategy!
Digital offers clients a full suite of communication
resources to assist employees in better understanding
and enrolling in the their benefit options;
Electronic Enrollment
Web Based enrollment
Toll Free Telephonic Enrollment
Core Enrollment
Employee Total Compensation Statements
On-site one-to-one meetings
Let us assist with the design of an employee
communication strategy that assures employees;
Appreciate your investment in the welfare of
themselves and their families
Understand the options you offer them and
how to make appropriate choices
Have access to answers and support after
the enrollment period
Know how and when to make changes to
their election throughout your plan year
A well executed Benefits Communication and Education
campaign may be one of the most important investments
What Is An “Advocate”?
One who supports or promotes the interests of
others.
Insurance is complicated. Digital understands. Workers call us from the pharmacy, needing immediate answers. We respond. Employees call us from emergency rooms, desperate because of an insurance mix-up. We act. Many e-mail right from home, pleading for assistance on a claims or billing issue. We help.
Do you really have the time to deal with all your
workers’ questions about insurance claims, plan eligibility, provider networks or billing? Here’s the perfect solution to increase employee satisfaction and productivity, while saving you time and money.
We respond. We act. We help.
With Digital, your employees have an ally by their side every step of the way (an ally that saves you time). Our customer advocates are eager to provide confidential answers to your employees questions about claims, eligibility, provider networks, plan design features, pharmacy issues and more.If your employees have a benefits-related problem, Digital’s Customer Advocate Center will solve it. We’re all about simplifying the health care journey – and fixing insurance snags, glitches and hold-ups of all types.
How we help your employees:
Educate employees on how to use their benefits Help employees understand enrollment options Facilitate resolution on eligibility/billing issues Assist workers with claims
Interpret insurance payment outcomes
Provide alternative suggestions to satisfy patient needs Locate in-network providers
And much, much more
Because we specialize in creating great customer experiences for small and mid-sized businesses, meeting your needs is a priority. Digital has the expertise, resources and technology to follow through on that promise.
A phone call is always quickest, but we’re also available by e-mail, fax and online chat.
Phone:866-736-6640
Fax:866-736-6647
Email:[email protected]
For more information, please visit our website www.digitalinsurance.com
