Background - Overview
Lasik most frequently performed elective surgery in America
60 million Lasik candidates in the United States
Over 7 million treated on a cumulative basis since 1996 Approximately 1.4 million Lasik procedures in 2007
Lasik attracts younger, healthier population
Typically under 55
Typically more active, healthier lifestyles
Plans and organizations looking for new “add on” benefits
Differentiating
Meaningful benefit Strong member value
How It Works - Covered Procedures
Covered refractives surgical procedures
Lasik
Including Custom Wavefront and IntraLase initiated Lasik
Lasek
A slight variation of Lasik
PRK
Like Lasik but removes surface layer of cornea to expose
treatment area without making a flap
Procedure must be completed by a doctor licensed under state
law to perform refractive surgery
How It Works - The Benefit & Pricing
Insured levels available up to $600 to each employee
and covered dependent on covered refractive surgical procedures; other benefit levels available upon request
Rates beginning at $0.50/employee/month
Offered on non voluntary basis to all employees or
100% of the population selecting an ancillary “host” benefit to which insured Lasik product is attached
How It Works - The Insurer
Standard Security Life Insurance Company of New
York (SSL)
Wholly owned subsidiary of Independence Holding
Company, NYSE listed company (symbol IHC); IHC has more than $1 billion in assets, as of January 2008.
Rated A- (Excellent) by A.M. Best
Licensed in all 50 states
Founded in 1958
Lines include life, health, disability and other
How It Works - The Marketing Partner
The Insured Lasik Group
Kevin Hassey, principal
Over 15 years experience in vision industry
Passion for developing and serving industry
with innovative products
Committed to working with clients to ensure
How It Works - Typical Products
Insured Lasik Might Be Packaged With
Vision
Pharmacy
Dental
How It Works - Supreme Lasik
Network
Employees have freedom of choice but have access
to a national panel of Lasik surgeons through the Supreme Lasik Network which provides additional savings on top of the insured benefit
Receive additional savings of 15% off Standard fees by
utilizing a Supreme Lasik Network provider
Over 550 Provider Locations available
Over 12 years experience in laser vision correction Over 85% of the U.S. population has access to a
How It Works - Sample Savings
Insured Lasik, combined with Supreme Lasik
Network provider savings, will typically create over $800 in member savings
Supreme Lasik Network Non Supreme Lasik Network
Price prior to discount at $1780/eye* $3560 $4100
SLN 15% Savings $534 $0
Member price $3026 $4100
Insured benefit/$300 $300 $300
Net cost $2726 $3800
How It Works - Benefit
Communication
Communicated in whatever medium the “host” benefit
is communicated
If no card, then wherever insured Lasik
information is outlined in “host” benefit material, simply note that insured Lasik provided through SSL
If there is a card but card refers member to get
vision information elsewhere, then wherever vision information/insured Lasik outlined, simply note
that insured Lasik provided through SSL
How It Works - Group
Master Policy and Certificate of Insurance
provided at group/employer level; group
makes certificate available to employees
Claim form added to group’s web site
Group sends membership file and premium
How It Works - Member Usage
Member calls 1-800 number in member materials
Member most often goes to Supreme Lasik Network
location, has surgery, gets 15% point of sale discount; at Supreme Lasik Network location, member assigns insurance benefit to provider; patient files no claim; provider files on behalf of member to receive payment
If member uses non Supreme Lasik Network location,
employee gets surgery and sends copy of receipt and claim form (from group’s web site or Supreme Lasik web site) to identified TPA for funded benefit
How It Works - Broker Commission
A 10% commission is included in rates
Organizations purchasing benefit to determine if this
is to be provided as a “pass through” to brokers or whether they themselves effectively represent the brokerage channel and should receive some or all of this revenue stream
Sample commission funds based on varying group
sizes and $300 insured benefit
Group size Monthly pmpm Annual Total Premium Annual Commission 5,000 .51 $30,600 $3,060
Why It’s A Win For All
Employees Reduce or totally eliminate the need for glasses or contact lenses Insured benefit applied on day of surgery if surgery at network
provider; no claim form
$300 benefit toward the cost of Lasik surgery
Insured benefit can be combined with additional 15% discount
provided if surgery at network provider Employers
Enhances the value of your benefit plans; can be used to offset rate
increases or benefit reductions
Provides affordability for a life-changing event. Offers employees a meaningful benefit.
Q & A
My base vision/pharmacy/dental is underwritten by another
carrier/healthplan. How will it work to add this benefit?
Per document, wherever details of insured Lasik are
communicated, simply indicate that benefit underwritten by SSL
What will term of benefit be?
Length consistent with length of benefit that insured Lasik is
attached to but no longer than 2 years unless otherwise agreed to
How will it work if half of my population adds the insured Lasik
product and the other half remains discount only?
The discount only materials would not change; when
Next Steps
Review how insured lasik can fit in your
Laser Vision Correction Member Reimbursement Claim Form Submit Completed Claim Form and Receipt for services to:
(Company Name Here) (Street Address) (City ST ZIP)
The section below to be completed by patient: (Please Print Clearly)
Member/Employee Information:
_____________________ ____ ________________________ ____________________ _________________
Member First Name M.I. Member Last Name Member’s Identification # Member DOB
Mailing Address: ______________________________ ___________________ ______ __________
Street Address City State Zip
Work Phone: ___________________________ Home Phone: ____________________________
Patient Information:
Patient Name: _______________________ ________ _______________________ First Name M.I. Last Name Relationship: Member Spouse/Domestic Partner Child (if child, include DOB:_________)
Plan Information:
Plan Name: ___________________________________________________
Member/Employee Certification:
Section below to be completed by Provider:
Practice Name: ________________________________ Federal Tax ID#: ___________________
Address: _________________________________ ___________________ ______ __________
Street Address City State Zip
Treating Surgeon: _________________________________
Type of Service OD, OS or OU (right eye, left eye or both eyes) Date of Service (MM/DD/YY) Amount Paid
Lasik (CPT code: 65760)
PRK or LASEK (CPT code: 66999)
______________________________________________ ________________________
