ridging the gap 2017overview and helpful suggestions. 2: types of medicare supplement policies. 3:...

BRIDGING THE GAP 2017 MEDICARE SUPPLEMENT COMPARISON (MEDIGAP) GUIDE

from the Arkansas Insurance Department Division of Senior Health Insurance Information Program (SHIIP)

This booklet contains

Page Topic

1 Overview and Helpful Suggestions

2 Types of Medicare Supplement Policies

3 Significant Medigap Insurance Laws

4 Special Circumstances for Medigap

5 Buyer Beware and Variables

6 2017 Medicare Costs Parts A & B

7 Medigap Plan Options A-N

8 Medigap Providers for Ages Under 65

9-14 Medigap Providers 65 and Older

15-46 Medigap Plans 65 and Older

47-48 Glossary

49-50 Notes and Helpful Phone Numbers

SHIIP can help in understanding your

Medicare choices

SHIIP is funded by the Administration for

Community Living, an agency of the U.S.

Department of Health and Human Services.

SHIIP works to help people save money and

make informed decisions about Medicare.

SHIIP offers telephonic and in-person

counseling to discuss Medicare choices and

answer questions.

SHIIP does not sell insurance or offer legal

advice. SHIIP certified Medicare counselors

offer unbiased information and referral

services.

Senior Health Insurance Information Program Arkansas Insurance Department

Medicare Plans Change. People Change.

Shop & Compare Plans Oct. 15—Dec. 7

FIND US ON FACEBOOK AND TWITTER

1200 W 3rd St Little Rock, Arkansas 72201 Toll Free: 1-800-224-6330

www.insurance.arkansas.gov

This guide summarizes the benefits of Medicare Supplement Policies approved by the Arkansas

Insurance Department for sale in 2017. Inclusion of information in this guide regarding a policy

does not, in any way, constitute an endorsement of the policy or company by the Arkansas

Insurance Department.

● For quotes and exact premium cost contact company or agent to purchase.

● Be advised that some new policies may have entered the marketplace since this publication

was printed and will not be included. See the back cover of this publication, lower left corner

for revision date.

● Don't be alarmed if your Medicare Supplement Policy does not appear in this booklet. You

may choose to keep your policy as long as you pay the premium.

● Publication of this guide is for information purposes only. Please refer to the policy itself for

the complete and actual terms of coverage since the policy constitutes the contract between

the insurer and the insured and will ultimately be the basis of final determinations.

SHOP WITH CAUTION. Do not just buy the cheapest policy without weighing other factorsand determining the company’s financial stability and reputation for resolving complaints.

● AVOID HIGH PRESSURE SALES TACTICS. Take time and avoid being pushed into buying aninsurance policy. Do not buy a policy under the pressure of limited enrollment periods or of“last chance to enroll.” Be wary of agents and sales material that imply a policy is connectedwith or endorsed by the government. Medicare Supplement Insurance and Long-term Careinsurance are not connected with or endorsed by the federal government.

● DON’T BE MISLED BY ADVERTISING. Do not buy a policy because celebrities endorse it ontelevision, radio, newspaper, or other advertisements. Ask questions before buying a policy.

● BE CAREFUL HOW YOU PAY FOR POLICIES. Do not pay in cash. When purchasing MedicareSupplement Insurance, it is always best to pay by check, money order, or bank draft.Premium payments should always be made payable to the insurance company, not the agentselling the policy. If you must pay in cash, be sure to get a company-authorized receiptsigned by the agent.

KEEP YOUR POLICY IN A SAFE PLACE. Select a friend or relative in advance to handle yourmedical affairs in case of illness and let that person know where to locate your policy.

KEEP RECORDS. Write down and keep the correct name, telephone number, and permanentaddress of the agent and the insurance company. Ask for a toll-free number in case youneed to call long distance. Record important policy, company and agent information andkeep it in a safe place.

1

HELPFUL SUGGESTIONS:

TYPES OF MEDICARE SUPPLEMENT INSURANCE/MEDIGAP

Most companies offer two rates: Preferred and Standard. The monthly premium amount is

based on medical underwriting. Underwriting is the method insurance companies use to

evaluate your health status to determine risk and insurability (if they’ll sell you a policy).

Preferred Premium

The Preferred insurance premium is typically

lower than the standard premium. Insurance

companies base their decision to offer a

preferred premium on a variety of factors

including but not limited to: smoking/tobacco

use, weight, cholesterol, blood pressure,

substance abuse, etc.

The Preferred Premiums are offered to those

purchasing during the Medigap Open

Enrollment Period (OEP) as well. See page 9

for more information about the Medigap OEP.

Standard Premium

The standard rates apply outside the

Medigap Open Enrollment Period and

for those with less favorable medical

histories.

Medigap Select Policy

The select policy usually offers the lowest cost premium. In Arkansas, three companies offer select

policies:

1. AARP/United Healthcare Insurance Company

2. Marquette National Life Insurance Company

3. Sterling Life Insurance Company

A select policy has a NETWORK or specific list of providers (hospitals) an insured person can use. In

general, Medicare SELECT policies are not required to pay any benefits (claims/bills) if you do not

use a preferred/network provider for non-emergency services. Medicare, however, will still pay its

share of approved charges regardless of the provider you choose. If you choose a Medicare Select

Policy, be sure your hospital is in-network (see page 44).

2

SIGNIFICANT MEDIGAP INSURANCE LAWS

► A free-look period of 30 days is required, duringwhich time the applicant may return the policyto the insurance company and receive a fullrefund. The free-look period begins from theday the applicant receives the certificate orpolicy, not the day of the application.

► A pre-existing condition waiting period mayextend no longer than six months for healthconditions diagnosed or treated within the sixmonths immediately prior to the application.The medical questionnaire accompanying anapplication should have accurate informationand should be completed by the applicant, notthe agent.

► Should the applicant be replacing a Medicaresupplement policy, no new waiting period isallowed by the replacing insurer for equivalentcoverage.

► For replacement policies, the applicant isrequired to sign a replacement form indicatingthat he/she understands the hazards ofchanging.

► No agent in Arkansas may sell a new MedicareSupplement Policy to anyone who already has aMedicare Supplement unless the applicantagrees to drop his or her previous insurance.

► All Medicare supplement policies must beguaranteed renewable.

► The 101st Congress (1990) passed strong federallegislation, which made uniform requirementsfor Medicare Supplement Insurance policies ineach state. Policy holders are not required tochange from their old supplemental policies to apolicy with the new standards unless they sochoose.

► MEDIGAP OPEN ENROLLMENT: A Medicaresupplement insurer may not deny an applicant apolicy during the six months period known asthe Medigap Open Enrollment Period. The sixmonth period begins with the Medicarebeneficiary is BOTH enrolled in Part B and age65 or older. During this enrollment period aninsurance company can not deny a policy basedon the applicants health status. This is aone time enrollment period. Once the MedigapOpen Enrollment Period begins, it can not bestarted again.

In Arkansas, there is no open enrollment period for Medicare Beneficiaries who are not yet 65. However, they are entitled to a six-month Open Enrollment Period when they reach age 65.

► An insurer must suspend Medicare SupplementPremiums and benefits while the policyholder isentitled to Medicaid. The insurer mustreinstate policy benefits upon request ifMedicaid entitlement ends. This suspensionmay last up to two years. Policyholders areresponsible for informing the insurer of theirMedicaid eligibility within 90 days of eligibilitydetermination.

MEDIGAP OPEN ENROLLMENT

If Medicaid eligible, may suspend

Medigap for two years.

3

CATEGORY 1:

If a Medicare beneficiary is enrolled in an employer-sponsored plan and the plan terminates or ceases to provide some or all supplemental benefits to Medicare, or the insured chooses to leave the plan.

Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans.

CATEGORY 2:

If a Medicare beneficiary is enrolled in a Medicare Advantage Plan and

the plan’s certification is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during

marketing, or there are other circumstances as determined by HHS

Secretary,


CATEGORY 3:

If a Medicare beneficiary is enrolled in a Medicare Risk, Cost, Demonstration, Health Care Prepayment Plan, or select plan, and

the plan’s certification is terminated, or the plan ceases to provide all services, or the enrollee moves out of the service , or the plan violates the contract, misrepresents during

marketing, or there are other circumstances as determined by HHS

Secretary,


CATEGORY 4:

If a Medicare beneficiary is enrolled in a Medigap policy and any of the following occur:

the Insurer becomes insolvent or bankrupt, or there is involuntary termination of coverage or

enrollment, or

there is material violation of the policy, or there is material misrepresentation during marketing,


CATEGORY 5:

If a Medicare beneficiary is enrolled in a Medigap policy, terminates it and enrolls for the first time in a Medicare Advantage Plan, Risk, Cost, Demonstration, HCPP, or Select plan, and disenroll from the chosen coverage within the first 12 months as permitted under federal law,

Then guarantee issue of Medigap Plans A, B, C, F, K or L with any company selling these plans or his/her prior Medigap plan, if it is still available.

CATEGORY 6:

If an individual is first eligible for Medicare Part A at the age of 65, and

enrolls in a Medicare Advantage plan , and disenroll within the first 12 months after enrollment as

permitted by federal law,

Then guarantee issue of any Medigap plan sold by any insurer.

CATEGORY 7:

If an individual leaves a Medicare Advantage Plan or drop a Medigap policy because the company has not followed the rules or misled the individual,

Then guarantee issue of Medigap Plans A, B, C, F, K, L, M, or N sold by any insurer.

SPECIAL CIRCUMSTANCES FOR GUARANTEED ISSUE FOR MEDIGAP

If you believe you meet the criteria in one of these categories and have been denied a policy, contact

SHIIP

1-800-224-6330 or email [email protected]

Federal and state laws guarantee acceptance into Medicare Supplement insurance (Medigap), if a Medicare beneficiary

qualifies in one of seven categories listed below. This means the insurance company can not deny a policy nor impose a

pre-existing waiting period based on medical history. There is a strict time limit! The Medicare beneficiary has ONLY 63 days

from the date of loss of coverage to apply for a Medigap policy and be granted a guaranteed issue.

The Arkansas Insurance Department is committed to seeing that your rights are upheld in all circumstances pertaining to

guaranteed acceptance into Medicare Supplement Insurance.

4

When describing the benefits of Medicare Supplement Plans, all insurers use the same format, language, and definitions. They are required to use a uniform chart and outline of coverage to summarize the benefits of the plans they offer. These requirements make it easier to compare policies from different insurers. As you shop for a policy, keep in mind that each company’s products are standard, products compete based on price, service, and reputation.

PRICE. While the benefits are identical for allMedicare Supplemental Plans of the sametype, the premiums vary from one company toanother and from area to area. The plan withthe lowest price is not necessarily the bestplan. The price should not be the onlyconcern. You may prefer a particular scheduleof payments. Some companies bill thepremium each month, while others bill eachquarter or once a year. In addition, prices arebased in part on the services a companyprovides and on their reputation. Some plansadd benefits but remember the basic coverageis the same from plan to plan based on federallaw.

CUSTOMER SERVICES. You should ask aboutthe insurer’s customer services. For example,some companies link their computers with thecomputers at the federal Medicare office toprocess your health insurance claims withoutadditional paperwork. This is called MedicareCrossover. This and other available customerservices may be important considerations inmaking a decision.

REPUTATION. You should consider the reputation of the insurer before buying a policy. Find out about the company by asking for referrals, asking others about their experiences, and check out the number of complaints filed at this website: https://eapps.naic.org/cis/

POLICY FEE: Some policies add a one-time policy fee.

These are not allowed in Arkansas.

UNDERWRITING: Most companies underwrite.

However, a few policies are “guaranteed issue.”

PREMIUM TYPE: The premium for your policy may

increase every year, primarily due to inflation in

medical costs and the use of more advanced

technology. The amount your premium goes up may

depend upon the manner in which the company has

reflected the aging of its policyholders in its rates. The

general approach that companies use are described

below. In Arkansas, the no age rating method is used.

1. Attained Age: In addition to medical inflation and

advancing technology, your premium will also rise

due to the increased use of medical services as

people age.

2. Issue Age: The premium you pay will initially be

somewhat higher than under the attained age

approach because a portion of the initial premium

is used to pre-fund the increased claims cost in later

years. As a result, in subsequent years your

premiums should be somewhat less than they

would be under an attained age approach.

3. No Age Rating: Under this approach, the premium

is the same for all customers who buy this policy,

regardless of age.

DIRECT RESPONSE/AGENT: Premiums are basically the

same when comparing a direct response sale to an

agent-marketed sale.

NON-SMOKER: Few companies have non-smoker

discounts.

MEDICARE CROSSOVER: This is one of the more

significant service enhancements that companies can

offer. A “crossover” company has a contract with

Medicare requiring Medicare to send the policyholder’s

balance bills directly to the Medicare Supplement

Insurance Company.

BUYER BEWARE VARIABLES

5

2017 COSTS OF MEDICARE

PART A HOSPITAL INSURANCE COVERED SERVICES

SERVICES BENEFITS MEDICARE PAYS YOU PAY

Hospitalization Semi-private room, general nursing, miscellaneous services and supplies-

First 60 days

61st to 90th day

91st to 150th day

Beyond 150 days

All but $1,316

All but $329 per day

All but $658 per day

Nothing

$1,316 deductible

$329 per day

$658 per day

All charges

POST-HOSPITAL Skilled Nursing Facility Care (SNF) after a 3 night hospital stay

First 20 days

21st to 100th day

Beyond 100 days

100% of approved

All but $164.50 per day

Nothing

Nothing if approved

$164.50 per day

All costs

Home Health Care following a 3-night inpatient hospital or SNF stay

Part-time care as long as you meet guidelines

100% of approved Nothing if approved

Hospice Care Full scope of pain relief and support services for the terminally ill

As long as doctor certifies need

All but limited costs for drugs & respite care

Limited costs for drugs & respite care

Blood Blood All but first 3 pints First 3 pints

PART B MEDICAL INSURANCE COVERED SERVICES

SERVICES BENEFITS MEDICARE PAYS YOU PAY

Medical Expense Physician services and medical supplies in and out of the hospital

Medical services in and out of the hospital

80% of approved amount (after $183 deductible)


Clinical Laboratory Diagnostic tests 100% of approved Nothing if approved

Home Health Care Medically necessary skilled care, home health aide services, medi-cal supplies, etc. after a 3-day in-patient hospital stay .Requires a prescription

Part-time care as long as you meet guidelines

100% of approved Nothing if approved

Outpatient Hospital Treatment

Unlimited if medically necessary

80% of approved 20% of approved amount (after $183 deductible)

Durable Medical Equipment Prescribed by doctor for use in home



Blood Blood All but first 3 pints First 3 pints

6

Reading the chart: If a “x” mark appears in a column of this chart, the Medigap policy covers 100% of

the desired benefit. If a column lists a percentage, then the policy covers that percentage of the

described benefit. If a column is blank, then the policy does not cover that benefit.

Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the

Medigap policy also covers the deductible).

Note: Out-of-Pocket Limit K and L, $5,120 & $2,560

MEDIGAP PLAN OPTIONS

Medigap Plan Benefits A B C D F* G K** L** M N

Medicare Part A eligible hospital costs up to an additional 365 days after all Medicare hospital benefits are ex-hausted

X X X X X X X X X X

Medicare Part B Coinsurance or Copay-ment (20% of Medicare Assignment)

X X X X X X 50% 75% X X

Blood (First 3 Pints) X X X X X X 50% 75% X X

Part A Hospice Care Coinsurance or Copayment

X X X X X X 50% 75% X X

Skilled Nursing Facility Care Copayment (Days 21-100 = $164.50 per day in 2017)

X X X X 50% 75% X X

Medicare Part A Deductible ($1,316.00 per benefit period in 2017)

X X X X X 50% 75% 50% X

Medicare Part B Deductible ($183 per year in 2017)

X X

Medicare Part B Excess Charges (up to 15% above Medicare approved amount if provider does not accept Medicare assignment)

X X

Foreign Travel Emergency (Up to Plan Limits)

X X X X X X

Medicare Preventive Part B Coinsur-ance (as of 2011 most preventive screenings no longer require coinsur-ance payment)

X X X X X X X X X X

***Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up

to a $50 copayment for emergency room visits that don't result in inpatient admission.

Plan F offers a high-deductible plan. This means you must pay for Medicare-covered costs up to the deductible amount $2,200 in 2017 before Medigap high-deductible plan pays anything.

After you meet the 2017 out-of-pocket yearly limit and yearly Part B deductible ($183 in 2017), the Medigap plan pays 100% of covered services for the rest of the calendar year. Out-of-pocket limit is the maximum amount you would pay.

7

MEDIGAP PROVIDERS FOR PEOPLE UNDER AGE 65

Medigap for Medicare recipients under age 65

Federal law does not require people under the age of 65 with Medicare Part B be granted a Medigap Open Enrollment Period. Younger Medicare beneficiaries are subject to medical underwriting and may be denied a policy based on medical history. There is no assurance that those under age 65 will be issued a Medigap Policy.

Liberty National Life Insurance Company P. O. Box 8080

McKinney, TX 75070

1-800-331-2512

www.libertynational.com

United American Insurance Co P.O. Box 8080

McKinney, TX 75070

1-800-331-2512

www.UnitedAmerican.com

8

MEDIGAP PROVIDERS FOR PEOPLE AGE 65 & OLDER

AARP (United Healthcare Insurance Co.) P.O. Box 130

Montgomeryville, PA 18936

1-800-523-5800

www.aarphealthcare.com

American Continental Insurance Company (Subsidiary of Aetna) 101 Continental Place

Brentwood, TN 37027

1-800-264-4000

American Republic Insurance Company P.O. Box 2780

Omaha, NE 68103-2780

1-800-987-8988

www.americanrepublic.com

American Retirement Life Insurance Company 11200 Lakeline Blvd., Suite 100

Austin, TX 78717

1-866-459-4272

Arkansas Blue Cross & Blue Shield P.O. Box 2181

Little Rock, AR 72203

1-800-392-2583

www.arkansasbluecross.com

Assured Life Association/Woodmen of the World 6030 Greenwood Plaza Blvd., Suite 100

Greenwood Village, CO 80111

1-800-777-9777

www.denverwoodmen.org

Bankers Fidelity Life 4370 Peachtree Rd. NE

Atlanta, GA 30319

1-866-458-7500

www.BFLIC.com

Central States Indemnity Co. of Omaha Medicare Sup. Admin. Offices

P.O. Box 10817

Clearwater, FL 33757-8817

1-855-664-5517

Colonial Penn Life Insurance Company Admin. Address 600 West Chicago Ave.

Chicago, IL 60654-2800

1-312-396-6000

9


Combined Insurance Company of America 5050 North Broadway

Chicago, IL 606040

1-800-225-4500

www.combined.com

Companion Life Insurance Company P.O. Box 100102

Columbia, SC 29202

1-800-753-0404

www.companionlife.com

Coventry Health and Life Insurance Company (Subsidiary of Aetna) 800 Crescent Centre Dr., Suite 200

Franklin, TN 37067

1-800-264-4000

Equitable Life & Casualty Insurance Company 3 Triad Center

Salt Lake City, UT 84180

1-800-352-5170

Family Life Insurance Company P. O. Box 924408

Houston, TX 77292-4408

1-800-877-7705

First Health Life & Health Insurance Company 800 Crescent Centre Dr., Suite 200

Franklin, TN 37067

1-800-264-4000

Gerber Life Insurance Company 1311 Mammaroneck Avenue

White Plains, NY 10605

1-914-272-4000

Globe Life & Accident Insurance Company P.O. Box 2440

McKinney, TX 75070

1-800-801-6831

www.globecaremedsupp.com

Government Personnel Mutual Life Insurance Company P.O. Box 659567

San Antonio, TX 99999

1-800-929-4765

10

Guarantee Trust Life Insurance Company 1275 Milwaukee Avenue

Glenview, IL 60025

1-847-460-4772

Heartland National Life Insurance Company 10689 N. Pennsylvania Street

Indianapolis, IN 46280

1-816-478-0120

Humana Insurance Company P.O. Box 14601

Lexington, KY 40512

1-800-866-0581

www.humana.com

Individual Assurance Company, Life, Health & Accident P.O. Box 3270

Salt Lake City, UT 84110-3270

1-888-524-3629

Liberty National Life Insurance Company P. O. Box 2612 (35202)

Birmingham, AL 35233

1-800-331-2512

www.libertynational.com

Loyal American Life Insurance Company (Subsidiary of Cigna) P.O. Box 559004

Austin, TX 78755

1-800-633-6752

www.loyalamerican.com

Madison National Life Insurance Company 1241 John Q. Hammons Dr.

Madison, WI 53717

1-800-356-9601

Manhattan Life Insurance Company 10777 Northwest Freeway

Houston, TX 77092

1-713-529-0045

Marquette National Life Insurance Company (Subsidiary of Aetna) 411 N. Baylen Street

Pensacola, FL 32502

1-800-934-8203

www.marquettenationallife.com


11


Medico Corp Life Insurance Company 11808 Grant St

Omaha, NE 68103-0160

1-800-822-9993

Medico Insurance Company 1515 South 75th Street

Omaha, NE 68124

1-800-695-5976

Old Surety Life Insurance Company P.O. Box 54407

Oklahoma City, OK 73154

1-800-272-5466

Order of United Commercial Travelers of America P. O. Box 159019

631 North Park Street

Columbus, OH 43215-8619

1-800-848-0123

Philadelphia American Life Insurance Company P.O. Box 4884

Houston, TX 77210-4884

1-800-713-4680

Physicians Mutual Insurance Company 2600 Dodge

Omaha, NE 68131

1-800-228-9100

Puritan Life Insurance Company (formerly known as Admiral Life Insurance Company

of America) P.O. Box 10860

Clearwater, FL 33757-8860

1-800-513-3243

QualChoice Life and Health Insurance Company P. O. Box 25626

Little Rock, AR 72221-5626

1-855-633-4765

Reserve National Insurance Company 6100 North West Grand Blvd.

Oklahoma City, OK 73118

1-800-654-9106

www.reservenational.com

12


Standard Life & Accident Insurance Co. One Moody Plaza

Galveston, TX 77550

1-888-350-1488

www.AINCO.com

State Farm Mutual Automobile Ins. Co. One State Farm Plaza

Bloomington, IL 61710

www.statefarm.com

1-309-763-8104

State Mutual Insurance Company One State Mutual Drive

Rome, GA 30162

1-855-764-4000

www.statemutualinsurance.com

Thrivent Financial For Lutherans 4321 North Ballard Road

Appleton, WI 54919

1-800-847-4836

www.thrivent.com

Transamerica Life Insurance Company

Medicare Supplement Sales 300 Eagleview Blvd.

Exton, PA 19341

1-800-247-1771

www.TAMedSupp.com

United American Insurance Co P.O. Box 8080

McKinney, TX 75070

1-800-331-2512

www.UnitedAmerican.com

United National Life Insurance 1275 Milwaukee Ave.

Glenview, IL 60025

1-800-207-8050

www.unlinsurance.com

United of Omaha Life Insurance Company Mutual of Omaha Plaza

Omaha, NE 68175

1-800-775-6000

13


United Teachers Associates P.O. Box 26580

Austin, TX 78755

1-800-880-8824

www.UTAIC.com

USAA Life Insurance Company 9800 Fredericksburg Road

San Antonio, TX 78288

1-800-531-8000

www.USAA.com

World Corp Insurance Company 1000 World Corp Plaza, North Park

P.O. Box 3160

Omaha, NE 68103-0160

1-402-496-8000

14

Aetna Life Insurance Company800 Crescent Centre Dr. Franklin, TN 37067

F - Female

M - Male

NT - Non Tobacco User

T - Tobacco User

HD - High Deductible Plan

888-624-6290

www.aetnaseniorproducts.com

Medical Underwriting: Yes/No questions, outside of open enrollment and other guaranteed issue periods

Pre-existing condition waiting period: None Policy

Fee: None SEL - Select Plan

Medicare Crossover: Yes

Annual Premiums: Rates available as annual, semi-annual, quarterly and monthly. Plan B also available

Zip Code Areas: Rest of state Preferred Non-Tobacco User

Zip Code Areas: Rest of state Standard Tobacco User

Zip Code Areas:72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-72120, 72124,72135, 72142, 72164, 72180, 72183, 72190, 72198, 72199, and all ZIP codesbeginning with 722 Standard II Non-Tobacco User

SUPERSCRIPT MEANINGS

IN THE CHARTS

85+ 160.14 239.28 218.66 166.39

65 160.14 239.28 218.66 166.39

70 160.14 239.28 218.66 166.39

75 160.14 239.28 218.66 166.39

80 160.14 239.28 218.66 166.39

80 140.94 210.67 192.34 146.52

85+ 140.94 210.67 192.34 146.52

AGE A F G N<65 Preferred Non-Tobacco User Preferred Non-Tobacco User

<6565 140.94 210.67 192.34 146.52

70 140.94 210.67 192.34 146.52

75 140.94 210.67 192.34 146.52

85+ 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11

AGE A F G N

75 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.1180 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11

65 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.1170 128.12 128.12 191.42 191.42 174.93 174.93 133.11 133.11

AGE A F G NF M F M F M F M

<65

A.M. Best

Rating:

NR

DISCLAIMER: These rates were correct at the time of Provider's submission. For the most current rates, CONTACT THE INSURANCE COMPANY DIRECTLY.

15

Aetna Life Insurance Company (Continued)

Zip Code Areas:72002, 72053, 72065, 72076, 72078, 72099, 72103,

72113-72120, 72124, 72135, 72142, 72164, 72180, 72183,

72190, 72198, 72199, and all ZIP codes beginning with 722 Standard III Tobacco

4

Zip Code Areas:All other Zip Codes beginning with 720 or 721 Preferred Non-Smoker

Zip Code Areas:All other ZIP codes beginning with 720 or 721 Standard Smoker

MFMFMFMFNGFAAGE

80 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.3285+ 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32

70 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32

75 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32

<6565 149.40 149.40 223.31 223.31 203.88 203.88 155.32 155.32

85+ 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10


75 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10

80 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10

65 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.1070 135.80 135.80 202.91 202.91 185.43 185.43 141.10 141.10


<65

80 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.1685+ 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16

70 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16

75 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16

<65 Standard Tobacco User Standard Tobacco User

65 176.18 176.18 263.33 263.33 240.42 240.42 183.16 183.16


16

American Continental Insurance Company800 Crescent Centre Dr. Franklin, TN 37067

F - Female

M - Male

888-624-6290

www.aetnaseniorproducts.com

Medical Underwriting: Yes/No questions, outside of open enrollment NT - Non Tobacco User

and other guarantee issue periods T - Tobacco User

Pre-existing waiting period: None HD - High Deductible Plan

Policy Fee: None SEL - Select Plan

Medicare Crossover: YesAnnual Premiums: Rates available as annual, semi-annual, quarterly and monthly. Plans B and High

Zip Code Areas: 722 Preferred Non-Tobacco User

Zip Code Areas: 722 Standard Tobacco User

Zip Code Areas: 72202, 72053,72065 Standard II Tobacco User


IN THE CHARTS

70 198.55 288.37 249.89 184.46

75 198.55 288.37 249.89 184.46

80 198.55 288.37 249.89 184.46

85+ 198.55 288.37 249.89 184.46

85+ 220.76 320.56 277.53 205.11

AGE A F G N<65 Preferred Non-Tobacco

65 288.37 249.89 184.46

65 220.76 320.56 277.53 205.11

70 220.76 320.56 277.53 205.1175 220.76 320.56 277.53 205.11

80 220.76 320.56 277.53 205.11

AGE A F G N

<65 220.76 320.56 277.53 205.11

85+ 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46

75 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.4680 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46

65 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.4670 198.55 198.55 288.37 288.37 249.89 249.89 184.46 184.46


<65

A.M. Best

Rating:

___


17

American National Life Insurance Company of TexasOne Moody Plaza Galveston, TX 77550

888-350-1488 www.slaico.com F - Female

M - Male


T - Tobacco User


Medical Underwriting: Outside open enrollment Pre-existing condition waiting period: None Policy Fee: None


Annual Premiums: Community Rated SEL - Select Plan

Zip Code Areas: 716-717, 725-729 Preferred Non-Tobacco User

Zip Code Areas: 716-717, 725-729 Standard Tobacco User

Zip Code Areas: 718 Standard II Tobacco User


IN THE CHARTS

85+ 1415.18 2011.03 1554.83

65 1415.18 2011.03 1554.8370 1415.18 2011.03 1554.8375 1415.18 2011.03 1554.8380 1415.18 2011.03 1554.83

80 1397.70 1986.2185+ 1397.70 1986.21 1535.63

AGE A F G N<65 N/A N/A N/A

<65 N/A N/A N/A

65 1397.70 1986.21 1535.6370 1397.70 1986.21 1535.6375 1397.70 1986.21 1535.63

85+ 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07

AGE A F G N

75 1257.94 1257.94 1787.58 1787.58 1382.07 1382.0780 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07

65 1257.94 1257.94 1787.58 1787.58 1382.07 1382.0770 1257.94 1257.94 1787.58 1787.58 1382.07 1382.07

NF M F M F M F M

<65 N/A N/A N/A N/A N/A N/A

AGE A F G

A.M. Best

Rating:

A


1535.63

18

American National Life Insurance Company of Texas (Continued)

Zip Code Areas: 718 Standard III Tobacco User

Zip Code Areas: 719-724 Preferred Non-Smoker

Zip Code Areas: 719-724 Standard Smoker

85+ 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20

75 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20

80 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20

65 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20

70 1537.47 1537.47 2184.83 2184.83 1689.20 1689.20



80 1383.73 1383.73 1966.34 1966.34 1520.28 1520.2885+ 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28

70 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28

75 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28


65 1383.73 1383.73 1966.34 1966.34 1520.28 1520.28

85+ 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59


75 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59

80 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59

65 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59

70 1572.42 1572.42 2234.48 2234.48 1727.59 1727.59




19

F - Female

M - Male


T - Tobacco User

American Republic Corp Insurance Co. PO Box 14510 Des Moines, IA 50306

888-755-3065

www.AmericanRepublic.com

Medical Underwriting:

Preexisting condition waiting period:

Policy Fee: No Medicare Crossover:

Annual Premiums:


SEL - Select Plan

Zip Code Areas: 71700-71799, 72600-72999 Preferred


Zip Code Areas: Rest of State Preferred

Zip Code Areas: 72200-72299 Preferred


IN THE CHARTS

80 1984.92 1984.92 2958.28 2958.2885+ 1984.92 1984.92 2958.28 2958.28

70 1984.92 1984.92 2958.28 2958.28

75 1984.92 1984.92 2958.28 2958.28

85+


65 1984.92 1984.92 2958.28 2958.28

AGE

6570

2829.651898.62 1898.62

7580

A F G NF M F M

80 1795.06 1795.06 2675.31 2675.31

85+ 1795.06 1795.06 2675.31 2675.31

70 1795.06 1795.06 2675.31 2675.31

75 1795.06 1795.06 2675.31 2675.31

<6565 1795.06 1795.06 2675.31 2675.31

85+ 1708.76 1708.76 2546.69 2546.69


75 1708.76 1708.76 2546.69 2546.69

80 1708.76 1708.76 2546.69 2546.69

65 1708.76 1708.76 2546.69 2546.69

70 1708.76 1708.76 2546.69 2546.69


<65

1898.621898.621898.621898.62

1898.621898.621898.621898.62

F

2829.652829.652829.652829.65

M2829.652829.652829.652829.652829.65

F M

A.M. Best

Rating:

NR


20

American Republic Corp Insurance Company (Continued)

Zip Code Areas: 71700-71799, 72600-72999 Standard


Zip Code Areas: Rest of State Standard

Zip Code Areas: 72200-72299 Standard

80 2335.20 2335.20 3480.32 3480.32

85+ 2335.20 2335.20 3480.32 3480.32

70 2335.20 2335.20 3480.32 3480.32

75 2335.20 2335.20 3480.32 3480.32

<6565 2335.20 2335.20 3480.32 3480.32

85+ 2233.67 2233.67 3329.01 3329.01


75 2233.67 2233.67 3329.01 3329.01

80 2233.67 2233.67 3329.01 3329.01

65 2233.67 2233.67 3329.01 3329.01

70 2233.67 2233.67 3329.01 3329.01


<65

80 2111.83 2111.83 3147.42 3147.42

85+ 2111.83 2111.83 3147.42 3147.42

70 2111.83 2111.83 3147.42 3147.42

75 2111.83 2111.83 3147.42 3147.42

<6565 2111.83 2111.83 3147.42 3147.42

85+ 2010.30 2010.30 2996.10 2996.10


75 2010.30 2010.30 2996.10 2996.10

80 2010.30 2010.30 2996.10 2996.10

65 2010.30 2010.30 2996.10 2996.10

70 2010.30 2010.30 2996.10 2996.10


<65


21

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Americo Financial Life & Annuity Insurance Co. 300 West 11th Street, Kansas City, MO 64105

800-231-0801

www.americo.com

Medical Underwriting: Yes Preexisting condition waiting period: No Policy Fee: NoMedicare Crossover: YesAnnual Premiums:

Zip Code Areas: 720-722 Preferred Non-Tobacco User

Zip Code Areas: 720-722 Standard Tobacco User


Zip Code Areas: 716-719, 723-729 Standard Tobacco User


IN THE CHARTS

AGE A F G NM/F M/F M/F M/F

All $1622 $2075 $1738 $1492

All $1411 $1804 $1511 $1297


All $1807 $2311 $1935 $1661


All $1571 $2010 $1683 $1444


A.M. Best

Rating:

A


22

Arkansas Blue Cross & Blue ShieldPO Box 2181, Little Rock, AR 72203

F - Female800-392-2583www.arkansasbluecross.com M - Male

Medical Underwriting: Only outside of open enrollment NT - Non Tobacco User

Pre-existing condition waiting period: None T - Tobacco User

Policy fee: None HD - High Deductible Plan

Monthly Premiums SEL - Select Plan

Zip Codes: 716, 721‐723 Monthly Standard Non- Tobacco

Zip Codes: 716, 721‐723 Monthly Standard Tobacco

Zip Codes: 717‐720, 724‐729 Monthly Standard Non-Tobacco

Zip Codes: 717‐720, 724‐729 Monthly Standard Tobacco

SUPERSCRIPT MEANINGSIN THE CHARTS

117.26 117.26 175.32 175.32 150.76 150.76 NA NA

80 117.26 117.26 175.32 175.32 150.76 150.76 NA NA

106.69 106.69 159.43 159.43 137.12 137.12 NA NA

191.26 191.26 164.47 164.47 NA NA

127.91 127.91 191.26 191.26 164.47 164.47 NA NA

<65 127.91 127.91 191.26 191.26 164.47 164.47 NA NA

65 127.91 127.91 191.26 191.26 164.47 164.47 NA

85+ 117.26 117.26 175.32 175.32 150.76 150.76 NA NA

F M F M F

70 116.39 116.39 173.94 173.94 149.59 149.59 NA

116.39 116.39

NA

173.94 173.94 149.59 149.59 NA NA

75

AGEF M F M F M F M

A F G N

6570 117.26 117.26 175.32 175.32 150.76 150.76 NA NA

<65 117.26 175.32 175.32 150.76 150.76 NA117.26

80 106.69 106.69 159.43 159.43 137.12 137.12 NA NA

85+ 106.69 106.69 159.43 159.43 137.12 137.12 NA NA

7075 106.69 106.69 159.43 159.43 137.12 137.12 NA NA

65 106.69 106.69 159.43 159.43 137.12 137.12 NA NA

AGEF M F M F M F M

A F G N

<65 NA NA106.69 106.69 159.43 159.43 137.12 137.12

85+ 116.39 116.39 173.94 173.94 149.59 149.59 NA NA

AGEF M F M F M F M

A F G N

7580 116.39 116.39 173.94 173.94 149.59 149.59 NA NA

AGE A F G NF M M

NANA149.59149.59173.94173.94116.39116.39

85+ 127.91

NANA149.59149.59173.94173.94116.39116.3965

127.91

<65

NA

117.26 117.26 175.32 175.32 150.76 150.76 NA NA

NA

70 127.91 127.91 191.26 191.26 164.47 164.47 NA NA

75 127.91 127.91 191.26 191.26 164.47 164.47 NA NA

80

A.M. Best

Rating:

NR


23

Assured Life Association

PO Box 2397

Omaha, NE 68103-2397 F - Female

877-223-3666 M - Male


T - Tobacco User


SEL - Select Plan

Medical Underwriting: Yes (Outside open enrollment & guaranteed issue periods)

Pre-existing condition waiting period: NonePolicy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown belowZip Code Areas: 716-717, 724-729 Non-Tobacco user

Zip Code Areas: 718-721 Non-Tobacco User


Zip Code Areas: 716-717, 724-729 Tobacco User

Zip Code Areas: 718-721 Tobacco User



IN THE CHARTS

$1,779.94

65+ $1,849.25 $2,138.45 $2,581.21 $2,115.43 $2,639.15 $2,115.43 $1,906.02

AGE A B C D F G N

65+ $1,984.98 $2,295.40 $2,770.65 $2,270.69 $2,832.85 $2,270.69 $2,045.91

AGE A B C D F G N65+ $1,696.56 $1,961.88 $2,368.08 $1,940.76 $2,421.24 $1,940.76

AGE A B C D F G N

65+ $1,608.85 $1,860.45 $2,245.65 $1,840.42 $2,296.06 $1,840.42 $1,658.24

B C D F G NAGE A65+ $1,726.93 $1,997.00 $2,410.47 $1,975.50 $2,464.58 $1,975.50

AGE A B C D F G N65+ $1,476.01 $1,706.84 $2,060.23 1,688.46 $2,106.48 $1,688.46 $1,521.32

AGE A B C D F G N

$1,748.64

A.M. Best

Rating:

NR


24

F - Female

M - Male

Bankers Fidelity Life Insurance Company 4370 Peachtree Road, N.E., Atlanta, Georgia 30319 866-458-7504 x 876

www.bflic.com

Medical Underwriting: Yes, all available plans NT - Non Tobacco User

T - Tobacco User


SEL - Select Plan

Pre-existing condition waiting period: NA

Policy Fee: No


Annual Premium: Issue Age

Zip Codes: 720-722 Preferred Non-Tobacco User

Zip Codes: 720-722 Standard Tobacco User

Zip Codes: 720-722 Standard II Non-Tobacco User


IN THE CHARTS

85+ 1704 2571 1940

65 1704 2571 1940

70 1704 2571 1940

75 1704 2571 1940

80 1704 2571 1940

80 1704 2571 1940

85+ 1704 2571 1940

AGE A F G N<65

<6565 1704 2571 1940

70 1704 2571 194075 1704 2571 1940

85+ 1425 1425 2137 2137 1619 1619

AGE A F G N

75 1425 1425 2137 2137 1619 1619

80 1425 1425 2137 2137 1619 1619

65 1425 1425 2137 2137 1619 161970 1425 1425 2137 2137 1619 1619


<65

A.M. Best

Rating:

NR


25

Central States Indemnity Co. of Omaha1212 North 96th Street, Omaha, NE 68114-2200

F - Female

M - Male


T - Tobacco User


866-644-3988

Medical Underwriting: Yes

Pre-existing condition waiting period: No Policy Fee: No


Annual Premiums: SEL - Select Plan


Zip Code Areas: All except 720-722 Preferred Non-Tobacco User

Zip Code Areas: 720-722 Standard Smoker

Zip Code Areas:All except 720-722 Standard Smoker

CM/F


IN THE CHARTS

AGE A B F

AllM/F M/F M/F

$1582 $1827 $2224 $2286

M/F M/F M/F M/FAGE A B C F

AGE A B C FM/F M/F M/F M/F

All $1425 $1662 $2001 $2058

AGE A B C FM/F M/F M/F M/F

All $1605 $1872 $2254 $2318

GM/F

$1,400

NM/F

$1,200

M/F

G NM/F

$1,576M/F

$1,352

NM/F

$1,334

M/F$1,751

GM/F

$1,555

G N

$1782 $2057 $2505 $2575 $1,502All

A.M. Best

Rating:

A+


26

Colonial Penn Life Insurance Company11825 North Pennsylvania Street, Carmel, IN 46032

800-800-2254 F - Female

https://www.bankerslife.com/products/medicare-supplement-insurance/ M - Male


T - Tobacco User


SEL - Select Plan

Medical Underwriting: YesPre-existing condition waiting period: Yes Policy Fee: NoneMedicare crossover: YesAnnual Premiums: Yes

Zip Code Areas: All Zips - Preferred Preferred Non-Tobacco User

Zip Code Areas: All Zips - Standard Standard Tobacco User

Zip Code Areas: All Zips - Substandard Standard II Non-Tobacco User


IN THE CHARTS

85+ 2,555.54 3,129.46 2,751.58 1,831.95

65 2,555.54 3,129.46 2,751.58 1,831.95

70 2,555.54 3,129.46 2,751.58 1,831.95

75 2,555.54 3,129.46 2,751.58 1,831.95

80 2,555.54 3,129.46 2,751.58 1,831.95

80 2,299.94 2,816.59 2,476.56 1,648.79

85+ 2,299.94 2,816.59 2,476.56 1,648.79

AGE A F G N<65 - - - -

<65 - - - -

65 2,299.94 2,816.59 2,476.56 1,648.79

70 2,299.94 2,816.59 2,476.56 1,648.7975 2,299.94 2,816.59 2,476.56 1,648.79

85+ 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84

AGE A F G N

75 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84

80 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84

65 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.8470 2,069.98 2,069.98 2,535.14 2,535.14 2,228.93 2,228.93 1,483.84 1,483.84


<65 - - - - - - - -

A.M. Best

Rating:

A-


27

Gerber Life Insurance Company P.O. Box 2271Omaha, NE 68103-2271 F - Female

877-778-0839 M - Male


T - Tobacco User


SEL - Select Plan

Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: None Policy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below

Zip Code Areas: 716-719, 723-729 Non-Tobacco User

Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,

72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,

72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,

72178-179, 72181-182, 72189 Non-Tobacco User

Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135, 72142, 72164, 72180,

72183, 72190, 72198-199, 722 Non-Tobacco User


Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,

72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,

72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,

72178-179, 72181-182, 72189 Tobacco User

Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135,

72142, 72164, 72180, 72183, 72190, 72198-199, 722 Tobacco User


65+ $1,994.23 $2,880.86 $2,413.82

AGE A B C D F G N65+ $2,190.09 $3,163.81 $2,650.90

AGE A B C D F G N65+ $1,780.56 $2,572.20 $2,155.20

AGE A B C D F G N

65+ $1,734.98 $2,506.35 $2,100.02

AGE A B C D F G N65+ $1,905.38 $2,752.51 $2,306.28

AGE A B C D F G N65+ $1,549.09 $2,237.81 $1,875.02

AGE A B C D F G N

A.M. Best

Rating:

A+


28

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Globe Life and Accident Insurance Company 3700 S. Stonebridge Drive

PO Box 8080, McKinney, TX 75070

800-801-6831

www.globecaremedsupp.com

Medical Underwriting: Simple underwriting with yes/no questions Pre-existing condition waiting period: 2 months

Policy Fee:

Medical Crossover:

Annual Premiums: Yes

Zip Code Areas Preferred Non-Tobacco User

Zip Code Areas: All Areas Standard Tobacco User


IN THE CHARTS

80 1123 1861

85+ 1123 1861

<6565 1123 1861

70 1123 1861

75 1123 1861

85+

AGE A F G N

7580

6570

AGE A F G NN/A N/A N/A N/A N/A N/A N/A N/A

<65

A.M. Best

Rating:

A+


1970 16971970197019701970

1697

16971697

1697

29

Government Personnel Mutual Life Insurance Company P.O. Box 2679

Omaha, NE 68103-2679F - Female866-242-7573

www.gpmlife.com M - Male


T - Tobacco User


SEL - Select Plan

Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: NonePolicy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below








NG

65+ 2042 $2,852.51 $2,921.59 $2,182.66 $1,936.84

AGE A B C D F G N65+ $2,243.08 $3,132.66 $3,208.53 $2,397.02 $2,127.06

AGE A B C D F G N65+ $1,823.64 $2,546.88 $2,608.56 $1,948.80 $1,729.32

AGE A B 65+ C D F G N

65+ $1,776.96 $2,481.68 $2,541.78 $1898.91 $1,685.05

AGE A B C D F G N65+ $1,951.48 $2,725.41 $2,791.42 $2,085.41 $1,850.54

65+ 1,586.57 $2,215.79 $2,269.45 $1,695.46 $1,504.51

B C D F G N

AGE A B C D F

A.M. Best

Rating:

A-


30

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Humana Insurance Company500 West Main Street

Louisville, Ky 40202

888-310-8482

www.Humana.com


Pre-existing condition waiting period: 3 months Policy Fee: N/A


Annual Premiums: No

Zip Code Areas: Pulaski Preferred Non-Tobacco User

Zip Code Areas: Pulaski Standard Non-Tobacco User

Zip Code Areas Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Springs,

Jackson, Lonoke, Monroe, Montgomery, Perry, Pike, Polk, Prairie,

Saline, Van Buren, White, and Woodruff Standard II Non-Tobacco User


IN THE CHARTS

A.M. Best

Rating:

NR

AGE B C HD K LF M F M F M F M F M

<65 65 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7470 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7475 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7480 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74

85+ 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74


<65 65 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7470 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7475 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.7480 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74

85+ 186.36 186.36 216.94 216.94 76.01 76.01 100.42 100.42 142.74 142.74


<65 65 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85

70 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85

75 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85

80 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.8585+ 178.68 178.68 216.94 216.94 72.88 72.88 96.28 96.28 136.85 136.85


31

Humana Insurance Company (Continued)

Zip Code Areas: Rest of state Standard III Non-Tobacco User

Zip Code Areas: Pulaski Standard Tobacco User

Zip Code Areas Arkansas, Clark, Conway, Faulkner, Garland, Grant, Hot Springs, Jackson, Lonoke, Monroe, Montgomery, Perry, Pike, Polk, Prairie, Saline, Van Buren, White, and Woodruff Standard II Tobacco User

Zip Code Areas: Rest of State Standard III Tobacco User

AGE B C HD K L F M F M F M F M F M

<65 65 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 70 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 75 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00 80 164.52 164.52 191.52 191.52 67.10 67.10 88.65 88.65 126.00 126.00

85+


<65 65 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 70 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 75 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32 80 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32

85+ 278.55 278.55 324.26 324.26 113.61 113.61 150.10 150.10 213.32 213.32

AGE B C HD K L F M F M F M F M F M

<65 65 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 70 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 75 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53 80 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53

85+ 267.07 267.07 310.90 310.90 108.93 108.93 143.91 143.91 204.53 204.53


<65 65 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 70 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 75 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32 80 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32

85+ 245.90 245.90 286.26 286.26 100.29 100.29 132.50 132.50 188.32 188.32


32

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Medico Corporation Life Insurance Co. 11808 Grant St., Omaha, NE 68103-0160

800-547-2401, option 3

www.goMedico.com



Policy Fee: NoMedicare Crossover:




Zip Code Areas: Rest of State Preferred

Zip Code Areas: 72200-72299 Preferred


IN THE CHARTS

85+ 2066.15 2066.15 2788.82 2788.82

75 2066.15 2066.15 2788.82 2788.82

80 2066.15 2066.15 2788.82 2788.82

65 2066.15 2066.15 2788.82 2788.82

70 2066.15 2066.15 2788.82 2788.82

85+ 1976.32 1976.32 2667.56 2667.56


65 1976.32 1976.32 2667.56 2667.56

70 1976.32 1976.32 2667.56 2667.56

75 1976.32 1976.32 2667.56 2667.56

80 1976.32 1976.32 2667.56 2667.56

80 1868.52 1868.52 2522.06 2522.06

85+ 1868.52 1868.52 2522.06 2522.06

AGE A F G N

<6565 1868.52 1868.52 2522.06 2522.06

70 1868.52 1868.52 2522.06 2522.06

75 1868.52 1868.52 2522.06 2522.06

85+ 1778.69 1778.69 2400.81 2400.81

AGE A F G N

75 1778.69 1778.69 2400.81 2400.81

80 1778.69 1778.69 2400.81 2400.81

65 1778.69 1778.69 2400.81 2400.81

70 1778.69 1778.69 2400.81 2400.81


<65

A.M. Best

Rating:

NR


33

Medico Corporation Life Insurance Company (Continued)



Zip Code Areas: Rest of State Standard

Zip Code Areas: 72200-72299 Standard

85+ 2430.77 2430.77 3280.96 3280.96

75 2430.77 2430.77 3280.96 3280.96

80 2430.77 2430.77 3280.96 3280.96

65 2430.77 2430.77 3280.96 3280.96

70 2430.77 2430.77 3280.96 3280.96


<65

80 2325.08 2325.08 3138.31 3138.31

85+ 2325.08 2325.08 3138.31 3138.31

70 2325.08 2325.08 3138.31 3138.31

75 2325.08 2325.08 3138.31 3138.31

<6565 2325.08 2325.08 3138.31 3138.31

85+ 2198.26 2198.26 2967.13 2967.13


75 2198.26 2198.26 2967.13 2967.13

80 2198.26 2198.26 2967.13 2967.13

65 2198.26 2198.26 2967.13 2967.13

70 2198.26 2198.26 2967.13 2967.13


<65

80 2092.57 2092.57 2824.48 2824.4885+ 2092.57 2092.57 2824.48 2824.48

70 2092.57 2092.57 2824.48 2824.4875 2092.57 2092.57 2824.48 2824.48

<6565 2092.57 2092.57 2824.48 2824.48



34

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Medico Insurance Company PO Box 10386, Des Moines, IA 50306 800-228-6080

www.goMedico.com



Policy Fee: No Medicare Crossover:


Zip Code Areas: 716, 720-723 Preferred

F


NF

Zip Code Areas: 716, 720-723 Standard

F


F G

F G N

2561.842234.05 2234.05 1918.72 1918.72

2561.84 2234.05 2234.05 1918.72 1918.722561.84 2234.05 2234.05 1918.72 1918.722561.84 2234.05 2234.05 1918.72 1918.72

198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75

M M F2234.05 2234.05 1918.72 1918.72

198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75198.05 1724.10 1724.10 1480.75 1480.75

G N

1942.65

1942.65

1942.651942.651942.651942.65

1942.65

1942.65

1942.65

F M

1668.461668.461668.461668.461668.46

1668.461668.461668.461668.461668.46

M F M


IN THE CHARTS

80 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87

85+ 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87

70 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87

75 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87

G NF M F M F M F M

65 1522.70 1522.70 2273.63 2273.63 1982.72 1982.72 1702.87 1702.87

70 1715.72 1715.72 2561.84

75 1715.72 1715.72 2561.84

80 1715.72 1715.72 2561.84

85+ 1715.72 1715.72 2561.84

AGE A F

2561.84

85+ 1324.83 1324.83 1978.05

AGE AF M F M

65 1715.72 1715.72 2561.84

<6565 1324.83 1324.83 1978.05

70 1324.83 1324.83 1978.05

75 1324.83 1324.83 1978.05

80 1324.83 1324.83 1978.05

80 1492.76 1492.76 2228.78

85+ 1492.76 1492.76 2228.78

2228.782228.782228.78

AGE AF M F M

<6565 1492.76 1492.76 2228.78

70 1492.76 1492.76 2228.782228.782228.78

1942.65

75 1492.76 1492.76 2228.78

AGE AF M F M M

F

A.M. Best

Rating:

NR


35

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Omaha Insurance Company Mutual of Omaha Plaza, Omaha, NE 68175 800-667-2937www.mutualofomaha.com

Medical Underwriting: Yes (Outside open enrollment and guaranteed issue periods)Pre-existing condition waiting period: None Policy Fee: 0Medicare Crossover: YesAnnual Premiums: Annual premiums shown below


Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,

72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,

72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,

72178-179, 72181-182, 72189 Non-Tobacco User

65+

Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135, 72142, 72164, 72180,

72183, 72190, 72198-199, 722 Non-Tobacco User

65+


65+

Zip Code Areas: 72001, 72003-007, 72010-048, 72051-052, 72055, 72057-061, 72063-064, 72066- 075,

72079-089, 72101-102, 72104-108, 72110-112, 72121-123, 72125-134, 72136-137, 72139-141, 72143, 72145,

72149-150, 72152-153, 72156-158, 72160, 72165-170, 72173, 72175-176,

72178-179, 72181-182, 72189 Tobacco User

65+

Zip Code Areas: 72002, 72053, 72065, 72076, 72078, 72099, 72103, 72113-120, 72124, 72135,

72142, 72164, 72180, 72183, 72190, 72198-199, 722 Tobacco User

65+


AGE A F HDF G N N

2088.47 638.15 1732.31 1334.25

F HDF G N N

65+ 1513.39 1991.34 608.47 1651.74 1272.19

F HDF G N N

N

2152.80 657.80 1785.66 1375.34

F HDF G N N

2379.89 727.20 1974.03 1520.42

F HDF G N N

2572.85 786.16 2134.09 1643.70

AGE A

AGE A

AGE A

AGE A

AGE A

1587.22

1808.69

1636.10

1715.91

1955.34

2257.81 689.89 1872.77 1442.43

F HDF G N

A.M. Best

Rating:

A+


36

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

Physicians Mutual Insurance Company 2600 Dodge Street Omaha, NE 68131

800-228-9100

www.physiciansmutual.com


Preexisting condition waiting period: 0 Medicare Crossover: YesPolicy Fee: NoAnnual Premiums:

Zip Code Areas: 71600-71899 & 72300-72999 (AREA E) Preferred Non-Tobacco User

Zip Code Areas: 71900-72199 (AREA F) Standard Non-Tobacco User

Zip Code Areas: 72200-72299 (AREA H) Standard II Non-Tobacco User

Zip Code Areas: 71600-71899 & 72300-72999 (AREA E) Standard Tobacco User


IN THE CHARTS

85+ $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293

75 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293

80 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293

65 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293

70 $1,888 $1,888 $1,574 $1,574 $806 $806 $2,430 $2,430 $2,293 $2,293

F M F M F M F M F M<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

85+ $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390

AGE A F HD G N

75 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390

80 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390

65 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,39070 $1,968 $1,968 $1,641 $1,641 $840 $840 $2,532 $2,532 $2,390 $2,390


85+ $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173

AGE A F HD G N

75 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,17380 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173

65 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173

70 $1,789 $1,789 $1,494 $1,494 $764 $764 $2,302 $2,302 $2,173 $2,173


85+ $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064

AGE A F HD G N

75 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,06480 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064

65 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064

70 $1,699 $1,699 $1,417 $1,417 $726 $726 $2,187 $2,187 $2,064 $2,064

HD G NF M F M F M F M F M

<65 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

AGE A F

A.M. Best

Rating:

A


37

Physicians Mutual Insurance Company (Continued)

Zip Code Areas: 71900-72199 (AREA F) Standard II Tobacco User

Zip Code Areas: 72200-72299 (AREA H) Standard III Tobacco User

85+ $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

75 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

80 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

65 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

70 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

F M F M F M F M F M<65 $2,186 $2,186 $1,823 $1,823 934 934 $2,814 $2,814 $2,655 $2,655

85+ $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414

AGE A F HD G N

75 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,41480 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414

65 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414

70 $1,988 $1,988 $1,657 $1,657 849 849 $2,558 $2,558 $2,414 $2,414


AGE A F HD G N


38

F - Female

M - Male


T - Tobacco User


SEL - Select Plan

S.USA Life Insurance Company100 West 33rd Street, Suite 1007, New York, NY 10001 877-725-4872

www.sbliusa.com


Preexisting condition waiting period: No

Policy Fee: No

Medicare Crossover: YesAnnual Premiums: Shown Below


Zip Code Areas: 720-722 Standard Tobacco User


Zip Code Areas: Standard Tobacco User

All $1823$1,413

AGE A F

M/F M/F

All $1253 $1620

AGE A F

M/F M/F

AGE A F

M/F M/FAll $1592 $2054

All $1411 $1825

AGE A FM/F M/F


IN THE CHARTS

A.M. Best

Rating:

A-


39

F - Female

Standard Life & Accident Insurance Company One Moody Plaza Galveston, TX 77550888-350-1488www.slaico.com M - Male


Medical Underwriting: Outside Open Enrollment T - Tobacco User

Pre-existing condition waiting period: None HD - High Deductible Plan

Policy Fee: $0.00 SEL - Select Plan

Medicare Crossover: YesAnnual Premiums: Community Rated

Zip Code Areas: 716-717, 719, 724-726, 728 Preferred Non-Tobacco User

Zip Code Areas: 716-717, 719, 724-726, 728 Standard Tobacco User

Zip Code Areas: 718, 723 Standard II Non-Tobacco User


85+ 2468.45 2627.69 1940.11 1267.32

75 2468.45 2627.69 1940.11 1267.3280 2468.45 2627.69 1940.11 1267.32

65 2468.45 2627.69 1940.11 1267.3270 2468.45 2627.69 1940.11 1267.32

<65 N/A N/A N/A N/A

AGE A F G N

80 2455.46 2613.86 1929.90 1260.6585+ 2455.46 2613.86 1929.90 1260.65

70 2455.46 2613.86 1929.90 1260.6575 2455.46 2613.86 1929.90 1260.65

<65 N/A N/A N/A N/A65 2455.46 2613.86 1929.90 1260.65

AGE A F G N

M F F M F MN/A N/A N/A N/A N/A N/A

2221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.592221.60 2364.92 1746.10 1746.10 1140.59 1140.59

75 2221.60 2364.9280 2221.60 2364.92

85+ 2221.60 2364.92

<65 N/A N/A65 2221.60 2364.9270 2221.60 2364.92

AGE A F G N

F M

A.M. Best

Rating:

NR


40

Standard Life and Accident Insurance Company (Continued)

Zip Code Areas: 718,723 Standard III Tobacco User

Zip Code Areas: 727,729 Preferred Non-Smoker

Zip Code Areas: 727,729 Standard Smoker


2728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.722728.29 2904.29 2144.33 2144.33 1400.72 1400.7285+ 2728.29 2904.29

70 2728.29 2904.2975 2728.29 2904.2980 2728.29 2904.29

F M<65 N/A N/A

65 2728.29 2904.29

AGE A F G N


1987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.531987.75 2115.98 1562.30 1562.30 1020.53 1020.53

75 1987.75 2115.9880 1987.75 2115.98

85+ 1987.75 2115.98

<65 N/A N/A65 1987.75 2115.9870 1987.75 2115.98

AGE A F G N

F M


2208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.922208.61 2351.09 1735.89 1735.89 1133.92 1133.92

80 2208.61 2351.0985+ 2208.61 2351.09

65 2208.61 2351.0970 2208.61 2351.0975 2208.61 2351.09

AGE A F G N

F M<65 N/A N/A


41

F - Female

M - Male

United American Insurance Company 3700 S. Stonebridge DrivePO Box 8080, McKinney, TX 75070800-331-2512www.unitedamerican.com NT - Non Tobacco User

T - Tobacco User

Medical Underwriting: Simple underwriting with yes/no questions HD - High Deductible Plan

Pre-existing condition waiting period: 2 months SEL - Select Plan

Policy Fee: NoMedicare Crossover: YesAnnual Premiums:

Zip Code Areas: All Preferred Non-Tobacco User

Zip Code Areas: Standard Tobacco User

Zip Code Areas: Standard II Non-Tobacco User

Zip Code Areas: Standard III Tobacco User

SUPERSCRIPT MEANINGSIN THE CHARTSA.M.

Best Rating:

A+

p

8085+

7075

<6565

AGE A F G N

85+ 1662 2609 3080 1870

75 1662 2609 3080 1870

80 1662 2609 3080 1870

65 1662 2609 3080 1870

70 1662 2609 3080 1870

<65

AGE A F G N

M F F M F M

7580

85+

<656570

AGE A F G NF M

M F F M F M

7580

85+

<656570

AGE A F G NF M


42

United American Insurance Company (Continued)

Zip Code Areas: Preferred Non-Smoker

Zip Code Areas: Standard Smoker

Zip Code Areas: Standard II Non-Smoker

Zip Code Areas: Standard II Smoker

M F F M F M

7580

85+

<656570

AGE A F G NF M

M F F M F M

7580

85+

<656570

AGE A F G NF M

M F F M F M

7580

85+

<656570

AGE A F G NF M

M F F M F M

7580

85+

<656570

AGE A F G NF M


43

The Order of United Commercial Travelers of America1801 Watermark Dr., Suite 100Columbus, OH 43215

F - Female 800-848-0123 www.uct.org M - Male


T - Tobacco User


SEL - Select Plan

Medical Underwriting: YesPre-existing condition waiting period: N/A Policy Fee: 0Medicare Crossover: YesMonthly Premiums: Shown Below

Zip Code Areas: 722 Preferred Non-Tobacco User

Zip Code Areas: 722 Standard Tobacco User

Zip Code Areas: All except 720-722 Preferred Non-Tobacco User

80 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17085+ $174 $174 $211 $211 $242 $242 $214 $214 $170 $170

70 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17075 $174 $174 $211 $211 $242 $242 $214 $214 $170 $170

<65 $174 $174 $211 $211 $242 $242 $214 $214 $170 $17065 $174 $174 $211 $211 $242 $242 $214 $214 $170 $170

AGE A B F G NF M F M F M F M F M

80 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249

85+ $257 $257 $310 $310 $356 $356 $315 $315 $249 $249

70 $257 $257 $310 $310 $356 $356 $315 $315 $249 $24975 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249

<65 $257 $257 $310 $310 $356 $356 $315 $315 $249 $24965 $257 $257 $310 $310 $356 $356 $315 $315 $249 $249


80 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19985+ $205 $205 $248 $248 $285 $285 $252 $252 $199 $199

70 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19975 $205 $205 $248 $248 $285 $285 $252 $252 $199 $199

<65 $205 $205 $248 $248 $285 $285 $252 $252 $199 $19965 $205 $205 $248 $248 $285 $285 $252 $252 $199 $199



A.M. Best

Rating:

B+


44

The Order of United Commercial Travelers of America (Continued)

Zip Code Areas: All except 720-722 Standard Tobacco User

Zip Code Areas: 720, 721 Preferred Non-Tobacco User

Zip Code Areas: 720, 721 Standard Tobacco User

80 $231 $231 $279 $279 $321 $321 $283 $283$283

AGE A B F G

<65

$225 $225

85+ $231 $231 $279 $279 $321 $321 $283 $283 $225 $225

70 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225

75 $231 $231 $279 $279 $321 $321 $283 $225 $225

<65 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225

65 $231 $231 $279 $279 $321 $321 $283 $283 $225 $225

NF M F M F M F M F M

80 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180

85+ $185 $185 $223 $223 $256 $256 $227 $227 $180 $180

70 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180

75 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180

$223 $223 $256 $256 $227 $227 $180 $180

65 $185 $185 $223 $223 $256 $256 $227 $227 $180 $180$185 $185


80 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212

85+ $218 $218 $264 $264 $303 $303 $268 $268 $212 $212

70 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212

75 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212

<65 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212

65 $218 $218 $264 $264 $303 $303 $268 $268 $212 $212



45

United Healthcare Insurance Company PO Box 30607, Salt Lake City, UT 84130888-378-0254 F - Female

M - Male

Medical Underwriting: Yes NT - Non Tobacco User

Pre-existing condition waiting period: 3 months T - Tobacco User

Policy Fee: none HD - High Deductible Plan

Medicare Crossover: Yes SEL - Select Plan

Annual Premiums:

Zip Code Areas: ALL Preferred Non-Tobacco User

Zip Code Areas: ALL Standard Non‐Tobacco User

Zip Code Areas: ALL Preferred Tobacco


IN THE CHARTS

A.M. Best

Rating:

A

AGE A F HD G N F M F M F M F M F M

<65 65 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 70 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 75 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75 80 $108.50 $108.50 $193.50 $193.50 $135.75 $135.75

85+ $108.50 $108.50 $193.50 $193.50 $135.75 $135.75


<65 65 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 70 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 75 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62 80 $162.75 $162.75 $290.25 $290.25 $203.62 $203.62

85+ $162.75 $162.75 $290.25 $290.25 $203.62 $203.62


<65 65 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 70 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 75 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32 80 $119.35 $119.35 $212.85 $212.85 $149.32 $149.32

85+ $119.35 $119.35 $212.85 $212.85 $149.32 $149.32


46

Approved Charges, also known as allowable charges, Medicare eligible expenses, or Medicare covered charges, apply to the specific dollar amount on which Medicare will base its payment for every medical procedure under Part B. Medicare will pay 80% of this "approved" amount.

Assignment is the means by which doctors or suppliers receive payment directly from Medicare. When assignment is used, the provider of medical service agrees that his or her total charge for the covered Medicare Part B service will be the charge approved by the Medicare Carrier. Medicare then pays your doctor or supplier 80% of the approved charge, less any part of the $183 annual deductible. You are responsible for the 20% of the approved amount not paid by Medicare plus the $183 annual deductible. Accepting assignment means that the doctor or medical provider will not bill you for the difference between the actual charge and the Medicare approved amount. Find out in advance whether your doctor or medical provider will accept assignment. When assignment is not accepted, you will be responsible for any amount up to 15% above the charges approved by Medicare. Using doctors or suppliers who accept assignment will save you money. Any physician may take assignment on a claim-by-claim basis whether he is a "participating" provider or not.

Carrier is the Medicare Part B claims processor. In Arkansas, the Medicare "Carrier" is Novitas-Solutions (www.novitas-solutions.com). For questions about your Part B claims payments, telephone 1-800-633-4227.

Contestable Clause is a policy provision that gives an insurer the right to rescind your insurance policy in the event there are any material errors, omissions or misstatements on your insurance application or enrollment form. The contestable period is generally the two years following the effective date of the policy.

Coordination Of Benefits (COB) means that one of your health insurance policies may reduce its benefits if you are also covered by another insurance plan. Important! This usually applies only to employer-sponsored plans.

Private Medicare supplements ordinarily do not have COB regardless of how many policies you have.

Co-payment is the amount that you or your insurance plan must pay to supplement Medicare's payments for Part A and Part B expenses. For example, for charges incurred in 2017, you will have a $329 per dayco-payment for days 61-90 and a $658 per day co-payment for days 91-150 while in a hospital. There is also a co-payment of $164.50 for skilled nursing days 21-100 and a co-payment of 20% for all Part B services after your annual deductible of $183.

Deductible is the dollar amount that you will have to pay before either Medicare or your insurance plan will begin paying benefits. Your Medicare Part A deductible is $1316 per benefit period for 2017. Your Medicare PartB deductible is $183 of approved charges each calendar year.

Effective Date is the date your policy becomes effective. When you talk to your insurer, ask what the effective date will be. The effective date is printed on your insurance policy or certificate.

Exclusions or Exceptions is the list of specific conditions or circumstances that are not covered by the policy. The exceptions in Medicare supplements are limited by state law and cannot exclude or limit coverage for any specific health condition for more than six months. Other health insurance plans such as hospital indemnity or medical-surgical expense plans may have a 12-month exclusion for pre-existing conditions and/or permanent exclusions for certain health conditions.

Excess Charge are additional charges approved by Medicare if your doctor or provider does not accept Medicare Assignment (Medicare approved amount). The maximum excess charge is 15% of the Medicare approved amount.

Free Look is the time period after you receive the policy in which you can review its benefits. State law requires Medicare supplement insurers to give the consumer 30 days to review the policy. If you return the policy within the 30-day free look period, you will get a full refund. Other types of individually marketed health insurance plans are limited to a 10-day free look period.

GLOSSARY

47

GLOSSARY

Grace Period is the time period (usually 31 days) or the payment of an overdue premium, during which time the policy remains in force.

Hospice is a program for the terminally ill. Medicare does reimburse most Hospice expenses if the Medicare patient chooses to take Hospice benefits instead of regular Part A and Part B benefits. There may be a co-payment for outpatient drugs and inpatient respite care. Care must be provided through certified Hospice organizations.

Intermediary is the Medicare Part A claims processor. In Arkansas, the Medicare Part A "intermediary" is Pinnacle Business Solutions. For questions about Part A claims payments, contact Pinnacle Business Solutions at 1-866-799-2110.

Limiting Charge is the limit on the amount physicians who do not accept assignment can charge a Medicare beneficiary. The limiting charge is no more than 15% over Medicare's approved amount. Limiting charge information appears on the Medicare Summary Notice (MSN) form.

Material Misrepresentation is a misrepresentation that was important or essential to the decision to issue or not issue an insurance policy.

Medicaid is a federal and state program that provides health insurance benefits for certain low-income, disabled or blind individuals, and families. There are strict income eligibility guidelines. Applications must be made at the local county office of the Department of Human Services. 1-800-482-8988

Medicare Crossover is one of the more significant service enhancements that insurance companies can offer. A "crossover" company has a contract with Medicare requiring Medicare to send the insured's remainder of the bill directly to the Medicare supplement insurance company.

Medicare Advantage is a part of the Balanced Budget Act (BBA) of 1997 that authorizes the Centers for Medicare & Medicaid Services to enter into contracts with insurance companies, managed care organizationsand other entities to give Medicare beneficiaries a choice in how they receive their Medicare benefits.

Participating Physicians are doctors who have contracted with Medicare to accept assignment for all Medicare patients, file all claims for Medicare patients, and agree to all Medicare rules. Check the MedPard database http://www.pinnaclemedicare.com/bene/medpard/default.aspx

Non-Participating Physicians have not signed a contract with Medicare to accept assignment, but may do so on a case-by-case basis. Non-participating physicians must still file all claims with Medicare.

Pre-Existing Conditions are health conditions for which you have been diagnosed, treated, or had symptoms during the time before your policy's effective date of coverage.

Pre-Existing Condition Waiting Period is the amount of time after your effective date of coverage during which your insurance plan will not cover any pre-existing conditions. Medicare supplement law in Arkansas says your waiting period cannot be any longer than six months. Many Medicare supplements offer plans with shorter waiting periods. When a Medicare supplement policy replaces an existing Medicare supplement policy, the replacing issuer must waive any time period applicable to pre-existing conditions.

Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) are groups of doctors and health care professionals who are paid by the federal government to review Medicare hospital admissions and reimbursements and to monitor inpatient quality of care. BFCC-QIO’s have the authority to deny hospital payments if care is not medically necessary. They also handle patient appeals and complaints the patient makes regarding non-payment of service or quality of care. If you have any questions, please contact them at 1-844-430-9504.

Underwriting is the method insurance companies use to evaluate risks and determine insurability.

Usual, Customary and Reasonable (UCR) typically means the fees most frequently charged in a geographic by providers with similar training and experience for the same or like service or supply.

48

Notes

My Medigap Information

Agent Name: __________________________________________________

Company Name: _____________________________________________

Company Address: _____________________________________________

Phone Number(s): _____________________________________________

Email: ______________________________________________________

Arkansas Insurance License Number: _______________________________

Medigap Plan Choice (A-L): ________

Monthly Premium: $____________ How do I pay? _________________

Is my spouse covered? ________ Spouse Premium: $___________

49

Comparing Medicare drug plans can save you money. Provide a list of current medications and SHIIP uses

the Medicare website to compare plans www.medicare.gov

Call 1-800-224-6330 for information

Helpful Phone Numbers

1-800-Medicare Helpline 1-800-633-4227

Arkansas Attorney General’s Office 1-800-482-8982

Beneficiary and Family Centered Care Quality

Improvement organization (BFCC-QIO) (KEPRO)

1-844-430-9504

Arkansas SMP (Medicare Fraud) 1-866-726-2916

Marketplace (Affordable Care Act) 1-800-318-2596

Medicaid (Department of Human Services) 1-800-482-5431

Senior Health Insurance Information Program

(SHIIP)

1-800-224-6330

Social Security Administration 1-800-772-1213

Tricare 1-866-773-0404

Veterans Administration 1-800-827-1000

www.insurance.arkansas.gov

Allen Kerr, Commissioner 1200 W 3rd St.

Little Rock, Arkansas 72201

Toll Free: 1-800-224-6330

This publication is produced by the State of Arkansas Insurance Department division of Senior Health Insurance Information Program (SHIIP) with financial assistance through a grant from the Administration for Community Living, an agency of the U.S. Department of the Health and Human Services.

Revised 06.17 50

ridging the gap 2017overview and helpful suggestions. 2: types of medicare supplement policies. 3:...

Documents