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Disability Products & Services. The Anthem Life Disability Philosophy. Create optimal disability outcomes for both the employee and the employer while providing a positive member experience. Customized care

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The Anthem Life Disability Philosophy

  • Create optimal disability outcomes for both the employee and the employer while providing a positive member experience.

  • Customized care

    • We evaluate a member’s functional ability based on clinical and vocational information—not just statistics and norms.

    • The team intervenes early and stays with the case, continuously working with the employee, provider and employer to develop an action plan designed to achieve the best possible outcome.


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Our Advantage

  • Strength & Stability

  • Broad Product Offerings with Added Value

  • Benefit Features That Make The Difference

  • Flexible Reporting

  • Superior Customer Service

Our strength, innovation and dedication makes us the right solution to your needs.


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Life & Disability’sStrength and Stability

  • A.M. Best: A (Excellent) agency rating

  • Parent company ranked 38th on the Fortune 500 list

  • Parent company named Most Admired Health Insurance Company by Fortune Magazine

  • Parent company ranked 2nd on 2006 Business Week’s Top 50 Performing Companies

  • More than 96,000 group customers and 5.8 million members*

  • Large Case/National Accounts Expertise

  • More than 50 years of experience*

Each affiliated life company is a separate, independent legal entity for financial purposes and is solely responsible for its own contractual obligations and liabilities.

*Anthem Life internal data 2006


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Broad Product Offerings

Disability Product Portfolio

Voluntary STD and LTD (Insured)

25% participation required

Short-Term Disability (STD)(Insured & ASO)

Long-TermDisability (LTD)

(Insured & ASO)


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Vocational

Rehabilitation

Flexible

Reporting

Features That Make A Difference

Behavioral

RN

Review

Health

Review

Disability

Resources

Social Security Advocacy

Dedicated

Disability

Case Manager


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Features That Make A Difference

  • Short-Term Disability (STD)

    • ASO case management models - Levels 1, 2, 3

    • Flexible Advice to Pay services

  • Behavioral Health Disability Program

  • Resource Advisor Program

  • Return to Work Assistance (Vocational Rehabilitation)

  • Social Security Advocacy

  • Optional paperless claims intake process

  • W-2 reporting and employer FICA matching services available


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Features That Make A Difference

STD Case Management Models

Level 2

More proactive management

Level 3

Most proactive management

Level 1

Least intensive management

ASO Only

ASO Only

Fully Insured & ASO

ASO = Administrative Service Only


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Short Term Disability Case Management Models

Level One (ASO only)

Disability approval based on attending physician statement

Payment continues until notification from client of return to work

Desirable option when governed by management request,labor restriction or company culture

Level Two (ASO only)

Disability payments begin based on initial attendingphysician statement

Estimated time off work compared to optimal durationguidelines for given diagnosis or procedure

Disability leave beyond normal duration requires periodic medical updates for continued benefits

Features That Make A Difference


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Short Term Disability Case Management Models

Level Three (Fully Insured or ASO)

Objective medical documentation required to support disability

Claimant’s job description evaluated to determine functional impairment

Clinical information and functional requirements assessed in conjunction with duration guidelines

Full vocational rehabilitation services included

100% review of all behavioral health claims by staff psychologist

Registered Nurses assist in case management

Independent Medical Examinations available for use when appropriate

Features That Make A Difference


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Features That Make A Difference

  • Flexible Advice to Pay Services

    • Full range of case management options available

    • Reporting frequency based on client need to meet payroll requirements

    • Disability claim reporting can be tailored for customer absence tracking


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Features That Make A Difference

  • Behavioral Health Program

    • In-house Behavioral Health professionals

    • All claims reviewed

      • For appropriate diagnosis, treatment and disability determination

      • For early identification of depression in chronic and acute medical conditions

    • Ongoing behavioral healthtraining for disability case managers


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Life & Disability Insurance Products

  • Innovative Supplemental Programs

    • Resource Advisor

      • Included with group Disability plans at no additional cost

      • Provides employees and family members with resources that may help them achieve a healthier balance including:

        • 24 hour toll-free telephone counseling

        • Legal/Financial Counseling for employees

        • Face to face counseling sessions for beneficiaries and for employees who become disabled

        • Access to Online Resources: resources and providers for child care and elder care, legal and financial resource center, excellent articles and links to a myriad of helpful resources

        • Online will preparation and identity theft information


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Features That Make A Difference

  • Return To Work Assistance

    • Certified Vocational Rehabilitation Consultants on staff

    • Vocational rehabilitation assistance

      • Return-to-work assistance (STD and LTD)

        • In-house transferable skills analyses

        • Internet access for rehabilitation opportunities


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Disability Products and Services

  • Social Security Advocacy

    • In-house Social Security Consultants with years of experience working for Social Security Administration

      • Immediate involvement in claims with catastrophic/terminal conditions

      • Award activity

        • 67% within 12 months*

        • 86% over 24 months*

    • Saved an average of 15% in attorneys’ fees during each of the past 5 years

    • Highly successful overpayment recovery program

*Anthem Life internal data 2006


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Flexible Reporting

  • Frequency based on client need

    • Daily or weekly authorization reports available for Advice to Pay customers or upon client request

    • Quarterly and annual reporting on closed cases

  • Financial data

    • Gross and net benefit, withholdings, tax reporting, W-2 issuance

  • Report elements

    • Data for International Classification of Diseases (ICD),Major Diagnostic Categories (MDC), age/gender, tenureand alternate duty programs

    • Trends

    • Client data sorting

    • Comparative reporting

    • Claims costs


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Superior Customer Service

  • Dedicated Service Center

  • Over 98.1% financial accuracy in 2006*

  • 93% of calls answered in <30 seconds in 2006*

    • Average speed to answer - 8 seconds

  • Call abandonment rate - 1.5%*

  • Busy Rate - 0%*

*Anthem Life internal data 2006


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Life and Disability products are underwritten by Anthem Life Insurance Company. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In most of Missouri: RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. (serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.). In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ® ANTHEM is a registered trademark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.


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