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Balance Critical Illness & Accident Plans. Brought to you by: Anthem and The IHC Group CO/NV. Confidential and Proprietary – may not be used or distributed without Anthem consent. What is Balance ?.

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balance critical illness accident plans

BalanceCritical Illness & Accident Plans

Brought to you by:

Anthem and The IHC GroupCO/NV

Confidential and Proprietary – may not be used or distributed without Anthem consent

what is balance
What is Balance?
  • Anthem brokers now have access to a guaranteed issue product that is a great complement to your client’s medical plan - Balance
    • Balance is an association membership that provides a package of insurance coverage, services and discounts, which include:
      • Critical Illness
      • Medical Expenses Due To Accidents
      • Hospital Confinement Due To Accidents
      • Disability Income Due To Accidents
    • Balance helps members “Balance” their finances in the wake of a critical illness or accident
  • With four membership levels, Balance allows your clients to focus on getting well because payments help cover everyday expenses such as:
    • Mortgage payments
    • Daycare
    • Household bills
    • Credit cards
  • Balance insurance benefit payments go directly to your clients
health care reform consumer perspective
Health Care Reform: Consumer Perspective

Affordability is still an issue

  • Average deductible in 2010 for single coverage on individual plans was $2,632and $3,531 for a family¹
  • Higher deductibles and out-of-pocket limits disproportionately impact those with lower incomes²
  • 21 percent of adults surveyed indicated that they paid a medical bill late in the past 12 months³
  • Anecdotal information indicates that employees are choosing not to insure their dependents on employer sponsored plans due to cost

1 eHealth Insurance Cost Report; 2 NHEA (Centers for Medicare and Medicaid Services & Deloitte Analysis); 3 Harris Poll, National Quorum telephone survey

critical illness and accident
Critical Illness and Accident
  • Carriers are developing more new products than years past
  • Critical Illness and Accident plans leading the way
  • The heightened burdens and costs of regulation imposed by healthcare reform on health insurance is leading carriers to explore other products and means of providing protection from illness, accident or injury.

Source: Eastbridge Consulting's annual “U.S. Worksite Sales Report”

health care reform consumer perspective1
Health Care Reform: Consumer Perspective

How Balance Helps

How Balance Helps

  • Critical illness and accident plans assist in funding out-of-pocket cost
    • Payments may be assigned to providers or paid directly to insured
  • Critical illness can provide income in excess of plan out-of-pocket to help defray the impact of significant illnesses on family budgets
balance participants
Balance Participants

Communicating For America

Madison National &

Independ-ence Holding Co.



communicating for america association
Communicating for America Association
  • Approximately 50,000 members across all 50 states
  • Separate board of directors not affiliated with The IHC
  • Group or Madison National Life Insurance Company
  • Offices in Fergus Falls, Minn. and Minneapolis, Minn.
  • National membership organization founded in 1972
  • Active in the Alliance for International Educational and
  • Cultural Exchange
why balance the broker perspective
Why Balance? The Broker Perspective

Balanceis easy to sell and service

Single Product Source

  • No need to deal with multiple underwriters or administrators for the ancillary plans
  • Outstanding customer service for all bundled Balance products at one location
  • Bundling ancillary products lessens the impact of selection
  • Lower administrative cost due to multiple products on single bill

Low Cost

  • Guaranteed issue products
  • Co branding arrangement limits client confusion
  • Online policy fulfillment

Product Ease

why balance the broker perspective1
Why Balance? The Broker Perspective

Balancebenefits you directly

  • Balance values you and your client – commissions of 30%
  • Supplements your medical commissions


  • Diversifies your book of business
  • Improves retention and monthly sales

Broker Benefits

balance is technology focused
Balance Is Technology Focused
  • Interested brokers (in good standing with Anthem) can be easily appointed with MNL by simply submitting a sub-agent agreement
  • Each broker will receive a unique URL that allows him or her to enroll customers online*
  • If a client applies online through the Anthem site they will be offered the opportunity to enroll in Balance at the end of the medical application
  • The broker number is carried over from the Anthem enrollment site through secure web services
  • Policies are fulfilled online immediately upon payment verification

*Multiple URL’s are possible if writing broker has multiple parent TINs



Plan Benefits


Balancemembership includes:

  • Bundled guaranteed issue insurance coverage consisting of:
    • Critical illness
    • Medical Expenses Due To Accidents
    • Hospital Confinement Due To Accidents
    • Disability Income Due To Accidents
  • Additional benefits include:
    • Teledoc
    • Low-rate student loans
    • Reimbursement for towing and emergency roadside services
    • Discounts on remote meeting, remote PC access and backup
    • Legislative hotline to let your voice be heard in Washington
balance benefits appeal to
Balance Benefits Appeal To:
  • Families with children looking for accident medical expense coverage
  • Those over the age of 45 in need of critical illness insurance
  • Sole proprietors and the self employed who cannot find disability coverage
  • Consumers who want the convenience of guaranteed issue coverage, online enrollment and credit card payment
critical illness and accident benefit levels
Critical Illness and Accident benefit levels

Exclusions and limitations apply

*Underwritten by Madison National Life Insurance Company, a Wisconsin Insurance company. All benefits terminate at age 70 and coverage is not

available in all states. Accident Medical Expense benefits are reduced by benefits payable under other insurance plans. Additional limitations and

exclusions apply and provisions may vary by state. Refer to the policy form number GAO-P-1207 for a complete listing of benefits, exclusions and


Confidential and Proprietary – may not be used or distributed without Anthem consent

Confidential and Proprietary – may not be used or distributed without Anthem consent

critical illness
Critical Illness
  • Pays a lump sum benefit upon diagnosis of:
  • Life-threatening cancer
  • Heart attack
  • Kidney failure
  • Stroke
  • Coma
  • Coronary bypass
  • Loss of sight,
  • speech or hearing
  • Major organ
  • transplant
  • Paralysis
  • Severe burn
critical illness1
Critical Illness
  • Some additional points regarding Critical Illness Coverage:
  • A family membership covers the primary insured and spouse only
    • Dependent children are not covered for Critical Illness Coverage
  • Subject to a 12 month pre-existing condition limitation (based on date of first diagnosis)
  • Benefit varies by type of illness and other terms; benefit reduces by 50% when the insured attains age 65
    • Coverage terminates at age 70
  • Unless otherwise noted, coverage must be in effect for 30 days before benefits are payable
accident medical expense
Accident Medical Expense
  • After the deductible, benefits are payable for medical expenses incurred as a result of each covered accident
  • Pays medical expenses resulting from a covered accident
  • Non-duplication of benefits: The benefit is reduced by the amount paid by any other health care plan
  • A family membership covers the primary member, spouse and all dependents up to age 26

Confidential and Proprietary – may not be used or distributed without Anthem consent


accident hospital confinement
Accident Hospital Confinement
  • Benefits are available for up to 30 days when hospital confined due to a covered injury
  • A family plan covers the primary member, spouse and all dependents to age 26

Confidential and Proprietary – may not be used or distributed without Anthem consent


accident disability income
Accident Disability Income
  • Pays a monthly benefit up to 12 months for disability due
  • to a covered accident
    • After a 90 day elimination period
  • This benefit is available only to the primary insured

Confidential and Proprietary – may not be used or distributed without Anthem consent


critical illness example
Critical Illness Example

Request and complete claim form for IHC

IHC Reviews

  • Member suffers from a stroke
  • Member completes a claim form and sends to IHC
  • IHC Reviews
  • IHC (on behalf of Madison National) sends check for a lump sum (depending on plan selection) to the member

Check sent to customer

Confidential and Proprietary – may not be used or distributed without Anthem consent


accident medical expense1
Accident Medical Expense

Insured receives an EOB from their medical insurance company

Insured sends a completed accident medical claim form to IHC with copy of medical EOB

  • Example - $5,000 claim:

The member’s major medical coverage:

$5,000 deductible

  • Balance plan selected:
  • Balance 1 ($2,500)

IHC reviews, and on behalf of MNL, sends a check to the client for $2,250 ($2,500 minus the $250 deductible)

Confidential and Proprietary – may not be used or distributed without Anthem consent


member welcome kit
Member Welcome Kit
  • Your member will receive a welcome kit via email that will include:
  • A contact list including information on how to submit a claim
  • A brief explanation of the Balance ancillary services
  • Link to specific set of critical illness and accident certificates (based on membership level purchased)
commissions external broker
Commissions – External Broker
  • The average monthly cost of a Balance Plan is $60. If you sell 5 memberships a week, you could earn $90 in commissions. Here’s the math:
  • In a week:
    • $60 x 5 memberships = $300 premium
    • $300 x 30% = $90 commission each week
  • In a month:
    • $90 x 4 weeks = $360 commission
  • In a year:
    • $90 x 52 weeks = $4,680 each year!

Let’s take a look at what you could be earning:

As you can see, Balance plans can be a good source of supplemental income!

external broker contracting appointment process
External Broker Contracting & Appointment Process
  • Here’s how the contracting and appointment process will work:

Broker completes the sub-agent agreement

Broker sends signed contract to Anthem via fax or email to Licensing and Credentialing

Anthem sends daily file of brokers to IHC


Note: Anthem’s Licensing and Credentialing department will need to confirm the broker is active w/ Anthem and is in good standing before logging the contract and sending the file to IHC.

IHC loads brokers into their admin system

IHC will send NV broker to DOI for appointment

(This step is not necessary in CO)

IHC sends welcome email with personalized broker URL within 4 business days

once appointed by ihc external brokers
Once appointed by IHC – External Brokers
  • Broker receives a welcome email that includes their IHC broker number and instructions to access the IHC website ( This website is the online source for:
    • Viewing new business case status/application
    • Downloading forms
    • Statements
    • Accessing compensation statements (external broker)
    • IHC Broker Support
  • Brokers should include the IHC broker number on all Balance correspondence and paper applications to ensure sales are properly credited, and commissions are paid
  • Broker receives an email that contains their unique URL for forwarding to customers to apply for Balance
      • Available to current medical clients who wish to add Balance, and clients without medical coverage

Application Process

How do my customers

sign up?


When an applicant visits Planfinder, they will see a new icon on all Medical Plans/Deductibles. Hovering over the icon will provide a description.

Critical Illness and Accident Coverage offered through Balance

Balance is a package of benefits designed to supplement your health insurance plan and give you additional financial support when you need it most. Balance is provided by Communicating for America which provides financial benefits to help you recover from a covered critical illness or accident as well as other valuable services.

planfinder final confirmation page
PlanFinder – Final Confirmation Page

By clicking continue, the applicant will be taken to the Balance website to start

the application process. There, they will fill out a short, simple application.

Broker number will carry over from Planfinder.

planfinder final confirmation page1
PlanFinder – Final Confirmation Page
  • Upon selecting the continue button, the applicant will see a pop-up message:

“You are now leaving Anthem’s website and will be routed to the IHC Secure

Website to complete the Balance application. If you do not wish to apply

for Balance, please click cancel.”


Disclaimer at bottom of page: Balance is a membership in Communicating for America, Inc. and includes benefits underwritten by Madison National Life Insurance Company, Inc., along with valuable discounts and services. Association membership services are provided by Communicating for America, Inc. There is no ownership affiliation between Madison National Life Insurance Company, Communicating for America or Anthem Blue Cross and Blue Shield. Each entity is separate, independent and unaffiliated with Anthem Blue Cross and Blue Shield and its products and services Anthem Blue Cross and Blue Shield, or its affiliates, may receive compensation from membership fees or otherwise in connection with association membership.

ihc url
  • A second way to direct applicants to the Balance website is to email them the Balance URL link directly. This will take them directly to the website, and will credit the sale to your IHC Broker Number.
  • Whether the applicant arrives at the Balance website via Planfinder or by clicking on the IHC link, the application process will be the same. The applicant will then complete the enrollment process on the Balance website.
balance website application process
Balance Website – Application Process
  • Once the applicant arrives at the IHC Website, the application process is quick and easy!
balance website application process1
Balance Website – Application Process
  • Step 1 – Applicant completes basic demographic information
balance website application process2
Balance Website – Application Process
  • Step 2 – Payment information
balance website application process3
Balance Website – Application Process
  • Step 3 – Summary
  • It’s as easy as that!
balance payment methods
Balance – Payment Methods
  • Monthly Payment Options Include:
    • Automatic Withdraw From Checking Account
    • Recurring Credit Card Payment
  • (Paper Billing is not an option)
balance effective dates
Balance – Effective Dates
  • Possible Effective Dates Include:
    • 1st, 8th, 15th, and 22nd.
    • Example:
      • If the application is submitted prior to 9:00 PM Mountain time on the 1st, the applicant will receive the 1st as the effective date (unless they request a later date.) If the application is submitted after 9:00 PM Mountain time on the first, the effective date will default to the 1st of the following month (unless otherwise specified.)
member collateral
Member Collateral
  • There are two places where brokers can view and download Balance brochures:
    • AgentAccess Site
    • IHC Agent Website
important dates
Important Dates

*Commissions will be paid once commissions reach $25


The information included in this training is an outline of features, plan provisions, benefits and other information about the Balance membership benefit packages. Plans offered may be subject to change and terms and limitations apply. Availability and benefits may vary based on state of residence.

This training is not intended to serve as legal interpretation of benefits. Benefits exclusive to the Balance series are provided under master policies (GAO-ACC-C-1207, GAO-CI-C-1207,GAO-P-1207) issued to Communicating for America, Inc. and underwritten by Madison National Life Insurance Company, Madison, Wisconsin. Policy form numbers may vary by state.

Refer to the insurance policies all riders for complete eligibility information, termination provisions and a full list of exclusions and limitations.

thank you
Thank you!

Go get ‘em!