TrioMED AME | CI | AD&D from National General - YouTube

Welcome to this product video for National General Accident and Health’s TrioMED: a

plan for unexpected out-of-pocket costs associated with accidents, critical illness, and accidental

death and dismemberment.

In this video, we are going to introduce you to our TrioMED product. We’ll go over TrioMED’s

plan design, plan details, including eligibility requirements and enrollment, and resources

that NatGen makes available both to you as an agent as well as to your clients.

So why should your clients consider purchasing a TrioMED plan? Well, employer-sponsored health

programs have higher deductibles and less benefits than ever before. As a result, studies

have estimated that 41 million Americans are currently underinsured, leaving them especially

vulnerable to the higher financial burdens of unexpected out-of-pocket costs. In fact,

each year 530,000 Americans declare personal bankruptcy due to medical bills.

TrioMED is an ancillary product that helps your clients cover unexpected medical costs.

It offers three different types of coverage in one plan, combining Accident Medical Expense,

Critical Illness, and Accidental Death and Dismemberment benefits. Additionally, NatGen

offers two types of TrioMED plans: a standard issue version and a guaranteed issue version.

It is important to note that TrioMED is supplemental coverage and does not satisfy the government’s

requirements for Minimum Essential Coverage.

Now let’s cover TrioMED’s plan options.

For the guaranteed-issue version of TrioMed, you or your client can choose one of three

available benefit levels. The lowest benefit level offers clients $2,500 worth of coverage.

The mid-benefit level increases the coverage amount to $5,000. The highest benefit level

provides clients with $10,000 worth of coverage. The benefit amount that your client chooses

will be the same for each type of coverage. If a client purchases the guaranteed-issue

TrioMED at the $5,000 benefit level, they can receive a maximum of $5,000 in the event

of an accident, $5,000 in the event of a critical illness, and $5,000 in the event of an accidental

death or dismemberment. These coverages are not mutually exclusive. For example, if a

client experienced both a critical illness and an accident in the same year, that client

would be eligible to receive up to $5,000 for each, for a total of $10,000.

The standard-issue version of TrioMED has two build options. Both of these options offer

a $5,000 benefit for Accident Medical Expense and AD&D. However, the plans differ in the

Critical Illness coverage. You and your client can choose between two Critical Illness benefit

levels: either $15,000 or $30,000. It is important to note that standard-issue TrioMED plans

require that your client completes a health questionnaire.

TrioMED’s Accident Medical Expense benefit pays covered expenses up to your client’s

selected benefit amount per injury, and there is no maximum on the number of injuries that

can be claimed on a yearly basis. However, there is a $250 deductible per accident. So,

if you sell a $2,500 TrioMED to a client, and afterwards, they sprain their ankle and

their treatment totals $2,500, your client will receive $2,500 minus the $250 deductible

for a total of $2,250. In the event of experiencing a covered accident, clients must seek treatment

within 30 days of the covered accident, and all sequential follow-up visits must occur

within 26 weeks of the covered accident.

Let’s look at an example of how TrioMED’s Accident Medical Expense coverage works. Jon

was out walking his dog when he tripped & fell, breaking his hand. His treatment cost $4,500.

Jon has a primary insurance plan with a $5,000 deductible, and he also has a TrioMed plan

with $5,000 in AME coverage. As a result, Jon’s TrioMED plan would pay him $4,250,

or the $4,500 for the cost of his treatment minus the $250 deductible. This leaves Jon

with a total out-of-pocket cost of only $250.

TrioMED’s Critical Illness benefit has three categories of covered conditions. Your client

would receive one lump-sum payment per category, meaning that they could receive a total of

three lump-sum payments from the TrioMED plan. The Critical Illness benefits are only payable

upon a first-ever diagnosis of a covered critical illness. Best of all, there are no deductibles,

waiting periods, or network restrictions.

So, again, TrioMED’s Critical Illness benefits cover three categories of covered conditions.

Under Category One, the plan pays out 100% of your client’s selected benefit amount

in the event of a first-ever heart attack, stroke, heart transplant, or another major

organ transplant that includes the heart. Clients would receive 25% of their selected

benefit amount in the event of their first-ever coronary bypass surgery or heart valve replacement

or repair. So, if your client selects $10,000 in Critical Illness coverage, and they have

their first-ever heart valve repair, they would receive a check for $2,500 dollars.

However, your client would receive no additional payments from this category in the event they

experience a first-ever heart attack, stroke, or etcetera. Additionally, since the payouts

are for first-ever diagnoses, if your client has already had a heart attack prior to their

enrollment into TrioMED, this plan would not pay for any heart-related claims, but your

client could still receive a Category One payout if they experience a first-ever stroke.

Under Category Two, the plan pays out 100% of your client’s selected benefit amount

for the first-ever diagnosis of invasive cancer or 25% for their first-ever diagnosis of cancer

in situ, which is cancer that has not metastasized or spread to neighboring tissue. However,

if your client is diagnosed with either invasive cancer or cancer in situ within the first

90 days of enrolling in TrioMED, their benefit would be reduced to 10% of the maximum allowed

benefit, so 10% for invasive cancer and 2.5% for cancer in situ.

Under Category Three, the plan pays out 100% of your client’s selected benefit amount

for the following conditions: End-stage renal failure; Major organ transplant, excluding

those covered in Category One; Advanced Alzheimer’s Disease; Coma; ALS or other Motor Neuron Diseases;

Paralysis; Or severe burns.

For TrioMED’s Critical Illness benefits, the amount payable to the maximum benefit

amount depends on which person on the plan has been diagnosed with the illness. Primary

policy holders would receive 100% of the payout, covered spouses would receive 50% of the payout,

and dependent children would receive 25% of the payout.

TrioMED’s Accidental Death and Dismemberment provides your clients with a lump-sum cash

benefit in the event of dismemberment or death resulting from a covered accident. The benefit

payout depends on the client’s selected benefit level as well as the type of covered

medical issue that the client experiences. The lump-sum benefit is not restricted to

just medical expenses; it can be used for a wide variety of out-of-pocket costs.

TrioMED’s AD&D benefits are divided into three levels of coverage: 100%, 50%, and 25%.

For example, if your client loses both hands as a result of a covered accident, they would

receive 100% of their selected benefit amount. Therefore, if your client purchases a TrioMED

plan with $10,000 in AD&D coverage, then they would receive the full $10,000 benefit.

If your client loses one hand and one foot as a result of a covered accident, they would

receive 50%, or $5,000. If your client loses hearing in one ear due

to a covered accident, they would receive 25%, or $2,500.

Most clients don’t plan for accidents that result in death or dismemberment, and experiencing

one has a devastating effect on their life as well as the lives of their family members.

Having this additional coverage can make a traumatic situation less stressful and help

your client focus more on their life change, while spending less time worrying about how

they are going to pay their bills.

As with TrioMED’s Critical Illness benefits, the amount payable to the maximum AD&D benefit

depends on which covered person experiences the incident. Primary policy holders and their

covered spouses would receive 100% of the payout, while dependent children would receive

50% of the payout.

When your client purchases TrioMED through a LIFE Association membership, they get access

to special programs and savings that can positively impact their day-to-day lives. The L.I.F.E.

Association is a not-for-profit, members-only organization, which provides members with

lifestyle-related benefits and discounts.

Members will get access to TeleMed for LIFE – this an innovative solution for non-emergency

illnesses and general care. It provides members with direct access to consult with state-licensed

physicians via phone or video to treat common ailments and offer health care advice — 24

hours a day, 7 days a week. There are no additional costs or limits on the number of consultations

for members. When needed, physicians can call in prescriptions as long as they are non-narcotic.

Members get access to LIFE Mental Well-Being, a program designed to provide safe, secure,

and private means of seeking mental health assistance from licensed counselors via virtual

or phone counseling sessions from 7 am – 10 pm, 7 days a week. During the 30-minute appointments,

counselors can assist members with conditions such as depression, anxiety, grief, relationship

problems, and more.

Members can receive discounts on services from DirectLabs and Life Line Screening.

LIFE Association members can also take advantage of the Active and Fit Direct program, where

they can choose from 9,000+ fitness centers for just $25 per month, plus an enrollment

fee and any applicable taxes, as well as access to over 2,500 on-demand workout videos for

use in their home or while they’re on the go.

Members receive a variety of other discounts and services, including personal concierge

services, cellular care coverage, access to veterinarian telehealth services, and more.

It is important to note that LIFE Association Membership benefits may vary by state. Lifestyle

and wellness benefits and discounts are not insurance. Your agent and National General

Accident & Health may receive financial compensation in connection with membership fees.

Now let’s discuss TrioMED’s plan details, including its eligibility, state availability,

limitations and exclusions, and enrollment and payment options.

To be eligible for TrioMED, the primary applicant and spouse, if applicable, must be between

the 18 and 64 years of age at the time of application. Dependent children can stay on

their parents plans up to age 26. TrioMED is guaranteed renewable up to age 70. However,

Critical Illness benefits reduce by 50% at age 65.

NatGen’s TrioMed is available in the states shown on your screen. States and new products

are always being added to our portfolio, so remember to always read your broker alerts

for the most up-to-date information.

TrioMED does have some limitations and exclusions. The policy does NOT cover any loss caused

in whole or in part by any of the following: Full-time service in the Armed Forces or Reserve

or National Guard active duty for training extending beyond 31 days; Intentionally self-inflicted

injuries, suicide, or any other attempt while sane or insane; Illegal acts; Hazardous activities,

including flying (commercial, military, ultra-light plane, etc.), hang gliding, parachuting, bungee

jumping, using off-road vehicles (including ATV’s), participating in rodeos, or engaging

in motor sports; Participation in or practice for intercollegiate sports, semi-professional

sports, or professional sports; If the treatment is eligible for coverage by Medicare. This

Medicare exclusion only applies to AME benefits, and even if the insured is under the age 65;

If the treatment is eligible for coverage by Disability or Worker’s Compensation.

Please note: This is not a comprehensive list of limitations and exclusions. You can refer

to the product brochure for a more comprehensive list, but you should always refer to the policy

contract for a complete listing.

Clients can enroll in TrioMED any date, and their plan's effective date can be as soon

as the following day. For the initial payment, clients can choose any date between the time

of their application and before their plan effective date. Reoccurring payments occur

five days before the monthly anniversary of the plan effective date, and acceptable forms

of payment are EFT, Visa, MasterCard, or Discover.

NatGen Accident and Health has some great resources and tools for our agents to help

with your process and resources for our members as well.

Our website, www.NatGenHealth.com, is a one-stop shop for you, as an agent, and for your client.

On our Agents & Brokers page, you will be able to: Access agent tools, such as your

agent back office, coverage builder, which is your quoting engine, and our YouTube page

with training videos on all of our products; Explore our coverage options for individuals,

so you can help your clients choose the right coverage to meet their needs; Find information

about working with National General and starting to build your portfolio; View and download

marketing materials, such as the most up-to-date plan brochures and flyers along with our state

availability grid.

On our Existing Customers page, we offer places for your clients to: find a provider, view

general policy documents, submit claim forms, and access their member portal.

When enrolling in TrioMED or any plan from National General Accident & Health, your client

must review the application and billing authorization and provide an e-signature attesting to their

underwriting. Clients who complete their application on their own do this during their application

process. Clients who agents assist through their application and submission process must

do this via the member portal. As soon as the agent clicks submit on the application,

the client will receive an email or text message containing a link to their member portal at

www.MyNatGen.com. This is where they will review their application and billing authorization

and e-sign. When the client logs in, they will be prompted to read the authorizations

and provide an e-signature as verification. This process will take clients just a few

short minutes. Members can also view all their policy documents and plan information, check

current and past payments and current payment methods, and download ID cards through their

member portal.

To recap, TrioMED combines Accident Medical Expense, Critical Illness, and Accidental

Death and Dismemberment coverage into one plan. It includes the LIFE Association membership

benefits, is available in a large number of states, has three possible Critical Illness

payouts and a $250 AME deductible, and a guaranteed-issue plan is available.

So, why National General? NatGen has roots dating back to 1939. We've been given an A+

rating from AM Best, indicating that we’re financially sound, and we are are specialists

in Short Term Medical and supplemental plans.

If you have any questions regarding TrioMED or any other National General Accident and

Health product, or if you have questions regarding how to become contracted with NatGen, please

contact [email protected]. Thank you for your time and for your attention, and have

a wonderful day.