Clover Health Investments, Corp. · NASDAQ:CLOV
Clover Health Investments — Investor Presentation (2015)
38 slides from Clover Health Investments's investor presentation, 2015
Slide 1: Clover Sales Presentation
Clover Sales Presentation The first insurance company built with technology to make healthcare work. Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of bene
Slide 2: How can we help?
How can we help? • What type of coverage do you currently have? • What do you like about the plan? • What would you like to change about your current coverage? • Does someone help you with your healthcare decisions? 2 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare cont
Slide 3: Allow me to introduce you to Clover…
Allow me to introduce you to Clover… 3 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover app
Slide 4: Clover is the new name of CarePoint Advantage
Clover is the new name of CarePoint Advantage • CarePoint Advantage began open enrollment in 2012 for coverage effective January 1, 2013 • It started in Hudson County, NJ because of its strong relationship with local hospitals (Bayonne Hospital, Christ Hospital, and Hoboken University) • It is a Pre
Slide 5: Clover Timeline
Clover Timeline 2012 CarePoint Health plans established 2013 Debuts with members in Hudson County 2014 Membership in Hudson County increases to 2000 people, capturing #2 market share in county 2015 Expands to 5 counties (Bergen, Essex, Passaic, Somerset, Union counties) Summer 2015 CarePoint Health
Slide 6: Clover is a PPO Medicare Advantage Plan
Clover is a PPO Medicare Advantage Plan 1 2 3 Clover covers all All Clover plans Clover provides benefits under include Part D additional benefits original Medicare that traditional Part A and Part B Medicare does not 6 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare co
Slide 7: Qualifying for Clover
Qualifying for Clover Must Have Parts Not have ESRD A and Part B* Clover does not cover members with ESRD (End-Stage Renal Disease) or on dialysis Live in one of our service areas Atlantic, Bergen, Essex, Hudson, Mercer, Monmouth, Passaic, Somerset, or Union counties *You must continue to pay your M
Slide 8: Medicare Enrollment Periods
Medicare Enrollment Periods Medicare Advantage Initial Coverage Annual Enrollment Special Enrollment Disenrollment Period Enrollment Period Period (AEP) Period (SEP) (MADP) (ICEP) 7 months of eligibility: includes the 3 months October 15th to January 1st to Varies based on before, the month of Decem
Slide 9: Part D Prescription Drug Coverage
Part D Prescription Drug Coverage 9 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply.
Slide 10: Part D (Prescription Drug Coverage)
Part D (Prescription Drug Coverage) Clover offers Rx coverage on all plans • Each plan has a formulary, a list of medications covered by the plan • Drugs are placed in tiers • Drugs in each tier have a different cost, i.e. lower tier will cost less than a drug in a higher tier • Due to strategic cha
Slide 11: The Medicare Part D Model
The Medicare Part D Model Stage 1 Stage 2 Stage 3 Stage 4 Deductible Co-Insurance Coverage Gap Catastrophic After $4,850 limit is TrOOP* reached: 25% until reach Brand Rx: 45% Brand Rx: Greater of 100% to $360 What the $3,310 limit Generic Rx: 58% 5% cost or $7.40 member pays Generic Rx: Greater of
Slide 12: Part D (Prescription Drug Coverage)
Part D (Prescription Drug Coverage) Clover uses a preferred and non-preferred pharmacy networks. Preferred Pharmacy Network: A group of preferred pharmacies that involve a prescription drug plan willing to give plans a larger discount than other pharmacies Non-Preferred Pharmacy Network: A network p
Slide 13: Clover plan options
Clover Health has 4 products to choose from to accommodate your individual healthcare needs: Clover CarePoint (001) Clover Classic (004) Clover Prestige (006) Clover Premier (007) All of our plans include Part D prescription coverage. 13 Clover Health is a Preferred Provider Organization (PPO) plan
Slide 14: Clover CarePoint Plan (001)
Clover CarePoint Plan (001) 14 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Bene
Slide 15: Eligibility for CarePoint (001)
Eligibility for CarePoint (001) • Only available in Hudson County • $0 premium PPO Medicare Advantage Plan • To qualify, must be a Hudson County resident entitled to Medicare Part A and B • Must not have ESRD (End-Stage Renal Disease) • Must continue to pay your Part B Premium 15 Clover Health is a
Slide 16: CarePoint (001) Benefits at a Glance
CarePoint (001) Benefits at a Glance Benefits In-Network and Out-of-Network Plan Premium $0 Part D Premium $0 Primary Care $0 Specialist $15 Inpatient Hospital Days 1–6: $290 Days 7–365: $0 Ambulance $200 Emergency Room $75 Lab Services $0 $90–$290 copay, Outpatient Surgery depending on the service
Slide 17: CarePoint (001) Part D Coverage
CarePoint (001) Part D Coverage $150 Deductible Preferred Network Non Preferred Network Tier 1 = $0 Tier 1 = $4 Tier 2 = $10 Tier 2 = $15 Tier 3 = $35* Tier 3 = $45* Tier 4 = $85* Tier 4 = $95* $3,310 Tier 5 = 25%* Tier 5 = 25%* Coverage Gap (You will pay 45% for Brand Name Drugs and 58% for Generic
Slide 18: Clover Classic Plan (004)
Clover Classic Plan (004) 18 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Benefi
Slide 19: Eligibility for Classic (004)
Eligibility for Classic (004) • Only available in Atlantic, Bergen, Essex, Mercer, Monmouth, Passaic, Somerset, and Union counties • $0 premium PPO Medicare Advantage Plan • To qualify, must reside in one of the counties above and entitled to Medicare Part A and B • Must not have ESRD (End-Stage Ren
Slide 20: Classic (004) Benefits at a Glance
Classic (004) Benefits at a Glance Benefits In-Network and Out-of-Network Plan Premium $0 Part D Premium $0 Primary Care $0 Specialist $15 Days 1–6: $290 Inpatient Hospital Days 7–365: $0 Ambulance $250 Emergency Room $75 Lab Services $0 $90–$290 copay, Outpatient Surgery depending on the service 20
Slide 21: Part D Coverage for Classic (004)
Part D Coverage for Classic (004) $150 Deductible Preferred Network Non Preferred Network Tier 1 = $0 Tier 1 = $4 Tier 2 = $10 Tier 2 = $15 Tier 3 = $35* Tier 3 = $45* Tier 4 = $85* Tier 4 = $95* $3,310 Tier 5 = 25%* Tier 5 = 25%* Coverage Gap (You will pay 45% for Brand Name Drugs and 58% for Gener
Slide 22: Clover Premier Plan (007)
Clover Premier Plan (007) 22 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Benefi
Slide 23: Eligibility for Premier (007)
Eligibility for Premier (007) • Only available in Bergen, Essex, Hudson, Mercer, Passaic, and Union counties • PPO Medicare Advantage Plan • $40 Part D premium (see note below) • To qualify, must reside in one of the counties above and entitled to Medicare Part A and B • Must not have ESRD (End-Stag
Slide 24: Premier (007) Benefits at a Glance
Premier (007) Benefits at a Glance Benefits In-Network and Out-of-Network Plan Premium $0 Part D Premium $0–$40 (based on subsidy eligibility) Primary Care $0 Specialist $0 Inpatient Hospital Days 1–6: $170 Days 7–365: $0 Ambulance $200 Emergency Room $75 Lab Services $0 $90–$175 copay, Outpatient S
Slide 25: Part D Coverage for Premier (007)
Part D Coverage for Premier (007) $235 Deductible Preferred Network Non Preferred Network Tier 1 = $0* Tier 1 = $3* Tier 2 = $7* Tier 2 = $10* Tier 3 = $30* Tier 3 = $40* Tier 4 = $80* Tier 4 = $90* $3,310 Tier 5 = 25%* Tier 5 = 25%* Coverage Gap (You will pay 45% for Brand Name Drugs and 58% for Ge
Slide 26: Clover Prestige Plan (006)
Clover Prestige Plan (006) 26 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Benef
Slide 27: Eligibility for Prestige (007)
Eligibility for Prestige (007) • Only available in Bergen, Essex, Hudson, Monmouth, Somerset, and Union counties • $178 premium PPO Medicare Advantage Plan • Composed of $117.80 Part C premium and $60.20 Part D premium • Must not have ESRD (End Stage Renal Disease) • Must continue to pay your Part B
Slide 28: Prestige (006) Benefits at a Glance
Prestige (006) Benefits at a Glance Benefits In-Network and Out-of-Network Plan Premium $117.80 Part D Premium $60.20 $0 for doctor/preventive services; $750 Plan Medical Deductible yearly max for other covered services Primary Care $0 Specialist $0 Inpatient Hospital* $0 Ambulance* $0 Emergency Roo
Slide 29: Part D Coverage for Prestige (006)
Part D Coverage for Prestige (006) $0 Deductible Preferred Network Non Preferred Network Tier 1 = $0 Tier 1 = $4 Tier 2 = $7 Tier 2 = $12 Tier 3 = $40 Tier 3 = $47 Tier 4 = $80 Tier 4 = $90 $3,310 Tier 5 = 25% Tier 5 = 25% Coverage Gap (Tiers 1 and 2 are covered) You will pay 45% for Brand Name Drug
Slide 30: Additional Benefits
Additional Benefits 30 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Benefits, pr
Slide 31: Gym Membership
Gym Membership • Benefit is available to all members • Locations include but not limited to: • YMCA • Bally’s • NYSC • 24 Hour Fitness • Retro • Curves • Jersey Fitness • Complete listing at www.silversneakers.com 31 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contr
Slide 32: Preventive Services
Preventive Services • No copayment for these preventive services in all plans • Services include, but are not limited to: • Bone Mass Measurement • Cardiovascular Disease Screening • Mammograms Screening • Colorectal Cancer Screenings • HIV Screening • Prostate Cancer Screenings • Wellness Visit • D
Slide 33: Vision Benefits
Vision Benefits • Clover pays $175 towards eyeglasses or contact lenses every 2 years • Routine eye exam co-pays: • CarePoint (001): $20 • Classic (004): $20 • Premier (007): $10 • Prestige (006): $0 33 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollmen
Slide 34: The Late Enrollment Penalty
The Late Enrollment Penalty The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your initial enrollment period is over, there is a period of 63 or more days in a row when you don’t have Part D or other creditable pr
Slide 35: Applying for Extra Help
Applying for Extra Help Program Helps Pay Your: How to Apply Visit your local Social Security office, www.ssa.gov, or call LIS Prescription drug premium 1-800-772-1213. If you are also eligible for QMB, PAAD or Low-Income Subsidy and costs SLMB, there is no need to apply to SSA separately. Part A an
Slide 36: How to Enroll
How to Enroll 36 Clover Health is a Preferred Provider Organization (PPO) plan with a Medicare contract. Enrollment in Clover Health depends on Contract Renewal. This information is not a complete description of benefits. Limitations, copayments, and restrictions may Clover apply. Benefits, premiums
Slide 37: Enrollment
Enrollment Step 1: Complete and sign an enrollment application. You can also enroll online at cloverhealth.com or contact our telesales department at 1-888-657-1207 Step 2: You will receive a confirmation letter noting your application was received Step 3: Once CMS Approves your application, you wil
Slide 38: Clover 2016 Membership Cards
Clover 2016 Membership Cards Clover 2016 CarePoint PPO Plan Clover 2016 Classic PPO Plan Jane G. Sample Jane G. Sample Member ID <123456789> Effective Date 01/01/2016 Member ID <123456789> Effective Date 01/01/2016 Health Plan 80840 Copayment IN OUT Health Plan 80840 Copayment IN OUT RxBIN 004336 PC
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