|| - NCAS - || For Brokers

NCAS: Simple Solutions in Health Care

Brokers, to Get the Best Quote Possible for Your Client, Please Provide the Following Information:

1. ACCOUNT INFORMATION:

SIC Code/Nature of Industry.

Number of years in the business.

Address of Headquarters and for prospects with other locations or subsidiaries (city/state/zip and # of employees at each location). If nature of industry is different by subsidiary, please provide details.

2. CENSUS DATA:

Data to include for each participant: name (or name identification for each participant); date of birth; sex (can not use first names to determine); dependent status by each line of coverage (i.e., single medical/family dental); and, if multiple plans are offered - which plan the participant is enrolled in (i.e., PPO/EPO/Indemnity). Locations: by 5-digit zip code, for employees - needed for network match if PPO is to be investigated.

Enrollment counts by month for last 36 months - needed by underwriter to develop the aggregate (best if single and family data is provided).

Other Plans - if the employer provides other medical plans that are not being marketed (i.e., HMO) - provide how many programs and the enrollment for each.

3. CLAIMS EXPERIENCE:

Paid Claims information by month for the last 36 months - needed to develop aggregate coverage.

Large or Ongoing Claim Information - large claims at 50% of the specific for the last 36 months (diagnosis, prognosis, $s for each year, onset of condition, treatment plan/LCM notes). There are conditions that may not have reached 50%, but are ongoing (i.e., cancer, asthma, AIDS) that are of serious nature and are required to be disclosed.

4. CARRIER HISTORY:

Show carriers for the past 5 years and give the prior, current and renewal rates, and factors and details of current coverage, if self- funded. Specific Level, contract basis, coverage under the Spec and Agg and any special contract provisions.

5. PLAN:

Copy of the current plan of benefits (Plan Document or handbook) or a current schedule of benefits and details for any benefit changes desired.

Please contact our sales offices in Maryland, Virginia or North Carolina to discuss your clients' current benefit booklets or policies.