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NOTE: You must have Adobe Acrobat Reader installed on your system to read forms. If you do not have it installed, click the button below to download it.
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Easy & Affordable Health Insurance
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 Marketing Materials & Forms
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| Guarantee Issue Health Insurance |
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Value Access Guarantee (Not available in: CA, CT, HI, ID, IN, MT, NH, NJ, NY, OR, SD, WA, WV) |
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Value Guarantee (Not available in: CT, KY, LA, ME, NJ, NY, OR, UT, WA) |
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Alabama Residents VBA Form |
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| VBA 24 Hour Accident Coverage |
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| Value ER Plan |
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24 Hour Emergency Room
Coverage for Sickness & Accidental Injuries |
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| • Discount & Savings - Earn dividends
through The Dividend Club
Merchandise, Travel, Entertainment
and more |
| • Family Keys Program - Unique
Software that helps you organize your
personal and financial information
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| • Benefit provides up to $1,000.00 per
Hospital Emergency Room visit,up to
$2,000 per Covered Person/Family per
membership year (Benefits are subject to a $100 deductible) |
| • Affordable monthly cost of $30 for
Single or Family Membership |
| • Issue Ages Through Age 69 |
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| Underwritten by Presidential Life Insurance Company. Not available in all states. |
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| VBA Trucker Occupational Accident Plan |
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| HIPAA Authorization Forms - Required with every application |
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| Agent Underwriting Guidelines |
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Value Accident Links
VBA
24 Hour Accident Coverage - Get A Quote
Covers accident
medical
expenses
- Choice of
coverage Medical
Limits
$2,500, $5,000, $7,500 or
$10,000
AD&D & Air ambulance of $4,000
included
- Monthly Cost by
Plan
$2,500: $34.95* per month (Individual or Family)
$5,000: $44.95* per month (Individual or Family)
$7,500: $54.95* per month (Individual or Family)
$10,000: $64.95* per month (Individual or Family)
*Standard monthly bank draft rates - Add $3.00 monthly if paying by credit card
VBA 24 Hour Accident Coverage
VBA 24 Hour Accident Sample Certificate
Value Health Plan
Value Health Plan (AIG)
Choice of 3 plan benefit
schedules.
The Platinum option pays:
- In-hospital $1,000 daily up
to 365 days
- ICU care $4,000 per day for 30
days
- Per Surgery up to
$20,000
- Per Anesthesia up to $4,000
- Accidental injury up to
$250
- Ambulance up to $500
- Members can save by using members
PPO and Hospital Network,
lab and x-ray and pharmacy discounts
- Fully insured by an AM Best rated
A++ Carrier
- Sample of monthly unisex
rates:
Ages 19-39
$80; Ages 40-49 $100; Ages
50-59 $150; Ages 60-64
$180; per child
$40
There is a
$15 monthly administration fee per application.
The VBA dues are $5
monthly.
Value Health Kit - Alabama
Value Health Kit - Generic
Value Health HIPAA Form
Value Health Underwriting Guide
Value Health Sample Certificate - Platinum
Value Hospital
Value Hospital Kit - Alabama
Value Hospital Kit - Generic
Value Hospital HIPAA Form
Value Hospital Underwriting Guide
Value Med Plan
Get A Quote (GTL)
Medical & Hospital
Coverage
- Doctors Office
Visits $75 each, up to 10 per year per
adult and 5 per year for children
- In-Hospital
$500 per day for 365 days
- Hospital OP
treatment for x-ray, lab,
medical supplies up to $250 per visit (max of
$1,000 per year / insured)
- Ambulance up to
$200
- Fully insured
by an AM Best rated
carrier
- Sample of monthly unisex
rates:
Ages 18-39 $43.00; Ages
40-44
$45.40;
Ages 45-49 $47.80; Ages
50-54
$69.00;
Ages 55-59 $78.60; Ages 60-64
$110;
1st child $49.80 plus 4.80 each added
child.
The VBA dues are $5 monthly.
There is no added administrative
fee.
Value Med HIPAA Form
Value Med Underwriting Guide
Value Med Sample Certificate
Value Med Kit - Alabama
Value Med Kit - Arizona
Value Med Kit - California
Value Med Kit - Colorado
Value Med Kit - Florida
Value Med Kit - Georgia
Value Med Kit - Illinois
Value Med Kit - Indiana
Value Med Kit - Louisiana
Value Med Kit - Michigan
Value Med Kit - Missouri
Value Med Kit - Mississippi
Value Med Kit - Ohio
Value Med Kit - Oklahoma
Value Med Kit - Pennsylvania
Value Med Kit - South Carolina
Value Med Kit - Tennessee
Value Med Kit - Texas
Value Med Kit - Virginia
Value Med Kit - West Virginia
Value Med Kit - Wisconsin
Truckers Occupational
Accident
Coverage
Solutions for Motor
Carriers, Owner-Operators and Contract
Drivers
- Up to $1,000,000 for Medical
Expenses
from a covered injury
- $250,000 Accidental Dismemberment
- $250,000 Paralysis
- $2500 Accidental
Death
- Temporary & Continuous Total
Disability
up to $500 weekly to age 65
- Hernia & hemorroid
coverage
- Monthly cost:
$141.oo
VALUE
DENTAL PLUS:
- This
fully insured plan (A.M. Best Reports rated A carrier) is a unique
combination of a Hospital Indemnity benefit with Dental, Hearing and
Vision expense benefits rider.
- HIP
benefit pays up to $400 per day (or $200 for ages 65 - 99
years old). Due to the hospital benefits, there are 2 health
questions on the application to determine eligibility.
- Dental,
Hearing and Vision benefit pays 80% of covered expenses
(preventive, basic & major care, eye glasses, lenses & hearing
aids), after a $100 deductible, up to $1,000 per
year.
- No
waiting period except 12 months for replacement services, i.e. dentures
or eye glasses.
- Return
of Premium up to of 50% of the HIP portion, if there are no hospital
benefits paid after 5 years. (Not
available in all states.)
- Affordable
rates: ages 18-29 Dental, Hearing & Vision plus $400 daily
HIP is $37.44, at age 50-54 it’s $63.36 and 60-64 it’s
$87.80. There is a $20 one time application fee.
- Issue
ages 18 through 99 years old! (There
is no child coverage and a couple will need to complete two
applications, one for each.)
- Generous
commissions are the same percentage as paid on the Value Med
Plan.
- Agents must first be appointed before an application can be
written. Agents are required to pay the state
appointment fee (if any) at time of contracting.
AR, NE, TN Brochure and Application
GA Brochure and Application
SC Brochure and Application
TX Brochure and Application
Value Dental General Agent Contracting
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