Transcript Health Access (Fixed Benefit) Power Point

Assurant Health AccessSM
Having Access Pays®
For agent use only
Not for use in AZ
Assurant Health Access features
• Excepted benefits
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Event–based fixed-indemnity benefits
Same great commissions from pre-reform era
No deductible, copays or coinsurance
National network discounts
Affordable to buy AND affordable to use
Choice of three plan designs
The value your clients are looking for!
Assurant Health Access
Choosing words carefully
What Assurant Health Access is and is not
What it is:
• Excepted-benefit, fixed-indemnity plan
• Known benefit amount for each type of care
• First-dollar (immediate) benefits*: no deductible, copays or
coinsurance
What it is not:
• Medical expense coverage
• Major medical
• Covered charges
• Reimbursement
• Creditable coverage
*In cases of pre-existing conditions, the plan will pay benefits related to the condition after 12 months.
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Assurant Health Access
Compare clients’ answers to this list to
recommend best plan
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Assurant Health Access
customers
Individual major medical
customers
More likely to have been uninsured due to
insurance cost
More likely to be replacing group or other
major medical plan
Looking for help with everyday, common
medical expenses
Looking for major medical protection,
coverage for bigger health care expenses
Value help paying for everyday expenses;
willing to give up security of out-of-pocket
maximum
Value a plan that protects assets and
income through limited out-of-pocket
exposure; willing to pay for everyday,
smaller costs in return
Willing to pay premium but unwilling or
unable to pay other front-end costs
(deductible and coinsurance); willing to
pay remainders after plan pays fixed
benefits for specific medical events
Willing to pay more in premium and frontend cost sharing (deductible and
coinsurance) in exchange for plan paying
remainder
Assurant Health Access
Why Having Access PaysSM
Access to affordable,
quality health care
More for your money
Confidence
Benefits start right away —
no deductible or copays
Access to network
discounts
Dedicated customer service
team
Cash to help clients pay for
expenses
Retail health clinic
discounts
Guaranteed cost
information on certain
common services with
Assurant® Price Check
Guarantee not available in GA
Access to health care with
insurance plan ID card
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Prescription discounts
Help finding the right
providers from Patient Care
Discounts on outpatient lab
services
Help negotiating medical
bills from expert
negotiators at Health
Payment Advocates
Assurant Health Access
Having Access Pays agents too
• Agents earn more with Assurant Health Access
– Pays the full commission you’re used to earning
– Pays annualized advance up to $1,000 per policy — same as
major medical
• Addresses the changing market — will have huge appeal
– Uninsured population steadily rising because of increasing
premiums
– Brings new customers — more than 75% of buyers are uninsured
and looking for different value
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Assurant Health Access
Assurant Health Access prospective
customers
Whom is Assurant Health Access right for?
• Customers who don’t see value in a traditional high
deductible health plan — meeting that deductible
might as well be catastrophic
• Place highest value on access to basic health care
– They need to stay healthy to keep working
– If something really bad happens, they’ll deal with it
• Haven’t had coverage recently or can’t afford
traditional plans
• Dropping an individual or group major medical plan
• When major medical is not an option
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Assurant Health Access
Who can buy Assurant Health Access?
• Individuals
• Families
– Same affordable price for two or more children on plan
• Adults
• Children (child-only plans available)
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Assurant Health Access
Anita
Customers like Anita feel that it’s hard to pay for everything that comes up
each month. They can’t afford an unexpected doctor visit. They need to
stay healthy so they can work and earn the most possible.
You’ll recognize Anita because she’s
likely to be:
• Age: Late 20s to 30s
• Single mom with children who also
need coverage
• Working as a waitress or in several
part-time jobs
• Unsure exactly what her monthly
income will be; it varies
Statements are illustrative.
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Assurant Health Access
Benefits Anita is looking for:
• Basic preventive care to keep her
working
• Coverage for her children at an
affordable price
• Help paying for inpatient or
outpatient care and ER if something
happens
• Preventive dental care
Tanya
Customers like Tanya know their health is important. But they can’t
afford to pay a high premium and a deductible. They want a plan
that offers assurance that they can see the doctor when they need to
and go in for an annual exam.
You’ll recognize Tanya because she’s
likely to be:
• Single
• Age 25-34
• A high school graduate with no
college degree
• Employed full time as a sales
assistant
• Renting her apartment downtown
• Shopping at Walmart
Statements are illustrative.
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Assurant Health Access
Benefits Tanya is looking for:
• A plan she can use right away, not one
with a deductible she can’t afford
• A plan that saves her money
• Additional coverage for inpatient
hospitalization
• Dental coverage
Dennis
Customers like Dennis are worried about their employer’s rates
going up, and they need a new option. They like to know how
their benefits are working and how they can save the most
money. They’re always looking for a deal.
You’ll recognize Dennis because he’s
likely to be:
• Recently married and in need of
benefits for his wife
• Age 31-40
• A graduate of his local commuter
college
• At an income level of $75K
• Employed full time
• Using coupons and rebates on day-today purchases
Statements are illustrative.
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Assurant Health Access
Benefits Dennis is looking for:
• A plan that will pay benefits for his
ongoing prescriptions
• Good coverage for things he can’t
anticipate, just in case
• Added peace of mind from Accident
or Critical Illness plan
• Dental plan
Chuck
Customers like Chuck are getting older but are still in good
shape. Premiums are too high for them. They wish to be
covered, but they’d rather save money for retirement than
spend it on premiums, especially when they’d still have to
pay for most of what they need anyway.
You’ll recognize Chuck because he’s
likely to be:
• In his late 50s or early 60s — too
young for Medicare
• Showing a few minor health
conditions
• Working as a truck driver or other
contracted position
• Earning about $60K or more per year
Statements are illustrative.
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Assurant Health Access
Benefits Chuck is looking for:
• A plan that will get him through until
Medicare
• Help with costs of an unexpected
illness or accident
• Premiums that cover only what he
needs so he can keep more money in
his pocket
• Dental coverage
Assurant Health Access features and
benefits
How Assurant Health Access plans work
• Patient Care – call for help with:
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Finding a high-quality doctor in your network
Resolving billing and claims issues
Comparing quality and cost ratings for doctors and facilities
Making the most of your health care plan
• Assurant Price Check
– An accurate, guaranteed* online estimate for certain common
services, tailored to your plan and area
– Know the cost of a service before you visit the doctor
– For Assurant Health Access customers only
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*Guarantee not available in GA.
Assurant Health Access
continued …
How Assurant Health Access plans work
• Use your benefits
– Receive eligible services
– Have us pay your providers directly
– Receive negotiated network discounts even if plan limits
exceeded
– Register at medco.com for tips on prescription savings
• Receive your cash payment (or have it paid to providers to
take advantage of First Health Network discounts)
• Health Payment Advocates (HPA)
– Use professional negotiators at HPA to reduce outstanding bills or
set up a payment plan
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Assurant Health Access
How it all works at the point of service
• Providers
– No claim forms when client assigns benefits
– Providers paid directly when client assigns benefits
– Clients can find participating First Health Network doctors at
assuranthealth.com/FHN or by calling Patient Care
• Pharmacy
– For all plans, client pays discounted rate at pharmacy
– For Fundamentals and Enhanced
• Medco informs us of claim
• Client receives benefit check 2-4 weeks later
• Benefit can more than cover out-of-pocket expense
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Assurant Health Access
More for your money
First Health Network
• Save an average of 40% at more than
595,000 health professionals when you have
us pay your providers
Retail health clinics
• Save on office visits — as low as $65 per
visit including labs (at Walgreens TakeCare
clinics)
Medco®
• Save an average of 30-40% on prescriptions
• Find lower cost alternatives
Outpatient lab services
• Save up to 60%
Discount card
• Save on vision care, chiropractic care,
alternative health and wellness, vitamins
and more
Discount card is an additional benefit; availability varies by state; card mailed separately.
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Assurant Health Access
Medco.com and My Rx Choices®
prescription benefits
In addition to discounts for all plans and cash benefits for
Fundamentals and Enhanced, all customers have access
to Medco.com
• Online prescription management
• Compare costs of prescribed drugs and suitable
substitutions
• Check for drug interactions
• Effortless auto refills on prescriptions
• Extended payment plans for mail orders
• Mobile app for convenience
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Assurant Health Access
Additional value
Patient Care
Convenient access to independent advocates who can
compare prices of doctors and hospitals
Assurant Price Check
Accurate, guaranteed1 online cost estimates for certain
common services, tailored to the customer’s plan and
area
Health Payment
Advocates
Help negotiating payment plans or reductions on medical
bills
Dedicated service team
Brings quick resolution to any questions or issues and
suggests ways to save money
Benefits guide
Helps new customers understand how to get the most
from their plan
Welcome call
Interactive call to welcome new customers, inform them
about benefits and encourage them to learn how plan
works
1Guarantee
2020
not available in GA.
Assurant Health Access
Patient Care advantages
• Call Patient Care, your independent health advocacy
service, for personalized help navigating the health
care system. Patient care can …
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Answer questions about your benefits
Compare costs and quality ratings of doctors and hospitals
Schedule a doctor appointment for you
File your claims for you
Research and resolve claims issues
Help plan for non-emergency medical services, e.g.
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Colonoscopies
Hospital stays
MRIs
Knee surgery
Assurant Health Access
Patient Care benefits to agents
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You’ll call it Customer Care!
Offer another unique, customer-valued feature
Team of experts helps with customers’ post-sale needs
and questions, giving you more time to sell
No additional paperwork required—service is
automatically included
You spend more time selling
Customers can call 800.305.0377 Monday through
Friday, 7 a.m. to 9 p.m. CT
Assurant Health Access
Assurant Price Check guaranteed pricing
With Assurant Price Check, your customers can visit AssurantPriceCheck.com
at their own convenience and …
Get accurate, guaranteed cost estimates for certain common services from network
doctors
Choose their doctor and know before their appointment what certain services will cost
Get details that are specific to them, down to their plan and ZIP code
Gain valuable knowledge that will help them navigate the health care system with
confidence
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Assurant Price Check is available only to Assurant Health Access customers!
Assurant® Price Check Guarantee
Customers will not be responsible for any cost that exceeds the quoted price range, provided they receive services for the
procedure code shown, from the doctor listed, and for which their First Health Network discounts apply. This price guarantee is
good for services received up to 30 days after the date Assurant Price Check provides pricing.*
Assurant Price Check is not insurance. It is a price estimate of what you would be charged after your network discount is applied.
Assurant Price Check is not a guarantee of Assurant Health Access plan benefits. The program is subject to change.
*Guarantee is not available in Georgia.
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Assurant Health Access
Assurant Price Check example search
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Assurant Health Access
HPA capabilities
HPA expert negotiators work to:
• Negotiate bills of about $300 and higher
• Reduce amount owed by policyholder
• Establish payment plan to ease financial burden
• Review final bill for accuracy of charges (including
verifying network discounts, questionable charges)
• Identify charitable or financial assistance programs
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Assurant Health Access
How Health Payment Advocates works
• No money or credit card information is exchanged between
policyholder and HPA
• The policyholder drives the type of conversation between HPA and
the provider
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Assurant Health Access
Assurant Health Access benefit levels
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Assurant Health Access
The Assurant Health Access portfolio
Value
• For access to health care and Assurant Health
discounts, choose the affordability of Value.
– Access to network and prescription discounts
– Benefits for preventive care and unexpected illnesses and
injuries
– Sickness and wellness benefits
– Benefits for office visits
Fundamentals
Enhanced
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Assurant Health Access
Benefit details - Value
Everyday Needs
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Office Visits
– $50 per office visit
– 2 visits maximum per calendar year
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Discounts on prescription drugs
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Allergy Shots and Immunizations
– $10 per immunization and $10 per allergy
shot
– $100 per calendar year maximum
Outpatient Medical Events
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$1,000 per calendar year maximum
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Laboratory Services
– $100 per surgical pathology test
– $15 per other laboratory service
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Radiology Services
– $130 per mammogram
– $300 per CT scan
– $450 per MRI scan
– $250 per PET scan
– $50 per other radiology service, including xray and ultrasound
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Physical Medicine Services
– $25 per occupational therapy, physical
therapy and speech therapy visit
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$25 per other outpatient event not listed
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Assurant Health Access
Hospitalization and Surgical
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Inpatient and Outpatient Surgery
– Includes surgical benefits for both inpatient
and outpatient surgery. Benefit amounts paid
are at least 100% of 2010 Medicare Physician
Fee Schedule rates. See surgical schedule
(Form 30353) for details.
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Anesthesia
– $200 per anesthesia event
– 1 event maximum per calendar year
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Ground and Air Ambulance
– $100 per ground transportation
– $1,000 per air transportation
– 2 trips maximum per calendar year for all
ambulance transportation
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Emergency Room or Urgent Care
– $150 per visit
– 1 visit maximum per calendar year
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Inpatient Hospital Confinement
– $1,000 per day for sickness
– $2,000 per day for injury
– $200,000 maximum per calendar year for all
inpatient confinements
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Lifetime Maximum
– $1 million
The Assurant Health Access portfolio
Value
Fundamentals
• Fundamentals will help you pay for doctor visits,
prescriptions and hospital charges for both preventive
care and sicknesses.
• It includes everything in Value plus:
– Cash benefits for prescriptions
– Benefits for two more office visits per year
– Increased benefits for unexpected illnesses and injuries
Enhanced
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Assurant Health Access
Benefit details - Fundamentals
Fundamentals includes all of the benefits of Value PLUS:
• Office Visits
– 4 visits maximum per
calendar year
• Prescription Drugs
– $10 per generic prescription
– $25 per brand prescription
– $750 maximum per calendar
year for all prescriptions
• Anesthesia
– 2 event maximum per
calendar year
• Emergency Room or Urgent
Care
– $250 per visit
• Inpatient Hospital
Confinement
– $2,000 per day for sickness
– $4,000 per day for injury
– $500,000 maximum per
calendar year for all inpatient
confinements
• Lifetime Maximum
– $2 million
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Assurant Health Access
The Assurant Health Access portfolio
Value
Fundamentals
Enhanced
• For a higher level of insurance benefits but still no
deductible, choose Enhanced.
• It includes everything in Fundamentals plus:
– Higher cash benefits for brand name prescriptions
– Higher cash benefits for each office visit
– Higher level benefits for unexpected illnesses and injuries
(surgery, hospital, ambulance, ER…)
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Assurant Health Access
Benefit details - Enhanced
Enhanced includes all of the benefits of Fundamentals
PLUS:
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Office Visits
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3 event maximum per calendar year
Assurant Health Access
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$400 per ER visit and $100 per Urgent
Care visit
1 visit maximum each per calendar
year
Inpatient Hospital Confinement
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Benefit amounts paid are at least 150%
of 2010 Medicare Physician Fee
Schedule rates. See surgical schedule
(Form 30354) for details.
Anesthesia
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$3,000 per calendar year maximum
$1,500 per air transportation
Emergency Room or Urgent Care
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$35 per brand prescription
Inpatient and Outpatient Surgery
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Outpatient Medical Events
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Ground and Air Ambulance
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Prescription Drugs
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$75 per office visit
4 visits maximum per calendar year
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$3,000 per day for sickness
$6,000 per day for injury
$1 million maximum per calendar year
for all inpatient confinements
Lifetime Maximum
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$3 million
Examples of how Assurant Health
Access pays benefits
Sickness benefits to make clients healthy
Take Care Clinic for strep throat
Medical costs:
$65
$5
$70
Negotiated rate, including lab
Generic amoxicillin
Total related charges
Value
Fundamentals
Enhanced
Total related charges
$70
$70
$70
Fixed-benefit office visit
$50
$50
$75
Fixed-benefit generic Rx
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$10
$10
Total fixed benefit paid
$50
$60
$85
Customer pays
(receives) balance
$20
$10
($15)
Customer must assign benefits to provider to get network discount.
Discount amounts based on Assurant Health claims data. Results may vary.
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Assurant Health Access
Broken arm (radius)
With an Accident
Fixed Benefit plan
this customer
would have
received $700 in
additional cash
benefits
Value
Fundamentals
Enhanced
$1,790
$1,790
$1,790
Total fixed benefit
paid
$585
$785
$1077
Remaining balance
$1205
$1005
$713
HPA @ 20%*
-$241
-$201
-$143
Customer pays
$964
$804
$570
Total related
charges
*Discount amounts based on Assurant Health claims data. Results may vary.
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Assurant Health Access
Heart attack with valvotomy
Medical costs:
Fundamental
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Enhanced
$51,145
$51,145
$51,145
$735
ER
$100
Office visit
Total charges
Inpatient hospital 4 days
ER
$150
$250
$400
$5,775
Surgery
Office visit
$50
$50
$75
$1,000
Anesthesia
Inpatient hospital
$4,000
$8,000
$12,000
Outpatient lab tests (20)
Surgery
$2,308
$2,308
$3,462
Generic Rx (25)
Anesthesia
$200
$200
$200
Brand Rx (5)
Outpatient labs (20)
$300
$300
$300
Total expenses
Generic Rx (25)
$0
$250
$250
Network discount*
Brand Rx (5)
$0
$125
$175
After discount
Total fixed benefits
paid
$7,008
$11,483
$16,862
Remaining balance
$44,137
$39,662
$34,283
HPA @ 20%*
-$8,827
-$7,932
-$6,857
Customer pays
$35,310
$31,730
$27,426
$54,800
$525
$1,900
$925
$65,760
-$14,615
$51,145
Customer must assign benefits to provider to get network
discount.
*Discount amounts based on Assurant Health claims data.
Results may vary.
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Value
Assurant Health Access
Heart attack with valvotomy
Value
Fundamentals
Enhanced
Total charges
$51,145
$51,145
$51,145
Total fixed benefits
paid
$7,008
$11,483
$16,862
Remaining balance
$44,137
$39,662
$34,283
HPA @ 20%*
-$8,827
-$7,932
-$6,857
Customer pays
$35,310
$31,730
$27,426
Customer must assign benefits to provider to get network
discount.
*Discount amounts based on Assurant Health claims data.
Results may vary.
Critical Illness rate based on $30k, 10 year term for 50-yearold male in FL.
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Assurant Health Access
$30K
of Critical Illness
coverage would
have covered most
out-of-pocket
expenses for just
$63/month!
OR customer could work
with HPA on a payment
plan for the balance.
Neoplasm of frontal lobe
With $25K
of Critical Illness
coverage, this
customer wouldn’t
have out-of-pocket
expenses she
can’t cover
Value
Fundamentals
Enhanced
Total charges
$30,575
$30,575
$30,575
Total fixed benefits
$6,665
$9,755
$13,955
Remaining balance
$23,910
$20,820
$16,620
HPA @ 20%*
-$4,782
-$4,164
-$3,324
Customer pays
$19,128
$16,656
$13,296
*Discount amounts based on Assurant Health claims data. Results may vary.
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Assurant Health Access
Assurant Health Access affordable
rates
Affordably priced within reach
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Assurant Health Access
Selling Assurant Health Access
Easy selling process
• Only a few medical questions to answer
• Instant decision in most cases
• Simplified rating
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Not gender rated
Not area rated
No height or weight restrictions
Not rated for risk class
No smoker status
Very broad age bands
Based on age of primary applicant
One-time, $25 processing fee
Simplified underwriting process improves placement
Effective date is either the 1st or 15th of the following month
Payment by recurring monthly credit card available
Assurant Health Access
Short application
Iowa application shown.
Application and questions
may vary by state.
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Assurant Health Access
Edelivery makes policy delivery easy
Your clients may choose electronic delivery of their policy
information
• Clients receive materials more quickly
• Clients receive access to policy materials online
• Save paper to help the planet
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Assurant Health Access
Wide availability
NH
WA
VT
MT
ME
ND
MA
OR
MN
ID
NY
WI
SD
RI
MI
WY
IA
NE
IL
NV
UT
OH
IN
DE
WV
VA
CO
CA
CT
NJ
PA
KS
MO
DC
KY
NC
AZ
OK
NM
TN
SC
AR
MS
AL
GA
AK
LA
TX
Assurant Health Access available
Not yet available
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Assurant Health Access
FL
HI
MD
Create customized coverage for clients
• Assurant provides integrated solutions allowing you to
add supplemental products to clients’ Assurant Health
Access plans
– Add accident and dental benefits with no additional medical
questions or underwriting
– Add critical illness plan with short separate application
• Help your clients fill gaps in coverage with
supplemental plans
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Assurant Health Access
Assurant Supplemental Coverage
provides added value for clients
Dental
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Term Life —
Critical Illness
Assurant Health Access
Accident Fixed
Benefit
Accident Medical
Expense
Sell on EASE: all 3 options + Supplemental
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Assurant Health Access
Assurant Health Access exclusions
Maintenance care and therapies:
• Routine hearing care, artificial hearing devices, cochlear implants, auditory prostheses, routine vision care, vision
therapy, surgery to correct vision, routine foot care and foot orthotics
• Routine dental care, unless you choose the dental insurance option
Cosmetic services and procedures:
• Services including chemical peels, plastic surgery and medications
• Any correction of malocclusion (irregular tooth contact), protrusion, hypoplasia (abnormality in dental enamel) or
hyperplasia (abnormality) of the jaws
Reproductive-related procedures or concerns:
• Diagnosis and treatment of infertility
• Maternity, pregnancy (except complications of pregnancy), routine newborn care, surrogate pregnancy, routine
nursery care and abortion
• Sterilization and contraceptive procedures, drugs or devices
Quality of life concerns:
• Inpatient treatment of chronic pain disorders
• Storage of umbilical cord stem cells or other blood components in the absence of sickness or injury
• Genetic testing, counseling and services
• Treatment, services and supplies related to sex transformation, gender dysphoric disorder and gender
reassignment; treatment of sexual dysfunction or inadequacy; or restoration or enhancement of sexual
performance or desire
• Treatment for smoking cessation and hair loss
• Cognitive enhancement
• Prophylactic treatment, services and surgery
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Assurant Health Access
Assurant Health Access exclusions, cont.
Prescription drug benefits do not include and will not provide benefits for:
• Over-the-counter products
• Drugs not approved by the FDA
• Drugs obtained from sources outside the United States
• Take-home drugs dispensed at an institution
This plan also will not provide benefits for:
• Any amount in excess of any maximum benefit or for non-covered events and associated complications
• Durable medical equipment and personal medical equipment
• Treatment undergone outside the United States
• Treatment of behavioral health or substance abuse
• Treatment, services, supplies, diagnosis, drugs, medication, surgery or medical regimen related to controlling
weight, obesity or morbid obesity
• Treatment for snoring or sleep disorders
• Experimental or investigational treatments; homeopathic treatments; alternative treatments, including
acupuncture; spinal and other adjustments, manipulations, subluxation and services; massage therapy
• Telehealth and telemedicine (including but not limited to treatment rendered through the use of interactive audio,
video or other electronic media)
• Illness or injury caused by war or while in the military; commission of a felony; or influence of an illegal substance
• Illness or injury caused or aggravated by suicide, attempted suicide or self-infliction
• Treatment or services due to injury from hazardous activities, such as extreme sports, whether or not for
compensation, including, but not limited to, hang-gliding, parachute or bungee jumping, rock or mountain
climbing
• Services ordered, directed or performed by a health care practitioner or medical provider who is an immediate
family member
• Treatment used to improve memory or slow the normal process of aging
• Home health care, hospice care, skilled nursing facility care, inpatient rehabilitation services, custodial care and
respite care
• Sickness or injury arising out of or as the result of any work for wage or profit that is eligible for benefits under
Workers’ Compensation, employers’ liability or similar laws
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Assurant Health Access
Assurant Health Access exclusions, cont.
Treatment for behavioral modification or behavioral (conduct) problems; learning disabilities; developmental delays;
attention deficit disorders; hyperactivity; educational testing, training or materials; memory improvement;
cognitive enhancement or training; vocational or work-hardening programs and transitional living
• Growth hormone stimulation treatment to promote or delay growth
• Treatment for TMJ and/or CMJ and certain jaw/tooth disorders
• Services incurred due to a pre-existing condition for the first 12 months the plan is in force
Pre-existing conditions (varies by state):
A pre-existing condition is a sickness or injury and related complications for which any of the following occurred
during the 12-month period immediately prior to the effective date of your Assurant Health Access plan:
• You sought, received or were recommended to receive medical advice, consultation, diagnosis, care or treatment;
• You were prescribed prescription drugs;
• You experienced signs or symptoms significant enough that either:
— the signs or symptoms should have or would have allowed a health care provider to diagnose the condition; or
— the signs or symptoms reasonably should have or would have caused an ordinarily prudent person to seek diagnosis
or treatment
We will not pay benefits for charges incurred due to a pre-existing condition or its complications until you have been
continuously insured under the plan for 12 months. After the 12-month period, benefits are paid for a preexisting condition as long as the covered event occurs while the plan is in force.
Exclusion for Value only:
• Charges for dispensation or fulfillment of prescription drugs
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Assurant Health Access
Thank you!
Assurant Health Access plans have limitations and exclusions. A list is available at
assuranthealth.com.
Assurant Health is the brand name for products underwritten and issued by Time Insurance Company,
Milwaukee, WI.
J-78881 (Revised 1/2012)