Corporate Health Portfolio: Challenges & Solutions

Transcript:Corporate Health Portfolio: Challenges & Solutions:
Corporate Health Portfolio: Challenges & Solutions Guide: Mr. K.K. Dharni Date : 19 December 2014 Presenters: Ms. Vandana Baluni Mr. Irvinder Singh Kohli Mr. Abhijit Pal Agenda 2 Historical background of Corporate Health 3 History Financing of employee health expenses, as a concept in India, was first put in place by the establishment of Employees State Insurance Corporation (ESIC) in 1948 . The act made it mandatory for blue collar workers to be covered by health insurance. Employees covered under the scheme are entitled to medical facilities for self and dependants. Cash benefits in the event of specified contingencies resulting in loss of wages or earning capacity were also provided under the scheme. Central Government introduced on 1st Jan 1954 the Central Government Health Scheme (CGHS) to provide healthcare benefits to the employees of central government. Voluntary health insurance for individuals and employees was introduced in 1987, by the launch of Mediclaim. 4 Corporate Health Plan – Product, Pricing & Underwriting 5 Product Features of Corporate Health Products offered under Group Health are very flexible and comprehensive, which can be on either Individual or Family Floater basis providing coverage to spouse, children and parents of the main policyholder The product typically covers in-patient treatment, out-patient treatment, maternity cover etc with waivers of 30 days, 1or 2 year and pre-exiting waiting periods. Sub-limits are offered for benefits for different benefits offered in the product. Products are offered with wide range of sum insured from few thousands to over 10 lacs. Some products also offers Wellness schemes/programs along with these policies. Some products offer Corporate Buffer feature under which if sum insured of an employee is exhausted, he/she can use the amount from the Corporate Buffer, which is additional sum insured at policy level. Additional benefit such as Personal Accident, Critical Illness, Hospital Cash etc are also offered with these products. Cafeteria /Menu Type plan are offered which provide options to choice from range of benefits to Employee 6 Characteristics of Corporate Health Portfolios A large number of different industries and occupations Big variation in the occupation of the insured Big variation in size of risk Heterogeneity High proportion of large claims Exposure to latent claims Volatility Policies typically sold through Brokers/Agents who: Want to reduce administrative costs Try to limit inconvenience for their customers Often provide bulk entered policies or claims Lack of structured data – data is often provided as