Health insurance coverage and employee health outcomes

Health insurance coverage and health outcomes article

We often hear people in the healthcare sector talk about ‘health outcomes’, but what does it really mean? According to World Health Organization, an outcome is “a change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status.” In other words, a health outcome can be described as the efficacy of interventions (healthcare or health insurance coverage, for example) in improving the health status of patients, employees, or the society at large.

As populations continue to age, and Non Communicable Diseases (NCDs) continue to rise at alarming rates, a growing proportion of the world’s population are experiencing a decline in their health status. As such, it’s become more important than ever for governments, key decision makers, health care providers, insurers, and employers to focus on improving the health status of patients, employees, and populations. To shed some light on the issue, today’s article looks at the relationship between health insurance coverage and employee health outcomes.

health outcomes and health insurance coverage article

Health-related quality of life

Before we look at the relationship between health insurance coverage and health outcomes, we’d first like to address how outcomes are usually measured. While there exists many variations of definitions for the term health outcomes, one primary aspect that almost all concepts focus on are the central measures or indicators used to measure the health status of patients.

One such indicator is health-related quality of life, which is a multidimensional concept that encompasses domains related to physical, mental, emotional, and social functioning. Put differently, it refers to how physically, mentally, emotionally, and socially healthy people feel when they are alive. An oft-used measurement of health-related quality of life is “healthy days”, which is generated by asking people about the number of physically or mentally unhealthy days they experience per month.

Healthcare costs and health outcomes

In the past 20 years, consumer price inflation (CPI) has grown at an average rate of about 2.2 percent, whereas the price level of medical care has grown at an average rate of 3.6 percent – that’s about 70 percent faster. Explanations are not hard to find. In our International Private Medical Insurance Inflation – 2017 report, we looked at the main forces behind hiking healthcare costs and, subsequently, health insurance costs: new medical technology, an imbalance of health resources, increased compensation for medical professionals, and healthcare overutilization.

As healthcare spending continues to exceed economic growth at an unsustainable level, more and more people are finding it increasingly hard to afford and access quality care. Demographic changes such as ageing populations, and the growing incidence of NCDs, are further exacerbating the healthcare ‘cost crisis’. Some commentators believe the challenge of delivering better health outcomes with lower overall costs can be attributed to ineffective cost measurement processes, leaving better value care out of reach for both providers and patients.

If healthcare costs are better controlled, people (in theory) have a greater ability to access the care they need to live healthier lives. For instance, patients can undergo more frequent screenings and health check-ups to ensure early detection of cancer, diabetes, and other serious conditions. This can help ensure that less costly and complex care is needed in the long run, and can also limit health deterioration.

The role of health insurance coverage

Health insurance is a key tool for managing financial risk and offsetting the cost of care. According to an article in the New England Journal of Medicine, there is abundant evidence that suggests having health insurance improves financial security. For example, the article cited a US-based study on the ACA’s 2014 Medicaid expansion’s links to reduced bill collection and bankruptcies, thus confirming that health insurance reduces the risk of unforeseen medical costs.

From an employee benefits perspective, the annual Employee Benefit Trends Study has long reported the importance employees place on financial security. One of the key ways businesses address this need is by offering employer-provided health insurance as part of their employee benefits package. In addition to bolstering employee financial security, there’s also a good chance that implementing the right employee health benefits leads to better workforce health outcomes, which translates to lower healthcare costs for employers in the long run.

Health insurance and access to care

According to the aforementioned New England Journal of Medicine article, several studies have shown that health insurance coverage has been linked to higher rates of patients being able to afford care, a factor which is oft-associated with better health outcomes. In fact, the CDC states that health insurance coverage provides a strong indication of a population’s access to care.

In recognizing the importance of ensuring universal access to quality care, a growing number of locations have made or are in the process of making health insurance mandatory. For example, Abu Dhabi introduced universal health insurance coverage in 2006, which led to an immediate 40 percent increase in hospital and clinic visits by people able to afford care for the very first time. A rise in the utilization of care has also been witnessed in Dubai, where employers of all sizes are now required to provide compliant health insurance coverage to employees.

Access to preventative services

The New England Journal of Medicine study further revealed that the expansion of coverage benefits increases access to preventative services, which can help patients detect health issues early on so they can better manage their health.

To mitigate rising healthcare costs, a growing number of employers are also seeing the importance of offering preventative care cover in employee benefit plans. In fact, a Willis Towers Watson study found that 39 percent of employers throughout the world now offer some form of preventative care and wellness program, and this percentage is projected to grow significantly in 2018.

Self-reported health and wellbeing

There’s also evidence to suggest that health insurance coverage improves patients’ perceptions of their health. Why is this important? According to World Health Organization, subjective physical and mental wellbeing (i.e. the notion of feeling better or feeling healthy) is one of the key goals that medical care should aim to achieve. Additionally, people who report that their health is poor have been found to have mortality rates 2 to 10 times higher than those who report being in the healthiest category.

What about mental health?

In addition to addressing physical health, the issue of mental health has also been brought into the spotlight as a key factor that is closely linked to health outcomes. In fact, as employee stress continues to rise, 61 percent of global insurers now offer coverage for mental health treatment and stress in their standard health insurance plans.

Our recent article, written in partnership with Asia Care Group, further revealed a number of key findings which show the importance of addressing employee mental health. These include:

  • Demanding jobs increase the chances of physician-diagnosed illness by 35 percent, and long working hours increase mortality by almost 20 percent.
  • Job insecurity increases the likelihood of reporting poor health by 50 percent.
  • The global cost of mental disorders is expected to reach USD 6 trillion by 2030, which primarily includes the costs and strains to the healthcare sector.

While health insurance plays a significant role in enabling access to better mental health care, employers are advised to look beyond health insurance in order to employ a more holistic approach to employee benefits which includes considerations for wellness benefits that target mental health. Examples of what employers can do to address mental health include:

  • Inviting a mental health professional to talk to employees about various mental health topics
  • Providing mental health management resources, such as online counselling services.
  • Partnering with an employee benefits specialist like Pacific Prime, who can help devise, implement, and manage your company’s benefits and mental wellness solutions.

Looking to learn more about improving your employees’ health outcomes?

As employee benefits specialists, we’ve had almost 20 years of experience delivering employee benefits solutions to companies of all sizes and industries. Holding the unique ability to devise, implement, and manage the most optimal plans that improve employee health outcomes, while also ensuring that they remain sustainable and cost-effective year-on-year, it’s no wonder why we are the broker of choice for over 3,000 corporate clients.

What’s more, we’re an insurance intermediary, which means we are not beholden to any one insurance provider. As such, we work for you, and not the insurer, so you can rest assured that we’ll find you the best plan for your employee’s needs. To learn more about how Pacific Prime can help your company, contact us today! Our corporate team are standing by to offer their impartial advice, as well as give you a no-obligation, free quote.

Out of the shadows: Making mental health a priority for Hong Kong employers

mental health article

Mental health issues are pervasive across the world, in virtually every population; affecting all of us either directly or indirectly. Hong Kong, with its frenetic and competitive work culture, is no stranger to this phenomenon. In fact, it has been estimated that about 32 percent of employees in 2016 were classed as having unsatisfactory mental health – up from 29 percent in 2015.

A 2014 survey commissioned by the Mental Health Association (MHA) further found that a whopping 60 percent of Hong Kongers report job-related stress and anxiety. Despite these alarming figures, there still remains widespread social stigma towards those battling with mental illness, leading many in the city to suffer in silence.

To that end, this article by Pacific Prime and healthcare advisory firm Asia Care Group looks at the state of mental health and illness in Hong Kong, its implications for employers, and what companies can do to address the issue of mental wellbeing and health in the workplace.

mental health article image

State of mental health in Hong Kong

Talking about and addressing mental health in Hong Kong is something many don’t do, or refuse to acknowledge. Candace Albert from the Asia Care Group further explained, “Fear drives discrimination and myth, and prevents people from seeking care. Encouraging an open dialogue on these subjects and increasing the level of mental health literacy among the general public are established strategies to drive change. At a societal level, increased openness about mental health will reduce stigma, promote earlier identification of common mental disorders, and enhance the likelihood that individuals explore health resources”.

This stigma has only recently started to be addressed by the government, who conducted their first-ever territory wide survey of mental illness in 2010. The report’s final study findings, which were published in a peer-reviewed journal in 2015, found that the prevalence of common mental disorders among adults aged 16 to 75 was 13.3 percent.

Given these findings, Dr. Chan Chung-mau, Chairman of the Hong Kong Association for the Promotion of Mental Health, wrote in his EJInsight article that it is possible that well over one million people in Hong Kong are in need of some form of mental healthcare. Healthcare, which in many cases, is under-supported.

Mental illness support: How Hong Kong compares with other Asia-Pacific countries

In addition to the above mentioned findings, a 2016 Mental Health and Integration report by The Economist Intelligence Unit gave Hong Kong an overall score of 65.8 out of 100 with regard to  their effort to integrate those suffering with mental health illness into the community.

Hong Kong’s worst performance was in the area of governance – including efforts to reduce stigma and promote human rights of mental healthcare patients, where Hong Kong is said to lack “a formal overarching mental health policy”. While the Hospital Authority’s 2010 Mental Health Service Plan helps fill the void in bringing coherence to the service provision, “coordination remains spotty”.

mental health index

Source: The Economist Intelligence Unit

For example, the Food and Health Bureau handles medical care of mental illness patients, whereas community support is managed by the Labour and Welfare Bureau. This fragmentation has led to a key support structure, trained psychiatrists, being largely understaffed.

Shortage of psychiatrists in Hong Kong

As of the time this article’s writing, the patient-psychiatrist ratio here is about 4.5 per 100,000 people, whereas the UK has 14.63 psychiatrists per 100,000 people, and Australia has 9.16 psychiatrists per 100,000 population.

The low number of psychiatrists in Hong Kong hurts access to mental healthcare services. This is especially true in the public sector, where people wait as long as 166 weeks for an initial visit. This, coupled with short appointment times of around 5 to 10 minutes per patient, and hiking demand for mental healthcare services, all point to the fact that it is getting harder for public sector doctors to invest their time into treating and supporting patients and their families.

In November 2016, this pressing situation led the government to announce their intentions of further extending their public-private partnership model, which has been in place in general outpatient clinics to handle “suitable and stable” follow-up patients in order to relieve the overburdened public system. As the private sector currently handles about 10 percent of psychiatric patients in Hong Kong, many see the potential in private doctors taking up more patients.

The issue of stigma and mental illness in Hong Kong

Another important issue to address here is the pervasive stigma that still surrounds those with mental illness conditions in Hong Kong and much of Asia. As this issue is multi-faceted, it can be very complex.

To reduce this stigma, in 2010 the Hong Kong government invested HKD 135 million into setting up a community network for people suffering from mental illness. A number of public programs were organized to promote mental well being and foster a greater understanding of mental illness.

On the success of these programs, Candace Albert commented, “The investment initiative to expand the Integrated Community Centres for Mental Wellness is a positive first step. The programs can be enhanced over time by clearly defined referral pathways, both with the existing Hospital Authority services for current and ex- mentally ill patients, and with primary care. The value of community-based programs is strengthened when they operate alongside other services, in an integrated health system.”

Why employers should address the mental health of their employees

The issue of mental health can be a touchy subject that many employers might not be willing to address openly. After all, many hold the widespread opinion that an employer has no business getting involved with their employees’ mental state in the first place. That being said, while employees have every right to maintain their privacy about personal / sensitive issues, it doesn’t mean that companies should completely ignore their employees’ psychological wellbeing.

The reason is clear: an employee’s mental state, if poor and left unaddressed, will likely permeate into the workplace. In fact, its impact is wide-reaching and can be detrimental not only to the employee, but also the employer and society at large. A 2017 Deloitte UK report, titled: At a tipping point? Workplace mental health and wellbeing, delved into this point further and discussed the following key findings:

  • Impact on employees: 85 percent of employees reported symptoms of poor mental health attributed to work-related stress. Demanding jobs increase the chances of physician-diagnosed illness by 35 percent, and long work hours increase mortality by nearly 20 percent.
  • Impact on employers: Poor employee mental wellbeing also results in loss of productivity. The report found that job insecurity increases the odds of reporting poor health by about 50 percent. Absence, however, is not the only cost. Other costs to the business include presenteeism (the loss in productivity from working at less than full capacity), and turnover.
  • Impact on society: Poor mental wellbeing is also costly to society. According to the WHO, the global cost of mental disorders is expected to reach USD 6 trillion by 2030. This primarily includes the costs and strains to the public healthcare sector. In Hong Kong, for example, demand for psychiatric care has grown from 39,770 cases in 2009/2010 to 47,958 cases in 2014/2015, thus leading to an increasingly overburdened public system.

In addition to the above, the University of Hong Kong found in their new study of mental health conditions in the workplace that 90 percent of respondents (both employees and managers) said they needed better support at work. What’s more, 60 percent of respondents believe that mental health issues in the workplace play a large role in pushing away talented staff. “With productivity losses in workplace settings being as high as they are, there’s a strong business case for reducing mental health stigma. Forward-thinking employers stand to benefit by investing in employee mental wellness initiatives because these programs result in reduced staff turnover, lower sick leave, and better employee performance.”, said Candace Albert.

What employers can do to address employee mental health

By addressing and opening up discussion about mental wellbeing in the workplace, employers can offer the support and tools employees need without intruding on their privacy; not to mention create a more positive and productive work environment overall. Here, we’ve included several key ways to address employees’ mental wellbeing and health in the workplace:

Educate your staff

Given the prevalence of mental health issues in Hong Kong, chances are a significant proportion of your staff are already struggling with a problem. A general lack of awareness and pervasive stigma at the workplace, however, can mean that many employees are not willing to acknowledge their problem, or are confused about how they want to deal with it.

To add to this confusion, “mental health” is a broad term that not only refers to disorders and illnesses like schizophrenia or bipolar disorder, but also a construct similar to physical health. What this means is that, similar to how we take care of our physical wellbeing by eating well and exercising regularly, mental health is not only about treating mental illness, but also about taking care of our bodies, getting enough sleep, stimulating our brain, and managing our emotions.

As part of your employee wellness strategy, one solution is to bring in a qualified mental health professional to educate your employees about the wide range of mental health topics. Topic examples include:

  • Spotting signs and symptoms
  • Supporting colleagues
  • Coping with, reducing, and preventing stress
  • Getting quality sleep
  • Building and enhancing emotional resilience
  • And more

The key is to encourage open discussion that allows employees to feel comfortable and ask questions, so that stigma at your workplace will begin to fade. “It’s not enough just to hang up posters with a helpline or website to encourage people to get help,” Candace Albert commented. “We need to encourage people to think and talk about the issue in a workplace setting, such as through educational sessions and workshops. Many employees are afraid to seek help early on, but the majority of common mental disorders can be treated. With appropriate support, individuals can remain productive and efficient members of the workforce.”

Provide a range of mental health management resources

While putting mental health professionals on site can be very beneficial to your staff, some employees could feel too anxious or embarrassed to talk or open up about their issues. Offering additional resources like telehealth (e.g. online counselling services) can, therefore, be a good way to further support employees. By offering these extra resources, not only are more mental health treatment and/or management options available, but they also enable employees to feel more comfortable in reaching out to get the help they need.

Partner with an employee benefits and wellness specialist

From the above, it is clear that there are many advantages to supporting and addressing mental health in the workplace. With that said, there’s no such thing as a one-size-fits-all mental wellness benefits approach, which is why it can be beneficial to partner with an expert like Pacific Prime, who has the skills and experience to identify, devise, implement, and manage your company’s benefits and mental wellness solutions.

We’re also experts in all things insurance, and are able to deliver employee health insurance solutions that includes considerations for mental health. By offering these extra mental health support benefits, employers can ensure that their valued employees are both physically and mentally healthy, and are never left feeling like they don’t have the support they need.

Do you have any more questions? Contact our team today to get the answers to all your questions, as well as a no-obligation free quote.

About Asia Care Group

Asia Care Group Limited is a boutique healthcare advisory firm that focuses on major strategic change projects in the Asia-Pacific region. ACG works across the industry spectrum, with Governments, Public and Private Providers, Health Insurers and Development Organisations in pursuit of more effective and efficient healthcare systems.

About Candace Albert

Candace Albert is a Managing Consultant with ACG, based in Hong Kong. She holds a BA in Public Health Studies from Johns Hopkins University and a dual MPH and MSc in Sustainable Health Systems. She has spent several years working in the areas of chronic disease, health systems strengthening, and strategic planning at previous posts with the Department of Health (US), OECD (Paris), and the Johns Hopkins School of Medicine.

International travel insurance requirements: What employers need to know

international travel insurance article

In an increasingly globalized marketplace, placing employees in assignments across international locations has become an essential part of doing business. Sending staff overseas, however, can be a fairly complex and involved task. Beyond organizing employee accommodation and travel arrangements, it is also imperative to arrange adequate international travel insurance coverage to safeguard the health and safety of your staff, as well as ensure that the trip runs smoothly.

While the importance of meeting insurance obligations is clear, many employers struggle to thoroughly consider the requirements of sending their staff overseas. Should employers have an international travel insurance policy in place? Are there any mandatory insurance requirements employers should be aware of? These are big questions, and if left unaddressed employers could face costly outcomes both legally and to the business.

To help clear up some of the uncertainty around international travel insurance requirements, today’s article looks at the travel insurance requirements in key locations, what employers should be aware of when purchasing travel insurance for employees, and further discusses the differences between travel and international health insurance.

Knowing the international travel insurance requirements of your employee’s destination

Recent news about Thai officials calling for mandatory travel insurance has highlighted the importance of ensuring that employees have adequate international travel insurance coverage when going abroad.

Due to skyrocketing medical costs, uninsured visitors can be a large liability for state healthcare systems, which is why an increasing number of locations have already made or are in the process of making travel insurance compulsory.

Here, we’ve identified some of the countries that have already implemented mandatory international travel insurance regulations:

Schengen countries

The Schengen area covers the majority of European countries except for the UK, as well as a few other countries such as Bulgaria and Croatia. One of the documents required to apply for a Schengen visa is proof of insurance that covers “any medical emergency with hospital care and travel back to one’s native country due to medical motives”. The travel insurance policy must also have a minimum medical coverage limit of EUR 30,000, and should be valid within the whole Schengen region and for the full duration of travel.

schengen italy
The UAE

Travel health insurance is mandatory for anyone applying for a UAE visit or tourist visa. Insurance policies must cover inpatient accident and emergency expenses incurred while the visitor is in the UAE, with a minimum coverage limit of AED 150,000. Repatriation of remains must also be covered.

It must also be noted here that employers are legally required to secure compliant medical insurance coverage for foreign workers in Abu Dhabi and Dubai. Employers who fail to adhere to the respective Emirate’s specific minimum coverage requirements will be charged hefty fines, and employees who do not have adequate insurance will not be granted new or renewed visas.

Ecuador

As addressed in our recent article on Ecuador visa requirements, those staying longer than 90 days in Ecuador must secure and show proof of having either international travel insurance or a health insurance policy that will cover the visitor for their entire stay in the country. Foreigners granted a Temporary Residency or Permanent Residency Visa must either show proof of having private health insurance or be affiliated with Ecuador’s social security system.

ecuador

Cuba

Visitors to Cuba must show proof of travel health insurance to immigration before they are granted entry. Policies must at the very least cover medical emergencies, medical evacuation, and repatriation of remains.

cuba

In addition to the above countries, other locations that have recently introduced mandatory travel insurance regulations include Turkey, South Africa, Saudi Arabia and Russia. As mentioned above, Thailand is also deliberating over a proposal requiring all foreign visitors to obtain international travel insurance before entering the country.

Things to be aware of when purchasing travel insurance for employees

One thing to be aware of when purchasing travel insurance is that the cheapest plan is in most cases not the most optimal and best value policy. Some travel insurance companies may issue very basic travel insurance for visa application/ entry purposes, but usually offer only very basic coverage with low limits and an extensive list of exclusions. Therefore, it can pay to search around for a travel insurance plan that offers higher levels of protection for all sorts of health and business travel related contingencies.

Please note here that even if you’re sending staff to a country that does not legally require insurance coverage, it’s still a good idea to consider what type of insurance coverage might be essential, since the employer is ultimately responsible for the health and safety of their employees. An ill or injured employee can be disruptive to your business, but one that can’t pay for care can represent a bigger problem.

Travel or international health insurance?

While travel insurance can be the best option for employees going away on short international assignments or visiting conferences, it’s likely not the best option for employees on mid-to-long term secondments or expatriation. Travel plans are generally of a short term nature intended for stays of between three to six months, and while they offer travel-related benefits such as emergency evacuation, as well as lost baggage and delay coverage, its health benefits are often limited to emergencies only.

International insurance plans, on the other hand, offer far more extensive medical coverage in both the employee’s home country and abroad. They provide coverage benefits in virtually every country and hospital in the world, and are also specifically designed to cater to the healthcare needs of globally mobile expats. They also often feature the option of including added benefits like dental, maternity, vision and other wellness benefits.

Get in touch with Pacific Prime today

Insurance can be a very complex market and trying to work out the travel health insurance requirements for your employees at the same time can be daunting. If you have any more questions or are unsure about your insurance obligations as an employer, the experienced corporate team at Pacific Prime can guide you through your options and specific requirements to ensure that your company and staff are protected at home and abroad.

To discuss your insurance requirements, contact the corporate team at Pacific Prime today!

Global health insurance provider Aetna buys Bupa Thailand

global health insurance provider Aetna acquires Bupa Thailand

At the end of July, leading global health insurance provider Aetna Inc. announced that it had acquired UK-based Bupa Group’s Thai business, Bupa Thailand, for an undisclosed amount. The acquisition allows Aetna to significantly increase its presence in the Asia region, and is key to their strategy to go ‘broader and deeper’ into local healthcare markets around the world. Shortly after the acquisition was announced, Aetna also outlined the launch of its new service approach for large organizations with over 1,500 staff overseas.

Read on to learn more about Aetna’s acquisition of Bupa Thailand, and to find out about the global health insurance provider’s new service approach for international corporations.

About Aetna’s acquisition of Bupa Thailand

Aetna’s latest acquisition strategically combines the strengths and deep reach of both insurance companies to provide enhanced offerings to health insurance customers in Thailand. Bupa Thailand’s in-depth knowledge of the Thai healthcare market, system and culture, coupled with Aetna’s vast product portfolio and global health insurance expertise, will ultimately result in broader insurance product offerings in Thailand, as well as build on Bupa Thailand’s exceptional service.

“This is a significant and exciting expansion for Aetna in Asia, and clearly demonstrates our commitment to investment and growth in the region and globally”, commented Richard di Benedetto, President of US-headquartered Aetna International. “Thailand is an important market for us, with increasing local wealth driving greater adoption of health insurance.  Aetna’s wide product portfolio, together with an excellent talent and knowledge base transferring from Bupa, will put us in a very strong position in the local market.”

Established more than 30 years ago, Bupa is one of Thailand’s top health insurance providers, with over 300,000 members and a network of over 400 medical providers in the region. For a short period of time, Bupa Thailand will continue operating under the Bupa brand name before rebranding as Aetna.

Thailand: A lucrative market for global health insurance providers

As one of Asia’s most lucrative markets, Thailand continues to attract the attention of world leading global health insurance providers, many of whom are keen on establishing and growing their presence in the region. One key reason for this is continual economic growth in Thailand, which has resulted in a wealthier population.

According to our Cost of International Health Insurance – 2017 report, it is anticipated that the middle class population in Thailand will exceed 200 million by 2020. Not only are we witnessing a growing middle class, but the number of High Net Worth (HNW) individuals is also increasing. For example, the number of HNW in the region increased from 49,800 in 2009 to 95,700 in 2015. This increase in wealth has led to a growth in demand for both local and global health insurance products in Thailand.

Aetna’s new service approach for international corporations

Shortly after announcing its latest acquisition in Thailand, global health insurance provider Aetna also outlined the details of its new service approach for international corporations with over 1,500 staff overseas. Following detailed health insurance broker consultations, the company has developed a fully flexible solution designed to meet the corporate insurance needs of large companies with international operations.

Damian Lenihan, Executive Director of UK Distribution at Aetna International, outlined the new service approach in this article by Health Insurance & Protection Daily. According to Lenihan, the proposition consists of the following four main pillars:

Member support

By focusing on member needs, employer-provided health insurance policies should cover both core benefits (like inpatient and outpatient treatment), as well as additional health and wellness benefits (like dental insurance), as per customer requirements.

Service delivery

Everything from language needs to claims processing requirements should be tailored around member specifications. Aetna will also be able to provide solutions to clients looking to self-insure.

Full program transparency

“Granular analytical data and bespoke management reporting” are instrumental in helping employers understand their group policy’s medical costs, and where savings are made.

Partnership approach

By adopting a partnership approach, Aetna focuses on providing clients with a fully resourced and responsive team, who are able to deal with and handle every eventuality.

Pacific Prime: Your global health insurance specialist

With almost two decades of experience advising and matching clients with the best global health insurance solutions, Pacific Prime has developed longstanding partnerships with the world’s largest and most reputable insurers, including Aetna, Bupa, Liberty Insurance, Cigna, MSIG, and many more. As we are not beholden to one particular insurer, you can rest assured that we will find you a local, regional, or global health insurance plan that provides the best value for your specific needs and budget requirements.

If you have any questions, or would like to learn more about your insurance options, be sure to get in touch with one of our helpful advisors today. Those looking for further information on corporate insurance solutions can also check out our new online resource for corporate clients here.

Australian households find private health insurance too complex

Private health insurance complex article

With over 40,000 plans on the market, private health insurance has become “a quagmire of cost and confusion” for Australian households, says Matt Levey, the Director of Campaigns and Communications at consumer group CHOICE. In a national survey commissioned by CHOICE, it was found that nearly half (44 percent) of Australian policyholders consider comparing health insurance too “difficult”, while the remainder was divided between “neutral” and “easy”.

Because of this perceived complexity, many people feel discouraged from looking for/ switching policies and taking the time to find a better deal compared to the insurance that they already have. Here, we look at the top reasons behind why so many Australians find private health insurance so complex, and provide some key tips on what you can do to educate yourself on the basics of insurance.

Why people find comparing private health insurance challenging

Respondents from the latest CHOICE survey revealed that many people find it hard to compare private health insurance. Here are the top reasons why:

  • 69% of respondents say they find it difficult to compare plans side-by-side
  • 54% find it difficult to compare out-of-pocket costs if they were to go to hospital
  • 53% say information from insurers is not set out consistently
  • 53% find it hard to compare extras* rebates
  • 45% believe not all policies are available for comparison
  • 43% of respondents find it hard to grasp insurance terminology
  • 39% say they are unable to compare cover for specific health problems that they’re worried about
  • 36% are unable to find independent information they can trust
  • 25% say they get too much information from insurers
  • 21% say they have experienced difficulties comparing what they would save on tax or get from a rebate

*Extras health insurance, also known as general or ancillary cover, provides coverage for non-hospital related medical services (e.g. dental, optical).

With so many people feeling overwhelmed by this complexity, Matt Levey from CHOICE believes that it could make a grudge purchase a bad one, leading to poor outcomes including securing an ill-fitting insurance plan. With this in mind, the survey results have illuminated the pressing need to improve health insurance literacy among the general public, so that people can make better, more informed choices.

How to educate yourself on health insurance

Private health insurance can be confusing at first, but the more you know about it, the better off you will be. This is especially true for those who are shopping for health plans for the first time, who may be understandably overwhelmed when faced with so many plans and insurance terms like “pre-existing conditions”, “coinsurance”, “deductibles”, etc. As such, having at least some basic knowledge of health insurance can go a long way in ensuring that, amid ever-rising premiums, you get the best value plan on the market.

So, how do you start your education? Looking for credible sources on the internet can be a great way to start, so that you can learn about the ins and outs of insurance at your own pace. In our goal to simplify health insurance, we’ve released a number of easy-to-read guides and reports that should be of use to anyone looking to learn more about insurance:

Our blog is also a great resource for various insurance-related topics; feel free to check it out here.

It’s also important to get impartial advice from an expert. We highly recommend that you talk to an established broker like Pacific Prime. With almost 20 years of experience in the field of private health insurance, we’re more than happy to answer any questions you may have regarding insurance terminology, finding the best plan that caters to your health and budget concerns, as well as give you a free quote and comparison of plans from the world’s leading insurers.

Do you have any more questions? Contact the helpful advisors at Pacific Prime today, or check out our free plan comparison tool here.

Source: CHOICE (2017). Making Private Health Insurance Simpler.

New Ecuador visa requirements: Expats must show proof of health insurance

Ecuador visa requirements blog article

New Ecuador visa requirements have now made it mandatory for all long term tourists, temporary residents, and permanent residents including expats to have health insurance that covers them for the entire duration of their stay in the country. It is therefore essential for anyone visiting or moving to Ecuador to be aware of the recent changes to their visa entry requirements in order to avoid having their visas/ entry denied. Read on to find out whether the new Ecuador visa requirements apply to you.

What exactly are the new Ecuador visa requirements?

As of the time of writing this article, those visiting Ecuador as a tourist for less than 90 days during any given year do not need to show proof of travel or health insurance. Visitors from most countries do not require a visa to enter Ecuador for up to 90 days, with some notable country exceptions including Afghanistan, Bangladesh, Cuba, Eritrea, Ethiopia, Kenya, Nepal, Nigeria, Pakistan, Somalia, and Senegal. Nationals of the following countries can stay in Ecuador for up to 180 days as a tourist: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay and Venezuela.

The new Ecuador visa requirements only applies to tourists who want to extend their stay in Ecuador, temporary residents, and permanent residents. Below are the new Ecuador visa requirements for each visa category:

Tourist Visa Extension

If tourists want to stay in Ecuador for longer than 90 days, they may do so by applying for a Tourist Visa Extension, which will allow them to stay in the country for an additional 90 days. Tourists may also apply to extend their stay for a maximum period of one year by sending a special request to the Human Mobility Authority. This special extension can only be granted once every five years.

Please note here that anyone who wants to apply for a Tourist Visa Extension must secure and show proof of having either a health insurance policy or travel insurance that will cover them for their entire stay in Ecuador.

Temporary Residency Visa

Foreigners who are granted a Temporary Residency Visa will be allowed to stay in Ecuador for up to two years. During this period of time, those with a Temporary Residency Visa in Ecuador are allowed to leave the country up to 90 days in the first year, and again up to 90 days in the second year. Temporary Residency Visas are subject to cancellation if the visa holder fails to comply to the 90 day requirement, in which case they will need to either re-enter Ecuador with a new Temporary Residency Visa and/or new Tourist Visa, depending on their circumstances.

There are thirteen categories under this type of migration status:

  • Worker
  • Independent means
  • Pensioner
  • Investor
  • Scientist, researcher or academic
  • Athlete, artist or cultural agent
  • Religious or religious volunteer
  • Volunteer
  • Student
  • Professional, technician, technologist or master craftsman
  • International convention
  • Dependent (i.e. children, spouse or common law partner, etc.)
  • International protection

Those applying for a Temporary Residency Visa must show proof of having private health insurance or must be affiliated with Ecuador’s social security system, commonly known as the IESS or Instituto Ecuatoriano de Seguridad Social. Please note here that the Temporary Residency Visa can only be renewed once.

Permanent Residency Visa

Permanent Residency Visas allow a foreign citizen to remain in Ecuador for an indefinite period of time. To obtain permanent residence status, applicants must meet the following criteria:

  • Have stayed in Ecuador for at least 21 months;
  • Have married or formed a legally recognized civil union with an Ecuadorian person;
  • Be a minor or a disabled person who depends on an Ecuadorian person or foreigner with permanent resident status;
  • Be related to an Ecuadorian person or permanent resident of Ecuador.

For the first two years from the date the visa is granted, those with a Permanent Residency Visa are not allowed to be out of the country for more than 180 days each year. Those who fail to comply with this requirement will be charged a hefty fine.

As with the Temporary Residency Visa health insurance requirements, those applying for a Permanent Residency Visa must also show proof of having private health insurance or be affiliated with the IESS.

Private health insurance or the IESS?

If you’re applying for a Temporary or Permanent Residency Visa, there are two health insurance options available:

  • Membership in the IESS
  • Obtain private health insurance

Here, we provide an overview of the two options:

IESS

Expats can choose to enroll in the IESS, which is paid for through contributions either by yourself, or by your employer (if you are employed). The cost is 17.6% of your income, and an additional 3.41% for your spouse or common law partner, as long as they have a cedula (national identification) number for registration. These percentages, for many expats, can be a considerable amount.

Public medical care is 100% free if you’re enrolled in the IESS, as long as you visit facilities that are contracted with the IESS. That said, sometimes IESS pharmacies may not have the medications that you require, meaning you may have to go to a non-IESS facility to purchase them.

What’s more, the quality of medical care provided by IESS facilities can vary significantly in Ecuador, with most high quality facilities located in large cities like Guayaquil. Healthcare standards in smaller towns and rural areas are often very poor. Combine this with the fact that the IESS can be restrictive for foreigners to be able to afford or utilize (not being Ecuadorian citizens themselves), and it is easy to see why so many expats prefer having private health insurance.

Private health insurance

Those looking for private health insurance can choose to obtain either a local or international policy. If you’re on a tight budget and rarely travel, a local plan may be the best option for you. Local plans are often much cheaper than international health insurance, primarily because it covers a lot less geographically. That said, expats and frequent travellers often prefer international health insurance to benefit from much greater flexibility and freedom in choosing where they can seek care. The cost of international health insurance in Ecuador can range from as little as USD 66 for a basic plan, to USD 942 for a more comprehensive plan with added benefits such as dental and maternity cover.

Looking for more information on Ecuador visa requirements?

To learn more about the new Ecuador visa requirements and your health insurance options, contact the helpful advisors at Pacific Prime today. Also feel free to have a look at our Ecuador page here for in-depth information on healthcare and health insurance in Ecuador.

What your company can do to tackle health insurance fraud

health insurance fraud article

Health insurance fraud is a serious problem for insurance providers and the greater health industry in general, amounting to “tens of billions of dollars” in losses every year. As discussed in our recently released Cost of International Health Insurance – 2017 report, healthcare fraud plays a significant role in driving up the cost of healthcare, and also leads to a subsequent rise in health insurance premiums. Here, we look at health insurance fraud and what can be done to minimize its impact.

What is health insurance fraud?

Medical insurance fraud can be defined asfalse or misleading information [that] is provided to a health insurance company in an attempt to have them pay unauthorized benefits to the policyholder‚ another party‚ or the entity providing services.

Simply put, insurance fraud is the act of misrepresenting facts or outright lying to make money from the health insurance system; potential offenders can be anyone – patients, doctors, hospitals, or even pharmacists. Popular examples of health insurance fraud include falsifying claims, misrepresenting the provider of service, and billing a non-covered service as a covered service.

There’s also abuse, which involves practices that are not deemed medically necessarily, or are outside acceptable standards of professional conduct, thus leading to unnecessary costs being paid (e.g. over-prescribing medications, ordering unnecessary tests, keeping patients at the hospital for longer than necessary).

The impact of health insurance fraud

There are many ways in which health insurance fraud can have an impact on employers and employees, including:

  • Increased health insurance premiums: Continuing challenges related to fraud is one of the main drivers behind increasing health insurance premiums. As premiums continue to increase, health insurance will quickly become unaffordable for both employers and individuals.
  • Cutbacks on benefits: As premiums become more costly, it is more likely that there will be cutbacks on the benefits included in employer-provided health insurance policies (e.g. the removal of dental cover, limits on who is covered, etc.
  • Increased copayments and deductibles: Copayments and deductibles are on the increase, as employees find themselves footing the bill for a higher proportion of their healthcare costs despite having insurance.

What can my company do to tackle fraud?

One of the most effective ways an employer can tackle health insurance fraud and abuse is by educating their employees. Employees should be aware of:

  • What is and isn’t covered by their group plan
  • What constitutes health insurance fraud and abuse
  • How fraud impacts employees and their benefits
  • How to spot fraud and abuse

Below is a checklist of what employees should keep their eyes on to protect themselves, their company, and the healthcare system at large from insurance fraud and abuse, and keep healthcare costs down for everyone:

  • Report any lost or stolen health insurance cards immediately
  • Fill out, sign and date one claim form at a time. Never sign empty or incomplete forms.
  • Always confirm the diagnosis and make sure it correlates with the information on the form
  • Question free offers (e.g. free tests, screenings, and treatments), especially when the healthcare provider asks for your insurance information
  • Know what’s covered and what is not covered by your health insurance
  • Alert the insurer of any suspected fraud or abuse

Partner with Pacific Prime today

By partnering with an insurance specialist like Pacific Prime, you’ll find that we not only help you source the most optimal group health insurance plan, but also answer any questions your employees may have regarding their benefits, or how to spot fraud. To learn more, contact our helpful advisors today, or check out our brand new corporate site.

Pacific Prime signs partnership agreement with Bahrain-based broker Protection Insurance Services

Pacific Prime and Protection Insurance Services logos

(Hong Kong, November 28, 2016) Pacific Prime, a leading global insurance advisor, is proud to announce a new strategic partnership with Protection Insurance Services, a leading insurance and reinsurance broking firm headquartered in Bahrain. This agreement will see both companies extend their operations within the Gulf Cooperation Council (GCC) countries and in other regions across the globe.

Providing mutual benefits to both parties, this exclusive partnership, finalized on November 17, 2016, now enables Pacific Prime to provide their services in the territories covered by Protection Insurance Service’s licence, and vice versa. For Pacific Prime, this means that they can now write business in KSA, Bahrain, Qatar and Kuwait, markets that they were not licensed to quote for business in, up until now.

“In partnership with Protection Insurance Services, Pacific Prime will expand its footprint across the GCC. We look forward to a long and fruitful relationship between the two companies” said Maria Loughran, Corporate Account Manager at Pacific Prime’s Abu Dhabi division, Medstar Insurance Brokers LLC. “Protection Insurance Services is a client centric brokerage, and as such, make for an ideal partner for our business. The values and ethical behavior of both brokerages align perfectly and both companies operate with the core value that; The client is at the heart of everything that we do.”

Protection Insurance Services has over 20 years of significant expertise in a comprehensive range of marine and non-marine insurance broking, consulting and claims-handling services, and as such, Pacific Prime sees this partnership as a unique opportunity to acquire deep insights into the industries that they operate in.

CEO of Protection Insurance Services, Samy Aziz, commented: “We at Protection Insurance Services are very excited about this partnership with Pacific Prime Middle East as it will strengthen relationships with our clients and insurance companies. We’re thrilled to be Pacific Prime’s partner while building upon our extensive experience, and bringing that robust expertise into the Employee Benefits insurance market.”

About Pacific Prime

Headquartered in Hong Kong, Pacific Prime International Limited is a leading international health insurance advisor that leverages its close relationships with over 60 leading insurance companies to provide the best value insurance services and products to individuals and corporations. With offices strategically located in China, Hong Kong, Singapore, and the UAE, Pacific Prime principally offers advice on international health insurance, business insurance and life insurance. For more information, visit: https://www.pacificprime.com/

About Protection Insurance Services W.L.L

Founded in 1996, Protection Insurance Services W.L.L is a leading insurance and reinsurance broking firm with sound reputation among the insurance community in the Kingdom of Bahrain. The company provides international specialized insurance, reinsurance services (including takaful and retakaful), and advisory services across the region of MENA, parts of Africa, the Indian Subcontinent and Asia. For more information, visit: http://www.protectionre.com/index.html

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