DO HEALTH INSURANCE BENEFITS PROVIDED TO EMPLOYEES NEED AN OVERHAUL? ANKITA SHREERAM EXPLORES

46 per cent of employers have a difficulty in understanding healthcare needs and selecting a suitable package for employees. Moreover, 45 per cent face a challenge in executing preventive healthcare programmes and want insurance companies to be a partner in the whole healthcare process. These are a few of the takeaways from the 'Trends in Employee Benefit Programme – 2013' research conducted by ICICI Lombard General Insurance Company Ltd. 

    In 2013, a total of 5.05 million claims were settled, as compared to over eight million claims in 2011 and 4.3 million in 2012. One of the causes for lower settlement of claims seems to be a gap in communicating these benefits to employees. Loop Mobile organises camps at the beginning of the year, where each department is provided with complete information on health insurance, so that employees don't have to go through multiple levels while settling claims. "A multi-pronged communication approach is adopted to communicate the health benefits - an annual communication containing highlights of the cover is communicated at the beginning of the year. Special weeklong road-shows are conducted in coordination with insurance service providers to create awareness. For ease of access, the policy details and process are also communicated via our internal employee portal," reveals Vikram Tandon, head of HR, HSBC India. 
    Organisations could try reaching out to employees and widening communication channels in order to understand their needs. "During the renewal of the mediclaim policy, we reach out to employees to take their feedback. We review their suggestions and accommodate them based on feasibility," says Venkataramana B, president (group HR), Landmark Group. "We face challenges on expectations of employees in terms of coverage for extended families and in managing changes arising out of divorces/ remarriages/adoptions, etc," says Ramesh Shankar, executive vice president and cluster HR head at Siemens Ltd. 
More than 50 per cent of employers surveyed consider increasing healthcare cost to be a major concern. This is also compounded by the fact that the incidence rates of critical illnesses have increased by 65 per cent in the last three years. "Till the year 2006, non-life insurance products in India such as fire, motor, property, etc, were under the tariff regime. Hence, general insurers usually offered health, personal accident and travel policies at heavy discounts along with other products to gain a competitive edge in the marketplace. With the introduction of de-tariffing in the health insurance segment, companies were encouraged to create scientific rating methodologies and adopt better risk management practices and independent pricing for each line of business. Alongside, the insurers also revised their cost structures in order to offer innovative products and services to the customers," explains Antony Jacob, chief executive officer, Apollo Munich Health Insurance. 
With rising focus on preventive healthcare and early detection of ailments, 43 per cent of employers are administering wellness initiatives. Siemens Ltd provides a preventive health check-up plan for workmen, staff and executives once in every two years. So what is the ideal sum that employers can offer as health insurance? "There are two aspects to this," says Sanjay Datta, chief, underwriting and claims, ICICI Lombard GIC. "It depends on your population mix and the ratio of critical and non-critical diseases. The sum has to be enough to cover 
all non-critical diseases. The sum for critical diseases, however, would have to be configured." Thus, there is no one magical sum that can fulfil the needs of every employee, but organisations must ensure that every one of their employees are aware of how much cover they possess, and do not hesitate to avail of it. 
    ankita.shreeram@timesgroup.com AVERAGE SUM INSURED OF THE 500 RESPONDENTS WHO WERE SURVEYED ACROSS INDIA, 43 PER CENT HAVE A SUM INSURED OF LESS THAN TWO LAKH RUPEES, WHICH IN VIEW OF RISING MEDICAL COSTS, COULD BE QUITE INADEQUATE. HSBC India: An overall employee medicalinsurance plan, which covers the employee and immediate dependents with a floater cover of six lakh rupees; Siemens Ltd: 60,000 to five lakh rupees, depending on the grade of the employee; Loop Mobile:Three levels ofinsurance coverage, which ranges between two to five lakh rupees for FY'13-14;Landmark Group: 50,000 to seven lakh rupees; Matrix Cellular Services:Upto ten lakh rupees.

HEALTH INSURERS HAVE REVISED THEIR COST STRUCTURES IN ORDER TO OFFER INNOVATIVE PRODUCTS AND SERVICES TO THEIR CUSTOMERS" 
ANTONY JACOB, 
CHIEF EXECUTIVE OFFICER, APOLLO MUNICH HEALTHINSURANCE 

DURING THE RENEWAL OF THE MEDICLAIM POLICY,WE REACH OUT TO EMPLOYEES TO TAKE THEIR FEEDBACK.WE REVIEW THEIR SUGGESTIONS AND ACCOMMODATE THEM BASED ON FEASIBILITY" 
VENKATARAMAN A B, 
PRESIDENT (GROUP HR), LANDMARK GROUP

FOR EASE OF ACCESS, THE POLICY DETAILS AND PROCESS ARE ALSO COMMUNICATED VIA OUR INTERNAL EMPLOYEE PORTAL" 
VIKRAM TANDON, 
HEAD OF HR,HSBC INDIA

DISCOUNTED HEALTH CHECK-UPS CREATE A SENSE OF SECURITY AND GREATER ENGAGEMENT WITH EMPLOYEES" 
PARIJAT THAKUR, 
VICE PRESIDENT - HUMAN RESOURCES,MATRIX CELLULAR (INTERNATIONAL) SERVICES PVT LTD

THE SUM HAS TO BE ENOUGH TO COVER ALL NON-CRITICAL DISEASES.THE SUM FOR CRITICAL DISEASES, HOWEVER,WOULD HAVE TO BE CONFIGURED" 
SANJAY DATTA, 
CHIEF – UNDERWRITING AND CLAIMS,ICICI LOMBARD GIC