Savings and improvements to the overall policy structure of a regional employer

Creating Sustainability

Carole Khalife

General Manager – Sales, Strategy & Innovation

In the Middle East, corporate medical insurance is commonplace. Within some geographies such as Abu Dhabi, Dubai and KSA, it is already mandatory. In other countries, such as Qatar, Bahrain, and Oman, it is expected to become mandatory in 2022-2023. However expensive your corporate health insurance programme may prove, there are ways to ensure that your policy’s loss ratio (the ratio of how much you pay for the programme versus the cost of claims made upon it, plus associated expenses) can be contained. Below are the strategies to adopt to mitigate the risk of prohibitively expensive healthcare.

1: Analysis of population & claims trends

Knowing the likely health risks of your employees helps you design a good wellness plan and maintain the right level of cover. A good broker and consultant would review your population health risks based on age brackets, ethnicity etc. in addition to auditing your claims trends. However, the most efficient and accurate way remains onsite campaigns where your employees’ risks are assessed individually and you as an HR would receive an aggregate report of risk exposures.

2: Innovative Product Solutions

Innovative product solutions might be offered in multiple pathways, some of which result in considerable cost savings. Participants can be dissuaded from choosing the priciest options when it comes to selecting a provider, without compromising their health outcomes. Ex gratia payments can be offered as deal sweeteners, or discounts provided on optical and dental plans to draw employees into commitments which are more realistic for employers. There are ways also to dissuade patients with minor complaints from attending expensive hospitals. Stand-alone programmes can be devised, some of which may have a preventative focus, such as smoking cessation schemes and obesity clinics. Chronic condition management may be more cost-effectively provided in specialist clinics, rather than occasional hospital visits. Such clinics offer more specialist care, and patients are seen more quickly, at a time convenient to them.

“Informed by analysis and trend following, it becomes possible for your broker to devise innovative solutions and design policies that are fit for purpose.”

3: Cost Effective Measures in Health Insurance Programme Design

There are a number of smaller, but no less consequential, changes a company can make to ensure value within health insurance schemes too. Here are just a few of them:

Prescribe more cost-efficient generics over known brands, with no impact on quality
Create targeted programs, such as wellbeing, elder yoga, or smoking cessation. Adopting such programmes can save money through prevention, rather than ongoing treatment or cure
Use in-house clinics rather than hospital or surgery-based sessions. The doctor or nurse visits the employer, reducing the friction of employees attending outside treatments. This can also be managed through a virtual clinic at the comfort of the employers’ office
Use a respected insurance broker to identify and negotiate the best policy. They will know the current status of competing insurers and be able to recommend one that best suits a particular business model, location, and set of circumstances.

Saving Money on Health Insurance Policies without Sacrificing Quality of Care

The aim with corporate health insurance policies is to strike a balance between competitive quality of care, and affordable policies. Clearly, such policies must appeal to their users, who often look to health insurance as a major perk of any potential job selection. To continue to recruit the best talent, HR departments need to maintain competitive standards in health insurance provision.

However, there are ways in which value for both employee and employer can be preserved through innovative solutions and your broker’s strategic partnerships. A robust, fit for purpose, responsive medical insurance policy is a must, however it must also be designed in a way to ensure sustainability for the future.

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