"We do not see a proportionate
impact of our investment on our
Group Health Policy; our
Employee engagement budget is
about 1/3rd and yet the benefits
seem apparent. "
" The only Employees who don't
seem to have any issue with the
policy are either ones who don't
seem to recollect that they are
contributing towards the premium
payment, or ones with ageing
parents who recognize they
cannot get a cheaper deal. "
" The ones who are aware of their
contribution aren't very happy with
the deduction from their salaries,
however meagre it is. "
" Our renewal premiums have
been constantly rising - neither is
the Management happy about
it, nor are the Employees. "
" A deduction of 1000 on a claim
settlement of 100000, still has
Employees walking up to us angry
and demanding a reimbursement of
the 1000. "
Agreed Human Resource Management is a thankless job, but that doesn't
mean your insurance woes should keep propounding year on year.
A good Insurance Broker can help you underwrite a good policy
and resolve at least your insurance related problems.
Amongst the various channels for distribution of health insurance policies, Insurance Brokers contributed a share of 45% of the total group health insurance premium sourced for the year 2020-21. This statistic is cognizant of the fact of the growing trust that Customers bestow on an Insurance Broker for their Group Health Insurance policies. The Group Health Insurance policies can be created as per the requirements of the customer and therefore require a high level of understanding of the product which is where the Insurance Broker comes into picture.
In Group Health Insurance, the whole employee experience is impacted by a triad that includes the Insurer, Third Party Administrator, and the Hospital.
The Broker understands the technicalities of a policy and translates them for you in simple English. In 2022, it remains a sad reality that the policy wordings the industry uses are the same antiquated ones that were used a century ago. While the industry has started realizing this fact and is moving toward simplicity, it will still be a while till we get there. Meanwhile the Broker can be the interface who translates this complexity into simplicity.
Having worked with Clients across Industries, a Broker is not only aware of the Insurance best practices but also best practices across other Industries. The Broker can therefore help with buying a good Insurance policy and help fine tune any gaps that you may face with its implementation; this short term investment can thus translate into a significant long term gain of time and energy.
An Insurance Broker is responsible for balancing TPAs' and Insurers' promises and delivering standardized experiences. The Broker can be your one point of contact. They know who to contact for what, and more importantly when to escalate issues to whom for resolution.
Health is undoubtedly one of the most technical verticals amongst all of the Insurance lines of businesses(LoB). The complexity of this LoB can be gauged from the fact that the frequency of circulars and clarifications on IRDAIs website are the most for this vertical. Miss one circular and it might cost your employee a good 30-40 thousand, but it can set ablaze a fire that could burn for an entire year. The Broker ensures this doesn't happen. Insurance Brokers represent their Clients as opposed to an Insurance Agent who is a representative of the Insurer. The Broker bears the legal responsibility of protecting your interests when you buy an Insurance policy. They are bound by the Insurance Regulator to perform as per the terms laid to them.
The Insurance Broker adds significant value to the whole experience and administration of group insurance. The Broker doesn't sit on the sidelines watching you go through a horrible claim experience. The industry experience they have gathered over the years translates into actionable items that ensure you have an "aha" experience, every single time
Hence buying Insurance from an Insurance broker is like
"Insuring the risk of insuring the risk".
Consider the following factors when evaluating your Insurance Broker
India has traditionally been an extremely price sensitive market across industries. While price sensitivity keeps the Insurers on their toes, it also pushes them into undercutting each other, to get a foothold into new businesses; this undercutting (while it might seem like a sweet deal for the Insured, especially in the present) has disastrous long term ramifications.
Over the last decade Organizations have had a fairly good ride, because they were able to pass on the risk of health insurance to the Insurers because of the cut throat undercutting. The industry standards were driven largely by expiring premiums, when a more appropriate metric to decide the renewal premium is the claims experience - defined as the quantum of claims (different from the number of claims) settled by the Insurer as a percentage of the premium borne (without tax) for the policy.
We have already started our steep ascent to a place where mediclaim premiums aren’t sustainable and Insurers have started pushing back on the costs. Read More....
We have just about reached the inflection point where premiums will start rationalizing; you will soon start looking at a scenario where the Insurers will either start increasing premiums or reducing benefits, and if you are extremely unlucky, both.
Understanding technicalities of your benefit policies was never as important as today. Your Insurance Broker has the arsenal that can equip you with tools to understand and thereby negotiate on technical grounds. Some parameters for negotiations could be -
All of these translate into increased topline for the Insurer and therefore an opportunity for you to bargain on the premium.
One of the most critical jobs for a Brokers is to find you a partner who would best suit your needs. While this is easier said than done, in our experience, exclusivity (of mandate) breeds a sense of trust. It not only shoulders the Broker with the total responsibility of the Benefits program but also reduces the Insurers overheads; thereby fostering a sense of mutual trust.
As a policy, Ethika does not work with companies that involve multiple insurance brokers. Trust and complete transparency are important to us.
Putting together a generous Benefits Program that will profoundly impact the life and loyalty of your employees requires legal and financial counsel. There is no one solution, and as any HR manager will testify, the demands of each workplace differ significantly.
Our discussion on structuring Benefits policies over the years has helped us evolve parameters that need due consideration, some of these are
Technology is reshaping how Employers select and offer Employee Benefits, put access to information at the fingertips of the Employees and create a seamless and interactive experience; that said, the ability to interact with a human being acquires a lot of significance when our loved one are at a Hospital and our claim processing is taking longer than usual - understanding this difference between which processes to automate and which ones to leave be for human intervention is going to differentiate the good from the great Insurers.
Technological advances ensure connectivity and information flow between appropriate parties at appropriate times. Acting as a facilitator, technology can ensure the Employers intervention is at a minimum. Employers can thereby divert their attention and energies to core business activities. The new age insurance technology is reducing risk, improving visibility, and increasing profitability. A picture perfect scenario has your Insurance Brokers optimize the use of technology to ensure repetitive tasks are dealt with while intervening whenever manual intervention is needed.
One such tool designed by Ethika automates simple, repetitive tasks and doesn't need constant supervision either by Employers or Agents.
To support employees during enrollment, Employers can adopt online platforms designed to personalize and simplify the experience. All the information related to their benefits is always available to them. The platform can also offer many tools to support the well-being of employees. Most of the insurance brokers including Ethika offer you a complimentary enrollment tool so that the employer or HR can manage the enrollment period online seamlessly and conveniently. With an online platform, the new employee can be onboarded, instantly. The additions and deletions of employees can be easily done. This facility is particularly enabling when your new joiner needs to avail of hospitalization benefits, a week into her job.
The premium for additions and deletions is generally calculated on a prorated basis and the credit or debit is made in the CD account, maintained with the Insurer. This tool also helps the Employer to see the balance anytime online for their policies. Online tool helps in managing the policies, adding or deleting members without any hassle, with just a click!
Employers, especially with the right employee benefits insurance, need to become experience-led and make their employees’ lives easier and better with technology. Partnering with technology is a necessity for growth.
As an Employer you may have created a great Benefits package for your Employees but do your Employees truly know or understand what is available to them? Our experience says less than 16% of employees avail the insurance benefits. Many of them may not even be aware of the full range of benefits available. That makes appropriate employee communication extremely important. It increases the overall perceived benefit score of an Employer. We have come across cases where Employees with two different Companies with the same benefits program had different perception of their Benefits policy.
Can we insert a picture art here - two colleagues communicating with each other
Colleague 1 - Dude, I heard Ashwin, our batch topper is looking for a job change, only because his Benefits program is a dud.
Colleague 2 - I think he will be a very good fit with us, moreover our EB program is world class.
The importance of communicating a well-structured and planned Employee Benefit Communication program cannot be over-emphasized.
The Employees should be aware of the overall compensation (this includes the premium the Employer is bearing for their mediclaim) and not just the cash value of their salary!
That’s where benefits communication plays its part by helping the employees to understand the value of their employment. A good, thought through employee benefits communication program tells the employees what options are available to them, what to choose wisely, what mistakes to avoid, like not selecting the plans that will later lead to increased out of pocket costs putting a burden on their pockets.
Ethika also designs and implements Comprehensive & Functional communications Programs for its clients to ensure the Employees are made aware of all the benefits our clients offer to them. With frequent communication you can ensure employees remain engaged and up-to-date about the various benefits and facilities available for them. Gamification of Benefits knowledge, Structured promotional mailers and Posters, Quizzes at well-planned intervals can ensure appropriate communication reaches and registers with the intended recipient. It is also important to ensure that the language used for communication is the one that Employees understand and can connect with.
Choose a partner who can provide the best support to your employees during their claims settlement process which is generally an unpleasant and stressful experience. Most Insurance Brokers act as forwarding agents with little to zero technical knowledge - when the Employee has questions about claims, the Broker directs them to the Third Party Administrator or the Insurer. There is absolutely zero value addition when information is flowing from either party to the other.
Your Broker should understand you and work by your side, they should be by the side of the Employees to achieve the best outcome for their claims. The Broker should provide Red Carpet Support Service to your employees, extending support to them at every step, from medical emergencies to claims settlement. Your Broker should be able to clear up billing disputes and reduce turn around times wherever possible.
Outsourcing the management of your Benefits program to an Insurance Broker has several advantages. Burdening crucial personnel with additional, unfamiliar responsibilities when their core competence lies somewhere else can be a heavy cost to bear.
Ethika believes in 'serving to care and serving with compassion’. We are sensitive to the claimant's losses and their expectations from an Insurer. Our exposure to diverse cases of claims redressal has shown us that each claim is unique in terms of conditions and requirements, and should therefore be dealt with uniquely. We take up the responsibility to address all concerns of the Employees during claims settlements; over the years we have fine tuned this entire architecture to an extent that it is seamless.