Market. intelligence

Transcription

1 Market intelligence

2 // Editor's Comment 3 What s happening in Health Insurance and Protection right now? Join Health Insurance on LinkedIn and follow us on Twitter to find out Contents Reviews 4 // Individual PMI 6 // Group PMI 8 // Cash Plans 10 // Occupational Health 12 // Group Risk 14 // Individual Income Protection 16 // Individual Critical Illness 18 // Group International PMI 20 // Individual International PMI Company Profiles 26 // Aetna 28 // Allianz 30 // Aviva 32 // Cigna 34 // Cigna International 36 // Denplan 38 // Globality 40 // Healix 42 // PruProtect 44 // Simplyhealth 46 // Westfield Health Intelligent business Market intelligence is your key to success To say that the past couple of years have been challenging for the health insurance and protection market would be an understatement. The global economic crunch has been felt in each strand of the sector from private medical insurance (PMI) through to protection, the group and individual markets have both felt the pain. The PMI market had a particularly difficult time in 2012, as key stakeholders private hospitals, consultants and insurers locked horns in an often bitter war of words over crucial issues such as patient choice and affordability. The group risk market had to deal with the introduction of legislation around retirement ages, while getting to grips with the prospect of auto-enrolment. The individual protection market, meanwhile, struggled to shrug off the reputational damage done to it by the payment protection insurance scandal. And while things looked brighter again for the international PMI market, as both individual and group lines of business continued to grow, there is no denying that the health insurance and protection market is, on the whole, facing difficult times. Nevertheless, the need for the market s products and services is greater than ever. An ageing workforce, increased stress levels, ever-stretched state budgets and increased personal financial vulnerability mean that it is vital that the industry steps up to the mark. And there are clear signs that it is doing so. In fact, against the backdrop of discord in the PMI market and uncertainty in the protection sphere, providers and intermediaries alike are recalibrating their efforts to remain relevant in these changing times. Here at Health Insurance we too are changing to meet the needs of today s market will see some brand new initiatives from us designed to help you do more business. This publication, for a start, marks a change in direction for our annual snapshot of the market. We have remodelled our annual Health & Protection Book to become Health Insurance Market Intelligence, giving you more data and insight than ever. In addition to bite-sized reviews of each part of the market, we have also included key facts and figures to help you form a clearer picture of how the sector stands. As ever, there are also profiles of some of the key providers in the market, outlining what services they offer, as well as details of some key contacts that will help you in your day-to-day business. So, as we move into 2013 it is true that the market is challenging. But, as you can read, there are plenty of opportunities out there too. David Sawers, Editor Simply visit and click on the LinkedIn and Twitter buttons on our homepage. You can also sign up to our FREE daily bulletin at Health Insurance 119 Farringdon Road, London, EC1R 3DA fax: tel: extensions as below Editor David Sawers ext.4154 david.sawers@informa.com Sales director & associate publisher Matthew Brookes ext.6779 matthew.brookes@informa.com Deputy advertising manager Annalisa Russell De Clifford ext.4124 annalisa.declifford@informa.com Designer Paul Pancham ext.6911 paul.pancham@informa.com Member of the Audit Bureau of Circulation Average net circulation for the period 1 July 2010 to 30 June ,622 ISSN: Health Insurance is published by Informa Business Information a trading division of Informa UK Limited Annual subscription: 350/ 510/US$630 Tel: Fax: subscriptions@informa.com Informa UK Limited, all rights reserved; no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electrical, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. Deputy editor Tessa Norman ext.7515 tessa.norman@informa.com Marketing & circulation manager Savinder Degun ext.4750 savinder.degun@informa.com For subscription queries and enquiries, or back issues, please contact Customer Services Department, Informa UK Limited, Sheepen Place, Colchester, CO3 3LP, UK Printer: ESP

3 4 Individual PMI // // Individual PMI 5 Following the example of Bupa and Aviva UK Health, it removed all limits on its cover for licensed drugs and extended cover to include chemotherapy or biological drugs given to prevent a recurrence of cancer or for maintenance of remission. Additionally its new cover funds experimental drug treatments, providing they are approved by AXA PPP first, and provides financial assistance towards the cost of wigs and external prostheses. Another emerging theme in 2012 was medical tourism. As a result of globalisation, people are becoming more and more comfortable with having medical treatment abroad, especially when it is cheaper than in the UK. Demand for treatment overseas was addressed with a couple of product launches. In June, Passport2Health, a new provider in the market, launched a scheme that gives policyholders access to private diagnostics in the UK followed by treatment in a European hospital. Although the plan also covers the cost of travel and accommodation for the policyholder and a companion, premiums, which start at 19 a month, are up to 50% lower than traditional medical insurance. Another insurer to go beyond the traditional medical insurance remit was PruHealth. As well as adding personal care assistance to help policyholders recover at home, it also extended the product to cover treatment for lifestyle issues such as birthmarks and breast reductions. Further, and building on its Vitality wellness programme, it introduced a non-smoker cash back deal, giving customers who are nicotine free money back every quarter. As well as product innovation, the industry also took steps to raise standards with the introduction of a health and protection qualification, Cert CII (Health and Protection). To achieve this, candidates must pass two health insurance related units plus the CII's Insurance, legal and regulatory unit, each of which requires approximately 50 hours of study followed by an examination. Did you know? The number of individual paid policies decreased by 4.2% in This follows similar falls of 4.6% and 3.7% in 2010 and 2009 respectively, and saw the number of policies fall below one million (to 993,000) for the first time. Source: Laing & Buisson Increased efforts from both intermediaries and insurers will be required, however, if they are to stem the leakage of members to the self -pay market. A study by industry Laing & Buisson shows that self-pay spending by individuals at private hospitals has grown steadily since 2008 or up 14% overall in real terms in the last three years suggesting that more needs to be done to make insured solutions more attractive to consumers on the whole. HI Individual PMI sales continue to slide Individual Private Medical Insurance 1,350,000 Bupa s decision to stop selling individual private medical insurance through brokers was easily the low point of However, innovation from other providers and continued strains on the NHS suggest that the fall in subscriber numbers can still be turned around Rising premiums, improvements in the NHS and the current economic climate have done little to raise the fortunes of individual medical insurance. Figures from the latest Laing & Buisson market report show that the number of policies fell by 4.2% in 2011 with the number of policyholders falling to fewer than one million. The report found that in spite of a wide choice of low cost policies and downgrade options, demand for individual medical insurance was continuing to fall. The 2011 figures also marked the third year in which the market had contracted, with falls of 4.6% and 3.7% recorded in 2010 and 2009 respectively. The sorry state of the market resulted in a shock announcement, with Bupa saying it would stop selling medical insurance to individuals through the intermediary channel. Instead of paying commission it put in place an introducer agreement where advisers would be paid a flat fee of 100 for referring potential customers. It blamed this decision on the challenging market, citing high business acquisition costs and a fall in the number of leads. But while the slide in the number of individual policyholders is unsettling for those in the industry, there are signs of changing fortunes on the horizon. Improvements to the economy are forecast for 2013 but, more significantly, as investment in the NHS reduces, there are reports of waiting lists beginning to increase and some treatments being rationed. This was recognised by the chairman of the Association of Medical Insurance Intermediaries (AMII), Wayne Pontin, at the AMII Private Healthcare Summit in July. Saying there had never been a better time to be in the private health insurance market, he called on insurance providers to deliver products that top up and complement existing public healthcare services. While the industry is still largely to respond to Pontin's request, it has been busy designing new products that will help to steady sales of individual medical insurance. At the beginning of the year AXA PPP healthcare addressed concerns over access to cancer treatment by unveiling improved cancer cover. Number of individual paid subscribers 1,200,000 1,050,000 1,229,000 1,206,000 1,181,000 1,162,000 1,119,000 1,100,000 1,109,000 1,128,000 1,086,000 1,036, , , Year Source: Laing & Buisson

4 6 Group PMI // // Group PMI 7 While these two initiatives may have dominated the headlines over the last 12 months, there has been plenty of other activity in the market too. Further consolidation occurred with Simplyhealth completing its acquisition of Groupama in April, making the group the fifth largest medical insurer in the UK. Although it is still in the process of aligning the two businesses, Simplyhealth has announced that it will be launching a new product, Simply Employee Health, next year. There was also plenty of product development in Wellbeing was a key theme with PruHealth launching a range of product changes including a care at home benefit for people recovering after surgery; cash back incentives for non-smokers; and cover for bariatric and lifestyle surgery such as the removal of birthmarks and breast reduction. Bupa also launched its Business Health Solutions, providing a range of health and wellbeing solutions for businesses of all sizes. The range includes Foundations, to provide a lower cost option by working in conjunction with the NHS; Business Fit, which is designed to address the two main causes of workplace absence musculoskeletal conditions and mental health problems; and Superior, which is a comprehensive worldwide cover product. This year also saw the first hybrid cash plan and medical insurance policy with the launch of Westfield Health's Hospital Treatment Insurance. With premiums starting as low as 5.37 a month, this aims to provide a low cost option for employers. The plan, initially launched as a company-paid option for schemes of five or more employees, covers more than 60 surgical procedures, or 1,300 on its more comprehensive option two, subject to a maximum lifetime benefit of 100,000, or 250,000 on option two. Did you know? Company-paid PMI policies returned to modest growth in 2011 with an increase of 1.2%, following falls of 3.3% and 4.7% in 2010 and 2009 respectively. There was a small contraction (1.3%), however, in the number of people covered by company-paid medical policies during the year. Laing and Buisson says this suggests some large employers have tightened eligibility criteria to cut costs. And while the anticipated increase in insurance premium tax failed to materialise in 2012, healthcare trusts continued to grow in popularity. Part of this was down to the launch of Aviva's Corporate Excess contract, which gives employers another option when looking for an alternative to an insured scheme. The scheme uses a similar concept to WPA's Corporate Deductible arrangement, which was launched in This sets a notional claims fund based on previous years' experience with a percentage of this, usually between 60% and 85%, used to pay claims. As this element is risk-free it's also free of insurance premium tax. HI Company paid PMI policies return to growth in ,500,000 Group Private Medical Insurance Open referral dominated the headlines during 2012 as hospital groups, consultants and insurers came head-to-head in an often bitter war of words, while consolidation was also on the agenda. The group private medical insurance market, though, was also characterised by some interesting new funding mechanisms that should mean a more constructive year ahead Cost containment was the key issue for the group medical insurance market in 2012, as medical inflation continued to drive premiums upwards in an otherwise flat economy. Addressing this issue has never been more important. Although Laing & Buisson's Health Cover UK Market Report 2012 showed a modest growth in the number of company paid medical insurance policies up 1.2% in 2011 compared with falls of 3.3% and 4.7% in 2010 and 2009 respectively the number of people covered was down by 1.3%. It speculated that this was down to a tightening of eligibility criteria to make cost savings on employee benefits. For the two largest medical insurers the lack of growth in the market has resulted in a new approach to managing specialist costs, with Bupa launching its Open Referral initiative and AXA PPP healthcare revamping its Healthcare Pathway product. Although there are differences between the two offerings, both shift much of the decision regarding which specialist the policyholder sees from their GP to the insurer. And while there are no immediate cost savings for employers with these products, both insurers are confident they will reduce claims costs in the long term. AXA PPP returns 6% of the client's hospital spend in BMI Healthcare, Nuffield Health, London Clinic and Aspen hospitals at the end of the policy year while Bupa claims its approach will lead to double digit reductions in premium by years three to four. The jury is still out on whether this approach will become the norm across the group medical insurance market, with many in the industry arguing against it on the basis of the more restricted choice of specialists it offers (open referral generally lets customers select a consultant from up to three of the insurer s choosing, rather than one chosen by themselves and their GP). In its favour, Bupa and AXA PPP have both enjoyed positive feedback. For example, Bupa says eight out of 10 of its corporate clients had moved to open referral by October and it was also reporting high levels of satisfaction among those using the service. Furthermore, some other insurers, such as Aviva UK Health, have expressed an interest in launching a similar model. Number of company paid subscribers 3,000,000 2,500,000 2,000,000 1,500,000 1,000, ,000 0 Source: Laing & Buisson 2,894,000 2,958,000 2,972,000 2,986,000 3,004,000 3,009,000 3,186,000 3,194,000 3,043,000 2,942,000 2,978, Year

5 8 Cash Plans // // Cash Plans 9 the dental insurance overlap. The product allows employees to select cover with or without dental benefit. A cash plan also formed part of the product offering from former Association of Medical Insurance Intermediaries chairman, Andrew Tripp's Perfect Health. The product suite, called Perfect Health Cash Plans, is aimed at SMEs and the self-employed and as well as a traditional cash plan, customers can add a short-term income protection plan, cover for surgical procedures and life assurance. A variety of new benefits were also added to plans in Many are designed to provide an easy way to access medical expertise for example Health Shield added a GP helpline; Westfield Health signed up second opinion service BestDoctors for its members; and HSF added a webcam GP consultation service, HSF Virtual Doctor. Another new benefit that grabbed attention in 2012 is the ability to use a cash plan to fund the excess on a medical insurance scheme. Although this has been happening informally for the last four years, a couple of the cash plan providers introduced it as an option on their plans this year. Simplyhealth includes it as an option on its corporate plan, starting at 25p per week for 100 of excess cover while Medicash automatically includes it, giving 200 of cover on its 1 a week Proactive corporate plan. While both providers say they are addressing customer demand, there are concerns that it could have some negative outcomes. As well as changing claims behaviour on medical insurance, as the excess will no longer serve as a deterrent, it could also drive up claims on cash plans. While it will take time for the full implications of this product feature to be understood, there were also some more concerning developments in the market. Fraud has become more of an issue for the cash plan providers, with Medicash reporting a 500% increase in the number of fraudulent claims since Instances of fraud include altered receipts and fake invoices for treatment. Although the cash plan providers admit the level of fraud is still relatively low, with the product dependent on claims being settled quickly and with minimum touch, it is essential that they do not allow this activity to get out of hand. HI Group market grows while individual numbers decline 3,500,000 Individual Contributors Company Paid Contributors Cash Plans Number of contributors 3,000,000 2,500,000 2,000,000 1,500,000 1,000, , ,829, , ,740, , ,684, , ,000 2,745, ,000 2,687, ,000 2,668, ,000 2,675, ,000 2,484, ,000 2,300, ,000 2,184, ,000 2,083, Cash plans remain a popular employee benefit and 2012 saw them evolve to include even more benefits, including hospital treatment options more akin to private medical insurance. Off-theshelf excess benefits also came to the fore as providers looked to help cash-strapped employers manage their budgets Source: Laing & Buisson Fewer people covered by cash plans In tough economic conditions, cash plans fare well. With premiums starting at less than a pound a week, they appeal to both individuals wishing to take some of the pain out of paying for their everyday health costs and employers wanting to provide a low-cost but highly appreciated benefit to their staff. Their popularity as an employee benefit is highlighted by a recent survey which was conducted by TNS on behalf of PMI Health Group. It found that more than a third of full-time employees rank cash plans as one of their top three preferred benefits, with cash plans regarded as the most valued benefit by 11% of those surveyed, behind contributory pensions, life assurance and medical insurance. Given this, it is not surprising that the sales results especially for the corporate market are good. Figures from Laing & Buisson show that although the number of people with cash plans fell by 1.5% in 2011, this was entirely down to the individual market which declined by 4.6%. In contrast, the corporate market fared well again, with employer paid contributor numbers growing by 13.5%. While this is positive for the market, with the average price paid for an employer cash plan falling by 14% as a result of competition and price cuts, there is still pressure on providers. Certainly competition is intense in the market with providers launching new schemes and enhancing their benefit lists to win more business. One of the most eagerly awaited launches was Westfield Health's Hospital Treatment Insurance, which builds on its acquisition of PatientChoice and has been designed with the aim of opening up a middle ground between cash plans and traditional private medical insurance. The product, which is available as a standalone as well as an addition to a cash plan, gives employees access to as many as 1,300 surgical procedures for premiums from as little as 5.37 a month. Health Shield has also been busy on the product development front in In September it unveiled a company paid cash plan, Elements and Elements Plus, for SMEs with three or more employees. Additionally, it launched a cash plan for flex schemes designed to address Year Number of people covered by a cash plan Proportion of population covered ,920,000 10% ,336,000 9% ,925, % ,049, % ,903, % ,836,000 8% ,779, % ,495, % ,113, % ,939, % ,778,000 6% Source: Laing & Buisson

6 10 Occupational Health // // Occupational Health 11 Did you know? The CIPD Absence Management Survey found that stress was the most common cause of long-term absence, with 40% of employers reporting an increase over the past year and only one in 10 saying the problem had lessened. Further, while 60% of employers are taking steps to address this problem, 27% of organisations are doing nothing in spite of reporting stress as one of the top five causes of absence. Capita also grew through acquisition in 2012, buying up Aviva UK Health's occupational health business to enable the insurer to concentrate on its core health insurance business. The deal, which was for an undisclosed sum, will see Capita take on the provision of occupational health services to more than 500 organisations as well as entering into an agreement to become a long-term strategic provider to Aviva UK Health. It also acquired screening services provider Medicals Direct for 13.2m in May. These two deals add to a long list of recent acquisitions for Capita, which has purchased Insurance Medical Group, screening and reporting firm Premier Medical Group and FirstAssist's EAP and absence management business in the previous two years. Cash plan provider BHSF also expanded its occupational health arm through the acquisition of Abbott Burke Associates and PTH Group Limited. Both firms are now part of a new division of BHSF called BHSF Occupational Health Limited, which it says it intends to grow substantially, through organic growth as well as further acquisitions, over the next few years. HI Occupational Health Absence and productivity still feature highly on the agenda of most forward-thinking employers and the world of occupational health worked hard throughout 2012 to combat the added pressures that the economic downturn is having on employees around the country insurance providers adding occupational health benefits to their products. Cigna UK Healthcare Benefits beefed up its occupational health offering, adding a toolkit to help line managers manage employee absence and health issues and an employee assistance programme (EAP) through its partnership with Workplace Options. The EAP is available on a standalone basis or alongside any of its other products. Several cash plan providers have also added occupational health services to their products. These include Health Shield, which added a GP helpline this year, and Medicash, which introduced an EAP with additional services such as a day-one stress intervention programme and a managers' support helpline. There were also changes in the occupational health market itself as providers looked to create the critical mass necessary to compete profitably. Market and Customer Insight's report had found that while an estimated 53% of occupational health services were outsourced to private companies in 2011, profits were proving elusive as a result of intense competition and the need to invest in technology. A year after acquiring Rood Lane Medical Group, HCA International made another move into occupational health by taking a stake in Blossoms Healthcare. The provider of primary care and occupational health services has clinical facilities in London, Birmingham and Edinburgh and delivers more than 45,000 health assessments and GP consultations each year. Most common causes of long-term absence in 2012 Average number of days absence taken per employee per year Number of days Source: CIPD Absence Management Survey 2012 Healthy, happy employees make for more productive workplaces but, with occupational health regarded as a discretionary spend, it is an area that has not always received the investment it deserves. Figures from Market and Customer Insight's UK Occupational Health Market Development Report show the market contracted by 3% in 2011 as a result of the recession and public sector cutbacks. This puts overall UK spending on occupational health at around 385m. It concluded that although there was huge potential for the market to grow, the sector lacked the stimulus needed to spark growth. In spite of the slightly downbeat findings, there was plenty of evidence to support the need for occupational health in these tough times. For the second year running, the Chartered Institute of Personnel and Development's (CIPD) Absence Management Survey found that stress was the most common cause of long-term absence, with 40% of employers reporting an increase over the past year and only one in 10 saying the problem had lessened. Further, while 60% of employers are taking steps to address this problem, 27% of organisations are doing nothing in spite of reporting stress as one of the top five causes of absence. Another study, which was conducted by the University of Nottingham and University of Ulster, found the current economic climate was making matters worse for employees. It found that work-related stress increases by 40% during an economic downturn. In addition, the study, which was conducted across thousands of civil servants in Northern Ireland, found that one in four workers experience work-related stress in times of recession. Further, the total time taken off due to psychological problems increased by more than a third during a recession. The importance of occupational health was also supported by research by Legal & General. Through analysis of Department for Work and Pensions statistics it found that work-related stress is the most common reason for employers seeking occupational health advice. To address the growth in stress in the workplace as well as provide solutions to other workplace health issues, there are plenty of examples of health Employers citing it as most common cause (%) Condition Manual Non-manual Stress Acute medical conditions (eg. stroke, cancer) Mental ill health (eg. clinical depression, anxiety) Musculoskeletal injuries (excluding back pain) 17 9 Back pain 9 5 Recurring medical conditions (eg. asthma, angina) 4 5 Source: CIPD Absence Management Survey 2012

7 12 Group risk // // Group Risk 13 are being imposed with insurers reserving the right to adjust the unit rate or restrict the amount of cover if scheme numbers increase by more than 25% or employees join who are long-term absent. But auto-enrolment hasn't been the only agenda item for group risk insurers this year. Although the industry was granted an exemption from the default retirement age legislation, insurers have had to respond to the changing needs of employers dealing with an ageing workforce. This has seen more limited term payment terms on group income protection, especially where an employer is introducing cover for the first time, as well as the growth of 'pay direct' initiatives, where the payment goes directly to the employee if their contract of employment is terminated. The Government's welfare reform programme could also affect the group risk industry. As state benefits continue to dwindle, there will be more pressure on employers to provide some assistance to their workforces, with the group income protection market likely to benefit. Insurers are keen to position their products to fill the gap, with many putting greater emphasis on early intervention and absence management. For instance, Ellipse launched two products in 2012 addressing this. One, InteractPlus, included an integrated absence management system to help identify potential claims at outset, while the other, Interact, includes a 10% reduction in premium if absences are notified promptly and no employee is absent for more than four consecutive weeks in a year. To help increase take up of group risk benefits, there have been calls for the Government to consider a form of auto-enrolment for group income protection. Likewise GRiD's Employer Research found that appetite for group risk benefits would increase if employers were given some form of incentive such as tax relief or reduced national insurance contributions. It found that 68% of employers would be more likely to introduce group life cover if that were the case, while the figures for group income protection and group critical illness were slightly lower at 60% and 61% respectively. As well as expectations that sales will increase, group risk insurers are also pleased that premiums are finally showing signs of hardening. Although this may put off some employers, in the current low interest rate environment, it will allow insurers to improve their profitability. HI Group risk premiums, bn 9.45bn 8.97bn 9.19bn 9.56bn bn 6.49bn In-force premiums bn 5.17bn 5.18bn Group Risk may prove to be a defining year for the group risk market, thanks to pensions auto-enrolment and the Government s welfare reform agenda. As 2013 begins, the signs are positive and employers look to be taking steps to ensure they have the right kinds of protection and support in place for staff m 45.40m 48.39m 50.25m 55.01m Source: Swiss Re Group Watch 2012 Death Benefit Income Protection Critical Illness 2012 was an upbeat year for the group risk industry. With demand for the products being fuelled by the introduction of auto-enrolment, the market is expected to have built on the growth it saw in This growth certainly helped buoy the industry's mood. According to Swiss Re's Group Watch report, sales of all three products increased in For group income protection this represented the first growth in the market since Further, while growth was relatively modest for both group life and group income protection, at 4.1% and 0.1%, sales of group critical illness increased, albeit from a small base, by 9.5%. Expectations for growth resulting from auto-enrolment are even more encouraging. With group risk benefits often linked to pension membership, some are predicting that this could mean sales double as the new pension regime is rolled out. Research by trade body Group Risk Insurance Development (GRiD) suggests there is a good appetite among employers for group protection. Its 2011 Employer Research, which was conducted in October 2011, found that 52.6% of the employers who did not already offer group risk benefits would consider implementing a group life scheme alongside their pension arrangements. The figures were even higher for group income protection and group critical illness insurance at 67.8% and 78.2% respectively. Unsurprisingly group risk providers are going into overdrive to capitalise on the opportunities around auto-enrolment, with marketing campaigns aimed at encouraging greater take-up. Although employers can avoid extending group risk benefits to all new pension members and many will to keep costs under control there are also some compelling arguments in favour of allowing them to take out these products. As well as providing a valuable employee benefit, as more employees join the pension, this is likely to reduce the average age of scheme members. This will reduce the unit cost of group risk and mean some employers may find they can extend cover for much less than expected. But there are also significant risks for the insurers. As more people join their employer's pension scheme and become eligible for group risk benefits, there is a danger that insurers will pick up poor risk. To avoid this, conditions Number of lives covered by group risk schemes Number of lives covered Cover Change Death benefit 7.86 million 8.20 million +4.4% Income protection 1.79 million 1.84 million +2.4% Critical illness 305, , % Source: Swiss Re Group Watch 2012

8 14 Individual Income Protection // // Individual Income Protection 15 Average weekly household expenditure on main commodities and services (2010) New individual IP sales, by volume Transport Housing, fuel & power Recreation & culture Food & non-alcoholic drinks Restuarants & hotels Miscellaneous goods & services Household goods & services Clothing & footwear Sales by Volume , , , , ,472 Communication Alcoholic drinks, tobacco & narcotics Education Health per week Source: Office for National Statistics, Family Spending 2011 Source: Swiss Re Term & Health Watch 2012 Individual Income Protection As the individual income protection (IP) market struggles against the continued fall-out from the payment protection insurance scandal, the jury is still out on what the emergence of new short-term IP products might mean for consumers. And as the EU gender directive kicks in, it will take more determination than ever to grow this important market complex. Adding the necessary range of options to the product would make it difficult to design a product that was simple. It did, however, acknowledge that a simple IP product would play an important role in the initiative's objectives and put its findings out for further consultation. While the Government's plans may have stalled, the Income Protection Task Force is also working hard to increase market penetration. Among the initiatives it is spearheading is the creation of a consumer charter. This would set some minimum standards for the industry such as publishing claims paid figures annually; using own occupation definitions where appropriate; and making policy wordings easy to understand. It also plans to establish a quality standard for the product to enable consumers to differentiate it from payment protection insurance (PPI) and provide the reassurance that it meets minimum standards. And insurers have carried out their own initiatives to raise awareness of the need for IP too, with both Aviva and Unum running television advertising campaigns to highlight the need for IP during While this multi-pronged approach should help to increase sales, though, there are also issues the industry must address. For starters, as the PPI mis-selling scandal still hangs over the industry, there are concerns that the problems could be repeated with short term income protection (STIP). Although arguments in favour of STIP run along the lines of 'some protection being better than none', the Financial Services Authority is among those concerned about the risk of mis-selling. At the tail-end of 2011 it warned that it would be taking a more intrusive approach to payment protection products, including STIP. There are also concerns that the protection industry might not have been able to deal with the volume of applications it receives in the run up to G-Day. Although some insurers, including Ageas Protect and Scottish Provident, had announced that any applications in the pipeline by 20 December would be given gender specific rates providing the underwriting process is completed within its deadlines, others, such as LV= and Zurich, brought forward the date on which they introduced gender neutral pricing. In any case, the fact that the gender directive got advisers thinking and talking about protection more in 2012 can only be a good thing and it will be up to them and insurers to keep up the momentum in 2013 and beyond. HI With its ability to replace income when someone is unable to work due to long-term illness or injury, income protection (IP) is one of the most important financial planning products. But with sales continuing to slide, the industry must find ways to underline this product's benefits. The latest figures from Swiss Re show that sales of new IP policies fell by a modest 0.2% in 2011, to 110,472. While this small contraction may have simply been a by-product of the tough economic climate, the figures meant the IP gap increased to 190bn annual benefit a 46% increase from the 130bn gap recorded in Reassuringly the report also found that the industry is working hard to close this gap, with several initiatives and events likely to create opportunities to raise the product's profile. The introduction of the EU gender directive in December is among those events. With gender-neutral prices being introduced, estimates from LV= suggest that men will see their premiums increase by an average of 20% while women will see theirs fall by 28%. This is contrary to what is happening in the life and critical illness markets, where female premiums are rising and male rates falling slightly. While the long-term impact of the directive is still uncertain, in the shortterm at least, insurers and advisers alike seized a marketing opportunity, promoting IP to male customers in the run up to G-Day and to women afterwards. As a result many reported an increase in sales, with expectations that this would continue into the new year. Another opportunity to raise awareness of IP stems from the Government's plan to develop simple financial products to better enable consumers to navigate the financial services market. The independent steering group set up by the Government published its initial recommendations in August. Although it proposed a couple of savings accounts and a simple life assurance product, plans for a simplified form of IP were put on hold. It found that while the product proposition was straightforward, the process required to select the most appropriate cover was much more Top five Income protection providers Provider 2011 sales 2010 ranking Friends Life 19,046 - Lloyds Banking Group 12,518 3 HSBC 12,120 1 LV= 11,898 4 Legal & General 9,989 5 Source: Swiss Re Term & Health Watch 2012

9 16 Individual Critical Illness // // Individual Critical Illness 17 Also dominating 2012 was the debate surrounding partial payments. These first became a significant part of the CI landscape when PruProtect launched its severity-based serious illness cover plan in And, although it was initially criticised for being overly complicated, many of the other insurers including Aviva, Bright Grey and Scottish Provident have now followed suit to some extent by introducing partial payments for certain conditions. While the insurers insist partial payments add value for policyholders, there are concerns that the industry could be embarking on a numbers game akin to when the list of CI conditions started to read more and more like a medical dictionary back in the 1990s. However, while there are concerns about how the number of partial payments are growing, consumer research conducted on behalf of PruProtect found that 61% of those surveyed preferred severity-based cover to traditional CI plans. In addition, 87% said that the likelihood of payout was the most important element of protection. Some of the partial payment conditions to be added to policies in 2012 include pituitary tumour, cerebral arteriovenous malformation and cerebral aneurysm, which were added by Friends Life; removal of an eyeball, Crohn's disease treated with intestinal resection, and significant visual impairment, from Aviva; and low grade prostate cancer, added by Legal & General. Children also came in for attention from the insurers' product development departments. Friends Life added child's hydrocephalus, more commonly known as water on the brain, to its child cover while Aviva and Legal & General increased the cut-off point for children's cover from age 18 to age 21, providing children are in full-time education. The importance of cover for children was also highlighted by Ageas Protect earlier in the year when its research found that that only 31% of parents with a CI policy knew whether their policy covered their children too. The insurer recommended that advisers highlight this important area of cover with their clients to demonstrate the value CI insurance offers. HI New individual CI sales, by volume , , , , , , , , , , ,000 Sales by volume Source: Swiss Re Term & Health Watch 2012 Top five Critical Illness providers Provider 2011 sales 2010 ranking Lloyds Banking Group 153,037 1 Individual Critical Illness A boost to consumer confidence in critical illness has seen sales bounce back at some providers, but the threat posed to the product s sustainability by the EU gender directive, as well as the potential impact of the Retail Distribution Review, is causing sleepless nights for some Legal & General 95,813 2 Friends Life 81,125 - Aviva 59,636 4 Bright Grey/Scottish Provident 44,530 3 Source: Swiss Re Term & Health Watch 2012 A third of babies born in 2012 expected to live to 100th birthday In spite of a tough economic climate, the critical illness (CI) market has cause to celebrate. Not only were sales up according to the latest figures from Swiss Re, but there are indications that this could be repeated in In its Term & Health Watch 2012 report, Swiss Re reported a 3.1% increase in new policies. The report's co-author, Ron Wheatcroft, said the growth reflected the work the industry had done to improve confidence among both consumers and advisers. One of the key confidence boosters for the CI industry has been the publication of claims data. Since the industry started publishing this information, the figures have risen steadily and now show that more than 90% of claims are paid by most of the major providers. This has helped dispel the image of the big bad insurer refusing to pay claims that was becoming far too common in the consumer press. As the industry continues to build on this, and a number of changes take place in the market, many are expecting sales for 2012 to be even higher. Several of the insurers have already reported sales increases. For example, LV= reported a 20% increase in protection sales in the first half of 2012 as a result of improvements to its CI product; Friends Life wrote 28m of new business in the first half of 2012, more than the 16m it wrote in 2011; and, by the end of Q3, Legal & General had written 41m of new business, up 28% on the previous year. Sales are also likely to increase as a result of the introduction of the EU gender directive on 21 December, which bans insurers from offering different prices to males and females. The effect of the move to gender-neutral pricing coupled with the introduction of the I-E tax change in January 2013 means that both men and women are likely to see premiums rise, by an average of 6% and 16% respectively according to LV=. This has resulted in a spot of 'buy now while stocks last' promotional activity on the part of insurers and advisers. Another legislative change that could help to increase sales of CI is the Retail Distribution Review. With commission on investment sales outlawed from January, there are expectations that more advisers will consider moving into the protection market. Age in 2012 % of males expected to survive to 100 % of females expected to survive to % 39% 10 28% 35% 20 23% 30% 30 20% 26% 40 16% 22% 50 13% 18% 60 11% 15% 70 9% 13% 80 8% 10% Source: ONS, What are the chances of surviving to age 100? (2012)

10 18 Group International PMI // // Group International PMI 19 Given the increasing demand for cover, competition between the insurers has been rife in As a result, much more has been done in the way of improving the end client experience. For example, Globality Health launched its Globalites proposition in 2012, a global network of carefully selected partners, which include third party administrators as well as insurers, to give customers a seamless service wherever they are in the world. Because all the partners are on a common IT platform and follow the same processes, wherever the customer is, they will receive the same level of service. Meanwhile, at the beginning of the year AXA PPP International announced its intention to become a top three provider, promising to bring in more expertise and develop its product offering to achieve this. There has also been a flurry of product launches to satisfy the needs of businesses sending their employees overseas. These have focused on a number of key requirements including enhanced benefits, flexibility and cost control. At the start of the year, Expacare launched a modular plan, Choices, for small groups of five to 29 employees, allowing them to have cover written on a medical history disregarded basis. Alongside the core inpatient treatment cover, employers can choose to add various modules such as outpatient treatment, chronic conditions cover and wellness options. Living up to its promise, AXA PPP International introduced a range of add-ons to its current plans. These include an enhanced outpatient cover option on its Standard plan which includes diagnostic treatment, vaccinations, consultations, physiotherapy and complementary practitioner charges. Meanwhile on its Comprehensive plan, SMEs can now add extra dental cover for routine treatment or up to 5,000 towards routine pregnancy, childbirth and postnatal medical expenses. The issue of cost was also addressed this year with Bupa International bringing out a short-term international medical insurance plan, Flex. This provides cover for between three and 11 months, making it suitable for shorter assignments. Insurers have also beefed up their products with added value services to assist employees based overseas. Many now offer expat guides to help employees find their feet in a new country. Aviva UK Health has taken this a step further, allowing its customers to put all their medical information such as blood group and GP details on its online My Health Passport system. This ensures the information is available wherever they are in the world. As well as health information, insurers have also added wellness related tools such as online health risk assessments, health information telephone services and employee assistance programmes. Some insurers have also added practical support for expats and their families. For example, if a policy member needs to be evacuated, Allianz Worldwide Care will take care of up to 1,660 of travel costs for their family members. These developments will ensure that, as interest in overseas expansion continues, insurers will be well positioned to look after the health and wellbeing of those employees on foreign assignments. HI 32% 4% What factors do employers take into account when purchasing ipmi? 24% 41% 50% 46% Source: Aviva Relocation Trends Report 2012 Quality of package Global strength Expertise in ipmi market Value for money Known trusted brand Comprehensive benefits Group International PMI Most popular new territories for foreign assignments As employers look increasingly overseas to emerging BRIC countries and beyond for new opportunities, international private medical insurance providers are coming up with new and innovative ways to guide them through the maze of regulation that stands in their way 2012 was a good year for international medical insurers. With the UK economy still failing to show any real signs of recovery, more and more businesses are looking for opportunities overseas, with international medical insurance a must for those sent on foreign assignments. The demand for cover is high. According to research by Aviva UK Health, more than half of UK employers are planning to expand their business internationally, with 21% of employers saying they had sent more employees abroad over the past few years. In terms of destinations, although Europe, the US and the United Arab Emirates remain important markets, emerging BRIC (Brazil, Russia, India, China) economies are also becoming popular choices. Aviva's research found that 41% of British businesses are eyeing India and China, with Russia on employees' travel itineraries for a further 25% of UK employers. But the Aviva research also found that while employers were keen to expand internationally, they were unsure about how to pull together a suitable package for employees being sent overseas, with 60% admitting they found the different rules and regulations challenging. This is supported by research by Jelf Employee Benefits which found that only 5% of employers were confident that they understood the rules for international healthcare in all the countries in which they had employees deployed. Certainly the maze of regulations for anyone posted overseas can be complicated. More and more countries are introducing requirements around the type of cover expatriates must have, with some such as Dubai set to make health insurance mandatory. Dealing with these new countries is also challenging for insurers and brokers. Regulations can often require them to gain a licence or establish partnerships or a fronting arrangement with a local provider. For example, to operate in China it is necessary for both insurers and brokers to have a local licence. Additionally, as these markets open up to overseas business, costs are rising. The cost of treatment in some hospitals in China, for instance, can be as high as in the US. 1) India 2) China 3) Russia 4) Brazil 5) Australia 6) USA 7) UAE Source: Aviva Relocation Trends Report 2012

11 // individual international pmi 21 Because your clients are our number one priority too Individual International PMI A global recession, political instability across different regions the individual international private medical insurance market should perhaps be one of the sector s most volatile. But, as the figures prove, it is in fact one of the sector s most vibrant Allianz Worldwide Care Limited is regulated by the Central Bank of Ireland. Registered in Ireland: No Registered Office: 18B Beckett Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland. As the global economic crisis continued throughout 2012, pessimists could have predicted that many individuals would be more reluctant to take the plunge and leave their home country for a better life abroad. However, it seems that the downturn has prompted many to make the move overseas for prolonged periods of time or indeed forever. In fact, research carried out for Lloyds TSB International suggests that a new breed of global citizen is emerging. Research from the bank, published in 2012, looked at over a thousand affluent UK citizens and found that as many as one in five spent at least one month outside Britain in the previous 12 months, equating to around half a million people nationally. The results showed that about 340,000 respondents spent more than a month abroad in one trip. Furthermore, the research for the bank shows that 68% of British expats are far happier in their adopted countries than in the UK. Spain is where British expats feel happiest, in spite of the country's gloomy economic situation, while Canada and Germany rank second and third respectively as locations where UK expats are most content. And while, of course, many expats live abroad because they are on overseas business assignments, many and a significant part of the overall international private medical insurance (ipmi) market for individuals are older people moving abroad in the hope of enjoying sunnier climes in their retirement. In fact, 40% of expats surveyed for Lloyds TSB International said they were spending more time abroad because they had retired in the last five years. Those figures are backed up by research from HSBC, whose 2012 Expat Explorer survey found that a high proportion of British expats living around the world fall into the over 55 age bracket. According to HSBC, of the British expat community, 38% are 55 or over, compared to just 22% of expats falling into this age bracket worldwide. Furthermore, just 15% of British expats are aged 18-34, compared to a global average of 32%. And while only 9% of all expats who completed the survey are retired, that is true for 17% of British expats. HSBC says this could be a result of Britons choosing to build their career in the UK before moving abroad to capitalise on better weather and quality

12 22 individual international pmi // // individual international pmi 23 The age/employment profile of British expats Of the British expat community, two thirds (38%) are aged 55 and over, compared to just 22% of expats falling into this age bracket worldwide. In comparison, relatively few British expats are from the age bracket - only 15% of British expats fall into this age range compared to a global average of 32%. British-born expats are also more likely to be retired than most other nationalities. While one in ten (9%) expats who completed the Expat Explorer survey are retired, nearly one in five (17%) British expats describe themselves as the same Source: HSBC Expat Explorer survey 2012 Best and worst cities for quality of living for expats 5 of life in countries such as France and Spain or, perhaps, an indication that those who move away from Britain are more inclined to stay in their new country long-term. One of the major trends to have emerged in the individual ipmi market over recent years has been a willingness among some ipmi providers to offer cover for pre-exisiting chronic conditions something which can be a major stumbling block for someone wanting to live overseas. After all, living abroad means that individuals no longer have the NHS to rely on to treat whatever their chronic condition might be, should they have one. In the past, while corporate groups, which are assessed on a medical history disregarded basis, could generally access cover for all chronic and pre-existing conditions, it was a different story when it came to individuals and their families and indeed smaller corporate groups. Historically, most insurers have been unwilling to offer them cover for chronic conditions due to their associated high medical costs, leaving the treatment and maintenance of chronic conditions to the public health system, if available, or simply leaving it up to the individual to fund their care themselves. However, some insurers are now using sophisticated underwriting systems and morbidity modelling techniques to assess the medical risk Britons abroad There are almost five million Britons living and working abroad Australia, Spain, the US, Canada and South Africa are the top countries for British expats Over 40 countries out of 196 have a British population of 10,000 or over Australia, with approximately 1.4 million British expats is the top expat destination, and Spain with 940,000 expats, the US with 794,000 expats and Canada with 630,000 expats follow closely behind Source: NatWest International Personal Banking Quality of Life Index Expats in Europe stay put despite economic woes Expats living in the Eurozone seem determined to stay in their new country of residence despite the economic woes there. In fact, although more than half (58%) of expats living in Spain think the country is getting worse as a place to live for expats, none (0%) are actively looking to leave in favour of their home country, while around three-quarters (74%) are intending to stay. Similarly, expats in the UK and France are also, by and large, intending to stay in their country with 71% and 69% respectively intending to stay put (compared to a global average of 62%). Source: HSBC Expat Explorer Survey Sponsor Commentary and likely cost of treatment associated with various chronic conditions. They have found that there are many conditions, such as allergies, that have little impact on the insurance risk and that can be covered without any additional cost. And while for some other chronic conditions a surcharge or exclusion may apply, the fact that more can now be covered at all means that many more expat individuals can access more comprehensive cover than before. There will certainly be no shortage of demand for comprehensive healthcare cover from individuals in the years ahead as not only are more people moving abroad than before, but those that are already overseas are increasingly reluctant to return home. NatWest International Personal Banking s Quality of Life Index shows that 72% of British expats say that their quality of life has not reduced over the last five years, while the number planning to return home to the UK has fallen from 23% in 2007 to 17% in As a result, the individual ipmi market will continue to be a vibrant one and one which brokers will do well to tap into. HI In terms of the profile of this market segment, the results of our own surveys of individual clients, based on our global membership list, would tend to follow the global averages mentioned in this article. The highest proportion are aged between 36 and 50 and only 23% are aged 51 plus. Some of the most popular countries for our members to live in are Germany, the UK, Brazil, China and Switzerland. CITIES WITH BEST QUALITY OF LIVING CITIES WITH WORST QUALITY OF LIVING 10 3 For us, providing a comprehensive level of cover to our individual clients is very important. We always provided cover for chronic conditions, and now we can provide cover for pre-existing chronic conditions also. Each year we review and enhance our plan benefits, flexibility and/or services e.g. we introduced a range of core plan deductibles in November 2012, for an even greater level of flexibility and choice. We also appointed a Relationship Manager in 2012 to provide additional support to intermediaries targeting individual business. 1 Vienna 2 Zurich 3 Auckland 5 Vancouver 6 Düsseldorf 7 Frankfurt 8 Geneva 1 Khartoum, Sudan 9 10 Copenhagen Bern/Sydney 2 3 N Djamena, Chad Port-au-Prince, Haiti 4 Bangui, Central Africa Republic 5 Baghdad, Iraq I believe that there is further opportunity for growth within this segment, as health insurance in general evolves towards more geographically flexible cover in line with the trend for global mobility, and the demand for cover for chronic conditions increases, in line with the rising proportion of older people in the world s population. 4 Munich Source: Mercer 2012 Quality of Living Survey Susan Landers, Head of Marketing and Client Management, Allianz Worldwide Care

13 app for iphone Tm ANd ipad Tm In association with Company Profiles The only app encompassing health insurance and protection news and analysis This includes your favourite sections from including, insider view and people moves news on The go News stories are cached within the App so you can read the news offline anytime, anywhere. instant access To Timely news The news feed can be refreshed automatically or manually and the homepage gives you a snapshot of the most recent top headlines

14 26 Company Profile // Quality health plans and benefits Healthier living Financial well-being Intelligent solutions Does your ipmi insurer product range Profile International Healthcare Plan for Individuals Group International Healthcare Plans for SMEs Group International Healthcare Plans for Large Corporates Wellness Programs Health Management Services Contact details London Office Serving Europe and Russia Aetna International 1st Floor, 69 Park Lane Croydon CR9 1BG United Kingdom T // +44 (0) E // europeservices@aetna.com Video - A History of Aetna: Key Contact: Nic Brown European Sales Director E // BronwnN7@aetna.com T // +44 (0) Aetna International offers innovative global healthcare cover, wellness and care management solutions for multinational corporations and globallymobile individuals across the world. With more than 150 years experience in the US and over 35 years internationally, Aetna offers you an abundance of healthcare expertise. We aim to be the global leader in empowering people to live healthier lives by making quality healthcare more affordable and more accessible. Health insurance for expatriates and globally-mobile individuals Aetna International offers a full suite of products and programmes, including medical, dental, vision, emergency assistance and health management. Our global coverage with local expertise meets employers needs in attracting and retaining qualified employees for international assignments. As specialists in providing health insurance for expatriates, we understand the needs and preferences of people living abroad. With our expertise we are able to offer flexible and portable benefits plans to help them gain access to the services they require. Health risk assessments, cancer outreach support and health and wellness education The Aetna experience works for you, wherever you are in the world. Our number one priority is placing the people who use our services at the centre of everything we do. We re continually challenging ourselves to take the service we provide to the next level - this includes our enhanced global website, which makes it easier to do business with us than ever before. We focus on health and wellness, providing resources to help members reach their optimal health. Our new international healthcare plans include our complimentary wellness offering, Aetna Global Health Connections, which includes: Health risk assessment Cancer outreach and support Health and wellness education and access to informative materials through our electronic wellness centre In addition to offering flexible cover plans, we are expanding our health management solutions. We are collaborating with organisations around the world to improve health, quality and cost outcomes through wellness programmes, disease management, case management and other solutions. Global medical services network Dedicated to building strong and secure partnerships with healthcare professionals around the world, we have negotiated simplified prepayment and reimbursement procedures with practitioners and medical facilities worldwide. This gives our customers added convenience and reduces costly up-front expenses. Solutions to address local regulatory and compliance requirements Compliance is a core competency at Aetna International. We are able to provide solutions across the globe, based on local regulatory and compliance requirements. To provide solutions for expatriates, third-country nationals and local nationals, we utilise our licensed insurance entities and have arrangements with locally admitted carriers and alliances to expand our reach. Whether we re working to improve access to care, or providing tools to help drive a healthier and more productive workforce, our actions and vision remain consistent with our core values. As one of the world s most respected health insurance providers, Aetna International has the ability to deliver fully-integrated products, services and programmes to multinational corporations and individuals around the globe. go this far? We do. At Aetna, we provide more than international medical protection. We re dedicated to being your proactive partner, looking after you, your clients and your employees health with the greatest care and attention. With truly global reach and expertise provided to over 500,000 members globally, we re trusted to deliver seamless world class service that s with you for the long haul. Recommend us with confidence EuropeSales@aetna.com X (0/00) Aetna is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna International plans, refer to Aetna Inc.

15 28 Company Profile // The Client is at the Heart of Our Culture Exceptional care. Anywhere. product range Profile International healthcare plans Regional healthcare plans Specialised plans for different industry sectors Short term healthcare plans Allianz Worldwide Care specialises in providing international health insurance for employees, individuals and their dependants. As an A+ rated (Standard & Poor s) wholly owned subsidiary of AA rated Allianz SE, the company is able to draw on the resources and expertise of one of the world s leading insurers and financial services providers. Allianz Worldwide Care was the first international health insurance provider to offer a 48-hour turnaround on submitted medical claims, under its Clear to Zero claims handling initiative. Allianz Worldwide Care s clientdriven approach and commitment to service excellence is evident in its 95% client retention rate, underpinned by a strong emphasis on the ongoing development of its people. Contact details Product Details Individual and Corporate Sales Support Allianz Worldwide Care 18B Beckett Way Park West Business Campus Nangor Road Dublin 12 Ireland Providing truly global health insurance solutions for individuals and companies: International Healthcare Plans for private individuals and families Allianz Worldwide Care offers a range of international healthcare plans for individuals and Regional Healthcare Plans The company also offers healthcare plans for specific regions, including the UK, Channel Islands, the United Arab Emirates, Australia, China, Latin America and the Caribbean. Employee Benefits for T // E // sales@allianzworldwidecare.com families. Core Plans, which cover a wide range of in-patient treatments, can be supplemented by a choice of Out-patient, Maternity, Dental Intergovernmental and Nongovernmental Organisations Allianz Worldwide Care Services can administer a and Repatriation Plans. An even greater level of range of global insurance risks for IGOs and NGOs, Key Contacts: flexibility and choice has been added with the introduction of a range of Core Plan deductibles including life, medical, dental, temporary incapacity, permanent disability and long term care. Andrew Seale Regional General Manager (UK, Italy & Middle East) T // M // E // andy.seale@allianzworldwidecare.com in These healthcare plans are fully underwritten and cover can be provided for the vast majority of pre-existing/chronic conditions. International Healthcare Plans for companies There are a range of international healthcare plans Marine Healthcare Plan These are healthcare plans designed specifically around the needs of shipping companies and their crew. available for large groups and SMEs, on a medical Short Term Plan Duncan Wright Business Development Manager (United Kingdom) T // M // E // duncan.wright@allianzworldwidecare.com history disregarded or fully underwritten basis, depending on group size. The Core Plans cover a wide range of in-patient and day-care treatments as well as other benefits such as medical evacuation, local ambulance and nursing at home. Core Plans can be supplemented by a choice of Out-patient, Dental and Repatriation Plans and clients have a choice of regional area of cover. Plans can be completely tailored for large groups. This plan is suitable for employers who want to cover the medical emergency needs of employees who travel abroad regularly on business. Employees are covered for single or multiple trips of up to 90 or 300 travel days per year. Information on the most current rating is available at or from Standard & Poor s at +44 (0) A rating is an opinion of an insurer s financial strength; it is not a recommendation of an insurer s products. Allianz Worldwide Care Limited is regulated by the Central Bank of Ireland. Registered in Ireland: No Registered Office: 18B Beckett Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland.

16 30 Company Profile // For financial adviser use only. Not approved for use with customers. It s good to feel valued. Especially in these tough times. product range Group/Individual PMI Group/Individual International PMI Wellness solutions Absence solutions Contact details Chilworth House, Hampshire Corporate Park, Templars Way Eastleigh, Hampshire SO53 3RY Profile At Aviva we understand that everyone s healthcare needs are different and we continue to provide innovative solutions to meet these needs. Being the world s sixth largest insurance company and the UK s largest insurance services provider we have a breadth of knowledge, expertise, and experience in the health insurance market. We are delighted and extremely proud to have been awarded Health Insurance Company of the Year and Best Group Private Medical Insurance Provider, both for the third year running. We also won Best Customer Service, Best Innovative New Product for International Solutions and Best Use of Marketing to Intermediaries. These 5 awards recognise our commitment to our intermediaries and customers in delivering tailored solutions. Our innovative approach and constant commitment to service has made us a major player in the market. We work with a broad range of industries, supporting everyone from small groups to multinational corporations. We recognise that our clients needs are varied and constantly evolving, and we continue to provide innovative solutions to meet these changing needs. For us, that means prioritising excellent service, providing added value and incorporating the kind of flexibility that will take your clients needs into consideration. We are committed to providing intermediaries with the tools and support you need to offer relevant and timely solutions for all your clients needs. In addition to our corporate offering we also offer a wide range of individual private medical insurance products. The link between health, performance and productivity has been well documented, which is why our offering provides you and your clients with a varied and modular menu of Health and Wellbeing products: PROTECTION Providing private medical insurance and international private medical insurance products to assist employers in mitigating against short and long-term absence and help employees return to work as soon as possible. Health insurance from Aviva A turbulent economy can mean that many clients are looking to drive maximum value from their employee benefits. At Aviva we understand that this doesn t need to come at the expense of employee recognition or protection. Our range of health and wellbeing solutions has been designed to meet clients needs and budgets. So they can control their overheads and still continue to help protect and motivate their employees. To find out more about our health and wellbeing solutions, simply visit aviva.co.uk/healthcarezone KEY CONTACTS: Group PMI (50+ lives) Health & Wellness North T // E // nationalaccountsnorth@aviva.co.uk WELLNESS A range of preventative health products and services that aim to identify potential employee health risks early on and enable employers to put in place a range of options that can help keep employees in good health. Health & Wellness South T // E // nationalaccountssouth@aviva.co.uk Individual PMI/Small Group PMI (2-49 lives) Healthcare Bureau T // Individual International PMI /Group International PMI (2+ lives) International sales team T // E // international.sales@aviva.co.uk Calls to and from Aviva maybe monitored and or recorded. Product portfolio Group Private Medical Insurance Extensive medical cover for companies of all sizes, offering modular and flexible benefits to suit your clients needs and budget. Individual Private Medical Insurance Healthier Solutions is a flexible, modular-based product including a no claim discount, subject to application. Group/Individual International Private Medical Insurance Our International Solutions product provides an extensive core cover, with a choice of options to upgrade or reduce cover, allowing your clients to tailor their benefits to their needs and the country in which they are based. Wellness solutions A range of products for companies and individuals aimed at encouraging a healthy lifestyle with the ability to identify potential health risks or trends, for example MyHealthCounts and MyHealthCounts for Business. We also provide access to 24-hour GP and stress counselling helplines. Aviva Health UK Limited. Registered in England Number Private Medical Insurance is underwritten by Aviva Insurance Limited. Registered in Scotland Number 2116, Registered Office Pitheavlis, Perth PH2 0NH. Income Protection & Group Life Insurance is underwritten by Aviva Life & Pensions UK Limited. Registered in England Number Registered Office 2 Rougier Street York YO90 1UU. Authorised and regulated by the Financial Services Authority. ADV /2012

17 32 Company Profile // product range Healthcare plans Dental plans Occupational health services Wellbeing solutions Profile At Cigna UK HealthCare Benefits (UKHB) we proactively manage employee health benefits and employee health risks by providing leading edge managed healthcare plans, occupational health services and dental benefit solutions. We support each of our services with complementary health and wellbeing solutions. You can rely on Cigna UKHB to: Understand your clients needs and treat them as individuals. Deliver a consistently high quality service. Develop innovative solutions which achieve a good ROI. Use intelligent care pathways that support your clients, their employees and manage costs. Provide useful information which helps manage health. Product portfolio Corporate private medical plans We manage employer medical plans for medium and large sized organisations with a leading approach to Care Management. We balance careful cost control with delivering the most appropriate treatment for members. Our HealthCare Choices range of plans offers a solution for every employer. Your clients can enjoy comprehensive and flexible cover through CompanyHealth, balance reward strategy and budget with YourHealth or address absence and productivity problems with EssentialHealth. Contact details Company HQ Address: 1 Knowe Road, Greenock PA15 4RJ T // (Main): F // (Main): Key Contact: Will Shaw Head of Corporate Sales T // E // will.shaw@cigna.com Corporate dental plans We offer a range of plans and cover levels, so your clients have options to suit their needs and budgets. We also add value by going beyond the basics. We review plans for major treatment, saving time and costs on unnecessary treatments. We regularly lead the way in the market and were the first to supply regular management information on larger dental schemes. With good take up and satisfied members, you can be confident Cigna has a dental plan to suit your clients needs. Occupational health services We design occupational health (OH) solutions to suit the size and shape of each organisation and to meet specific business needs. Our experienced OH teams can deliver absence case management, health surveillance, policy advice and wellbeing services on the telephone, online and on site. We improve productivity by supporting over 10,000 employees back to work each year. Wellbeing solutions We proactively support your clients health and wellbeing strategies with a range of tools and resources. This includes topical lifestyle advice on our secure member portals, online condition management booklets and onsite health promotion activity. We also provide health and wellbeing services through Cigna Connect. These include health assessments, gym services, EAP services and private GPs. Our Connect affiliates match Cigna in terms of quality of benefit, service delivery and value.

18 34 Company Profile // product range Profile CORE MEDICAL PLANS Premier expatplus Nordic Energy (for Oil & Gas industry) CoverN GO (for Non-Governmental Organisations) Tailor-made solutions ADDITIONAL PROGRAMMES AND NON-MEDICAL SERVICES Dental & Vision Travel Life, accidental death & disability Health and Wellbeing Programmes International Employee Assistance Programme Continuation Option The global leader in health services Cigna Global Health Benefits has over 50 years of experience in providing group healthcare and employee benefits solutions for globally mobile employees of small, medium and large businesses and IGOs/NGOs on a global basis. A truly international organisation with operations in more than 30 countries, covering over 870,000 expatriates on a 24/7 basis across 192 countries and more than 3,800 corporate clients worldwide. Employing 1,650 staff members, we maintain 8 service centres in 5 time zones with local office representations across Europe. Every year our teams process more than 5 million medical bills for an amount of approximately 550 million. Cigna Global Health Benefits is part of Cigna, a US-based global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Creating a culture of health In a world of ever-increasing healthcare expenses, new ways and means are called for. At Cigna Global Health Benefits, we feel it s time for a change of perspective. Our vision, as a world leading health service company, is to concentrate on people. We want to keep them healthy rather than react to sickness. Because at Cigna we passionately believe this is the only path to a healthy and happy life. And to a healthy bottom line for your business, too. Looking into the future of healthcare, we actively help your employees to take their health spending in their own hands and engage them in improving their health through our various prevention and well-being programmes. Healthier and more productive employees. Lower sickness costs. Lower claims expenditure. These are just a few benefits of this innovative approach. Contact details Cigna, your healthcare plan s best partner 1 Knowe Road Greenock Scotland PA15 4RJ KEY CONTACTS Mark Coleman Regional Sales Director, Europe T // M // E // mark.coleman@cigna.com Simon Parker International Sales Manager, UK M // E // simon.parker@cigna.com Mark Massey International Sales Manager, UK M // E // mark.massey@cigna.com Your company is like no other. That s why we get to know what makes your organisation unique and tailor your plans accordingly. Cigna provides you with globally-compliant and integrated solutions supported by exceptional customer service and an unrivalled global network of healthcare providers. We care. Knowing your people are in safe hands frees you from any worries and reduces your workload so you can focus on other business priorities. We know. We give you expert advice on international employee benefits and compliance and always look to futureproof our offering when designing and managing your plan. We save. We look beyond benefits structure and network discounts, combining cost-containment measures with an innovative approach to managing healthcare. We are local. We provide your employees with personal support and affordable healthcare on their doorstep, thanks to our local consultants and worldwide provider network. We integrate. We offer you and your employees the simplicity of one point of contact for both medical and nonmedical insurance cover and services. BEST GROUP INTERNATIONAL PMI PROVIDER The leader in the globally mobile employee market

19 36 Company Profile // Something your clients can smile about product range Profile Dental payment plans With flexible plans that offer reimbursement for routine and restorative dental treatment, dental is attractive to employees as it can be used regularly. 79% of employees who have access to employee benefits through their work choose benefits that they can use regularly* *Survey conducted online by Yougov on behalf of Denplan in January 2012 with a nationally representative sample of 4110 UK adults, 2005 of which who are employed full or part time. Contact details Denplan has been at the heart of dental care for over 25 years and by listening to our members, we ve learnt what works and why. That s why we arrange dental plans designed to suit companies needs, as well as supporting employee wellbeing. Denplan now has around 2,000 corporate schemes and believes that a dental plan is one of the most useful benefits a company can offer their employees. It s a valuable part of a corporate wellbeing package because 76% of UK adults visit the dentist regularly*, so it s a product that employees can really benefit from. BROKER SUPPORT We keep you fully informed of the most up-to-date and relevant information about the dental market with our broker-specific online newsletter BiteSize News. We also complete annual independent research with corporate decision makers, alongside employee research, undertaken by YouGov, to reveal employer and employee attitudes to benefits. COMPANY SUPPORT We re committed to supporting companies and have dedicated account managers who are focused on providing companies with effective help and support from set up to maintaining and communicating the dental scheme to employees. We pride ourselves on our proactive approach to developing long term meaningful partnerships. We have a market-leading online claims facility for employees where they can submit and track claims. And with our dedicated Corporate Marketing Team, we ve developed a range of marketing materials for employers to use helping them with employee engagement. Product portfolio 71% of companies think a dental plan is a valuable benefit to enhance employee wellbeing * 79% of employees who have access to employee benefits through their work choose benefits that they can use regularly. ** 84% of employees believe good oral health supports overall wellbeing. ** A dental plan is an ideal addition to a benefits package. Denplan Limited, Denplan Court, Victoria Road, Winchester, Hampshire, SO23 7RG T // F // KEY CONTACTS: Gary Williams The Dental Wellbeing Range of dental plans place a strong focus on preventive care and are designed to encourage regular attendance at the dentist. And for those with different budgetary needs, Denplan Lucent is available. Denplan Lucent is very competitively priced, and provides cover for a full range of dental treatments. We also arrange dental plans specifically for voluntary (employee paid Direct Debit) opportunities. These provide up to 2,500 cover for eligible routine and restorative treatment plus 100% reimbursement for NHS treatment. We have a unique service to help employees get the most out of their chosen dental payment plan: Money towards routine and restorative dental treatment Immediate cover with no initial mouth health check or authorisation from Denplan necessary prior to receiving treatment 24-Hour Worldwide Dental Emergency Helpline A Find a Dentist service to help employees locate a dentist from our network of 6,500 Denplan member dentists Brokers benefit from a dedicated account management team Employees benefit from a claims management team who aim to reimburse claims within five working days Get in touch to find out how we can help you and your clients Call or corporatesales@denplan.co.uk * Survey conducted online by Denplan with 510 employee benefit decision makers in UK companies in January ** Survey conducted online by Yougov on behalf of Denplan in January 2012 with a nationally representative sample of 4110 UK adults, 2005 of which who are employed full or part time. National Relationship Manager T // E // corporatesales@denplan.co.uk 100% reimbursement of NHS dental charges (on all plans except Denplan Key) All plans include worldwide dental injury and dental emergency cover and up to 12,000 mouth cancer cover Part of the Simplyhealth Group, Denplan Limited is an Appointed Representative of Simplyhealth Access. Authorised and regulated by the Financial Services Authority. Registered in England no Registered office: Hambledon House, Waterloo Court, Andover, Hampshire SP10 1LQ CAM

20 38 Company Profile // product range Globality CoGenio Internationally operating companies and their expatriate staff Globality CoGenio Business Travel Private health insurance for short-term business travellers Globality YouGenio Private health insurance for individuals and their families Profile Globality Health is the international health insurer with a special focus on expatriates people who study, live or work abroad. As a member of Munich Health we bring together more than 5,000 experts at 26 locations worldwide to offer innovative healthcare solutions for clients and partners all over the world. As an integral part of Munich Re, we give you the financial strength and security of an AA- rated world-leading insurer and reinsurer. Following our philosophy of Outstanding care for outstanding people we offer excellent care and safety all over the world. Internationally operating companies and their expatriate staff as well as individuals and their families place their trust in 80 years of experience in the healthcare market now concentrated in one focused organisation. With Globality CoGenio and Globality YouGenio we offer flexible underwriting solutions, high-level products with comprehensive outpatient, inpatient and dental insurance cover around the globe. Globality Health is taking international healthcare service to a new level. An integrated international locally based service and assistance model unified under one brand: Globalites.This worldwide network of Healthcare Service Satellites offers direct access to world-wide local expertise, seamless service and first-class care. Globalites are always at your service. Wherever you are. Product portfolio Contact details Contact details Globality S.A 13, rue Edward Steichen L-2540 Luxembourg T // Globality CoGenio Outstanding care for outstanding employees Flexible and modular insurance solutions for internationally operating companies with comprehensive benefits (for inpatient, outpatient and dental treatment), as well as special assistance services. Seamless cover of global workforce: Easy handling across borders, global cost containment, detailed management reporting and key accounting. Pre-existing medical conditions covered No waiting periods for pregnancy, childbirth, dental treatment and dentures No maximum age-restrictions Flexible payment methods without surcharges Double maximum sums for all plans including USA Scopes of cover: Classic, Plus, Top with wide range of deductibles Globality CoGenio Business Travel Comprehensive health insurance cover on business trips High-class private health insurance for short-term business travel for all employees of the policyholder, its subsidiaries and affiliates, who temporarily reside in a foreign country for business reasons as an additional option to CoGenio. Simple and easy business travel processes: the customer simply purchases a number of travel days per year which he can then use at his discretion, with no need to register the individual travellers. Outpatient, inpatient and dental treatments by licensed doctors worldwide, as well as evacuation and repatriation costs No qualifying periods, no maximum annual aggregate limit existing, no co-payments Period of 90 days per trip (possible extension of the insurance cover up to maximum 180 days) Globality YouGenio Individual care in a globalized world Private health insurance for individuals and their families, who reside abroad for at least three month. Optimum outpatient, inpatient and dental cover throughout the world, comprehensive advice and best possible organizational support in case of illness. Pre-existing medical conditions covered after risk assessment No minimum or maximum age-restrictions Cover for chronic conditions Scopes of cover: Classic, Plus, Top with wide range of deductibles Seamless service and first-class care unified in one brand. With Globalites, a coalition of selected, high-quality healthcare service partners, Globality Health takes international healthcare service to a new level. Globalites guarantee unified location based service and assistance worldwide. That means wherever a Globality Health client goes, he gets the best of both worlds the benefit of a worldwide leading health insurance company combined with the local market knowledge of its satellites. Globalites ensure maximum service quality with straightforward access to professional care and medical services in each of their respective regions. A strong selling point for your potential clients and another good reason to make Globality Health your first choice for global expatriate and business travel health risk solutions. Call your Country Manager at or visit to find out more. Globality Health. New name, same drive.