CZ Health Insurance, absence prevention and solutions via your intermediary. For a. fit. and healthy business

Transcription

1 CZ Health Insurance, absence prevention and solutions 2014 via your intermediary For a fit and healthy business 1

2 People are the energy source of every business Keep your business healthy and vital And let us help you do that Good group health insurance is the basis of a healthy and vital enterprise. This is what CZ stands for. And this is why CZ offers a number of healthcare services apart from the group health insurance, to help you with prevention and absence. A comprehensive range of healthcare, prevention and absence solutions With this brochure we want to tell you about our healthcare, prevention and absence solutions. We start with the basis of this service: our group health insurance, together with the accompanying healthcare services for you and your employees. We will go on to tell you about our other prevention and absence products, supplemented with our solutions for income and incapacity for work. One partner for all your questions It is disappointing when an employee falls ill. Not just for them, but also for you as their employer. You are confronted with a two-year obligation to continue paying their wage, monitoring the absence, providing guidance and helping them return to work as soon as possible. You are also confronted with a plethora of agencies: from health and safety and the UWV to the reintegration service, and from the medical officer and care providers to income and health insurers. You also need to consider measures to prevent sickness at work as much as possible - and the associated high costs of absence. One partner who arranges everything for you We can handle all these healthcare and absence obligations for you, including the relevant paperwork. CZ can coordinate and harmonise all these obligations and parties for you. From the day the employee reports sick, we do our utmost to help them with their recovery, get them back to work and prevent a relapse. In short: CZ is your partner for healthcare, absence and reintegration. 2 3

3 Group health insurance Complete and with full support CZ's group health insurance offers your employees an attractive premium discount, as well as extra reimbursements. This is interesting for them, but also for you. Because it often concerns reimbursements to prevent or reduce absence. In addition, we offer many extras that help your employees to stay fit and healthy. For you, the employer, we have the Care Broker ( Zorgmakelaar ), the Healthy for Work Test ( GezondWerkenTest ) and The Healthy Workplace ( Gezonde Werkplek ). The general insurance The general insurance covers the most essential healthcare costs. The government decides what is covered by the general insurance. CZ's general insurance options are two in-kind packages and a refund package. The in-kind package The refund package Your employees use care providers contracted by CZ. Our agreements with these providers concern quality and price. This means that your employees receive good quality care, while healthcare in the Netherlands remains affordable. This gives CZ more control over the price and therefore the costs. This is why the in-kind policy costs less than the reimbursement policy. 1 'CZ Zorgbewustpolis': 2 'CZ Zorg-op-maatpolis': specific choice especially easy 19% chose this 73% chose this The 'CZ Zorgbewustpolis is for With the 'CZ Zorg-op-maatpolis employees who specifically choose your employees can go to any care an in-kind policy, where things are provider who has a contract with CZ. organised in a different way. And This means nearly every provider in therefore cheaper than the 'CZ the Netherlands. The CZ Zorg-opmaatpolis is particularly easy Zorg-op-maatpolis. For instance, they are opting for all communication by internet and direct debit invoice directly to CZ. because the care provider sends the payments. The Best Doctors service is not included. Your employees can also use care providers not contracted by CZ. With non-contracted care providers, CZ has less influence over the price of the care. This is why the premium is higher than with an in-kind policy. 1 'CZ Zorgkeuzepolis : choose your doctor 8% chose this The CZ Zorgkeuzepolis offers the same cover as the CZ Zorg-op-maatpolis, but it is a little more expensive. However, your employee is free to choose a care provider. This can also be a care provider with whom we have not made an agreement. The maximum reimbursement is the (usual) market rate applicale in the Netherlands. Additional insurance Your employee can take out additional insurance for healthcare not included in the general insurance. At CZ, this includes certain extras that also benefit you, the employer. For instance, there are packages with extra cover for physiotherapy, the flu jab and vaccinations abroad. Clear choices Your employee can choose from the additional policies 'Basis Collectief', 'Plus Collectief', and 'Top Collectief', with a graduated level of cover. Plus Collectief in combination with dental insurance is the perfect insurance for families. 'Jongeren' and '50+' We also offer special packages for certain stages of life. These additional packages are customised: you only pay for cover that is relevant for the particular life phase. For instance, if you take out an additional 'Jongeren' or '50+' package, you do not pay for additional obstetric care. The 'Jongeren' package already provides cover for dental costs. Dental insurance We offer two separate dental insurance packages: 'Tandarts Collectief' and 'Uitgebreide Tandarts Collectief'. With complete cover for orthodontics expenses for children aged up to and including 21! Would you like to know more about our cover? Would you like to know exactly what we reimburse? You will find it all at werkgever (information in Dutch). Under Verzekeringen you will find all the information about the cover provided by our group health insurance. 4 5

4 Your own Care Department This is how we support your health policy Apart from insuring healthcare, CZ also provides advice and support for your health and sickness absence policy. Companies with CZ group health insurance can use our range of healthcare services. This level of support from CZ gives you as it were a whole new department: the Healthcare Department. CZ Care Broker The CZ Care Broker ( Zorgmakelaar ) will help you sustain minimum absenteeism. They will help you find solutions to prevent absenteeism. The CZ Care Broker can be used for all your company's employees. Even if they are not insured with CZ. No additional costs will be incurred for this. A few specific examples of the tasks with which the CZ Care Broker helps you and your employees are: Mediation for waiting lists Employees can go to hospital or see a specialist or other care provider faster. Therefore get treatment and be back at work faster. This mediation can start on the first day of absence. Assistance with absence When absence occurs, the CZ Care Broker will find the best place for treatment. Quality comes first, but the Care Broker doesn't just assess occupational care! This can save you, the employer, a lot of expenses. Sow now to reap later Advice The CZ Care Broker also offers advice on non-medical issues such as mediation, assistance in the home or trauma care, medical aids and courses. Healthy For Work Test It is important for your policy to know how healthy and fit your employees are. You can easily gain this valuable insight by asking your employees to do our online 'GezondWerkenTest' (Healthy For Work Test). This takes twenty minutes. Subsequently, you can develop or adjust company policy based on the test results of your employees' health and lifestyle. Privacy is guaranteed. The Healthy Workplace An interactive website specially for your employees. On this site they can find extensive information and personal advice on staying fit and healthy. For example: online advice from experts, including a physiotherapist, a psychologist, a physical activity counsellor, and an 'ARBO' doctor; online coaching programmes for employees suffering from injuries or back trouble, who want to stop smoking or lose weight; various health tests; review and modify insurance policy information; calculate the premium or take out a policy online. 6 7

5 Healthcare advice and support If your employee needs healthcare If your employee needs a care provider, such as a physiotherapist, general practitioner or speech therapist, they can find them at www. cz.nl/findcare. If they need hospital treatment, or are due to go into labour, they can compare the quality of the hospitals or maternity centres on our site. This will help them make the best possible choice for their needs. If your employee needs advice If your employee wants to know the best place to go for treatment, our care advisers are here to guide them. All our advisers have a medical background, so that they can properly assess the situation. They can offer advice, for instance, about waiting lists, or if your employee wants a second opinion from another doctor. With our single point of contact, we will help your employee find the best healthcare solution for their needs. A solution is always to hand If your employee is not happy If your employee is not happy with a care provider, CZ can help them write a letter of complaint and tell them where to send it. If your employee has a medical question If your employee has a question about their health or lifestyle, they can call the CZ Healthline. They will be able to speak to a nurse who can answer their questions. Alternatively, they can send an . For example, to a psychologist, dietician, physiotherapist or dentist. If your employee is on holiday Accidents can happen when you least expect them. If something happens on holiday and your employee needs medical care, they can call the CZ Helpline. A Dutch expert will give them advice and information. For instance if they should go to a doctor, or where the nearest hospital is. Healthcare services for your employees Extra service, without extra costs At CZ your employees can use all sorts of services such as waiting list mediation, the CZ Healthline and e-experts. If you've chosen the CZ Zorg-op-maatpolis or the CZ Zorgkeuzepolis you can also use Best Doctors. Best Doctors is an international network of the best specialists in different fields. They can give a second opinion concerning the best treatment for an illness or condition. 8 9

6 Customised absence management We guide, you direct CZ sees absence management as an important support service for its customers. Together with the employer we try to limit the financial damage caused by absence as much as possible. To achieve this, CZ looks at ways to give your employee the best possible care. Enterprise means controlling risks A better handle on absence CZ can also approach absence from a non-medical angle, because we are not (financially) dependent on the input of the medical officer. Because of this holistic approach, the medical officer has more of an advisory role than a determining role in absence support and you, the employer, together with the case manager, will have more room for case direction. Because the medical officer is always asked a welldefined question, you receive the feedback that allows you to proceed with the process. Dynamic support in managing absence Together with you we analyse the nature of the absence within your company. We look at your absence management and the results you want to achieve. Naturally, we want to hear where your organisation wants to allocate the responsibilities for absence management and which support you want to receive for this. We then propose the best direction model for your situation. Because the more you hold the strings, the lower the costs of the support. Absence management CZ Absence Management ( CZ Verzuimmanagement ) is available in three packages. Each package contains: use of the absence software; cooperation with medical officers from a certified health and safety ('ARBO') service or individual certified medical officers; guidance from a CZ case manager; the services of the care broker. If you unexpectedly need extra support, we can provide this on a performance basis. So that you know exactly what the costs are for our support. Intervention insurance An absence process can require various treatment and counselling procedures (interventions). Many of these procedures are not reimbursed under the health insurance because the treatments are not covered by the general or additional insurance. The intervention insurance is an additional employer's insurance that limits the risk of specific expensive treatments not covered by your employees' health insurance. In addition, intervention insurance provides your employees with swift access to the appropriate work-related care. Intervention insurance is particularly suitable for small and medium-sized employers because the financial risks for these companies cannot (or not easily) be predicted. Absence prevention Are your employees working in a safe and healthy environment? A good health and safety ('ARBO') policy will contribute to this and therefore to a reduction of absence and occupational incapacity. There are statutory requirements for health and safety. You can let us check whether your organisation fulfils these. We would be pleased to discuss any means required to set up and implement a good health and safety policy

7 A safe course to the future Income and incapacity for work For employers who want to protect their employees against a significant loss of income due to long-term incapacity for work, we can deliver a total service together with our partner Delta Lloyd

8 Legal information Good care within reach Do you want to know more? For more information about our services please contact your intermediary; he or she knows your organisation the best. You can also find a lot of information for companies at (information in Dutch). For instance, you will find an overview of all the reimbursements in our group health insurance. Intermediary location Sittard Wilhelminastraat 39 Postbus 222, 6130 AE Sittard verkoop.intermediairs@cz.nl telephone: (046) Intermediary location Goes Wulfaertstraat 25 Postbus 163, 4460 AD Goes verkoop.intermediairs@cz.nl telephone: (0113) Organisation 'OWM Centrale Zorgverzekeraars groep', Zorgverzekeraar U.A. (KVKnr ) 'Aanvullende Verzekering Zorgverzekeraar U.A.' (KVKnr ) Stichting Intermediair CZ verzekeraars, (KVKnr ) Address Postbus LD Tilburg CZ terms and conditions of insurance These can be inspected at a CZ office, the Tilburg Chamber of Commerce, or by calling us. Dutch law is applicable to the insurance contract. The risk and the administration of absence and income insurance are placed with 'Delta Lloyd Schadeverzekeringen NV'. No rights can be derived from the contents of this brochure. Dissatisfied? Please tell us at CZ is affiliated as a health insurer with the mediation body 'Klachten en Geschillen Gezondheidszorg', (information in Dutch). The following bodies monitor how we operate as an insurer: 'De Ned. Bank', 'Autoriteit Financiële Markten' (licences / ), the 'Ned. Zorgautoriteit' and 'College Toezicht Zorgverzekeringen'. 'Stichting Intermediair CZ verzekeraars' is registered as a broker with the 'Autoriteit Financiële Markten': licence number 'Stichting Intermediair CZ verzekeraars' is affiliated as a broker with the 'Klachteninstituut Financiële Dienstverlening', (information in Dutch). With thanks to 'De Zonnefabriek' (photo p. 9) and the Jeroen Bosch Hospital (photo p. 14)

9 Alles voor betere zorg