BUILDING AND MANAGING A TPA OPERATION IN EUROPE

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1 BUILDING AND MANAGING A TPA OPERATION IN EUROPE Andreas Opitz CEO BDAE Holding GmbH SIIA 29th Annual National Educational Conference Orlando, Fl, September 23, 2009 DEFINITIONS Concentration on EEA (an Econimic area = EC + Norway, Island, Switzerland and Liechtenstein) Self Insurance is restricted to Health Care Provision TPA s = Administrators for Health Care Provision 1

Concentration on EEA (an Econimic area = EC + Norway, Island, Switzerland and Liechtenstein)

2 STRUCTURE France France Case Study: (BDAE) EUROPEAN SOCIAL SYSTEMS TPA s Expat in Unlimited High complexity High variety in the different countries Public systems are common Highly important political factor EEA Social Security Treaty 2

variety in the different countries Public systems are

3 EUROPEAN SOCIAL SYSTEMS TPA s Expat in Unlimited Health insurance in the EEA Tax or contribution financed Statutory or private health insurance Medical Benefits provision in the EEA Public Health Services Private or semi-private Health provision Cost regulations => Less costs variations SELF INSURANCE IN EUROPE TPA s Expat in Unlimited More difficult than in U.S. because Population is generally integrated in social systems Very uncommon as medical cover Fiscal and social laws are restrictive Insurance market is extremely regulated 3

4 SELF INSURANCE IN EUROPE TPA s Expat in Unlimited Self Insurance is one driving factor for TPA s because External health related administration is appreciated for smaller groups or as support for non health related organisations Insurers / large health organisations see administration as own key element TPA S IN EUROPE TPA s Expat in Unlimited => TPA is a niche market in the EEA compared with U.S. because Health related organisations (public and private insurers / governmental health organisations) dominate the market Special groups with need of external administration are rare and vary in between EEA countries Medical costs are more regulated / less varying than in the U.S. (No Preferred Provider Organisations) 4

niche market in the EEA compared with U.S.

5 TPA S IN EUROPE TPA s Expat in Unlimited an TPA s Have different historical, cultural, political and economical backrounds May develop by coincidence as reaction to an unexpected demand Are difficult to setup from outside Often operate under non-regulated conditions Need very intense knowledge and observation of the legal backround TPA S IN FRANCE TPA s Expat in Unlimited Backround Big medical market in the EEA (60 Mio.) Residents are obliged by law to have state health insurance (sécurité sociale) All medical facilities are part of the state system Private health insurance only as top-up cover Service degree of French private insurers has a poor reputation 5

backround TPA S IN FRANCE TPA s Expat in Unlimited Backround Big medical market in the EEA (60 Mio.

6 TPA S IN FRANCE TPA s Expat in Unlimited Niche for TPA s Companies engage TPA s to ensure a high service level for own top-up cover The TPA is the steady partner who covers the risk with private insurers French Global Players use TPA s as well for global Expatriate health service => Some bigger TPA s with more than 100,000 insured lives are on the market TPA S IN GREAT BRITAIN TPA s Expat in Unlimited Backround Government organisation National Health Service (NHS) provides universal coverage NHS has a poor reputation Independant private health insurance sector offers a supplement (top-up) cover Out of 50 Mio. appr. 7,5 Mio. lives are covered privately, of which 1 Mio. are covered in self insured schemes of large employers Private health insurance is in no way encouraged by the government 6

Unlimited Backround Government organisation National Health Service (NHS) provides universal coverage NHS has a poor reputation Independant private health insurance sector offers a supplement

7 TPA S IN GREAT BRITAIN TPA s Expat in Unlimited Niche for TPA`s Since the 1990 s a small but growing number of TPA s emerged Major insurance companies responded offering similar types of administration service = > The market share attributable to independent TPA s has reduced over the last decade CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Backround Biggest market in the EEA (80 Mio.) Residents in Germany are since 2009 obliged by law to have health insurance Public or private schemes are available with a broad range of benefits Public cover can be topped-up with a supple-ment health insurance (appr. 60 $ a month) Service degree of insurers is accepted Self insurance is at present unknown 7

Backround Biggest market in the EEA (80 Mio.

8 CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Niche for TPA`s In the past TPA s where unknown The whole market (including appr. 5% expats) was dominated by insurers with powerfull own administration Claims handling is seen as core task of the insurer by the authority (BAFIN) Introducing self insurance is a challenge => Almost no niche CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Development of BDAE s TPA activities Started in 1995 with standard products for expatriates with focus on private clients 1997 first development of taylor-made own products, today with own BDAE terms and conditions 1999 introduction of own global claims handling due to unsatisfaction with insurers services => BDAE became a TPA 8

challenge => Almost no niche CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Development of BDAE s TPA activities Started in 1995 with standard products for expatriates with

9 CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Development of BDAE as TPA 1999 introduction of inpatriate cover 2000 introduction of company expatriate and inpatriate products Today appr. 10,000 lives are covered Global claims handling department is run with 7 employees BDAE has the biggest independant medical TPA in Germany CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Organisation BDAE Holding Dienstleistungsgesellscha ft für den BDAE EXPAT Services Policy Holder Premium collection Administration of Insured Broker Claims Handling 9

10,000 lives are covered Global claims handling department is run with 7 employees BDAE has the biggest independant medical TPA in Germany

10 CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Management challenges Typical TPA tasks are executed in two different organisations 10,000 lives are not not enough to finance a profitable stand-alone TPA business Clients expect a worldwide 24/7 support network and medical assistance => Yet strong dependany on broker commission by insurers (as GMU) CASE STUDY: A TPA IN GERMANY TPA s Expat in Unlimited Future perspectives Implementation of self insurance for company expatriates Encouragement of companies to introduce own top-up schemes for publicly insured employees as incentive Intrduction of a high level global medical product => We are convinced that a medical TPA could be run on a profitable basis even in an unfriendly environment like Germany 10

IN GERMANY TPA s Expat in Unlimited Future perspectives Implementation of self insurance for company expatriates Encouragement of companies to introduce own top-up schemes for publicly

BONDING AMAN UNION. November 21 st, 2012. Daniel Stausberg. Atradius Re

BONDING AMAN UNION. November 21 st, 2012. Daniel Stausberg. Atradius Re BONDING AMAN UNION November 21 st, 2012 Daniel Stausberg Atradius Re 0 Bonds Presentation - Agenda Introduction 1 - Overview Global Bonding Market 2 - Products 3 - Characteristics 4 - Atradius Re s expertise