How To Innovate Employee Benefits?

In the second annual Mercer China Medical Service and Employee benefits insurance At the supplier Roundtable Conference, Mercer experts urged that the development of China's employee welfare market needs innovation and cooperation.

Under Mercer's organization, more than 10 major groups of employees' welfare insurance providers are gathered at Expo InterContinental Hotel in Shanghai. They have conducted extensive and in-depth discussions on how to innovate and cooperate in the field of risk protection benefits, Medicare supplementary medical benefits and high-end medical benefits, in order to improve the level of employee protection and satisfaction with services, continue to expand the scale of the market, and promote the healthy development of the group welfare insurance market.

According to the statistics of China Insurance Statistics Yearbook, the market size of group employee benefits insurance (including life insurance, short-term accident insurance and health insurance) has remained at around 20 billion yuan in the past five years. Despite the increasing number of market players, the product innovation of group employee welfare insurance is far behind the demand of the market, the rate of compensation is rising, the rate is stagnant, and even the new segment of high-end medical welfare is broken down. market In recent years, it has gradually changed from the blue ocean to the Red Sea. Faced with this situation, Mr. Guo Xin, President and chairman of MMC China, said that in the process of communicating with business customers, Mercer found that there are still many security needs for enterprises and employees. There are no suitable products in the market to fully meet these needs, which is both a challenge and a rare opportunity for insurance providers.

Mr. Fan Zhihua, general manager of medical and employee welfare business in Mercer China and general manager of Shanghai Mercer Insurance Broker Co., Ltd., in his keynote speech, said that employee welfare innovation can start from the following three latitudes: system, protection and management.

In terms of system innovation, flexible welfare is a hot topic at present. A large part of the flexible welfare system is composed of core and optional insurance benefits. Mercer also has a flexible welfare management system and an outsourcing flexible welfare management team to serve a large number of employees. In this process, Mercer discovered that insurance providers have many innovative aspects in many aspects, such as increasing the portability of optional benefits, continuing their risk and medical care when employees leave or retire, providing more flexible underwriting arrangements, or having employees with past medical history, and buying the necessary security at the right price; making more use of the online registration and enquiry system to provide employees with convenience to join the optional scheme.

In terms of ensuring innovation, if the insurance providers can focus on making up for the huge gap existing in the current staff protection, the market size of the employee benefits insurance is likely to double in the next few years.

At present, the security gap of group employee benefits includes:

First of all, employees are faced with insufficient protection when they lose their jobs, lose their jobs or retire.

Satisfying employees' demand for safety is the basic value of employees' welfare. However, according to China's current statutory welfare requirements, employees who lose their working capacity after illness are generally only entitled to two years of medical treatment. Especially for employees of foreign enterprises, they are faced with the failure to release labor contracts with enterprises, the source of economic income and sustained medical expenses. In the developed countries, long term disability insurance, which is very common in the developed countries, is also a deterrent to China because of its lack of products, high price and lack of universally recognized disability identification methods. Mr. Fan Zhihua said that after four years of unremitting efforts, Mercer has successfully arranged the benefits for many leading enterprises, and the number of legitimate suppliers in China has increased from one to several. Through the design and pricing of products suitable for China's national conditions, this kind of insurance is very promising. It is expected to take the lead in the rapid popularization of the high-end population.

Secondly, staff There is still a huge gap in the protection of medical expenses. The misunderstandings in the market operation of supplementary medical insurance need to be reversed.

At present, China's medical insurance and the ongoing reform of medical and health system are still based on the principle of wide coverage and low security. If employees want to have comprehensive medical care and high-quality medical services, such as special needs clinic, advanced ward, private clinic, better self medication and treatment service, medical insurance or supplementary medical insurance provided by enterprises will rarely cover related expenses. China's health statistics show that in the current health care expenditure in China, the personal expense still accounts for more than 50%.

Chen Tong, a doctor of IBM, analyzed that if a worker had a very serious disease, such as a malignant tumor, the medical cost would be quite huge. Once the cost of an employee's leukemia was about 700 thousand, it would not be acceptable to the general working class. At present, the average insured product in the market is only 100 thousand, which is only a drop in the bucket. The supplementary medical insurance provided by enterprises is often unable to reimburse the cost of self medication and self medications. From the perspective of enterprises and employees, they are very eager to have relevant products to make up for the lack of protection.

An insurance company participant pointed out that there is a huge misunderstanding in the current commercial supplementary medical insurance, and the simple supplement to the payment line (deductible) and the proportion of CO payment has been made. The result is that the risk control mechanism of medical insurance has been sold out by commercial insurance, and the overall medical expenses of medical insurance has expanded, which in turn has led to a rapid rise in the annual rate of compensation for commercial insurance. If we need to truly return to the nature of insurance, commercial supplementary medical insurance should reduce outpatient small claims, and let employees take more responsibility for their own medical treatment through responsibility sharing, and focus on compensation for catastrophic risks and serious illness. {page_break}

Third, health management is introduced into the plan design of medical insurance, so as to control the health risks and reduce the odds.

In foreign countries, more and more enterprises and health insurance companies take an active part in intervening the health risks of employees. For example, if employees quit smoking, take part in exercise or lose weight, they can get certain rewards or premium premiums, and reduce medical expenses through case management of chronic diseases and major diseases.

In terms of management innovation, areas of concern include employee health management, welfare cost management and supplier service management, in order to effectively improve employee satisfaction, workforce productivity and long-term sustainability of costs. Dr. Chen Tong gave an example. IBM introduced the third party external audit a few years ago. The insurance company's service has improved significantly, the employee complaint rate has been significantly reduced, the accuracy and timeliness of claims can reach international standards, and the satisfaction of enterprises and employees has also increased significantly.

Through the round table talks and group discussions, the conference conducted a full discussion and interaction on all key areas of group insurance: product design, underwriting pricing, fund arrangement, system data analysis and customer service, and hoped to jointly promote the development of the group insurance industry through the innovation and cooperation of the major group employees' welfare insurance providers.