Sandi Saksena discusses some points that SMEs need to consider before opting for a health insurance cover for their businesses.With healthcare costs rising with each passing day, it is important for everyone to have a health cover, regardless of the size of their company. SMEs run on slim margins and do not have the cushioning provided by liquidity that larger companies enjoy. A host of options, levels of cover conditions (country) are available, which determine what is right for you and your budget. However, the only factor not in control is the impact your health conditions have on the cover you can get and the cost involved.
Now, insurance, like any other business, is complicated to the uninitiated and choosing the right policy means that you need to thoroughly understand the nuances of the various policies on offer. According to personal experiences, SMEs in the UAE choose medical products on the basis of affordability, convenience, reliability, simplicity to list a few.
I get these queries all the time:
Budget- I need to buy health insurance for my employees, but it needs to fit in company budget.
Premium stability – I may have cash flow issues, and so I must have stability in my insurance premium, which would help me in forecasting its settlement year-after- year.
Comprehensive quality product – My employees are my assets. I want to ensure their loyalty by offering them and their family health insurance to provide them with ‘peace of mind.
Convenience, service – I am too busy to look for and compare all insurance products every year. I just want to choose and keep the right one. I own and manage my company. I have no time to spend dealing with insurance issues.
Why can’t you get rid of jargon, three letter acronyms and legalese, so I can just understand what is possible or not.
What to watch out for?
Before you opt for a policy, there are several points you need to get clarity on. For example, in group medical, the business owner must know if there are any waiting periods, or maternity, dental, eyes covered, whether pre-existing diseases are covered from day one, and what are the exclusions – regions covered, nature of work (hazardous occupations)
Examine you options
Choice of categories – Choose a more comprehensive plan for yourself and the senior management and lower plans for employees. For instance, regional plans including GCC, MENA andthe Asian sub-continent, or worldwide coverage plans excluding USA, global coverage plan (including USA), annual limits per person per year.
Each policy has its own finer points and they should be aligned with your business needs. The insurance industry uses precise definitions of the limited conditions covered by a policy in order to manage the cost. The legal and medical language used often leaves consumers unsure about what was covered and as a consequence, consumers have sometimes found that their particular sickness was not covered by their specific policy.
My recommendation is to discuss your requirements/ queries with a broker, let them do the ‘homework’ and come back to you with all the options/answers. If the premiums and conditions are not reasonable/acceptable, speak with the underwriters of the provider to explain the finer nuances. Don’t reject or accept blindly. While price is the determining factor in most cases, one should look at a good quality company with the following factors:
- International standing, ranking in the list of the biggest Fortune 500 companies. The size of the company brings stability along with it.
- Extensive hospital and clinic network in the world, and more importantly in the GCC. This means that their medical cards are accepted worldwide, even the most basic health insurance plan should offer UAE as well as one home country, in its area of coverage and it should also have global coverage for emergencies.
- Direct Billing’, ‘pre-existing conditions’, and ‘chronic conditions’
- Personal accident cover and well-being cover.
A note of caution:
Medical underwriting among others is one of the basic deciding factors for premiums. It’s usually believed that hypertension and diabetes are common and a part of modern day stressful lives. People feel that they are being treated unfairly by medical insurance provides when their premiums are higher than the healthy normal public or if cover is refused for ‘pre existing conditions’.
Hypertension is considered one of the contemporary diseases as a result of the changes in the lifestyles. It is called the ‘silent deadly illness’, as it is not accompanied by any symptoms at the beginning.
Factors increasing the chances of hypertension are:
- Unhealthy lifestyle such as eating fat – rich foods and excessive consumption of table salt
- Obesity and lack of activity
- Alcohol drinking
- Excessive consumption of beverages such as coffee and tea
- Using some drugs such as contraceptive dugs and non-steroidal anti-inflammatory drugs.
- Repeated exposure to psychological pressures and emotions
These are cases of high blood pressure resulting from specific diseases such as: kidney, liver, or heart diseases, disturbances of the glands or the increase of minerals in the body.
New figures from International Diabetes Federation (November 14 2012) suggest that 18.9% of the UAE population are living with diabetes. The diabetes rate in our country is the second highest in the world. So, if you are part of this fast growing segment of the population you will be rated, accept it and get covered.