himi+lr

Market intelligence

HealtH Insurance Market IntellIgence 2013 // Editor's CommEnt 3

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 markets 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 todays market. 2013 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

Intelligent businessMarket intelligence is your key to success

Health insurance 119 Farringdon road, London, eC1r 3Da fax: 020-7017 4194 tel: 020-7017 + extensions as below

editor David Sawers ext.4154 [email protected]

Deputy editor tessa Norman ext.7515 [email protected]

Sales director & associate publisherMatthew Brookes [email protected]

Deputy advertising managerannalisa russell De Clifford [email protected]

DesignerPaul Pancham [email protected]

Marketing & circulation managerSavinder Degun [email protected]

Member of the audit Bureau of circulation average net circulation for the period 1 July 2010 to 30 June 2011 10,622 ISSN: 1477-9781

Health Insurance is published by Informa Business Information a trading division of Informa uk limited

Annual subscription: 350/510/US$630

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Printer: ESP

www.hi-mag.com

ContEnts

reviews

// Individual PMI// group PMI// cash Plans// Occupational Health// group risk// Individual Income Protection// Individual critical Illness// group International PMI// Individual International PMI

Company Profiles

// aetna// allianz// aviva// cigna// cigna International// Denplan// globality// Healix// PruProtect// simplyhealth// Westfield Health

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individual Pmi // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // individual Pmi4 5

Individual Private Medical Insurance

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.

Bupas decision to stop selling individual private medical insurance through brokers was easily the low point of 2012. However, innovation from other providers and continued strains on the NHS suggest that the fall in subscriber numbers can still be turned around

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.

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.

900,0002001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

1,050,000

1,200,000

1,350,000

Year

Num

ber

of in

divi

dual

pai

d su

bscr

iber

s

1,22

9,00

0

1,20

6,00

0

1,18

1,00

0

1,16

2,00

0

1,11

9,00

0

1,10

0,00

0

1,10

9,00

0

1,12

8,00

0

1,08

6,00

0

1,03

6,00

0

993,00

0

iNDiviDuaL PMi SaLeS CoNtiNue to SLiDe

Source: Laing & Buisson

Did you know?

the number of individual paid policies decreased by 4.2% in 2011. 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

HI

GrouP Pmi // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // GrouP Pmi6 7

Group Private Medical Insurance

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 insurers 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.

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

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 2012. 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.

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 2010. 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.

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

Num

ber

of c

ompa

ny p

aid

subs

crib

ers

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Year

2,89

4,00

0

2,95

8,00

0

2,97

2,00

0

2,98

6,00

0

3,00

4,00

0

3,00

9,00

0

3,18

6,00

0

3,19

4,00

0

3,04

3,00

0

2,94

2,00

0

2,97

8,00

0

CoMPaNy PaiD PMi PoLiCieS returN to growtH iN 2011


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.

HI

Cash Plans // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // Cash Plans8 9

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

2012. 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

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-the-shelf excess benefits also came to the fore as providers looked to help cash-strapped employers manage their budgets

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 2012. 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 2009. 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.

YEar numbEr of PEoPlE CovErEd bY a Cash Plan ProPortion of PoPulation CovErEd

2001 5,920,000 10%

2002 5,336,000 9%

2003 4,925,000 8.3%

2004 5,049,000 8.4%

2005 4,903,000 8.1%

2006 4,836,000 8%

2007 4,779,000 7.8%

2008 4,495,000 7.3%

2009 4,113,000 6.7%

2010 3,939,000 6.3%

2011 3,778,000 6%


HI

Num

ber

of c

ontr

ibut

ors

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

2001

2,82

9,00

032

9,00

0

2002

387,00

02,74

0,00

0

2003

342,00

02,68

4,00

0

2004

233,00

02,74

5,00

0

2005

229,00

02,68

7,00

0

2006

232,00

02,66

8,00

0

2007

292,00

02,67

5,00

0

2008

389,00

02,48

4,00

0

2009

404,00

02,30

0,00

0

2010

449,00

02,18

4,00

0

2011

510,00

02,08

3,00

0

Individual Contributors Company Paid Contributors


grouP Market growS wHiLe iNDiviDuaL NuMBerS DeCLiNe

Fewer PeoPLe CovereD By CaSH PLaNS

oCCuPational hEalth // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // oCCuPational hEalth10 11

Occupational Health

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

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.

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.

ConditionEmPloYErs CitinG it as most Common CausE (%)

manual non-manual

stress 21 30

acute medical conditions (eg. stroke, cancer) 21 28

mental ill health (eg. clinical depression, anxiety) 16 14

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

MoSt CoMMoN CauSeS oF LoNg-terM aBSeNCe iN 2012

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.

0 1 2 3 4 5 6 7 8

2012 6.8

2011 7.7

2010 7.7

2009 7.4

2008 8.0

Number of days

Average number of days absence taken per employee per year

Source: CIPD Absence Management Survey 2012

HI

GrouP risk // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // GrouP risk12 13

Group risk

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 2011. this growth certainly helped buoy the industry's mood. according to swiss

re's Group Watch report, sales of all three products increased in 2011. For group income protection this represented the first growth in the market since

2008. 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

2012 may prove to be a defining year for the group risk market, thanks to pensions auto-enrolment and the Governments 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

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.

CovErnumbEr of livEs CovErEd

ChanGE2010 2011

death benefit 7.86million 8.20million +4.4%

income protection 1.79 million 1.84million +2.4%

Critical illness 305,678 326,045 +6.7%

Source: Swiss Re Group Watch 2012

NuMBer oF LiveS CovereD By grouP riSk SCHeMeS

0

2

4

6

8

10

In-f

orce

pre

miu

ms

2007 2008 2009 2010 2011

Income ProtectionDeath Benefit Critical Illness

9.11bn

6.41bn

37.23m 45.40m 48.39m 50.25m55.01m

6.49bn

5.68bn

5.17bn 5.18bn

9.45bn8.97bn 9.19bn

9.56bn

Source: Swiss Re Group Watch 2012

grouP riSk PreMiuMS, 2007-11

HI

individual inComE ProtECtion // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // individual inComE ProtECtion14 15

Individual Income Protection

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 2002.

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 short-

term 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

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 2012.

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.

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

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

toP Five iNCoMe ProteCtioN ProviDerS

0 10 20 30 40 50 60 70

Health

Education

Alcoholic drinks, tobacco & narcotics

Communication

Clothing & footwear

Household goods & services

Miscellaneous goods & services

Restuarants & hotels

Food & non-alcoholic drinks

Recreation & culture

Housing, fuel & power

Transport

per week

5.00

10.00

11.80

13.00

23.40

31.40

35.90

39.20

53.20

58.10

60.40

64.90

Averageweeklyhouseholdexpenditureonmaincommodities and services (2010)

Source: Office for National Statistics, Family Spending 2011

0

30000

60000

90000

120000

150000

Sal

es b

y Vo

lum

e

2007 2008 2009 2010 2011

111,780

126,815

117,815

110,743 110,472

New individual IP sales, 20072011 by volume


HI

individual CritiCal illnEss // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // individual CritiCal illnEss16 17

Individual Critical Illness

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 2012.

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.

a boost to consumer confidence in critical illness has seen sales bounce back at some providers, but the threat posed to the products sustainability by the eU gender directive, as well as the potential impact of the retail Distribution review, is causing sleepless nights for some

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 2007. 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.

ProvidEr 2011 salEs 2010 rankinG

lloyds banking Group 153,037 1

legal & General 95,813 2

friends life 81,125 -

aviva 59,636 4

bright Grey/scottish Provident 44,530 3


aGE in 2012 % of malEs ExPECtEd to survivE to 100 % of fEmalEs ExPECtEd to survivE to 100

0 32% 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)

toP Five CritiCaL iLLNeSS ProviDerS

a tHirD oF BaBieS BorN iN 2012 exPeCteD to Live to 100tH BirtHDay

2011

2010

2009

2008

2007

Sales by volume

0 100,000 200,000 300,000 400,000 500,000 600,000

536,143

511,045

530,214

534,561

551,382

New individual CI sales, 20072011 by volume


HI

GrouP intErnational Pmi // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // GrouP intErnational Pmi18 19

Group International PMI

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.

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

given the increasing demand for cover, competition between the insurers has

been rife in 2012.

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.

1) India 2) China 3) Russia 4) Brazil 5) Australia 6) USA 7) UAE

1) USA 2) Australia 3) Spain 4) France 5) New Zealand 6) Italy 7) Canada

Source: Aviva Relocation Trends Report 2012

MoSt PoPuLar New territorieS For ForeigN aSSigNMeNtS

Quality of package

Global strength

Expertise in iPMI market

Value for money

Known trusted brand

Comprehensive benefits

4%

24%

50%

41%

32%

46%

What factors do employers take into account when purchasing iPMI?

Source: Aviva Relocation Trends Report 2012

HI

HealtH Insurance Market IntellIgence 2013 // individual intErnational Pmi 21

www.allianzworldwidecare.comAllianz Worldwide Care Limited is regulated by the Central Bank of Ireland. Registered in Ireland: No. 310852. Registered Office: 18B Beckett Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland.

Because yourclients are ournumber onepriority too

ADV-HIMag-EN-1112 Ind_Layout 1 13/12/2012 08:49 Page 1

Individual International PMI

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

a global recession, political instability across different regions the individual international private medical insurance market should perhaps be one of the sectors most volatile. But, as the figures prove, it is in fact one of the sectors most vibrant

individual intErnational Pmi // HealtH Insurance Market IntellIgence 2013 HealtH Insurance Market IntellIgence 2013 // individual intErnational Pmi22 23

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

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

Bankings 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 2012.

as a result, the individual iPMI market will continue to be a vibrant one

and one which brokers will do well to tap into.

CITIES WITH BEST QUALITY OF LIVING CITIES WITH WORST QUALITY OF LIVING

10

1

3

10

9

5

7 46

1 Vienna

2 Zurich3 Auckland4 Munich

5 Vancouver6 Dsseldorf7 Frankfurt

8 Geneva 1 Khartoum, Sudan

2

23

4

NDjamena, Chad

3 Port-au-Prince, Haiti

4 Bangui, Central Africa Republic

5

5

Baghdad, Iraq9 Copenhagen

10 Bern/Sydney

8

1

Source: Mercer 2012 Quality of Living Survey

BeSt aND worSt CitieS For quaLity oF LiviNg For exPatS

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 18-34 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

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

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.

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.

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 worlds population.

Susan Landers, Head of Marketing and Client Management, Allianz Worldwide Care

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

BritoNS aBroaD

SPoNSor CoMMeNtary

HI

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At Aetna, we provide more than international medical protection. Were 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, were trusted to deliver seamless world class service thats with you for the long haul.

Recommend us with confidence.+44 870 442 2676 [email protected] www.aetnainternational.com

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 www.aetnainternational.com.

2012 Aetna Inc.

Quality health plans and benefitsHealthier livingFinancial well-beingIntelligent solutions

ComPanY ProfilE // HealtH Insurance Market IntellIgence 201326

london office serving Europe and russiaaetna international1st floor, 69 Park laneCroydonCr9 1bGunited kingdom

t // +44 (0)208 774 6200E // [email protected]

video - a history of aetna: http://youtu.be/ExlwtxhGowY

kEY ContaCt:nic browneuropean sales Director

E // [email protected] // +44 (0)7557 970290

www.aetnainternational.com

International Healthcare Plan for Individuals

group International Healthcare Plans for sMes

group International Healthcare Plans for large corporates

Wellness Programs

Health Management services

www.twitter.com/aetnaglobal www.facebook.com/aetnaInternational

www.aetnainternational.com

ProduCt ranGE

ContaCt dEtails

ProfilE

aetna International offers innovative global

healthcare cover, wellness and care management

solutions for multinational corporations and globally-

mobile 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. Were 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 assessmentcancer 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 were 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 worlds

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.

Exceptional care. Anywhere.

www.allianzworldwidecare.comAllianz Worldwide Care Limited is regulated by the Central Bank of Ireland. Registered in Ireland: No. 310852. Registered Office: 18B Beckett Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland.

Information on the most current rating is available at www.standardandpoors.comor from Standard & Poors at +44 (0)20 7176 3800. A rating is an opinion of an insurersfinancial strength; it is not a recommendation of an insurers products.

ADV-HIMag-EN-1112_Layout 1 07/12/2012 12:57 Page 4


individual and Corporate sales supportallianz worldwide Care18b beckett wayPark west business Campusnangor roaddublin 12ireland

t // +353 1 630 1301 E // [email protected]

kEY ContaCts:

andrew sealeregional general

Manager (uk, Italy &

Middle east)

t // +44 1732 866547 m // +44 7824 636889

E // [email protected]

duncan wrightBusiness Development

Manager (united

kingdom)

t // +44 1344 774178m // +44 7920 817026

E // [email protected]

www.allianzworldwidecare.com

International healthcare plans

regional healthcare plans

specialised plans for different industry sectors

short term healthcare plans

www.allianzworldwidecare.com

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ContaCt dEtails

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ProduCt dEtails

allianz Worldwide care specialises in providing international health insurance for employees, individuals and

their dependants. as an a+ rated (standard & Poors) wholly owned subsidiary of aa rated allianz se, the

company is able to draw on the resources and expertise of one of the worlds 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 cares client-

driven 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.

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

families. core Plans, which cover a wide range

of in-patient treatments, can be supplemented

by a choice of Out-patient, Maternity, Dental

and repatriation Plans. an even greater level of

flexibility and choice has been added with the introduction of a range of core Plan deductibles

in 2012. 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

available for large groups and sMes, on a medical

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.

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

intErGovErnmEntal and non-

GovErnmEntal orGanisations

allianz Worldwide care services can administer a

range of global insurance risks for IgOs and ngOs,

including life, medical, dental, temporary incapacity,

permanent disability and long term care.

marinE hEalthCarE Plan

these are healthcare plans designed specifically

around the needs of shipping companies and

their crew.

short tErm Plan

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.

The Client is at theHeart of Our Culture


Chilworth house, hampshireCorporate Park, templars wayEastleigh, hampshireso53 3rY

kEY ContaCts:

Group Pmi (50+ lives)health & wellness northt // 0845 300 1530E // [email protected]

health & wellness southt // 0845 300 4451E // [email protected]

individual Pmi/small Group Pmi (2 - 49 lives)healthcare bureaut // 0845 300 0649

individual international Pmi /Group international Pmi (2+ lives)international sales teamt // 0800 015 5255E // [email protected]

Calls to and from Aviva maybe monitored and

or recorded.

www.aviva.co.uk/healthcarezone

group/Individual PMI

group/Individual International PMI

Wellness solutions

absence solutions

www.aviva.co.uk/healthcarezone

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at aviva we understand that everyones healthcare needs are different and we continue to provide innovative solutions to meet these needs. Being the worlds sixth largest insurance company and the UKs 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.

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.

GrouP PrivatE mEdiCal insuranCEExtensive medical cover for companies of all sizes, offering modular and flexible benefits to suit your clients needs and budget.

individual PrivatE mEdiCal insuranCEHealthier 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 up-grade or reduce cover, allowing your clients to tailor

their benefits to their needs and the country in which

they are based.

wEllnEss solutionsa 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 2464270. 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 3253947. Registered Office 2 Rougier Street York YO90 1UU. Authorised and regulated by the Financial Services Authority.

Health insurance from AvivaA turbulent economy can mean that many clients

are looking to drive maximum value from their

employee benefits.

At Aviva we understand that this doesnt 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

Its good to feel valued. Especially in these tough times.

For financial adviser use only. Not approved for use with customers.

),:;.96


Company Hq address:1 knowe road, Greenock Pa15 4rJ

t // (Main): 01475 492222f // (Main): 01745 492326

kEY ContaCt:

will shawHead of corporate sales

t // 01475 788779E // [email protected]

www.cigna.co.uk

Healthcare plans

Dental plans

Occupational health services

Wellbeing solutions

www.linkedin.com/company/cigna-uk-healthcare-benefits

www.cigna.co.uk

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ContaCt dEtails

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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.

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.

CorPoratE dEntal PlansWe 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 sErviCEsWe 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 solutionsWe 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.

The leader in the globally mobile employee market

www.CignaGlobalHealth.com

BEST GROUPINTERNATIONAL PMI

PROVIDER

HI ad3.indd 1 26/10/2012 9:25:07


1 knowe roadGreenockscotlandPa15 4rJ

kEY ContaCts

mark Colemanregional sales Director, europe

t // +44 1342 310425m // +44 7900 570943E // [email protected]

simon ParkerInternational sales Manager, uk

m // +44 7903 560971E // [email protected]

mark massey International sales Manager, uk

m // +44 7939 883851 E // [email protected]

www.cignaglobalhealth.com

CorE mEdiCal Plans

Premierexpatplusnordicenergy (for Oil & gas industry)coverngO (for non-governmental

Organisations)

tailor-made solutions

additional ProGrammEs and non-mEdiCal sErviCEs

Dental & Vision travel life, accidental death & disabilityHealth and Wellbeing ProgrammesInternational employee assistance

Programme

continuation Option

www.twitter.com/cignaglobal

www.cignaglobalhealth.com

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CiGna, Your hEalthCarE Plans bEst PartnEr

thE Global lEadEr in hEalth sErviCEsCigna 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 hEalthIn a world of ever-increasing healthcare expenses, new ways and means are called for. At Cigna Global Health Benefits, we feel its 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

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