Purple cow employee benefits 2011 (the long version)


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Purple cow employee benefits 2011 (the long version)

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  • Purple cow employee benefits 2011 (the long version)

    1. 1. Purple Cow 2011 Employee Benefits that stand out in the field (the long version)
    2. 2. 1. H ISTORY The Purple Cow DNA
    3. 3. “ What is a Purple Cow ?” A unique product that stands out in the field. Gotuaco’s Purple Cow is a unique Healthcare product that stands out in the field of EMPLOYEE BENEFITS. Mo o ! Mo o ! 1
    4. 4. The Purple Cow Vision: financial security through employee benefits. Mo o ! Mo o ! 2 Purple Cow believes that financial security can be achieved through equal access to employee benefits.
    5. 5. The Purple Cow Mission: to protect employees from financial insecurity. Purple Cow provides you with many layers of protection, to stop you from losing money to medical emergencies. Mo o ! Mo o ! 3
    6. 6. The Purple Cow Core Value: take care of the hands that take care of you! Purple Cow believes in helping those who help you grow: if not thru more compensation , then thru more benefits. Mo o ! Mo o ! 4
    7. 7. 2. V ALUE P ROPOSITION The Purple Cow USP
    8. 8. <ul><li>Purple Cow gives you all of today’s major employee benefits in one single package, designed to provide ‘SULIT’ protection: </li></ul><ul><ul><ul><li>Group Life: P100,000 – P1,000,000 </li></ul></ul></ul><ul><ul><ul><li>Group Accident: P100,000 – P1,000,000 </li></ul></ul></ul><ul><ul><ul><li>Group Health: P20,000 – P200,000 </li></ul></ul></ul>More VALUE… 1 You give MORE employee benefits to all of your staff! Purple Cow 2011 Value Proposition
    9. 9. <ul><li>Purple Cow saves you up to 60% on the 2 most frequently selected Room & Board categories, when you combine them with our recommended Maximum Benefit Limits: </li></ul><ul><ul><ul><li>Ward 20T : P5,445 or P5,990 </li></ul></ul></ul><ul><ul><ul><li>Semi-Pvt 30T : P6,756 or P7,444 </li></ul></ul></ul>+ Less PRICE…* 2 You get LOWER rates for most of your staff: big saving$! Purple Cow 2011 Value Proposition *(insured HMO plans apply to SME only; self-insured TPA plans apply to Large Companies)
    10. 10. <ul><li>Purple Cow provides Good News to each level of your organization: </li></ul><ul><ul><ul><li>Employees: More financial security </li></ul></ul></ul><ul><ul><ul><li>HR: Better recruitment & retention </li></ul></ul></ul><ul><ul><ul><li>Finance: Greater financial viability </li></ul></ul></ul><ul><ul><ul><li>CEO: Major ‘pogi’ points </li></ul></ul></ul>= More HAPPY-NESS  3 You make EVERYONE happy – at the same time! Purple Cow 2011 Value Proposition
    11. 11. 3. EB P RIMER A whole new world of Employee Benefits
    12. 12. What are Employee Benefits (EB) ? EMPLOYEE BENEFITS are incentives given to employees as part of an overall HR strategy to recruit or retain them. EB can help you win the war for talent 1 Purple Cow 2011 EB Primer
    13. 13. What is the purpose of EB ? <ul><li>“ The purpose of EMPLOYEE BENEFITS is to increase the economic security of employees.” </li></ul><ul><ul><li>Wikipedia </li></ul></ul><ul><li> </li></ul>EB can help your employees become financially secure 2 Purple Cow 2011 EB Primer
    14. 14. <ul><ul><ul><ul><ul><li>Paid vacations, 75% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Health insurance, 61% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Paid sick leave, 59% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Disability insurance, 41% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Education reimbursement, 39% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Pension plan, 30% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Life insurance, 29% </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Dental insurance, 24% </li></ul></ul></ul></ul></ul>What are the most common EB ? All 4 insurance benefits are offered in Purple Cow! 3 - Small Business Poll on Compensating Employees (NFIB, US: 2003) Purple Cow 2011 EB Primer
    15. 15. What makes Insurance ‘sulit?’ <ul><li>LIFE INSURANCE provides you with instant cash in the event of death or total and permanent disability; (.25% of population between 18-65) </li></ul><ul><li>ACCIDENT INSURANCE provides you with instant cash in the event of accidental death or disability; (10% of inpatient & outpatient cases) </li></ul><ul><li>HEALTH INSURANCE (Medical / Dental HMO and/or INS) protects you from losing money in the event of sickness or accident, and even takes care of you (if HMO). (10% inpatient / 100% outpatient) </li></ul>All insurance can make or save you money in multiples 4 Purple Cow 2011 EB Primer
    16. 16. Why give Insurance to employees? <ul><li>Because you want to take care of the hands that take care of YOU (Employees are your key success factors ); </li></ul><ul><li>Because you want to stop them from losing money to medical emergencies – the most common cause of their financial insecurity – in the most cost-effective manner; </li></ul><ul><li>Because Employee life & health is not just corporate wealth, but also your Corporate Social Responsibility. </li></ul>Insurance is the most cost-effective EB money can buy 5 Purple Cow 2011 EB Primer
    17. 17. Why get the Purple Cow ? <ul><li>The Purple Cow is UNIQUE: it’s not just an HMO plan, but all the major life, PA & health plans rolled into one; </li></ul><ul><li>The Purple Cow is a good SELLING tool: it has all the features & benefits our Clients say they want or need; </li></ul><ul><li>The Purple Cow makes a great PROPOSITION: Employee Benefits = Financial Security; therefore, More Employee Benefits = More Financial Security. </li></ul>Purple Cow Employee Benefits = more financial security 6 Purple Cow 2011 EB Primer
    18. 18. <ul><li>GRA is the #1 Filipino, Independent, Family-owned, full-line insurance brokerage in the country: it has >P1B in premiums, and has been around the Top 5 since 1965; </li></ul><ul><li>GRA is your outsourced Employee Benefits expert, Insurance Broker, and risk management consultant; </li></ul><ul><li>GRA ’s Tom Gotuaco is the Originator of PURPLE COW: a unique Employee Benefits plan designed for SME.  </li></ul>Why get GRA as Broker? GRA has your SME interest at HEART 7 Purple Cow 2011 EB Primer
    19. 19. Why get AsianLife (ALGA) as Insurer? <ul><li>ALGA is the BIGGE$T NAME in group life and medical insurance today, and the only insurance co. in the market that offers an HMO plan; (ALGA clients include Globe, Ayala, Smart, PLDT) </li></ul><ul><li>ALGA offers the BE$T VALUE for your money: you can get all the major Employee Benefits rolled into one plan; </li></ul><ul><li>ALGA offers the LOWE$T PRICE, when you compare all insurance and HMO features and benefits. </li></ul>ALGA has the biggest name, best value & lowest price 8 Purple Cow 2011 EB Primer
    20. 20. 4. B ENEFITS Your SECRET to Financial Security
    21. 21. 1 Purple Cow 2011 Benefits ACCIDENT 2. PERSONAL ACCIDENT a. Accidental Death * Murder b. Disability * Assault HEALTH 3. MEDICAL HMO * 21,519 MD, 352 hospitals, 358 clinics 4. DENTAL HMO * 775 dentists, 645 clinics 5. Opt. Annual Physical Exam * 124 hospitals, 241 clinics, 31 mobile 6. Opt. Reimbursement Plan * Prescribed Medicines, Dental & Vision LIFE 1. LIFE * Total & Perm. Disability Income LIFE – ACCIDENT – HEALTH Benefits Overview
    22. 22. 2 Purple Cow 2011 Benefits 18. Dental = HMO (775 dentists / 645 clinics) 6. Assault = __% of 5x MBL 24. Same benefits for all Dependents 23. Same benefits for all Employees 22. Opt. Reimb. for Rx meds, dental & vision 21. Opt. APE = designated or mobile clinic 20. 1 permanent filling, 2 oral prophylaxes, etc. 19. Dental access to major malls in Metro-Manila 17. Special procedures = 30%/100% of MBL 16. Benefits on top of Philhealth 15. 100% Congenital Conditions coverage 14. 100% Pre-Existing Conditions coverage 11. MBL per disability, per year 10. Combined inpatient & outpatient limits 12. HMO patient for no-cash-out 13. Private patient for reimbursement (HMO rate) 9. HMO buffet of benefits: IP/OP/ER 8. Access to Big 5 Hospitals & Healthway 7. Medical = HMO (21,519 MD / 352 hospitals / 358 clinics) 5. Accidental disability = __% of 5x MBL 4. Murder = 5x MBL 3. Accidental death = 5x MBL 2. Total & perm. disability income = 5x MBL 1. Life = 5x MBL LIFE – ACCIDENT – HEALTH Benefits Summary
    23. 23. 3 Purple Cow 2011 Benefits 1. Suicide within the 1 st year of coverage 5x MBL 1. Life 1 Life benefits are payable on top of Personal Accident and Health benefits 5x MBL EXCLUSIONS +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 1 Life insurance = 5x MBL, for death by any cause (suicide covered after 1 year); 2 Total & Permanent Disability Income (TPDI) = 5x MBL, in lieu of the Life benefit, after 6 months of TPD, whether sick or hurt. Example : If MBL = 20T, Life or TPDI = 100,000; If MBL = 40T, Life or TPDI = 200,000; If MBL = 60T, Life or TPDI = 300,000; If MBL = 80T, Life or TPDI = 400,000; If MBL = 100T, Life or TPDI = 500,000. 2. Total & Perm Disability Income 2 ASIANLIFE 1. LIFE (worldwide)
    24. 24. 4 Purple Cow 2011 Benefits _% 5x MBL _% 5x MBL 4. Assault 4 5x MBL 2. Murder 2 +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 1 Accidental Death = 5x MBL, for death from any type of accident; 2 Murder = 5x MBL, in lieu of the Accidental Death benefit, for death not due to accident but murder (provoked or not). Example : If MBL = 20T, Accidental Death or Murder = 100,000; If MBL = 40T, Accidental Death or Murder = 200,000; If MBL = 60T, Accidental Death or Murder = 300,000; If MBL = 80T, Accidental Death or Murder = 400,000; If MBL = 100T, Accidental Death or Murder = 500,000. +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 3 Disability = __% of 5x MBL, according to a long schedule of disabilities; 4 Assault = __% of 5x MBL, in lieu of the Disability benefit, for disability not due to accident but assault (provoked or not). Example : If MBL = 20T, Disability or Assault = __% of 100,000; If MBL = 40T, Disability or Assault = __% of 200,000; If MBL = 60T, Disability or Assault = __% of 300,000; If MBL = 80T, Disability or Assault = __% of 400,000; If MBL = 100T, Disability or Assault = __% of 500,000. Personal Accident benefits are payable on top of Life and Health benefits 5x MBL 3. Disability 3 1. Accidental Death 1 ASIANLIFE 2a. PERSONAL ACCIDENT (worldwide)
    25. 25. 5 Purple Cow 2011 Benefits Losses refer to total and permanent loss of use or complete severance 50% 8. Arm between elbow and wrist 100% 6. Any other injury causing Total Perm. Disab. +Multiple losses from 1 accident will be limited to the highest loss, not to exceed 100%. If a member suffered the loss of 1 hand/foot/eye prior to coverage, the benefit for a subsequent loss of the same will be ½. 19. Leg below knee 10% 13. Index finger 15% 12. Thumb 35% 11. Four fingers 50% 10. Four fingers and thumb of one hand 70% 4% 16. Little finger 100% 3. One hand and one foot 50% 5% 25% 50% 60% 3% - 2% 5% 6% 50% 25. Hearing - both ears 50% 24. Sight of one eye 7. Arm at or above elbow 22. Big toe 20. One foot 17. Metacarpals 1 st /2 nd - 3 rd/ 4 th /5 th 23. Any toe other than big toe (each) 21. All toes on one foot 18. Leg at or above knee 15. Ring finger 14. Middle finger 25% 26. Hearing - one ear 50% 100% 100% 100% 100% 5. Injuries resulting in being perm. bedridden 2. Both hands or feet or sight of both eyes 1% 9. One hand 4. Either hand or foot and sight of one eye 1. Life (same as Accidental Death) SCHEDULE OF DISABILITIES 2b. PERSONAL ACCIDENT…
    26. 26. 6 Purple Cow 2011 Benefits 13. Serving in the armed forces of any country, or international authority, whether in war or peace 4. Insect bites 5. Earthquake, volcanic eruption or tidal wave 11. Provoked murder / assault or attempted threat [waived] 10. Participation in any brawl, or committing any crime or felony 3. Poison, gas or fumes voluntarily or involuntarily taken 8. Accident occurring while or because the Insured is under the influence of alcohol or any drug 6. Atomic explosion, nuclear fission, or radioactive gas 12. War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war 2. Disease, sickness, parasite, or disorder of the body/ mind 15. Hunting, motorcycling or pillion riding, mountaineering which necessitates the use of ropes or pitons, racing of any kind, other than on foot, ice or winter sports, water-ski jumping and tricks, yachting beyond 5 km. off a coastline, underwater activities involving the use of underwater apparatus, or using woodworking machinery driven by mechanical power other than portable tools, applied by hand and used solely for private purposes without reward 14. Entering, operating, servicing, ascending or descending from any aerial or submarine device or conveyance, except as provided under a passenger aviation provision 9. Suicide or any attempted threat while sane or insane, or any intentionally self-inflicted injury 7. Pregnancy, childbirth, miscarriage or any complications 1. Bodily or mental infirmity, hernia, ptomaine, bacterial or viral infection (except pyogenic infection occurring with and through an accidental cut or wound) EXCLUSIONS 2c. PERSONAL ACCIDENT…
    27. 27. 7 Purple Cow 2011 Benefits TERMS & CONDITIONS 8. Separate Dependent utilization to reduce cost 8. 100% Congenital Conditions coverage +Same rates for Dependents in 2011 +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 10. Special Procedures = 30%/100% of MBL 9. Benefits on top of Philhealth 7. 100% Pre-Existing Conditions coverage 10. 1 st year Virgin promo rate, if applicable 5. Minimum group size = 10 5. Private patient for reimbursement (HMO rate) Medical HMO benefits are covered on top of Life and Personal Accident benefits 9. Buy now, pay later 7. Pooled Employee utilization to spread risk 6. Minimum mode of payment = monthly 4. No individual applications required 3. No utilization report required 2. No franchising required 1. Instant rates, regardless of size 6. Access to Big 5 Hospitals and Healthway 4. HMO patient for no-cash-out 3. MBL per disability, per year 2. Combined inpatient & outpatient limits 1. HMO buffet of benefits: IP/OP/ER ASIANLIFE (21,519 MD / 352 hospitals / 358 clinics) 3a. MEDICAL HMO (nationwide)
    28. 28. 8 Purple Cow 2011 Benefits 18. Accidental injuries All Dreaded & Non-Dreaded PEC are covered 100% to MBL 19. Diseases of the immune system 18. Collagen / connective tissue diseases 17. Hypertension, coronary artery disease / myocardial ischemia, cerebrovascular accident and other chronic cardiac diseases 16. Malignancies of the blood and bone marrow 15. Chronic musculo-skeletal malignancies 14. Moderately to far advanced tuberculosis 13. Seizure disorders 12. Endocrine illnesses 11. Polyps, ulcers, liver cirrhosis and other chronic gastrointestinal diseases 10. Chronic conditions of the genitourinary system 9. Calculus cholecystitis / cholelithiasis and/or urolithiasis 8. Chronic neurologic conditions 7. Sinus condition requiring surgery 6. Pathological abnormalities of nasal septum and turbinate 5. Diseased tonsils requiring surgery, cataracts & other opthalmo-otolaryngologic conditions 4. Hemorrhoids and other chronic colonic and ano-rectal illnesses 3. Chronic gynecologic conditions 2. Benign cyst / tumor and malignant conditions 1. Asthma, pleural effusion or other chronic airway obstruction conditions PRE-EXISTING CONDITIONS (Non-Dreaded) 19. Second and third degree burns 20. Surgical procedures requiring application / use of prosthesis for immediate treatment 17. Illnesses / injuries necessitating the use of isolation room / ICU or other IC facilities 6. Chronic hepatobiliary diseases 21. PEC (except congenital ones) subject to the provision on ‘PEC’ in this Agreement [waived] 16. Pathological / accidental fractures 15. Chronic musculo-skeletal diseases 14. Chronic opthalmo-otolaryngologic diseases 13. Antibiotic / chemotherapy-resistant diseases / bactemia / septicemia 7. Neuro-surgical / neurological conditions 8. Chronic pulmonary diseases 12. Endocrine abnormalities 2. Benign / malignant new growths 1. Blood dyscrasias 3. Chronic cardiac / cardio-vascular diseases 5. Diseases of the immune system 9. Chronic genito-urinary diseases 10. Chronic gynecological conditions 11. Chronic gastrointestinal conditions 4. Collagen / connective diseases PRE-EXISTING CONDITIONS (Dreaded) 3b. MEDICAL HMO…
    29. 29. 9 Purple Cow 2011 Benefits SPECIAL PROCEDURES – 100% of MBL 4. Sclerotherapy 4. Laser therapy (excludes use for correcting vision) 14. C-reactive protein (rheumatic & complications) 13. Anti-nuclear anti-body (ANA) 10. Pulmonary perfusion scan 7. Other new modalities of treatment for conditions with established etiologies and used as alternatives to conventional or traditional procedures 11. Endoscopy 8. Thallium scintigraphy 5. Physical & speech therapy 12. Bone densitometry scan 16. Sleep therapy 9. CT scan / MRI 7. Nuclear technologies 6. Angiography 3. Radiation oncology / therapeutic radiology 2. Chemotherapy 15. Lupus cell exam 1. Dialysis 6. Cost of artificial limbs, joint prosthesis and heart valve prosthesis 3. Laparoscopic procedures For the above special procedures, the remaining 70% of your Maximum Benefit Limit per disability per year can be used for conventional treatment of the same condition (unlike other HMO’s which exclude conventional treatment after a special procedure, and limit special procedures to 1x/year). 5. Nuclear / radioactive isotope scans 2. Arthroscopic procedures 1. Lithotripsy SPECIAL PROCEDURES – 30% of MBL 3c. MEDICAL HMO…
    30. 30. 10 Purple Cow 2011 Benefits 17. Organ transplant-expense relating to organ donation of the donating party/parties 7. Dental-related cases except those that may be provided by the Dental Benefits and to the extent that are necessary for the repair or alleviation of damage caused solely by accidental injury sustained (and not caused by the plan member) 6. Non-recommended confinement, convalescent / domiciliary / custodial care, rest cures 18. Executive check-ups, unless explicitly provided in the master policy, and/or confinements purely for diagnostic purposes, as well as non-recommended confinements 8. Circumcision, cosmetic / aesthetic procedures except re-constructive surgery to treat functional defects due to a covered disease and/or accidental injury 22. Medical / surgical procedures and/or diagnostic tests that are experimental in nature and/or not generally accepted by the medical profession such as, but not limited to, iridology, chiropractic services, and acupuncture 12. Illnesses / injuries resulting from the plan member’s active participation in hazardous activities such as, but not limited to, bungee jumping, hang-gliding, scuba diving, mountain/wall climbing, and professional sports 19. Take-home medicines, unless optional ‘Reimbursement of Prescribed Medicines’ benefit is provided, and vaccines, except for first doses of either anti-venom, anti-rabies or anti-tetanus used for emergency treatment 2. Services rendered or supplies provided free of charge 14. Self-inflicted injuries including, but not limited to, any form of suicide attempt 1. Expenses that should be taken care of by any government programs such as Philhealth 3. Additional hospital charges and/or professional fees resulting from a plan member taking a room accommodation more than his R&B limit (excesses and/or incremental costs) 16. Acquisition of prosthetic appliances, artificial aids, durable equipment, surgically implanted devices and external prosthetic devices except those that are explicitly covered and enumerated in the ‘Special Procedures or New Modalities of Treatment’ provision of this agreement 5. Sterilization of either sex or reversal of such, artificial insemination, sex change, consultation/confinement regarding fertility 9. Psychiatric disorders, psychosomatic conditions, treatment for any mental or nervous disorders, illness / injury / condition / complication arising from the plan member’s excessive alcohol intake and/or use of regulated/prohibited drugs 20. Medico-legal fees including the cost of Medical Certificates that a plan member may require for any purpose it may serve him or her 10. Illnesses and/or injuries arising from the plan member’s participation in brawls, riots, commission of a crime, violation of ordinances, or the like 21. Congenital disease / deformity that is evident to the plan member at birth and/or can be clinically determined to be congenital [waived] 11. Illnesses / injuries resulting from conditions of war or sustained from combat-related activities 15. Sexually transmitted disease, AIDS, rehabilitative treatment for alcoholism and drug abuse 13. Illnesses / injuries attributable to the plan member’s own misconduct / gross negligence / immoral habits, and willful and unnecessary exposure to danger or health hazards 4. Maternity and maternity-related conditions and/or complications except those benefits that may be provided by the (optional) Maternity benefit EXCLUSIONS 3d. MEDICAL HMO…
    31. 31. 11 Purple Cow 2011 Benefits 1 +No reimbursements allowed (unless you get the optional Reimbursement Plan for Rx Medicines, Dental & Vision). +Discounts of up to 20% available on procedures not included in the dental HMO plan. +Dental card and booklet provided, as well as an orientation and an annual utilization report. 8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays Dental HMO benefits are covered on top of Medical HMO benefits EXCLUSIONS HEALTH PARTNERS (775 dentists / 645 clinics) 9. Treatment of pain/lesions/wounds/burns +By appointment only (unless emergency) 10. Emergency dental procedures if necessary 7. Simple adjustment of dentures 6. Gum treatment except for alveolectomy/gingivectomy 5. Temporary fillings when indicated 4. Simple tooth extractions if indicated 3. Unlimited consultations 2. (2) oral prophylaxes 1. Dental procedures not included in the dental HMO plan 1. (1) permanent filling 4. DENTAL HMO (nationwide)
    32. 32. 12 Purple Cow 2011 Benefits +You can add additional procedures to your Basic 5 APE: call GRA to help design, source, price, and schedule your APE anytime during your plan year. +Nationwide (241 clinics, 31 mobile) or Metro Manila-wide (114 clinics, 24 mobile) APE also available to companies with multiple locations, at roughly triple or double the cost respectively (reflecting their average cost of a Basic 5 APE). Otherwise, individual clinics are best, whether designated or mobile. EXCLUSIONS ASIANLIFE (241 designated clinics, 31 mobile clinics) APE benefits are covered on top of Medical HMO benefits +The Annual Physical Exam (APE) is a diagnostic tool, not a cure for sickness or accident. Results can serve as a baseline for referral to specialists who can authorize tests and/or prescribe further treatment. +By appointment only, 30 days in advance. +Pay as you go, so you don’t lose it if you don’t use it (don’t pay in advance, as payment is not transferable). Basic 5 Cost +/- P300 (for designated or mobile clinics). 5. Fecalysis 4. Urinalysis 3. CBC Basic 5 only 2. Chest X-Ray 1. APE procedures not included in the Basic 5 APE plan 1. Physical examination 5. Optional Annual Physical Exam
    33. 33. 13 Purple Cow 2011 Benefits 3. Non-prescription lenses and frames 2. Dental 2. Dental procedures not included in the dental HMO plan 3. Vision EXCLUSIONS ASIANLIFE Rx Medicines, Dental & Vision are covered on top of Medical & Dental HMO benefits +Reimbursement for Prescribed Medicines, Dental & Vision benefits within 15 working days of receipt of all documents. +Reimbursement for Prescribed Medicines covers treatment for any covered sickness or accident. +Reimbursement for Dental covers the same schedule of benefits as the dental HMO, but with your choice of dentist for full reimbursement up to your aggregate limit. +Reimbursement for Vision covers tests for visual acuity and prescription lenses. +The annual aggregate limit for all prescribed medicines, dental and vision benefits together = 1/10 th your MBL. 1. Vitamins, supplements and/or non-BFAD approved medicines, herbal medicines, and other medicines that have no legal BFAD-approved therapeutic claims 1. Prescribed Medicines 6. Optional Reimbursement Plan
    34. 34. 5. C OSTS Your INVESTMENT in Financial Security
    35. 35. 1 Purple Cow 2011 Costs VIRGIN RATES Cost Summary (APE & Reimb. Plan extra) 3,281 9,188 17,391 32,813 3,054 8,550 16,184 30,536 200T 2,672 7,483 14,164 26,724 160T 1,304 3,651 6,912 13,041 70T 618 1,729 3,273 6,176 30T 1,347 3,772 7,140 13,472 80T 680 1,903 3,601 6,795 40T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 1,573 4,403 8,335 15,726 80T 676 1,892 3,581 6,756 30T 1,683 4,711 8,918 16,826 100T 742 2,076 3,930 7,416 40T 1,844 5,164 9,775 18,444 120T 812 2,274 4,305 8,122 50T 120T JR SUITE (Top rank Large co 200+) 879 2,460 4,657 8,787 40T SML PVT (Mgr) 951 2,664 5,042 9,513 50T 1,032 2,890 5,471 10,323 60T 1,199 3,356 6,352 11,985 60T REG PVT (Top rank Small co 10-100) 545 1,525 2,886 5,445 20T WARD (R+F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
    36. 36. 2 Purple Cow 2011 Costs VIRGIN RATES (+ Reimbursement Plan) Cost Summary (APE extra) 4,202 11,765 22,270 42,018 3,692 10,337 19,567 36,918 200T 3,077 8,617 16,310 30,774 160T 1,561 4,372 8,275 15,614 70T 796 2,230 4,220 7,963 30T 1,625 4,549 8,611 16,247 80T 880 2,463 4,662 8,797 40T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 1,850 5,180 9,806 18,501 80T 854 2,392 4,528 8,543 30T 2,002 5,606 10,611 20,020 100T 942 2,637 4,992 9,418 40T 2,249 6,298 11,922 22,494 120T 1,031 2,887 5,464 10,309 50T 120T JR SUITE (Top rank Large co 200+) 1,079 3,021 5,718 10,789 40T SML PVT (Mgr) 1,170 3,276 6,201 11,700 50T 1,270 3,556 6,731 12,700 60T 1,436 4,021 7,612 14,362 60T REG PVT (Top rank Small co 10-100) 671 1,879 3,556 6,709 20T WARD (R+F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
    37. 37. 3 Purple Cow 2011 Costs NON-VIRGIN RATES JR SUITE (Top rank Large co 200+) SML PVT (Mgr) 3,662 10,253 19,408 36,618 200T 1,140 3,191 6,039 11,395 60T Cost Summary (APE & Reimb. Plan extra) 3,423 9,583 18,139 34,225 3,005 8,415 15,928 30,052 160T 120T 1,449 4,056 7,678 14,487 70T 677 1,896 3,588 6,770 30T 1,492 4,179 7,910 14,924 80T 743 2,079 3,936 7,426 40T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 1,754 4,911 9,296 17,540 80T 744 2,084 3,945 7,444 30T 1,869 5,233 9,906 18,691 100T 815 2,281 4,317 8,146 40T 2,044 5,724 10,835 20,444 120T 890 2,493 4,719 8,903 50T 974 2,727 5,161 9,738 40T 1,052 2,945 5,575 10,518 50T 1,332 3,731 7,062 13,324 60T REG PVT (Top rank Small co 10-100) 599 1,677 3,175 5,990 20T WARD (R+F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
    38. 38. 4 Purple Cow 2011 Costs NON-VIRGIN RATES (+ Reimbursement Plan) JR SUITE (Top rank Large co 200+) SML PVT (Mgr) 4,471 12,519 23,696 44,710 200T 1,348 3,776 7,147 13,484 60T Cost Summary (APE extra) 3,984 11,154 21,113 39,836 3,361 9,412 17,815 33,613 160T 120T 1,675 4,690 8,877 16,749 70T 834 2,335 4,421 8,341 30T 1,736 4,862 9,203 17,364 80T 919 2,572 4,869 9,186 40T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 1,998 5,594 10,589 19,980 80T 902 2,524 4,778 9,015 30T 2,150 6,020 11,394 21,499 100T 991 2,774 5,250 9,906 40T 2,400 6,721 12,722 24,004 120T 1,083 3,031 5,738 10,826 50T 1,150 3,219 6,094 11,498 40T 1,244 3,483 6,594 12,441 50T 1,541 4,316 8,169 15,414 60T REG PVT (Top rank Small co 10-100) 710 1,988 3,764 7,101 20T WARD (R+F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
    39. 39. 6. S UMMARY What’s in it for…‘Me’?
    40. 40. 1 <ul><li>What’s in it for… Employees ? </li></ul>Purple Cow 2011 Summary You have 2-3 networks for no-cash-out Medical, Dental, and opt. APE networks You can see your own doctor and get reimbursed the HMO doctor’s fee Choice of doctor as a Private Patient for insurance reimbursement at HMO rates You are covered for existing illnesses as well as for conditions since birth 100% Pre-Existing Conditions and 100% Congenital Conditions coverage You get full HMO & Philhealth benefits Benefits on top of Philhealth You can add the best perks of medical insurance to your Employee Benefits Optional reimbursement plan for prescribed medicines, dental & vision You can get treated anytime, anywhere 1 health card for every employee You won’t need any life insurance, PA insurance, or memorial plans Life (or Disability Income) and Personal Accident (or Murder/Assault) = 5x MBL You get to experience even more financial security from your EB plan A complete Employee Benefits package made up of insurance and HMO plans EE Benefits EE Features
    41. 41. 2 <ul><li>What’s in it for… HR ? </li></ul>Purple Cow 2011 Summary You won’t have to stress over renewals Group renewal rates on New Year’s You can outsource your EB work, etc. Retention of a top insurance broker You won’t need to create any forms; you can just use ours 3 simple forms to fill out (1 master-list, 1 endorsement, 1 letter of guarantee) You can adjust your R&B/MBL combos to suit your organizational structure Multiple Room & Board as well as Maximum Benefit Limits to choose from You can promote equal treatment 1 schedule of benefits for all employees You can use Purple Cow as a tool to recruit and/or retain staff You won’t need to wait for a quote or negotiate: one price fits all SME You get life & accident to complement health in a single, integrated package HR Benefits A chance to use Employee Benefits for recruitment & retention purposes Instant rates, without utilization reports, regardless of the size of your SME A complete Employee Benefits package instead of just an HMO plan HR Features
    42. 42. <ul><li>What’s in it for… Finance ? </li></ul>3 Purple Cow 2011 Summary Your Cowboy runs the Herd Your Broker acts as Gatekeeper You can budget your healthcare costs according to your cash flow 4 ways to pay to suit your budget: annually, semi, quarterly, and monthly You can correct your past mistakes, and not wait a whole year to do so A chance to switch to Purple Cow anytime, even in mid-year You can limit your financial liability 1 set of fixed costs for all employees You can lower your EB costs instantly You can pay for your employees only, and not subsidize dependents at all You can spread your risk by joining the Purple Cow pool You get the benefit of scale whenever you buy Purple Cow Employee Benefits FIN Benefits A chance to compare rates instantly Separation of Employee vs. Dependent utilization Membership in a bigger & bigger pool of SME, to maintain financial viability A complete Employee Benefits package for the price of an HMO plan FIN Features
    43. 43. <ul><li>What’s in it for the… CEO ? </li></ul>4 Purple Cow 2011 Summary very pogi CEO! CEO Benefits Happier Finance  Happier HR  Happier Employees  CEO Features
    44. 44. 7. C ONCLUSIONS Purple Cow = more Employee Benefits = more Financial Security
    45. 45. <ul><ul><li>Wage scales in the Philippines cannot provide adequate financial security, and must rely on extra support; </li></ul></ul><ul><ul><li>Employee Benefits can provide that extra support, as most “emergencies” are either life, accident or health-related. </li></ul></ul>The Facts: 1 Employee Benefits = Financial Security Purple Cow 2011 Conclusions
    46. 46. <ul><li>Purple Cow = MORE Employee Benefits; </li></ul><ul><li>MORE Employee Benefits = MORE Financial Security; </li></ul><ul><li>Purple Cow = MORE Financial Security. </li></ul>The Formula: 2 MORE Employee Benefits = MORE Financial Security Purple Cow 2011 Conclusions
    47. 47. <ul><li> </li></ul><ul><ul><ul><ul><ul><li>anxiety </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>depression </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>constant state of emergency </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>heavy debt </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>silent desperation </li></ul></ul></ul></ul></ul>The world without financial security: 3 LESS financial security = LESS productivity Purple Cow 2011 Conclusions
    48. 48. <ul><ul><ul><ul><ul><li>security </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>peace of mind </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>happiness </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>focus </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>productivity </li></ul></ul></ul></ul></ul>The world with financial security: 4 MORE financial security = MORE productivity Purple Cow 2011 Conclusions
    49. 49. <ul><ul><li>5% of salary (max!): </li></ul></ul><ul><ul><ul><li>that’s all you need for Purple Cow.  </li></ul></ul></ul>The cost of Purple Cow: 5 Why pay MORE if you can pay LESS ? Purple Cow 2011 Conclusions
    50. 50. <ul><li>Treat Purple Cow as: </li></ul><ul><ul><ul><li>an investment in financial security; </li></ul></ul></ul><ul><ul><ul><li>a Corporate Social Responsibility; </li></ul></ul></ul><ul><ul><ul><li>a deductible business expense. </li></ul></ul></ul>Our Recommendation: 6 Purple Cow makes good business AND social sense Purple Cow 2011 Conclusions
    51. 51. 8. W HY P URPLE C OW ? 31 COMPETITIVE ADVANTAGES Appendix:
    52. 52. 1 ‘Large’ Size Fits All SME : If you are an SME, with 10+ employees, you can join Purple Cow, be part of a bigger group, and be treated like a large company. (Unlike most HMO plans) You can enjoy the same toys as the Big Boys 1 #1: Purple Cow 2011 Why Purple Cow?
    53. 53. 2 Ways to Access Healthcare : you can see an HMO doctor for free, or your own doctor for reimbursement at the HMO rate – each time you avail. (Unlike most HMO plans) You can see your own doctor, cheaper 2 #2: Purple Cow 2011 Why Purple Cow?
    54. 54. 3 Major Emp. Benefits in 1 Package : you get Life, Personal Accident & Health (medical HMO, dental HMO, opt. APE, opt. Reimbursement) – all in 1 package. (Unlike most HMO plans) You get all the Employee Benefits you will ever need 3 #3: Purple Cow 2011 Why Purple Cow?
    55. 55. 4 Modes of Payment : you can choose from annual, semi-annual, quarterly, or monthly modes of payment to suit your cash flow or budget. (Unlike most HMO plans) You can pay Annual (60%), S.A. (5%), Qtr. (30%) or Mo. (5%) 4 #4: Purple Cow 2011 Why Purple Cow?
    56. 56. Up to 5 R&B x 3 MBL Choices each : you can choose up to 5 SME Room & Board categories x 3 Maximum Benefit Limits each to suit your wants, needs or budget. (Unlike most HMO plans) You can try new combinations to see if they are ‘sulit’ 5 #5: Purple Cow 2011 Why Purple Cow?
    57. 57. 100% Pre-Existing Conditions: you get 100% Pre-Existing Conditions coverage, up to MBL, for cancer, hypertension, diabetes, asthma, etc. (Unlike most HMO plans) You are covered for dreaded & non-dreaded diseases 6 #6: Purple Cow 2011 Why Purple Cow?
    58. 58. 100% Congenital Conditions : you get 100% Congenital Conditions coverage, up to MBL, for mitral valve pro-lapse, rheumatic heart disease, hernia, etc. (Unlike most HMO plans) You are covered for medical conditions since birth 7 #7: Purple Cow 2011 Why Purple Cow?
    59. 59. 8 #8: Purple Cow 2011 Why Purple Cow? Benefits on Top of Philhealth : your HMO limits are on top of Philhealth , so you won’t need as much MBL. Your Benefits = Philhealth + MBL, not just MBL. (Unlike most HMO plans) You get full HMO benefits on top of Philhealth benefits
    60. 60. #9: Pooled Employee Utilization : your Employee utilization is pooled together with the employee utilization of all other groups, to spread your risk. (Unlike most HMO plans) Stick with the Herd: there’s safety in numbers  9 Purple Cow 2011 Why Purple Cow?
    61. 61. #10: Separate Dependent Utilization : your Employee and Dependent utilization are separate, so you won’t have to worry about Dependents affecting your rates. (Unlike most HMO plans) You can provide voluntary Dependent coverage w/o fear 10 Purple Cow 2011 Why Purple Cow?
    62. 62. Life Insurance : your Life insurance benefit = 5x MBL. Twist: if you don’t die, but you’re totally and permanently disabled, TPDI = 5x MBL. (Unlike all HMO plans) 11 You can get 1 year’s worth of income replacement #11: Purple Cow 2011 Why Purple Cow?
    63. 63. Accidental Death Insurance (PA) : your Accidental Death benefit = 5x MBL. Twist: if you don’t die by accident, but by Murder, you get 5x MBL. (Unlike all HMO plans) You can get another year’s worth of income replacement 12 #12: Purple Cow 2011 Why Purple Cow?
    64. 64. #13: Disability Insurance (PA) : your Disability benefit = __% of 5x MBL. Twist: if you don’t get disabled by accident, but by Assault, you get __% of 5x MBL. (Unlike all HMO plans) You can get up to 1 year’s worth of income replacement 13 Purple Cow 2011 Why Purple Cow?
    65. 65. #14: Medical HMO : you can get inpatient, outpatient and emergency treatment from 21,519 doctors, 352 hospitals, and 358 clinics nationwide. (unlike some HMO plans) You can go to MMC/ SLMC/ CSMC/ AHMC/ TMC/ Healthway 14 Purple Cow 2011 Why Purple Cow?
    66. 66. #15: Dental HMO : you can get 1 permanent filling, 2 oral prophylaxes, and 8 other benefits from 775 dentists and 645 clinics nationwide. (Unlike most HMO plans) You can go to SM/ Market 2 / Festival/ Robinson’s/ Shangrila/ ATC 15 Purple Cow 2011 Why Purple Cow?
    67. 67. #16: Optional Annual Physical Exam : you can customize your APE and request a designated or mobile clinic from GRA; or you can get a Basic 5 APE nationwide. (Unlike most HMO plans) You can decide if you want an APE, and if so, what kind 16 Purple Cow 2011 Why Purple Cow?
    68. 68. #17: Optional Reimbursement Plan : you can get reimbursed up to an aggregate limit of 1/10 th your MBL for Prescribed Medicines, Dental & Vision. (Unlike all HMO plans) You can get the best perks of medical insurance as well 17 Purple Cow 2011 Why Purple Cow?
    69. 69. Same Benefits for Dependents : Dependents can get the same benefits, terms and conditions as Employees (as well as the same costs in 2011). (Unlike most, if not all HMO plans) Your Dependents are treated like Employees 18 #18: Purple Cow 2011 Why Purple Cow?
    70. 70. #19: The Price is Right : Purple Cow rates are lowest where they matter the most: in the 2 lowest categories, where you enroll up to 99% of your staff. (Unlike most HMO plans) You get the greater good for the greater number 19 Purple Cow 2011 Why Purple Cow?
    71. 71. #20: The Design is Right : Purple Cow provides medical necessity, not luxury. Savings from excess R&B/MBL are reallocated to benefits of greater use. (Unlike most HMO plans) R&B/MBL combinations are good up to 99% of the time 20 Purple Cow 2011 Why Purple Cow?
    72. 72. #21: The Perfect Insurer : you get the biggest name in group life and medical, and the only insurance company in the PH today that offers an HMO-type plan. (Unlike all insurance companies) You can get the best of both worlds from ALGA 21 Purple Cow 2011 Why Purple Cow?
    73. 73. #22: The Perfect Broker : you get to retain the services of the #1 Filipino, family-owned, full-line insurance brokerage in the PH today. (Unlike most brokers) You can outsource EB and other insurance lines to GRA 22 Purple Cow 2011 Why Purple Cow?
    74. 74. #23: Buy Now, Pay Later : you can sign up today, get covered right away, and pay later when GRA bills you (during your EB orientation, at the earliest). (Unlike some HMO plans) Sign up today and take advantage of the float tomorrow 23 Purple Cow 2011 Why Purple Cow?
    75. 75. #24: <ul><li>Easy Sign Up : </li></ul><ul><ul><li> 1) Email the completed Masterlist; </li></ul></ul><ul><ul><ul><li>2) Fax the signed Endorsement; </li></ul></ul></ul><ul><ul><ul><li>3) Fax the signed Letter of Guarantee. </li></ul></ul></ul><ul><ul><li>(Unlike some HMO plans) </li></ul></ul>You can download all 3 forms from our website 24 Purple Cow 2011 Why Purple Cow?
    76. 76. #25: Utilization Reports : you get a detailed, user-friendly report that gives you insights into your own group’s utilization patterns, once a year. (Unlike some HMO plans) You will learn even more about your own company  25 Purple Cow 2011 Why Purple Cow?
    77. 77. #26: Group Renewal Rates : you get a group renewal rate increase or decrease at the start of every year, so you can plan accordingly. (Unlike most HMO plans) Renewals will become as smooth as clockwork 26 Purple Cow 2011 Why Purple Cow?
    78. 78. #27: Group Experience Refund : you get to share in the excess, if any, of the group’s favorable utilization experience: ((premiums x 60% ) – (YTD + IBNR claims)) x 50% = Exp. Refund (Unlike most HMO plans) Good experience refund formulas keep Suppliers honest 27 Purple Cow 2011 Why Purple Cow?
    79. 79. #28: <ul><li>Everyone Wins : </li></ul><ul><li>Your Company wins; </li></ul><ul><ul><ul><ul><ul><li> Purple Cow’s clients win; </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li> The SME Nation wins. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li> </li></ul></ul></ul></ul><ul><ul><ul><ul><li>(Unlike most HMO plans) </li></ul></ul></ul></ul>Everybody loves a Winner  28 Purple Cow 2011 Why Purple Cow?
    80. 80. #29: 29 Purple Cow 2011 Why Purple Cow? Non-Employees can Win, too : you can even cover agents, associations, and multi-purpose cooperatives, as long as certain selection & payment criteria are met. (Unlike most HMO plans) You can get Employee Benefits for Non-Employees
    81. 81. #30: Virgins can Win Even More : you get a 1 st year Virgin promo rate if your company has never had group insurance or HMO before. (Unlike all HMO plans) You can renew at the prevailing Non-Virgin rates in 2012 30 Purple Cow 2011 Why Purple Cow?
    82. 82. #31: Large Companies can do a TPA : if you become a Large Company, you can self-insure as a stand-alone account, using the same Purple Cow schedule of benefits. (Unlike all TPA plans) You can switch from insured to self-insured plans easily 31 Purple Cow 2011 Why Purple Cow?
    83. 83. For more information, please visit www.purplecow.ph , … or contact Tom Gotuaco via email or mobile phone.
    84. 84. Renowned author Seth Godin approved my use of the term PURPLE COW (2/4/09): “ It’s fine with me, just please make it clear that I haven’t endorsed your service .” Disclaimer