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Purple cow eb for sme 2012 (sales presentation)
1. It's more FUN in Purple Cow! Sales Presentation 2012 102pg
2. Disclaimer 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 .”
4. Gotuaco’s Purple Cow is a unique healthcare product that stands out in the field of EMPLOYEE BENEFITS. “ What is a Purple Cow ?” A unique product that stands out in the field. 1 “ Mo o !”
13. 3. M ACRO / M ICRO The Purple Cow BIG & SMALL PICTURE 2012
14. The P6T Philippine Economy FI R BS = Financial Services , Real Estate & Business Services (in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed. 1 Purple Cow 2012 Macro & Micro
15. The P600B Financial Services Sector Insurance includes Medical INS. ; Pre-Need Health = HMO (in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed. 2 Purple Cow 2012 Macro & Micro
16. The Insurance vs. HMO Industries Insurance Industry (123 Co./P99B) > HMO Industry (15 Co./P12B) HMO Figures: AHMOPI , 2009 Life & Non-Life Insurance Figures: Insurance Commission , 2009 (in Billions of Pesos) 3 Purple Cow 2012 Macro & Micro
17. The Medical INS. vs. HMO Markets HMO Figures: Delphi , 2009 Medical Insurance Figures: Delphi , 2009 Medical INS. market (5 of 123 Co./P2B) < HMO market (15 Co./P12B) (in Billions of Pesos) 4 Purple Cow 2012 Macro & Micro
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20. The Healthcare ‘Red Ocean’ The top 1% of all enterprises receive all the Healthcare attention… Figures : NSO 2001; DTI 2004 GROUP HEALTH GROUP HEALTH 7 Purple Cow 2012 Macro & Micro LG 2,958 (.4%) MEDIUM 2,923 (.4%) SMALL 61,762 (7.6%) MICRO 743,949 firms (91.6%) LG 100M200+ee MEDIUM P15-100M; 100-199 ee SMALL P3-15M; 10-99 ee MICRO <P3M assets; 1 – 9 ee
21. The Healthcare ‘Blue Ocean’ … while 99% of all enterprises remain un-served or under-served! Figures: NSO 2001; DTI 2004 GROUP HEALTH INDIVIDUAL HEALTH 8 Purple Cow 2012 Macro & Micro LG 2,958 (.4%) MEDIUM 2,923 (.4%) SMALL 61,762 (7.6%) MICRO 743,949 firms (91.6%) LG 100M200+ee MEDIUM P15-100M; 100-199 ee SMALL P3-15M; 10-99 ee MICRO <P3M assets; 1 – 9 ee
22. The Healthcare ‘Purple Ocean’ GOAL: to protect employers & employees from financial insecurity Figures: NSO 2001; DTI 2004 PURPLE COW EB 4 S M E 9 Purple Cow 2012 Macro & Micro LG 2,958 (.4%) MEDIUM 2,923 (.4%) SMALL 61,762 (7.6%) MICRO 743,949 firms (91.6%) LG 100M200+ee MEDIUM P15-100M; 100-199 ee SMALL P3-15M; 10-99 ee MICRO <P3M assets; 1 – 9 ee
23. 4. EB P RIMER A Whole New WORLD of Employee Benefits 2012
24. 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 2012 EB Primer
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32. 5. B ENEFITS Your SECRET to Financial Security 2012
33. 1 Purple Cow 2012 Benefits ACCIDENT 2. ACCIDENT INSURANCE a. Accidental Death * Murder b. Accidental Disablement * Assault HEALTH 3. MEDICAL HMO * 19,401 MD, 382 hospitals, 426 clinics 4. Opt. DENTAL HMO * Basic 10: 790 dentists, 659 clinics 5. Opt. Annual Physical Exam * Basic 5: mobile or clinic 6. Health & Wellness Program * up to 2x/yr; tailored to utilization report LIFE 1. LIFE INSURANCE * Terminal Illness Rider * Total & Perm Disability Income LIFE – ACCIDENT – HEALTH Benefits Overview
34. 2 Purple Cow 2012 Benefits 18. Pooled Employee utilization 6. Accidental Disablement = __% of 5x MBL 13. Access to Big 5 Hospitals & Healthway 1. Life = 5x MBL 23. Same benefits for Dependents 11. HMO patient for no-cash-out 24. Interactive access through Social Media 12. Private patient for reimbursement (HMO rate) 14. 100% Pre-Existing Conditions coverage 2. Terminal Illness = up to 50% of 5x MBL 20. Opt. Dental = HMO buffet of benefits 8. Medical = HMO buffet of benefits 22. Health & Wellness Program (up to 2x/yr) 21. Opt. APE = choice of mobile or clinic 19. Separate Dependent utilization 17. Benefits on top of Philhealth 16. 100% Special Procedures coverage 15. 100% Congenital Conditions coverage 10. Max. Benefit Limits per disability per year 9. Combined inpatient & outpatient limits 7. Assault = __% of 5x MBL 5. Murder = 5x MBL 4. Accidental Death = 5x MBL 3. Total & Perm. Disability Income = 5x MBL LIFE – ACCIDENT – HEALTH Benefits Summary
35. 3 Purple Cow 2012 Benefits 5x MBL 1. Suicide within the 1 st year of coverage 3. Total & Perm Disability Income Example : If MBL = 20T, Life or TPDI = 100,000; TIR = 50,000; If MBL = 40T, Life or TPDI = 200,000; TIR = 100,000; If MBL = 60T, Life or TPDI = 300,000; TIR = 150,000; If MBL = 80T, Life or TPDI = 400,000; TIR = 200,000; If MBL = 100T, Life or TPDI = 500,000; TIR = 250,000. 5x MBL 1. Life Life benefits are payable on top of Accident & Medical HMO benefits 2.5x MBL EXCLUSIONS +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo 1. Life benefit = 5x MBL, for death by any cause; 2. TIR benefit = up to 50% of 5x MBL, as an advance on the Life benefit, if terminally ill (< 12mos. to live); 50% balance upon death; 3. TPDI Benefit = 5x MBL, in lieu of the Life benefit, whether sickness or accident. 2. Terminal Illness Rider (up to 50%) ASIANLIFE 1. Life Insurance (worldwide)
36. 4 Purple Cow 2012 Benefits _% 5x MBL _% 5x MBL 4. Assault 5x MBL 2. Murder +Principals 18yo-65yo; Dependents 30dy-22yo / 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-22yo / 18yo-65yo 3. Disablement = __% of 5x MBL, according to a long schedule of indemnities; 4. Assault = __% of 5x MBL, in lieu of the Disablement 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. Accident benefits are payable on top of Life & Medical HMO benefits 5x MBL 3. Disablement 1. Accidental Death ASIANLIFE 2a. Accident Insurance (worldwide)
37. 5 Purple Cow 2012 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) LONG SCHEDULE OF INDEMNITIES 2b. Accident Insurance…
38. 6 Purple Cow 2012 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. Accident Insurance…
39. 7 Purple Cow 2012 Benefits 9. Buy now, pay later 9. 100% Special Procedures coverage TERMS & CONDITIONS 8. Split Dependent utilization to reduce cost 8. 100% Congenital Conditions coverage +Same rates for Dependents in 2012 +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo 10. Benefits on top of Philhealth 7. 100% Pre-Existing Conditions coverage 5. Minimum group size = 10 5. Private patient for reimbursement (HMO rate) Medical HMO benefits are covered on top of Life & Accident benefits 10. 1 st year Virgin promo rate, if applicable 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 & Healthway 4. HMO patient for no-cash-out 3. Max. Benefit Limits per disability per year 2. Combined inpatient & outpatient limits 1. Traditional HMO buffet of benefits ASIANLIFE (19,401 doctors, 382 hospitals, 426 clinics) 3a. Medical HMO (nationwide)
40. 8 Purple Cow 2012 Benefits 18. Accidental injuries Dreaded & Non-Dreaded PEC are covered 100% up 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…
41. Purple Cow 2012 Benefits 9 10. Radiation oncology / therapeutic radiology 9. Chemotherapy Special Procedures or New Modalities of Treatment are covered 100% up to MBL 14. Nuclear technologies 4. Laser therapy (excludes use for correcting vision) 23. Sleep therapy 20. Anti-nuclear anti-body (ANA) 7. Other new modalities of treatment for conditions with established etiologies and used as alternatives to conventional or traditional procedures 21. C-reactive protein (rheumatic & complications) 18. Endoscopy 15. Thallium scintigraphy 22. Lupus cell exam 19. Bone densitometry scan 17. Pulmonary perfusion scan 16. CT scan / MRI 13. Angiography 12. Physical & speech therapy 11. Sclerotherapy 6. Cost of artificial limbs, joint prosthesis and heart valve prosthesis 3. Laparoscopic procedures 8. Dialysis 5. Nuclear / radioactive isotope scans 2. Arthroscopic procedures 1. Lithotripsy SPECIAL PROCEDURES or NEW MODALITIES OF TREATMENT 3c. Medical HMO…
42. 10 Purple Cow 2012 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…
43. 11 Purple Cow 2012 Benefits 7. Simple adjustment of dentures 2. Reimbursements for seeing your own dentist 2. (2) oral prophylaxes 1. Dental procedures not included in the list of 10 benefits 1. (1) permanent filling 4. Simple tooth extractions if indicated 5. Temporary fillings when indicated 6. Gum treatment except for alveolectomy/gingivectomy 8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays 9. Treatment of pain/lesions/wounds/burns 1 +Access to HP Dental-accredited clinics in SM, Market 2 , Festival, Robinson’s, Shangrila, and ATC malls. +Dental card and booklet provided, as well as an orientation and an annual utilization report. +Discounts available on procedures not included in the dental HMO plan. Optional Nationwide Dental HMO: +/- P300 Optional Dental HMO benefits are covered on top of Medical HMO benefits EXCLUSIONS HP DENTAL (790 dentists, 659 clinics) +Appointment preferred (unless emergency) 10. Emergency dental procedures if necessary 3. Unlimited consultations 4. Optional Dental HMO (nationwide)
44. 12 Purple Cow 2012 Benefits 2. Chest X-Ray 3. CBC Basic 5 4. Urinalysis 5. Fecalysis Optional APE: +/- P400 or P500 (for mobile or clinic APE) EXCLUSIONS VARIOUS (mobile or clinic) Optional 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). +Call Lala Perido at GRA to help design, source, price & schedule your APE during the year [888-0001 x835]. 1. APE procedures not included in the Basic 5 APE plan 1. Physical examination 5. Optional Annual Physical Exam
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47. Purple Cow 2012 Costs: New VIRGIN Standard: Life INS / Accident INS / Medical HMO Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500) 1 Cost Summary 3,427 9,594 18,160 34,264 3,033 8,492 16,074 30,327 200T 2,694 7,542 14,275 26,933 150T 1,389 3,889 7,361 13,888 80T 545 1,524 2,885 5,442 20T 1,519 4,252 8,049 15,185 100T 621 1,738 3,290 6,206 30T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 1,628 4,558 8,627 16,277 80T 683 1,910 3,615 6,821 30T 1,743 4,879 9,234 17,422 100T 751 2,103 3,981 7,510 40T 1,912 5,353 10,132 19,116 120T 825 2,310 4,372 8,248 50T 100T JR SUITE (Top rank Large co > 200) 973 2,723 5,153 9,722 50T SML PVT (Top rank Small co 10-50) 1,058 2,960 5,603 10,570 60T 1,140 3,191 6,039 11,394 70T 1,234 3,454 6,537 12,332 60T REG PVT (Top rank Small co 50-100) 500 1,398 2,646 4,991 10T WARD (R&F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
48. 3 Purple Cow 2012 Costs: New NON-VIRGIN Standard: Life INS / Accident INS / Medical HMO Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500) Cost Summary 4,365 12,221 23,132 43,644 3,881 10,866 20,568 38,807 200T 3,469 9,713 18,386 34,689 150T 1,762 4,932 9,336 17,613 80T 691 1,933 3,659 6,903 20T 1,919 5,371 10,167 19,181 100T 784 2,194 4,153 7,834 30T LRG PVT (Top rank Med co 100-200) SEMI PVT (Spvr) 2,077 5,815 11,007 20,767 80T 865 2,421 4,583 8,646 30T 2,214 6,198 11,731 22,134 100T 949 2,656 5,026 9,483 40T 2,423 6,784 12,840 24,226 120T 1,039 2,908 5,504 10,385 50T 100T JR SUITE (Top rank Large co > 200) 1,234 3,453 6,536 12,332 50T SML PVT (Top rank Small co 10-50) 1,338 3,746 7,091 13,378 60T 1,440 4,031 7,629 14,394 70T 1,571 4,398 8,324 15,705 60T REG PVT (Top rank Small co 50-100) 638 1,786 3,381 6,378 10T WARD (R&F) MO QTR SEMI ANN MBL R&B MO QTR SEMI ANN MBL R&B
50. 1 ‘Large’ Size Fits All SME : If you are an SME, with 10 or more regular employees (per DTI), you can join the herd, and be treated just like a large Company. (Unlike most HMO plans) You can enjoy the same toys as the Big Boys 1 Why Purple Cow? Purple Cow 2012 Competitive Advantages
51. 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 Why Purple Cow? Purple Cow 2012 Competitive Advantages
52. 3 Major Employee Benefits in 1 Plan: You get Group Life, Accident & Health (medical HMO, optional dental HMO, optional APE, and Wellness) – all in 1 plan. (Unlike most HMO plans) You get all the Employee Benefits you will ever need 3 Why Purple Cow? Purple Cow 2012 Competitive Advantages
53. 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 Why Purple Cow? Purple Cow 2012 Competitive Advantages
54. 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 organizational needs. (Unlike most HMO plans) You can try new combinations to see if they are ‘sulit’ 5 Why Purple Cow? Purple Cow 2012 Competitive Advantages
55. 100% Pre-Existing Conditions: You get 100% coverage up to MBL for Pre-Existing Conditions such as cancer, hypertension, diabetes & asthma. (Unlike most HMO plans) You are covered for dreaded & non-dreaded diseases 6 Why Purple Cow? Purple Cow 2012 Competitive Advantages
56. 100% Congenital Conditions : You get 100% coverage up to MBL for Congenital Conditions such as mitral valve prolapse, rheumatic heart disease & hernia. (Unlike most HMO plans) You are covered for medical conditions since birth 7 Why Purple Cow? Purple Cow 2012 Competitive Advantages
57. 100% Special Procedures : You get 100% coverage up to MBL for Special Procedures such as arthroscopy, laparoscopy, chemotherapy, P/T & MRI. (Unlike most HMO plans) You are covered for newer modalities of treatment 8 Why Purple Cow? Purple Cow 2012 Competitive Advantages
58. 9 Benefits on Top of Philhealth : Your HMO limits are on top of Philhealth , so you won’t be needing as much MBL: Benefits = Philhealth + MBL (not just MBL). (Unlike most HMO plans) You get full HMO benefits on top of Philhealth benefits Why Purple Cow? Purple Cow 2012 Competitive Advantages
59. 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) You get to enjoy the safety of a bigger group 10 Why Purple Cow? Purple Cow 2012 Competitive Advantages
60. Separate Dependent Utilization : Your Employee and Dependent utilization are separate, so you won’t have to worry about Dependents affecting Employee rates. (Unlike most HMO plans) You can offer Dependent coverage without fear 11 Why Purple Cow? Purple Cow 2012 Competitive Advantages
61. Life Insurance : Your Life benefit covers death by any cause, including suicide after 1 year. For example: Ward 20T = 100T; Semi 40T = 200T. (Unlike all HMO plans) 12 Life = 5x MBL: 1 year’s worth of income replacement Why Purple Cow? Purple Cow 2012 Competitive Advantages
62. Terminal Illness Rider: Your TIR benefit is a 50% advance on your Life benefit, payable if you have < 12 mos. to live (50% balance payable upon death). (Unlike all HMO plans) 13 TIR = 50% of 5x MBL, in lieu of life, for living expenses Why Purple Cow? Purple Cow 2012 Competitive Advantages
63. Total & Perm. Disability Income : Your TPDI benefit is in lieu of your Life benefit, payable if you are unable to work at all, due to sickness or accident. (Unlike all HMO plans) 14 TPDI = 5x MBL, in lieu of Life, for living expenses Why Purple Cow? Purple Cow 2012 Competitive Advantages
64. Accidental Death Insurance : Your Accidental Death benefit is a double indemnity to your Life benefit, and covers death by accident only. (Unlike all HMO plans) Accidental Death = 10x MBL 15 Why Purple Cow? Purple Cow 2012 Competitive Advantages
65. Murder : Your Murder benefit is in lieu of your Accidental Death benefit, and payable if you don’t die by accident, but by murder. (Unlike all HMO plans) Murder = 10x MBL, in lieu of Accidental Death 16 Why Purple Cow? Purple Cow 2012 Competitive Advantages
66. Accidental Disablement Insurance : Your Disablement benefit is based on a long schedule of indemnities. For example: loss of hand = 50 % of Disablement benefit. (Unlike all HMO plans) Accidental Disablement = % of 5x MBL 17 Why Purple Cow? Purple Cow 2012 Competitive Advantages
67. Assault : Your Assault benefit is in lieu of your Disablement benefit, if you don’t get disabled by accident, but by Assault. (Unlike all HMO plans) Assault = % of 5x MBL, in lieu of Accidental Disablement 18 Why Purple Cow? Purple Cow 2012 Competitive Advantages
68. Medical HMO Network : You can get inpatient, outpatient & ER treatment from 19,401 affiliated doctors, 382 hospitals, and 426 clinics nationwide. (unlike some HMO plans) You can go to MMC/ SLMC/ CSMC/ AHMC/ TMC/ Healthway 19 Why Purple Cow? Purple Cow 2012 Competitive Advantages
69. Optional Dental HMO Network : You can get 1 permanent filling, 2 oral prophylaxes, and 8 other benefits from 790 dentists and 659 clinics nationwide. (Unlike some HMO plans) You can go to SM/ Market 2 / Festival/ Robinson’s/ Shangrila/ ATC 20 Why Purple Cow? Purple Cow 2012 Competitive Advantages
70. Optional Annual Physical Exam : You can order a Basic 5 APE or customize your APE; you can choose a nearby clinic for your staff or request a mobile APE. (Unlike some HMO plans) You can decide if you want an APE, and if so, what kind 21 Why Purple Cow? Purple Cow 2012 Competitive Advantages
71. Free Health & Wellness Program : ALGA will conduct a free Comprehensive Wellness Program for your group up to 2x per year, based on your own health issues. (Unlike most HMO plans) Call Asianlife at 890-1758, ext. 278, to request a CWP 22 Why Purple Cow? Purple Cow 2012 Competitive Advantages
72. Same Benefits for Dependents : Dependents get the same benefits, terms and conditions as Employees (as well as the same costs in 2012). (Unlike most HMO plans) Your Dependents are treated like Employees 23 Why Purple Cow? Purple Cow 2012 Competitive Advantages
73. Access through Social Media : You can access info and interact directly with suppliers via ‘C3’ (Command & Control Center), in www.purplecow.ph or Facebook. (Unlike most HMO & insurance plans) C3 enables you to proactively manage your own health 24 Why Purple Cow? Purple Cow 2012 Competitive Advantages
74. The Price is Right : Purple Cow rates are lowest where they matter the most: in the 2 lowest categories, where you enroll up to 90% of your staff! (Unlike most HMO plans) You get the greater good for the greater number 25 Why Purple Cow? Purple Cow 2012 Competitive Advantages
75. 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) Your R&B/MBL combos are good up to 99% of the time 26 Why Purple Cow? Purple Cow 2012 Competitive Advantages
76. The Perfect Insurer : You get serviced by the biggest name in group life & medical, and the only insurance company today that offers an HMO plan. (Unlike all insurance companies) You get the best of both INS & HMO worlds from ALGA 27 Why Purple Cow? Purple Cow 2012 Competitive Advantages
77. The Perfect Broker : You get represented by a legend in the industry, and the only insurance broker today that treats SME like a large company. (Unlike all insurance brokers) You get the perfect backroom support from GRA 28 Why Purple Cow? Purple Cow 2012 Competitive Advantages
78. 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) You can take advantage of a credit float 29 Why Purple Cow? Purple Cow 2012 Competitive Advantages
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80. Claims Utilization Report : You get a detailed, user-friendly report that gives you real insights into your company’s overall utilization patterns. (Unlike some HMO plans) You can learn a lot about the state of your group’s health 31 Why Purple Cow? Purple Cow 2012 Competitive Advantages
81. Group Renewal Rates : You get broker-negotiated group renewal rates for the calendar year, so you can plan in advance without hassling HR or FIN. (Unlike most HMO plans) Your renewals become semi-automatic for HR & Finance 32 Why Purple Cow? Purple Cow 2012 Competitive Advantages
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87. Virgins can Win Even More : You get a 1 st year Virgin promo rate if your company has never had group medical insurance or HMO before. (Unlike all HMO plans) You can renew at prevailing Virgin Renewal rates as well 38 Why Purple Cow? Purple Cow 2012 Competitive Advantages
88. Purple Cow is Perfect for SME : Purple Cow is designed by SME, for SME. It is the result of an AIM-ME business plan, and backed by years of broker experience. (Unlike most HMO plans) You can enjoy all the benefits of Purple Cow innovation 39 Why Purple Cow? Purple Cow 2012 Competitive Advantages
89. Purple Cow Grows as You Grow: If you grow BIG, you can opt to self-insure using the same Purple Cow schedule of benefits, as well as the same HMO network. (Unlike all TPA plans) You can transition smoothly from insured to self-insured 40 Why Purple Cow? Purple Cow 2012 Competitive Advantages