How to Reduce Health Insurance Cost & Cover

Health Insurance Risk management I

• 20% Co-insurance on high cost facilities:

Some insurers can add this option to plans to steer client members towards more reasonably priced facilities. It is generally only applied to outpatient treatments.

• Removal of Direct Billing Access:

Direct billing makes going to the hospital easy. It also keeps members from ever seeing how much they’re being charged. Removing direct billing can lead to a significant drop in frivolous claims and members that have a better idea of the costs involved which can make the difference between standard renewal increases and above market increases for your company.

• Deductible:

A deductible is the contribution the insured makes towards the cost of treatment each policy year before receiving reimbursement. You can improve the benefits of your plan by adding a deductible and keep the same premium.

• Avoid MHD:

While there are many instances where MHD underwriting can be offered without a loading, MHD will almost certainly negatively affect your companies plan. Moratoriums will increase the odds of stable renewals.

Health Insurance Risk management II

• Remove Outpatient Dental Benefits:

Outpatient dental benefits often add 2,000rmb premium for 2,000rmb cover. Further, if your company has low dental benefit usage, it may be a reasonable option to self-insure this benefit.

• Remove Maternity Benefits:

Generally speaking, insurers will spread the cost of maternity cover across the entire group. This means single men also get charges applied for benefits they will never use. Instead, if you have a larger group and must provide maternity for one or two women, it may be more cost effective to put those women on individual plans.

Health Insurance Risk management III

• Regular training to employees:

Most employees need to be guided on which hospital in China to visit. Companies HR can lead staff to hospitals that you know are good and affordable.

• Be Proactive:

By far, the best thing a director can do to maintain market rate (or below market rate) annual premium increases is to be active in monitoring their insurance performance throughout the year. Ask for feedback from the insurer as to the status of your policy through the year and catch problems before they start. If you find that 6 months into your plan that your insurer has already lost 60% of your premium to claims, you’ll need to help correct this, but at least you’ll have time to do so.