How do enterprises take the road of employee welfare innovation

Organized by Mercer, more than 65,438+00 major group employees' welfare insurance providers gathered at the Intercontinental Hotel Shanghai World Expo, and conducted extensive and in-depth discussions on how to carry out innovative cooperation in the fields of risk protection benefits, medical insurance supplementary medical benefits, high-end medical benefits, etc., in order to improve employees' security level and service satisfaction, continuously expand the market scale, and promote the healthy development of the group welfare insurance market. According to the statistics of China Insurance Statistical Yearbook, the market scale of group employee welfare insurance (including term life insurance, short-term accident insurance and health insurance, etc.) in recent five years. ) has remained at around 20 billion yuan. Although there are more and more market participants, the product innovation of group employee welfare insurance still lags far behind the market demand. The dividend payout ratio is rising, but the ratio is stagnant. Even the emerging market segment of high-end medical welfare has gradually changed from "blue ocean" to "red sea" in recent years. Faced with this situation, Mr. Xin Guo, President of Mercer Greater China and Chairman of MMC China, said, "In the process of communicating with corporate customers, Mercer found that enterprises and employees actually have many protection needs, and there are no suitable products in the market that can fully meet these needs, which is both a challenge and a rare opportunity for insurance suppliers." Mr. Fan Zhihua, General Manager of Mercer Medical and Employee Welfare Business in China and General Manager of Shanghai Mercer Insurance Brokerage Co., Ltd. introduced in the keynote speech that "employee welfare innovation can start from the following three dimensions: system, security and management". In terms of institutional innovation, flexible welfare is a hot topic at present. A large part of the flexible welfare system consists of core and optional insurance benefits. Mercer also has a special flexible welfare management system and outsourcing flexible welfare management team to serve a considerable number of employees. In this process, Mercer found that insurance providers have room for innovation in many aspects, such as increasing the portability of optional benefits and continuing their risks and medical security when employees leave or retire; Provide more flexible underwriting arrangements, or employees with past medical history can also purchase the required protection at a suitable price; Make more use of online registration and inquiry system to provide convenience for employees to join optional plans. In terms of "security innovation", if insurance suppliers can focus on making up for the huge gap in employee security at present, the market scale of employee welfare insurance is likely to double in the next few years. At present, the security gap of group employees' welfare includes: First, employees face great security problems when they lose their ability to work, lose their jobs or retire. Meeting employees' demand for "safety" is the basic value of providing employee benefits. However, according to the requirements of the current statutory welfare in China, employees who lose their ability to work due to illness can generally only enjoy a medical treatment period of two years at most, especially those in foreign companies, and then they will face the termination of their labor contracts with enterprises, loss of economic income sources and continuous medical expenses. However, the long-term disability insurance, which is very common in developed countries, is still not favored by enterprises in China because of its few products, high price and lack of universally recognized "disability" identification methods. Mr. Fan Zhihua said that after four years of unremitting efforts, Mercer has successfully arranged this benefit for many leading enterprises, and the number of legal suppliers in China has also increased from one to several. Through the product design and pricing suitable for China's national conditions, this kind of insurance has a bright future, and it is expected to take the lead in rapidly popularizing among middle and high-end people. Secondly, there is still a huge gap in the protection of medical expenses for employees, and the misunderstanding of market-oriented operation of supplementary medical insurance needs to be reversed. At present, China's medical insurance and ongoing medical and health system reform are still based on the principle of "wide coverage and low security". If employees want to enjoy comprehensive medical security and high-quality medical services, such as special needs clinics, advanced wards, private clinics, self-funded drugs and better medical services, the medical insurance and supplementary medical insurance provided by enterprises will not bear the relevant expenses. According to China health statistics, at present, out-of-pocket expenses still account for more than 50% of health care expenditure in China. Chen Tong, a medical doctor from IBM, analyzed that if an employee gets a very serious disease, such as malignant tumor, the medical expenses will be quite huge. I once saw that the cost of an employee suffering from leukemia was around 700,000, which the average working class could not afford. At present, the coverage of seriously ill products on the market is only 65,438+10,000 yuan, which is only a drop in the bucket. The supplementary medical insurance provided by enterprises often cannot reimburse the expenses of self-funded drugs and self-funded medical treatment projects. From the perspective of enterprises and employees, they are very eager to have related products to make up for the lack of this guarantee. A participant from an insurance company pointed out that there is a huge misunderstanding in the current commercial supplementary medical insurance, that is, simply supplementing the deductible and the * * * ratio that medical insurance will not pay, which leads to the risk control mechanism of medical insurance being offset by commercial insurance, and the overall medical expenses of medical insurance are constantly expanding, which in turn leads to the rapid rise of commercial insurance in payout ratio every year. If we really want to return to the essence of insurance, commercial supplementary medical insurance should reduce the small claims of outpatient service, let employees take more responsibility for their medical treatment behavior through responsibility sharing, and focus on catastrophe risk and self-funded medical treatment project compensation for serious illness. Thirdly, health management is introduced into the scheme design of medical insurance to change employees' behavior habits from the source, control health risks and reduce the claim rate. In foreign countries, more and more enterprises and health insurance companies actively intervene in the health risks of employees: if employees quit smoking, participate in exercise or lose weight, they can get certain rewards or premium concessions; Through case management of chronic diseases and major diseases, medical expenses can be reduced. In the aspect of "management innovation", we can pay attention to employee health management, welfare cost management and supplier service management, so as to effectively improve employee satisfaction, the productivity of the workforce and the long-term sustainability of costs. Chen Tong, MD, gave an example. A few years ago, IBM introduced a third-party external audit, which significantly improved the service of insurance companies, significantly reduced the complaint rate of employees, and the accuracy and timeliness of claims could reach international standards, thus greatly increasing the satisfaction of enterprises and employees. In the form of round-table talks and group discussions, the meeting fully discussed and interacted with key areas of group insurance, such as product design, underwriting pricing, fund arrangement, system data analysis, customer service, etc., hoping to promote the development of group insurance industry through the innovation and cooperation of major group insurance employee welfare insurance suppliers. At the same time, Mercer experts also predicted the main opportunities and development trends of the group insurance market.