Organized by Mercer, more than 10 major group employee benefits insurance providers gathered at the Intercontinental Shanghai Expo Hotel and had a wide and in-depth discussion on how to innovate and cooperate within the areas of risk protection benefits, Medicare supplemental medical benefits and high-end medical benefits in order to enhance the level of employee protection and satisfaction with the services provided, to continue to expand the market scale and to promote the healthy development of the group benefits insurance market, among other aspects. Extensive and in-depth discussions were conducted. According to the statistics of China Insurance Statistical Yearbook, the market scale of group employee benefit insurance (including term life insurance, short-term accident insurance and health insurance, etc.) has remained at around RMB 20 billion in the past five years. Despite the increasing number of market players, product innovation in group employee benefits insurance is still far from keeping up with market demand, with rising claim rates and stagnant rates, and even the emerging niche market of high-end medical benefits has slowly turned from a "blue ocean" to a "red ocean" in recent years. Even the emerging market segment of high-end medical benefits has slowly turned from a "blue ocean" to a "red ocean" in recent years. In the face of this situation, Mr. Xin Guo, President of Mercer Greater China and Chairman of MMC China, said, "Mercer has found in the process of exchanges with corporate clients that there are still a lot of protection needs for enterprises and employees, and there are no suitable products in the market to fully meet these needs, which is both a challenge and a rare opportunity for insurance providers. " Mr. Fan Zhihua, General Manager of Healthcare and Employee Benefits Business of Mercer China and General Manager of Shanghai Mercer Insurance Brokerage Co., Ltd. introduced in his keynote speech, "Employee benefits innovation can be started from the following three latitudes: system, coverage and management". In terms of "system innovation", flexible benefits are a hot topic nowadays. A large part of the flexible benefits system consists of core and optional insurance benefit programs, and Mercer has a dedicated flexible benefits management system and an outsourced flexible benefits management team to serve a sizeable group of employees. In the process, Mercer has found that there is room for insurance providers to innovate in many areas, such as increasing the portability of the optional benefits so that employees can continue their risk and healthcare coverage when they leave the company or retire; providing more flexible underwriting arrangements, or allowing employees with past medical history to purchase the coverage they need at the right price; making more use of the online enrollment and inquiry system to provide employees with the added More use will be made of the online enrollment and inquiry system to provide employees with the convenience of joining optional plans. In terms of "protection innovation", if insurance providers can focus on bridging the huge gaps in employee protection, it is entirely possible that the market for employee benefits insurance will double in size in the coming years. The current coverage gaps in group employee benefits include, first, the significant lack of coverage employees face when they become incapacitated, lose their jobs, or retire. Satisfying employees' need for "security" is the fundamental value of providing employee benefits. However, according to China's current statutory benefit requirements, employees who lose their ability to work due to illness are generally only entitled to a maximum of two years of medical treatment, especially for employees of foreign companies, who then face the termination of their labor contracts with the company, and are left without a source of financial income and ongoing medical expenses. Long-term disability insurance, which is very common in developed countries, is still prohibitively expensive in China due to the lack of products, high prices, and the lack of a universally recognized method of identifying "disability". Mr. Fan said that after four years of unremitting efforts, Mercer has successfully arranged this benefit for a number of leading companies, and the number of legitimate suppliers in China has increased from one to several. With product design and pricing tailored to China's national conditions, this insurance is fully promising and is expected to take the lead in rapidly spreading among the mid-to-high-end population. Second, there is still a huge gap in the coverage of medical expenses for employees, and the misconceptions that exist in the market operation of supplemental medical insurance need to be urgently reversed. Currently, China's medical insurance and the ongoing reform of the healthcare system are still based on the principle of "broad coverage and low protection". If an employee wishes to enjoy comprehensive medical protection and high-quality medical services, such as special outpatient clinics, high-class wards, private clinics, and more effective self-paid medicines and diagnostic and therapeutic services, the costs are rarely covered by either the health insurance or the supplemental medical insurance provided by the company. China's health statistics show that at present, individual out-of-pocket expenses still account for more than 50% of China's healthcare expenditure. IBM's Chen Tong, M.D., analyzes that if an employee gets a very serious disease, such as a malignant tumor, the medical expenses will be quite huge, and he has once seen that the cost of an employee's leukemia was around 700,000 yuan, which is unaffordable for the general working class. At present, the critical illness products on the market usually have a coverage of only 100,000, which is only a drop in the bucket, and the supplemental medical insurance provided by enterprises often cannot reimburse out-of-pocket expenses for medicines and self-financed diagnostic and therapeutic items. From the perspective of enterprises and employees, they are very eager to have relevant products to make up for the lack of protection in this area. An insurance company participants pointed out that there is a huge misunderstanding of the current commercial supplemental health insurance, that is, health insurance does not pay the starting line (deductible) and **** pay the proportion of the part of a simple supplement, resulting in the consequences of the health insurance risk control mechanism is offset by the commercial insurance, the health insurance overall health care costs of the expansion of the behavior of the insurance company, which in turn led to the commercial insurance each year, the rate of claims rose too fast. To truly return to the essence of insurance, commercial supplemental medical insurance should reduce outpatient small claims, make employees more responsible for their own medical behavior through liability sharing, and focus on paying for catastrophe risks and out-of-pocket medical treatment items for major diseases. Third, health management is introduced into the plan design of medical insurance, so as to control health risks and reduce claims by changing employees' behavior at the source. In foreign countries, more and more enterprises and health insurance companies are actively involved in intervening in the health risks of employees: for example, employees can get certain incentives or premium concessions for quitting smoking, participating in exercise or reducing weight; and medical expenses can be reduced through the case management of chronic diseases and major illnesses. In terms of "management innovation," areas of focus include employee health management, benefit cost management, and vendor service management to effectively improve employee satisfaction, workforce productivity, and long-term cost sustainability. Dr. Tong Chen, M.D., cited an example where IBM introduced a third-party external audit a few years ago, which resulted in a significant improvement in insurance company services, a significant reduction in employee complaints, and claims accuracy and timeliness meeting international standards, and a significant increase in corporate and employee satisfaction. Through roundtable talks and breakout sessions, the conference provided ample discussion and interaction on all key areas of group insurance: product design, underwriting and pricing, funding arrangements, system data analysis and customer service, etc. It is hoped that through the innovation and cooperation of the major group employee benefits insurance providers,*** together we can advance the development of the group insurance industry. Meanwhile, Mercer experts also forecasted key opportunities and trends in the group insurance market.
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