Jill Gale de Villa
Our Group Medical Insurance Plan (GMIP) continues to serve us well, by and large. The premiums, which were increased by 10% last year, remain level this year, and the stop loss ceiling has increased as usual by 5%. Members need to be aware that medical inflation continues to outstrip the general inflation, especially for the upper age groups, and we need to plan our personal finances accordingly.
Claims on the GMIP increased again in 2011, as may be expected given the increasing number and share of retirees enrolled. Among retirees, approximately 10% of expenses were covered by other plans (e.g., Medicare), and we continue to encourage retirees to enroll in national health plans where appropriate, to help keep all our premiums down. As in 2010, the amount attributable to “peak files” (cases costing over PHP2 million) is high. Vanbreda is working with the new US partner, Cigna, to rationalize expenses by assuring that charges from hospitals etc. are within acceptable limits, without however, impacting the quality of services provided. Vanbreda’s presentation on the 2011 health insurance is available at afe-adb.org.
ADB is slowly issuing new health insurance (Vanbreda) cards to replace the old ones—do send ADB new pictures for the new cards, but do not send in your old cards—keep them until the replacement arrives. Those who travel to or live in the United States should request cards that include the Cigna logo. Send the images as e-mail attachments to insurance@adb.org, or send hard copies to Insurance Unit, Staff Development and Benefits Division, BPMSD, Asian Development Bank, Mandaluyong City 1550, Metro Manila, Philippines.
ADB’s Long-Term Care Insurance Plan continues to serve those who are enrolled. As premiums escalate with age, members may wish to evaluate the costs and benefits of continuing to participate beyond a specific age, and this will depend on each individual’s means.
ADB will hold another health and wellness fair on October 17-19, details to be announced later. Retirees who are in the Manila area at the time are welcome to attend. Those who wish to bring spouses should contact the AFE office for assistance with access for them.
Tips for AFE Members who have Medical Care in the US
As you know, the AARP often has good information for people in the US, and some of it is applicable to those of us who are visiting the US or reside elsewhere. Click on the link provided here for an interesting article on saving medical costs:
http://search.aarp.org/browse?Ntt=8%20ways%20to%20save
Summary
- Despite the Towers Watson study recommendation to consider an age-related premium for the medical insurance, ADB decided not to consider this suggestion.
- Claims rose considerably in 2010, by 47% over 2009. This heralds a rise in premiums, but we do not yet know by what amount.
- Vanbreda and ADB are looking into optional additional coverage, to broaden the range of choices.
- ADB is issuing new insurance cards for everyone.
- On 19–21 October, ADB is holding a health and wellness fair, and retirees who are in Manila are welcome to attend.
Towers Watson Study
As you know, the Towers Watson report recommended that ADB consider an age-related premium for the health insurance, and ADB decided not to include this in recommendations to move forward. Such a change would potentially place a huge burden on retirees. Thus, there was great relief that ADB arrived at the correct decision for the well-being of retirees and staff.
Claims and Costs
On Thursday, 17 February, Hans and I met with BPDB’s Cristina Keppler and Alona Saludo and Vanbreda’s Bart Jordens and Vladimir Balinchenko. 2010 was not a good year for health matters. Reimbursements tallied to date had increased for both current and retired staff members— the rise was 47% over 2009, to a total of P547 million (approximately $12 million) from P372 million in 2009. The increase was partly attributable to an unusually high number of “peak files”—individual cases costing P2 million or more. In 2010 there were 29 peak files versus 18 in 2009. Of the 29 peak files, 8 were for active staff members and/or dependents, and 21 for retirees and/or dependents. Of the total, 11 are in the United States, and 9 of the 11 are retirees. We also need to continue, where feasible, to use primary insurance (such as national health plans) in order to keep our claims and thus premiums down.
Premiums collected were over P100 million below reimbursements. This is partly compensated for by the limit set on premium increases established in 2009. But the bottom line is we can expect a premium increase. The results in 2010 are considered to be anomalous, and we hope this proves true. The amount of the increase will not be known until about the middle of the year. Medical inflation continues to outpace the general cost of living inflation—and we all need to be aware of this and budget for it.
A pdf of the hand-out at the meeting is available on the AFE website.
Other Issues
Other matters discussed were (1) the need for a broader range of optional coverage, including but not limited to annual medical examinations and tests such as mammograms and colonoscopies; (2) alternate financing options such as a reserve fund for peak files; and (3) a widening of the premium scale so that higher earners contribute more to the plan. We also noted that retirees pay much more for healthcare than active staff because active staff members have free treatment at the clinic; a lower “coinsurance” (contribution) rate, at 20% versus 25% for retirees; and the fact that we pay for the full cost of the premium attributable to the amount over the stop loss. At an earlier meeting, we discussed the possibility of covering Ayurvedic medicine with Vanbreda’s Sook Kuan Leung. She noted that at this time Vanbreda does not have the capacity to administer claims for Ayurvedic medicines and treatments, but they will look into it for the future. We also note that the level of retirees’ coverage is similar on average to that of staff, because retirees have a lower stop loss limit than current staff.
Changes: US
Owing to problems with the current intermediary, Hygaea, Vanbreda is switching to Cigna. They feel this will be more user-friendly so that US-based clients have less issues, will provide better control on claims, and will allow for issuing one card from both Vanbreda and Cigna, versus the two that are currently issued. US residents who do not have their new cards by 1 August should contact Vanbreda directly through e-mail or phone (1-855-882-5267, toll free). Note that the US telephone number for Vanbreda will not change.
New Cards
For all retirees, ADB is issuing new cards and will be requesting you to send new photos (although we all know we look either the same as when we left ADB or even better…).
Health and Wellness Fair
Of interest to retirees based in or near Manila, ADB is holding its second Health and Wellness Fair on 19–21 October, including very helpful explanations of how we can facilitate using our insurance, plus booths of providers for “comparison shopping.” During the last health fair we were able to establish a relationship with Lifeline, where Metro-Manila-based members can have access to reliable ambulance service and emergency telephone consultations 24/7, for P500 annually per member and household of up to 10 people—this is half the normal price. Just call Lifeline (896-9191) and tell them you are an AFE member. Note also that holders of the SM Advantage Card are automatically Lifeline members.