Jill Gale de Villa
AFE’s Health Insurance Committee currently comprises Jill Gale de Villa (head), Lou de Belen, Ted Breckner, Dang Fook Lee, Evelyn Go, Fred Mesch, Hans-Juergen Springer, and Axel Weber. Our goals are to keep members informed of health events affecting the membership; to liaise with ADB’s compensation and benefits division, which has recently been renamed the Staff Development and Benefits Division (BPDB), on any pertinent matters; and to recommend to AFE–ADB any action needed.
Status of the Medical Insurance. In January, Hans Springer and Jill de Villa met with Cristina Keppler and Alona Saludo of BPMSD and representatives from Vanbreda. Vanbreda presented the current and historical status of medical claims. To summarize,
1. Claims reimbursed have trended up slightly in the last 4 years, but this has been covered by the premiums
2. Total claims of retirees slightly exceed those of active staff, who are less numerous tan retirees.
3. Of reimbursements for retirees, about 72% is paid by the insurer, 14% is paid by the insured, 11% pertains to the amount above the stop loss, and 4% is paid by other insurance.
4. Of reimbursements, 42% are paid in the US, 36% in the Philippines, and 22% in the rest of the world.
5. "Peak files" (reimbursements of PHP2 million/person and above) have ranged from about P43million total to about PHP63 million during the last 5 years, having dropped considerably since Vanbreda formed an alliance with a US administrator.
Click on "Vanbreda's Powerpoint Presentation" if you wish to review it.
Generics. Retirees in the US are taking good advantage of generics—which is helping to keep their bills and all our premiums down. However, retirees in some other countries are not following suit. We aren’t sure why—but among the reasons may be failure of doctors to prescribe generics, failure of patients to ask the doctors to do so, and concerns about the effectivity of generics. In the Philippines, where we have many retirees, locally manufactured generics—for example by Unilab (carried by Mercury Drug) and other known drug makers—are of good quality and are well monitored by the government. Imported generics are not so well monitored. Thus, the local brands should be preferred. Retirees in other countries may wish to check with their physicians regarding recommended brands of generics.
Vanbreda insurance is secondary. If you have another medical insurance or a medical discount, the amount will be deducted first from the total bill before the insurer computes for its share of 75%—not vice versa. For instance, if you have an operation that your national insurance covers, and it covers 80% of the cost, then Vanbreda will pay 75% of the balance, leaving the 25% as retiree share. Similarly, if you have a senior citizen discount of 20% then Vanbreda will compute for the plan’s share of 75% based on the amount after deducting the 20% discount.
Long-term care insurance. In 2009, ADB’s Cristina Keppler introduced a welcome ADB initiative—a proposal to make long-term care insurance available to staff, retirees, and their spouses. For information on