Group health insurance plans are complex things. There’s a huge amount that goes into them and many factors that contribute to their effectiveness. As such, driving the maximum possible value from a group health insurance plan isn’t easy.
Like many aspects of business operations, data has a valuable role to play. The issue is that brokers and insurers in the UAE have traditionally lacked access to the real-time insights needed to support decision making and proactively manage costs. This lack of data visibility is further complicated by the fact that insurance companies rarely provide claims data to companies with less than 100 employees and utilization data is not provided in real-time.
The simple truth is that the insurance sector is still lagging behind other industries. So, how can businesses get access to the insurance insights they need and how can real-time data be used to deliver tangible value?
Data can also be used to help employees use their policies in the right way, and provide visibility into processes such as claims submissions. HR teams can leverage data to advise employees so that they aren’t left out of pocket.
For example, our data shows that the most common reason for a claim being rejected is policy exclusions, accounting for more than half (54%) of all rejections. This is followed by a lack of pay & claim allowance (17%) and exceeding the policy limit (11%). We also know that 7% of general practitioner claims are only partially reimbursed, while nearly a quarter (22%) are rejected completely.
Armed with this information – along with other data such as the proportion of out-of-network claims that are submitted every year – HR professionals will be better placed to support employees and help them manage their package in the most effective way.
Ultimately, we’re living in a data-driven era and group health insurance should be no exception. Businesses that want to drive the most value from their insurance policy should focus on finding a partner with the right digital capabilities. More specifically, this partner must be geared towards improving the employee experience through deeper and more meaningful data insights. This is what will truly make a difference.
The first step for businesses must be to embrace a new mindset – one that puts technology and data at the centre of their insurance strategy. This starts by picking the right partner. A digital native, technology-driven and provider agnostic broker partner will be better placed to provide tailored insights and advice based on a company’s unique requirements, thereby providing more value than any broker or insurer ever could.
With these insights, the partner can develop more creative and cost effective solutions that meet employees’ evolving needs. It can also share tailored preventative plans to help manage claims and year-on-year premiums – empowering businesses to maximize the value of their insurance plans without breaking the bank.
For example, a digitally-driven broker will be able to provide visibility into the benefits and facilities that employees search for. This lets businesses rework policies based on how employees engage with them. On the one hand, specific benefits or clinics/hospitals that are rarely used can be removed or replaced during the renewal phase. This gives businesses an opportunity to reduce costs and optimize their policies without negatively impacting the employee experience.
On the other hand, real-time usage data also enables businesses to proactively adapt to any changes in behavior. If they see that more employees are searching for a specific benefit such as mental health support, they can quickly roll out additional services to meet this need and improve the level of preventative care. Or they could provide internal sports groups and fitness challenges that provide a platform for employees to meet their physical wellbeing needs – thereby offering a much greater employee experience.