Leading international health insurance provider, IHI Bupa recently announced their premium increases for 2013, which have come in at the lowest percentage increase recorded by the company in five years. This tapering off of increasing health insurance premiums is a trend that seems to be occurring across the health insurance industry. Globalsurance, one of the largest distributors of IHI Bupa plans, has seen many other providers offering premiums that are slowing down in their rate of increase and believes this is likely due to falling medical inflation worldwide.
For more than 30 years, IHI Bupa has been a leading provider of international health insurance policies for expatriates and high-net worth individuals all over the world. Distributors and customers all tout IHI Bupa to be one of the best in the industry, and the company has formed an especially strong presence in Asia. Their policies include coverage in all parts of the world, including in the USA and are guaranteed renewable for life, an option that other providers are often apprehensive about offering.
The distribution of offshore International health plans to wealthy individuals in South America has been a successful and lucrative market for many decades. IHI Denmark in particular, had built a considerable amount of its success in this part of the world over the years. In 2012 however, a combination of location regulation and poor plan performance has resulted in most key offshore providers pulling out of Latin America.
Bupa and IHI Bupa, who had perhaps the biggest offshore portfolio in South America, have stopped selling offshore plans into the market. In 2004, Bupa took over the IHI portfolio after acquiring IHI Denmark. The insurer then went on to purchase US-based AMEDEX Insurance in 2005 which serviced 100,000 people in 42 countries throughout Latin America.
Bupa are now looking to push the Latin American product range, citing reasons for the change being driven by compliance requirements. Several countries in Latin America have raised the stakes as international insurers are now exposed to draconian punitive fines for selling health policies within their country without a license. These potential fines are measured in sizeable percentages of global revenue. Bupa’s response is understandable; as they try to fill the gap with onshore Bupa Latin America plans (Bupa LA is now available in Brazil once more). However, Globalsurance analysts believe that Bupa’s offshore plans were better value for money, and that clients can now find deals from local onshore providers who have become competitive. That said, clients in the region are sensitive to branding, and the Bupa brand remains strong, thereby enabling it to access a large part of the market.
Filed Under Aetna, Africa, Allianz, Asia, AXA PPP, BUPA, China, China insurance, DKV, Europe, Expat Insurance, Health Insurance, Hong Kong, IHI Bupa, Insurance Company, International Healthcare, Medical Insurance, Middle East, Philippines, UAE Insurance, United Kingdom | 9 Comments
In this article we will first present our findings of the premium increases and premium inflation rates in each region and country we studied, with specific insurance findings to be presented at the end. Overall our findings were that International Private Medical Insurance (iPMI) premium inflation was very high, at roughly 10.8 percent per year over a 5 year average. While variations exist between countries, the reality is that iPMI inflation rates were extremely consistent throughout the world. However, it is important to note that this is medical insurance premium inflation at the high end of the sector, and not necessarily with regards to the mass market.
Even presenting the argument that premium increases are fairly consistent on a global basis, there are some immediate outliers – Hong Kong, for example, runs at an iPMI premium inflation rate of roughly 13 percent per year, while Kenya’s premium inflation rate is approximately 9 percent per year. Although there is a difference in premium inflation rates between Hong Kong and Kenya, the difference is not overly substantial – as will be seen inside this report.
Globalsurance is pleased to reveal the results of our latest study on the international health insurance industry and rates of international medical insurance inflation around the world as of August 1st 2012.
Using 7,916 data points from 8 different International Private Medical Insurance providers in 10 different countries, Globalsurance has been able to successfully identify a number of trends within Global Medical Inflation for individual International Private Medical Insurance (iPMI) plans during the time period from 2008 to 2012. iPMI is a subsector of the greater health insurance industry which services the global population of expatriates and international High Net-Worth individuals.
The companies sampled in the studies use Age and Geographical Area of Coverage as the main variables in their premium calculations. By selecting a sample which is community rated Globalsurance has been able to efficiently identify the actual rates for premium increases in different parts of the world. Our measure of inflation is based on a sample of policies, ages, and published rates for each insurer included in the study. Globalsurance selected the most common age groups and most common policy types for our data points to achieve realistic measurements in relation to medical insurance premium inflation around the world.
While individual insurance providers and underwriters may disagree with our findings, the figures represented in this report are based on our sample and present baseline figures for all of the regions and companies we chose to consider.
It is important to note that, unlike the recent Towers Watson Report on Medical Trends, the data contained in the Globalsurance insurance review is not survey based. Rather than looking at individual responses and feelings in reference to levels of health insurance premium inflation, which may have some inherent bias dependent on the respondent, Globalsurance is analyzing the actual premium data from insurance companies with exposure to the world at large, over locally based providers operating in a single country.
Additionally, we have analyzed premium data, and not healthcare pricing data. Consequently the figures represented in this report are indicative of the levels of healthcare cost inflation which insurance perceive to be in place in the locations we sampled; profit and operating costs of the individual insurers are assumed to be unchanged. While the increase or decrease in premium values may point to actual rates of medical inflation in the countries which were included in the study they do, in fact, represent the increased costs placed on policyholders.
However, it should be noted that, while the figures contained in this report are the actual rates of iPMI premium increases for the duration of the study, the removal of Age and Policy type means that the figures presented in this study of International Medical Insurance premium inflation can be used as a suitable proxy for rates of actual medical inflation in relation to healthcare costs around the world. It should be noted that the proxy does not represent medical inflation across the entire healthcare sector within a country or region; for example, NHS cost increases in the United Kingdom are not evident in our findings. The rates of iPMI premium inflation are only a proxy for healthcare costs in High-End, private medical facilities in the countries which we considered, due to the basic nature of the international medical insurance products we are studying.
So, without any further ado, here is the Globalsurance International Insurance Review:
In December, Bupa International joined the ranks of international private medical insurers that offer insurance policies with full medical underwriting (FMU) options that cover individuals for pre-existing conditions.
Until recently, it has been very difficult for expatriates to obtain coverage of pre-existing conditions on individual insurance policies, as few insurers would cover them. Many group policies may be underwritten with medical history disregarded once the group is sizable enough, however customers seeking individual coverage are often left with little choice but to take up policies that either exclude coverage of any pre-existing conditions or policies which will provide coverage after a moratorium.
Bupa International will now offer customers the ability to apply for full medical underwriting when enrolling in the Worldwide Health Options product, an option that would provide coverage of a list of over 60 pre-existing medical conditions the customer may already have.
Although the list of pre-existing conditions already includes cancer, high cholesterol, hypertension and asthma among others, Bupa International’s Medical Director Dr. Sneh Khemka has said that Bupa will hope to include cardiovascular conditions and diabetes in the list in the near future. One eventual aim is to work towards setting up a system where brokers could add the premium loading themselves in clear-cut cases, in order to streamline the process.
However, Bupa International is hardly the first to pioneer international health insurance products with full medical underwriting, with companies such as DKV Globality, InterGlobal and ihi Bupa already having earned names for themselves as providers which are more flexible in covering pre-existing conditions. While InterGlobal has been offering cover for pre-existing coverage in January 2010, DKV Globality has been extending individual customers that option since 2008 leveraging its access to Munich Re’s knowledge, group expertise and scale.
The Group Underwriting Director and InterGlobal, Barry Remington, said that “It has been welcomed by the market and is an excellent means for expats to have certainty that they will be covered for pre-existing conditions which may have become excluded if they had a reoccurrence of their condition under a moratorium scheme.”
Despite the fact that ihi Bupa, previously IHI Danmark, already offered FMU options prior to being purchased by Bupa in 2005, Bupa International decided not to emulate the product in its lineup due to the fact that their IT systems and medical technology were insufficient at the time. Another reason for keeping FMU products distinct was the fact that each appealed to different markets, with Bupa International finding traction in European markets and ihi Bupa performing similarly in Asian Markets.
As one of the largest international medical insurance providers, the announcement that Bupa International will introduce full medical underwriting options could cause a change in the landscape of the international PMI industry, potentially forcing competing major insurance companies to begin offering similar products.
Insurance Companies Mentioned:
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. As a provident association Bupa has no shareholders, because of this it uses its profits to invest in healthcare and medical facilities around the world. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, and China and across Latin America.
DKV Globality is a leading international health insurer with a special focus on expatriates, i.e. people working or studying abroad. Global companies and their expatriate staff as well as individuals and their families place their trust in DKV Globality’s expertise. The company stands for more than 80 years’ experience in health insurance and the proven competence of an international network of assistance and service partners. It is a member of Munich Health with more than 5,000 experts at 26 locations worldwide, providing its clients and partners around the world with innovative healthcare solutions. DKV Globality is a subsidiary of Munich Re, offering the financial strength and security of one of the world’s leading (re)insurers.
Originally dubbed IHI Danmark, the company has 30 years of history as an innovative international health insurer. The company was purchased by Bupa in 2005, and became a branch in 2009 beginning to operate under the banner of ihi Bupa.
InterGlobal is an international health insurance company offering international private medical insurance to expatriates, frequently traveling business people and companies around the world. InterGlobal was founded in the UK in 1998 as a joint venture company between the UK-based Inter Group and New Zealand-based Mike Henry Group. Since their founding, InterGlobal has expanded to the point where it now handles policies for clients in more than 189 countries around the globe, operating from 10 regional offices in the UK, Singapore, Kuwait, China, Dubai, Thailand, Japan, South Africa, Qatar and Vietnam.
Bupa, the UK’s largest private medical insurance provider, has announced its financial results for the first half of 2010. The report indicated that while the company’s UK membership numbers remained flat, there was considerable growth in international markets contributing to an overall increase in income of £3.71 billion(US$ 5.7 billion) for Bupa.
Trading conditions in the UK, US and Spain have been particularly difficult since 2008, reflecting the fallout from the general downturn in business activity in these countries. However, trading in Australia and other non-European countries, and the USA, has helped Bupa generate an overall increase in revenue for the first six months of 2010. The UK health insurer reports a 10 per cent increase in revenue to £3.71 billion (US$ 5.7 billion) producing a 5% increase in surplus funds amounting to overall growth of £183.6 million (US$ 285 million) for the same period. As Bupa is a provident association all funds are reinvested into the company, consequently Bupa does not recognize “profit” per-se, but rather “surplus” revenue.
The 10% increase in revenue for Bupa was driven by organic growth of 4% and agreeable foreign exchange movements of 6%. Higher sales in Australia contributed to higher revenue, and a favorable exchange rate from the Australia Dollar to the Sterling was a strong factor for the company’s success.
As a result of the tough economic conditions in the UK, Bupa experienced a 0.8% decline in membership numbers over the 6 month period. Revenue and profits from the UK market remained flat for the first half of 2010 following one-off restructuring costs, but significant loss was contained by lower claims payments and cost savings resulting from new a new administration system adopted in August 2009.
Trading in the USA private medical market was also adversely affected because of the economic downturn, high unemployment levels, and the reform of the healthcare system in the country. These factors all contributed to the slowdown in new business sales and renewals. Bupa continues to develop new products to meet the changing demands in the American private healthcare market, with new business opportunities arising following the passing of health reform legislation; industry watchers expect increased sales volume for USA private medical insurance as President Obama’s reforms roll out through to 2014.
In international markets, Bupa’s surplus increased from £51.3 million (US$79.8 million) to £88.7 million (US$138 million) over the six month period, until 30th of June 2010. Bupa International still remains the largest provider of international private medical insurance, with a global 2% increase in policyholders over the reporting period; primarily due to Bupa Arabia, and Bupa Australia experiencing increasing membership numbers.
Ray King, Chief Executive of Bupa commented on the future of the Australian health insurance market by saying: ‘In our Australian insurance business, the integration programme is almost complete and we look forward to the launch of a single product suite later this year which should further enhance our competitive position.”
In other markets, Bupa Latin America reported an increase in profits compared to the same period last year, explained by steady membership growth and lower claims being made. Bupa Hong Kong revenue increased modestly, and Max Bupa, the joint India venture launched in March 2010, has 6 retail offices in major cities across the country; this is planned to increase to 9 outlets by the end of 2010.
The future for Bupa in the UK and US remains unclear due to the stringent economic conditions and the impact on demand for private health insurance products. However with both governments implementing major reviews of healthcare provision it may give the UK medical provider opportunities to accelerate business in these markets. Chief Executive of Bupa, Ray King said “The UK and US government started to articulate their plans for reform of their healthcare systems and we believe that this should offer new opportunities for businesses in the future.”
The future outlook for Bupa internationally looks positive; consolidating their market presence in the international health insurance market. However, the markets in Europe and North America are still subject to difficult economic conditions.
Insurance Company Mentioned:
Bupa was established more than 60 years ago in the UK and is now has ten million customers in over 190 countries, and over 52,000 employees around the world. Bupa is a leading international healthcare provider, offering personal and corporate health insurance, workplace health services and health assessments. As a provident association Bupa has no shareholders, because of this it uses its profits to invest in healthcare and medical facilities around the world. Bupa has operations around the world, principally in the UK, Australia, Spain, New Zealand and the US, as well as Hong Kong, Thailand, Saudi Arabia, India, China and across Latin America.
Both Bupa and Allianz are making moves to expand their international operations this year. Bupa has added a sales and support center in Fuengirola, Spain to provide administrative support for Bupa International and IHI Bupa customers. The 12 person service center will also aid distributors in Europe, Africa and the Middle East.
Allianz, on the other hand, is opening new gateways in China. It has recently been given approval from regulators to change the status of their fully-owned Allianz Insurance Co. Guangzhou Branch from a branch office to a subsidiary of Allianz Versicherungs A.G.
Previously, China only allowed foreign joint-venture companies to enter two new provinces a year. Changing the status of the company to a subsidiary makes the company an independent legal entity which allows it to apply for setting up its own branch offices in other provinces in China. While this may allow Allianz to enter more than two provinces in China per year, it still depends heavily on collaboration and negotiations between the Allianz subsidiary and a variety of Chinese regulators.
The Allianz casualty and property branch office opened in 2003, they have been growing their business selling engineering, domestic credit, liability, property, marine, short-term health insurance and accident insurance in the province to clients both foreign and domestic.
Given the new opportunities for expansion into new provinces, Allianz intends to keep the focus on growing their core industrial and commercial business, as well as expanding retail distribution of their products during 2010.
Bupa – Since being started in 1947, The British United Provident Association, or Bupa, has grown to an international company offering health insurance, health and care services to over 10 million customers in 190 countries around the world.
IHI Bupa – Originally dubbed IHI Danmark, the company has 30 years of history as an innovative international health insurer. The company was purchased by Bupa in 2005, and became a branch in 2009 beginning to operate under the banner of ihi Bupa.
Allianz – Founded in 1890 as an accident and transport insurer, Allianz has grown into a international insurer with over 75 million customers in approximately 70 countries.