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Sales Presentation
2012
102pg
Disclaimer Renowned author Seth Godin approved my use of the term PURPLE
COW (2/4/09): “It’s fine with me, just please make it clear that I haven’t endorsed your service.”
Disclaimer Renowned author Seth Godin approved my use of the term PURPLE
COW (2/4/09): “It’s fine with me, just please make it clear that I haven’t endorsed your service.”
1. INTRODUCTION1. INTRODUCTION The Purple Cow STORY The Purple Cow STORY
2012
Gotuaco’s Purple Cow is a unique healthcare product
that stands out in the field of EMPLOYEE BENEFITS.
Gotuaco’s Purple Cow is a unique healthcare product that stands out in the field of EMPLOYEE BENEFITS.
“What is a Purple Cow?”A unique product that stands out in the field.
“What is a Purple Cow?”A unique product that stands out in the field. 1
“Moo!”
VisionVisionVisionVision 2
FINANCIAL FINANCIAL SECURITY…SECURITY…
through PURPLE COWPURPLE COW
Employee Employee Benefits.Benefits.
LIKE Purple Cow Employee Benefits on Facebook
MissionMissionMissionMission 3
To PROTECTPROTECT Employers & Employers & Employees...Employees...
from FINANCIAL FINANCIAL
ININSECURITY.SECURITY.
LIKE Purple Cow Employee Benefits on Facebook
SUPPORTSUPPORT SMESME:
they are the FUTURE FUTURE
HEROES HEROES of our economy!
AdvocacyAdvocacyAdvocacyAdvocacy 4
LIKE Purple Cow Employee Benefits on Facebook
DOING DOING BUSINESS BUSINESS
with SME:SME:
MORE FUNMORE FUN in the
PHILIPPINES! PHILIPPINES!
PhilosophyPhilosophyPhilosophyPhilosophy 5
LIKE Purple Cow Employee Benefits on Facebook
2. VALUE PROPOSITION 2. VALUE PROPOSITION The Purple Cow USPThe Purple Cow USP
2012
Purple Cow gives you all 3 of today’s major employee benefits in 1 package, designed to provide multiple layers of protection:
Group Life: P50,000 – P1,000,000
Group Accident: P50,000 – P1,000,000
Group Health: P10,000 – P200,000
More VALUE…
1
You can get MORE benefits for ALL of your staff
Purple Cow 2012
Value Proposition
Purple Cow saves you 25% - 50% on the 2 most frequently selected Room & Board categories (Ward & Semi-Private) when you combine them with our Max. Benefit Limits:
Ward 10-20-30T: starts at P4,991 / P6,378/yr*
Semi 30-40-50T: starts at P6,821 / P8,646/yr*
+ Less PRICE…
2
You can get LOWER rates for MAJORITY of your staff
Purple Cow 2012
Value Proposition
*(Starting rates for new Virgin / new Non-Virgin accounts. See Costs section for all the rates)
Purple Cow shares the Good News with each level of your SME organization:
Employees: More financial security
HR: Better recruitment & retention
Finance: Greater financial viability
CEO: Major ‘pogi’ points
= More HAPPINESS!
3
You can make EVERYONE happy
Purple Cow 2012
Value Proposition
3. MACRO / MICRO3. MACRO / MICRO The Purple Cow BIG & SMALL PICTURE The Purple Cow BIG & SMALL PICTURE
2012
Manuf., 2,716, 45%
Tran./Cm./Str., 503, 8%
Elec/Gas/Wat., 413, 7%
Cm.SocSv., 181, 3%
Min./Quar., 103, 2%
Constrctn., 94, 2%
Agr/Fis/For., 76, 1%
Wh/Re.Trd., 1,069, 18%
FIRBS, 841, 14%
Manuf.
Wh/Re.Trd.
Fin/RE/BzSvc.
Tran./Cm./Str.
Elec/Gas/Wat.
Cm.SocSv.
Min./Quar.
Constrctn.
Agr/Fis/For.
The P6T Philippine Economy
FIRBS = Financial Services, Real Estate & Business Services
(in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed.
1Purple Cow 2012
Macro & Micro
Pawnshop, 1, 0%
Inv.Co./Hous., 10, 2%
3 PreNd.Hlth, 6, 1%
PreNd.P/E/M, 12, 2%
21 Insurance, 104, 17%
Banking, 380, 61%
Fin.Hold.Co., 95, 15%
Mutual.Fund, 3, 1%
Fin./Lease, 2, 0%
Credit.Card, 6, 1%
Banking
21 L/NL. Ins.
Fin.Hold.Co.
PreNd.P/E/M
Inv.Co./Hous.
Credit.Card
3 PreNd.Hlth
Mutual.Fd.
Fin./Lease
Pawnshop
The P600B Financial Services Sector
Insurance includes Medical INS.; Pre-Need Health = HMO
(in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed.
2Purple Cow 2012
Macro & Micro
15 PreNd.HMO, 12, 11%
35 Life.INS, 57, 51%
88 Non-Lf.INS, 42, 38%
35 Life.INS
88 Non-Lf.INS
15 HMO
The Insurance vs. HMO Industries
Insurance Industry (123 Co./P99B) > HMO Industry (15 Co./P12B)
HMO Figures: AHMOPI, 2009
Life & Non-Life Insurance Figures: Insurance Commission, 2009(in Billions of Pesos)
3Purple Cow 2012
Macro & Micro
15 PreNd.HMO, 12, 92%
5/123 Med. INS, 2, 8%
15 HMO
5/123 Med.INS
The Medical INS. vs. HMO Markets
HMO Figures: Delphi, 2009
Medical Insurance Figures: Delphi, 2009
Medical INS. market (5 of 123 Co./P2B) < HMO market (15 Co./P12B)
(in Billions of Pesos)
4Purple Cow 2012
Macro & Micro
The QUESTION:
Q: “What should you get?”
the BIGGER product (HMO)
from the smaller industry? (HMO) (HMO is 90% of the healthcare market, but the HMO industry is 1/10 th the size of the Insurance Industry);
or the smaller product (medical insurance)
from the BIGGER industry? (insurance) (Medical Insurance is 10% of the healthcare market, but the INS. industry is 10x the size of the HMO Industry). Can you get the best of both worlds?
5Purple Cow 2012
Macro & Micro
The ANSWER:
A: “You should get…”
the BIGGER product (HMO plan)…♠ Buffet of benefits♥ Nationwide network♦ No-cash-out♣ No inner limits
...from the BIGGER industry (Insurance)!
♠ More Stability♥ More Underwriting♦ More Regulation ♣ More Experience
An HMO plan from an INS. CO. can give you the best of both worlds!
6Purple Cow 2012
Macro & Micro
The Healthcare ‘Red Ocean’
The top 1% of all enterprises receive all the Healthcare attention…
LG 2,958 (.4%)
MEDIUM 2,923 (.4%)
SMALL 61,762 (7.6%)
MICRO743,949 firms (91.6%)
LG100M200+ee
MEDIUM P15-100M; 100-199 ee
SMALL P3-15M; 10-99 ee
MICRO<P3M assets; 1 – 9
ee
Figures: NSO 2001; DTI 2004
GROUP HEALTH
GROUP HEALTH
7Purple Cow 2012
Macro & Micro
The Healthcare ‘Blue Ocean’
…while 99% of all enterprises remain un-served or under-served!
LG 2,958 (.4%)
MEDIUM 2,923 (.4%)
SMALL 61,762 (7.6%)
MICRO743,949 firms (91.6%)
LG100M200+ee
MEDIUM P15-100M; 100-199 ee
SMALL P3-15M; 10-99 ee
MICRO<P3M assets; 1 – 9
ee
Figures: NSO 2001; DTI 2004
GROUP HEALTH
INDIVIDUAL HEALTH
8Purple Cow 2012
Macro & Micro
The Healthcare ‘Purple Ocean’
GOAL: to protect employers & employees from financial insecurity
LG 2,958 (.4%)
MEDIUM 2,923 (.4%)
SMALL 61,762 (7.6%)
MICRO743,949 firms (91.6%)
LG100M200+ee
MEDIUM P15-100M; 100-199 ee
SMALL P3-15M; 10-99 ee
MICRO<P3M assets; 1 – 9
ee
Figures: NSO 2001; DTI 2004
PURPLE COW
EB 4 SME
9Purple Cow 2012
Macro & Micro
4. EB PRIMER4. EB PRIMERA Whole New WORLD of Employee BenefitsA Whole New WORLD of Employee Benefits
2012
What are Employee Benefits (EB)?
EMPLOYEE BENEFITS are incentives given to employees as part of an overall HR strategy to recruit or retain them.
EB can help you win the war for talent
1Purple Cow 2012
EB Primer
What is the purpose of EB?
“The purpose of EMPLOYEE BENEFITS is to increase the economic security of employees.”
- Wikipedia
EB can help your employees become financially secure
2Purple Cow 2012
EB Primer
1. Paid vacations, 75% 2. Health insurance, 61%3. Paid sick leave, 59%4. Disability insurance, 41%5. Education reimbursement, 39%6. Pension plan, 30%7. Life insurance, 29%8. Dental insurance, 24%
What are the most common EB?
All 4 insurance benefits are offered by Purple Cow!
3
- Small Business Poll on Compensating Employees (NFIB, US: 2003)
Purple Cow 2012
EB Primer
What makes Insurance ‘sulit?’
• LIFE INSURANCE provides you with instant cash in the event of death or total and permanent disability; (.25% of population between 18-65)
• ACCIDENT INSURANCE provides you with instant cash in the event of accidental death or disablement; (10% of inpatient & outpatient cases)
• HEALTH INSURANCE (medical insurance or HMO) protects you from losing money in the event of sickness or accident. (10% inpatient / 300% outpatient)
Insurance saves you from losing your money
4Purple Cow 2012
EB Primer
Why give Insurance to employees?
• Because you want to take care of the hands that take care of YOU (Employees are your key success factors);
• Because you want to STOP your Employees from
LOSING MONEY to medical emergencies – the most common cause of their financial insecurity;
• Because Employee health is not just Corporate wealth, but also Corporate Social Responsibility.
Charity begins at home: give your staff the gift of health
5Purple Cow 2012
EB Primer
Why get the Purple Cow?
• The Purple Cow is UNIQUE: no other insurance company, HMO, agent, or broker offers such a plan;
• The Purple Cow is SMART: it has all the features and benefits majority of our Customers say they want or need;
• The Purple Cow is PERFECT: the recommended R&B and MBL are the right combination up to 99% of the time. Why pay more if you can pay less?
Purple Cow is the right choice for your SME
6Purple Cow 2012
EB Primer
Why get AsianLife (ALGA) as Insurer?
• ALGA is the BIGGE$T NAME in group life & medical insurance, and the only insurance company today that offers an HMO plan; (ALGA clients include PLDT, Smart & Meralco)
• ALGA is the BE$T VALUE for your money, with the most useful life, accident & health benefits rolled into one;
• ALGA offers the LOWE$T PRICE, when comparing all its insurance & HMO features & benefits.
ALGA gives you the best of both INS and HMO worlds
7Purple Cow 2012
EB Primer
• GRA is the #1 Filipino, (2) family-owned, full-line insurance brokerage in the country today: it produces >P1B in premiums, and has been in the Top 5 since 1965;
• GRA’s partners, Larry Gotuaco & Albert del Rosario, are legends in the industry; the Next Generation of Meg Isleta, Andy Gotuaco & Tom Gotuaco carry on the Tradition;
• GRA’s Tom Gotuaco is the Creator of PURPLE COW: the only EB plan today that treats SME like a large company.
Why get GRA as Broker?
GRA offers the perfect admin backroom for Purple Cow
8Purple Cow 2012
EB Primer
5. BENEFITS 5. BENEFITS
Your SECRET to Financial Security Your SECRET to Financial Security
2012
Benefits OverviewLIFE – ACCIDENT – HEALTH
LIFE
1. LIFE INSURANCE
* Terminal Illness Rider
* Total & Perm Disability Income
HEALTH
3. MEDICAL HMO * 19,401 MD, 382 hospitals, 426 clinics
4. Opt. DENTAL HMO * Basic 10: 790 dentists, 659 clinics
5. Opt. Annual Physical Exam * Basic 5: mobile or clinic
6. Health & Wellness Program * up to 2x/yr; tailored to utilization report
ACCIDENT
2. ACCIDENT INSURANCE
a. Accidental Death * Murder
b. Accidental Disablement * Assault
1Purple Cow 2012
Benefits
Benefits SummaryLIFE – ACCIDENT – HEALTH
1. Life = 5x MBL 13. Access to Big 5 Hospitals & Healthway
2. Terminal Illness = up to 50% of 5x MBL 14. 100% Pre-Existing Conditions coverage
3. Total & Perm. Disability Income = 5x MBL 15. 100% Congenital Conditions coverage
4. Accidental Death = 5x MBL 16. 100% Special Procedures coverage
5. Murder = 5x MBL 17. Benefits on top of Philhealth
6. Accidental Disablement = __% of 5x MBL 18. Pooled Employee utilization
7. Assault = __% of 5x MBL 19. Separate Dependent utilization
8. Medical = HMO buffet of benefits 20. Opt. Dental = HMO buffet of benefits
9. Combined inpatient & outpatient limits 21. Opt. APE = choice of mobile or clinic
10. Max. Benefit Limits per disability per year 22. Health & Wellness Program (up to 2x/yr)
11. HMO patient for no-cash-out 23. Same benefits for Dependents
12. Private patient for reimbursement (HMO rate) 24. Interactive access through Social Media
2Purple Cow 2012
Benefits
1. Life Insurance (worldwide)ASIANLIFE EXCLUSIONS
1. Life 5x MBL 1. Suicide within the 1st year of coverage
2. Terminal Illness Rider (up to 50%)2.5x MBL
3. Total & Perm Disability Income 5x MBL
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo
1. Life benefit = 5x MBL, for death by any cause;
2. TIR benefit = up to 50% of 5x MBL, as an advance on the Life benefit, if terminally ill (< 12mos. to live); 50% balance upon death;
3. TPDI Benefit = 5x MBL, in lieu of the Life benefit, whether sickness or accident.
Example:
If MBL = 20T, Life or TPDI = 100,000; TIR = 50,000;
If MBL = 40T, Life or TPDI = 200,000; TIR = 100,000;
If MBL = 60T, Life or TPDI = 300,000; TIR = 150,000;
If MBL = 80T, Life or TPDI = 400,000; TIR = 200,000;
If MBL = 100T, Life or TPDI = 500,000; TIR = 250,000.
Life benefits are payable on top of Accident & Medical HMO benefits
3Purple Cow 2012
Benefits
2a. Accident Insurance (worldwide)ASIANLIFE
1. Accidental Death 5x MBL 3. Disablement _% 5x MBL
2. Murder 5x MBL 4. Assault _% 5x MBL
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo
1. Accidental Death = 5x MBL, for death from any type of accident;
2. Murder = 5x MBL, in lieu of the Accidental Death benefit, for death not due to accident but murder (provoked or not). Example:
If MBL = 20T, Accidental Death or Murder = 100,000;
If MBL = 40T, Accidental Death or Murder = 200,000;
If MBL = 60T, Accidental Death or Murder = 300,000;
If MBL = 80T, Accidental Death or Murder = 400,000;
If MBL = 100T, Accidental Death or Murder = 500,000.
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo
3. Disablement = __% of 5x MBL, according to a long schedule of indemnities;
4. Assault = __% of 5x MBL, in lieu of the Disablement benefit, for disability not due to accident but assault (provoked or not).Example:
If MBL = 20T, Disability or Assault = __% of 100,000;
If MBL = 40T, Disability or Assault = __% of 200,000;
If MBL = 60T, Disability or Assault = __% of 300,000;
If MBL = 80T, Disability or Assault = __% of 400,000;
If MBL = 100T, Disability or Assault = __% of 500,000.
Accident benefits are payable on top of Life & Medical HMO benefits
4Purple Cow 2012
Benefits
2b. Accident Insurance… LONG SCHEDULE OF INDEMNITIES
1. Life (same as Accidental Death) 100% 14. Middle finger 6%
2. Both hands or feet or sight of both eyes 100% 15. Ring finger 5%
3. One hand and one foot 100% 16. Little finger 4%
4. Either hand or foot and sight of one eye 100% 17. Metacarpals 1st/2nd - 3rd/4th/5th 3% - 2%
5. Injuries resulting in being perm. bedridden 100% 18. Leg at or above knee 60%
6. Any other injury causing Total Perm. Disab. 100% 19. Leg below knee 50%
7. Arm at or above elbow 70% 20. One foot 50%
8. Arm between elbow and wrist 50% 21. All toes on one foot 25%
9. One hand 50% 22. Big toe 5%
10. Four fingers and thumb of one hand 50% 23. Any toe other than big toe (each) 1%
11. Four fingers 35% 24. Sight of one eye 50%
12. Thumb 15% 25. Hearing - both ears 50%
13. Index finger 10% 26. Hearing - one ear 25%
+Multiple losses from 1 accident will be limited to the highest loss, not to exceed 100%. If a member suffered the loss of 1 hand/foot/eye prior to coverage, the benefit for a subsequent loss of the same will be ½.
Losses refer to total and permanent loss of use or complete severance
5Purple Cow 2012
Benefits
2c. Accident Insurance…EXCLUSIONS
1. Bodily or mental infirmity, hernia, ptomaine, bacterial or viral infection (except pyogenic infection occurring with and through an accidental cut or wound)
12. War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war
2. Disease, sickness, parasite, or disorder of the body/ mind
3. Poison, gas or fumes voluntarily or involuntarily taken
4. Insect bites 13. Serving in the armed forces of any country, or international authority, whether in war or peace5. Earthquake, volcanic eruption or tidal wave
6. Atomic explosion, nuclear fission, or radioactive gas 14. Entering, operating, servicing, ascending or descending from any aerial or submarine device or conveyance, except as provided under a passenger aviation provision7. Pregnancy, childbirth, miscarriage or any complications
8. Accident occurring while or because the Insured is under the influence of alcohol or any drug
15. Hunting, motorcycling or pillion riding, mountaineering which necessitates the use of ropes or pitons, racing of any kind, other than on foot, ice or winter sports, water-ski jumping and tricks, yachting beyond 5 km. off a coastline, underwater activities involving the use of underwater apparatus, or using woodworking machinery driven by mechanical power other than portable tools, applied by hand and used solely for private purposes without reward
9. Suicide or any attempted threat while sane or insane, or any intentionally self-inflicted injury
10. Participation in any brawl, or committing any crime or felony
11. Provoked murder / assault or attempted threat [waived]
6Purple Cow 2012
Benefits
3a. Medical HMO (nationwide)ASIANLIFE (19,401 doctors, 382 hospitals, 426 clinics) TERMS & CONDITIONS
1. Traditional HMO buffet of benefits 1. Instant rates, regardless of size
2. Combined inpatient & outpatient limits 2. No franchising required
3. Max. Benefit Limits per disability per year 3. No utilization report required
4. HMO patient for no-cash-out 4. No individual applications required
5. Private patient for reimbursement (HMO rate) 5. Minimum group size = 10
6. Access to Big 5 hospitals & Healthway 6. Minimum mode of payment = monthly
7. 100% Pre-Existing Conditions coverage 7. Pooled Employee utilization to spread risk
8. 100% Congenital Conditions coverage 8. Split Dependent utilization to reduce cost
9. 100% Special Procedures coverage 9. Buy now, pay later
10. Benefits on top of Philhealth 10. 1st year Virgin promo rate, if applicable +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo +Same rates for Dependents in 2012
Medical HMO benefits are covered on top of Life & Accident benefits
7Purple Cow 2012
Benefits
3b. Medical HMO…PRE-EXISTING CONDITIONS (Dreaded) PRE-EXISTING CONDITIONS (Non-Dreaded)
1. Blood dyscrasias 1. Asthma, pleural effusion or other chronic airway obstruction conditions
2. Benign / malignant new growths 2. Benign cyst / tumor and malignant conditions
3. Chronic cardiac / cardio-vascular diseases 3. Chronic gynecologic conditions
4. Collagen / connective diseases 4. Hemorrhoids and other chronic colonic and ano-rectal illnesses
5. Diseases of the immune system 5. Diseased tonsils requiring surgery, cataracts & other opthalmo-otolaryngologic conditions
6. Chronic hepatobiliary diseases 6. Pathological abnormalities of nasal septum and turbinate
7. Neuro-surgical / neurological conditions 7. Sinus condition requiring surgery
8. Chronic pulmonary diseases 8. Chronic neurologic conditions
9. Chronic genito-urinary diseases 9. Calculus cholecystitis / cholelithiasis and/or urolithiasis
10. Chronic gynecological conditions 10. Chronic conditions of the genitourinary system
11. Chronic gastrointestinal conditions 11. Polyps, ulcers, liver cirrhosis and other chronic gastrointestinal diseases
12. Endocrine abnormalities 12. Endocrine illnesses
13. Antibiotic / chemotherapy-resistant diseases / bactemia / septicemia 13. Seizure disorders
14. Chronic opthalmo-otolaryngologic diseases 14. Moderately to far advanced tuberculosis
15. Chronic musculo-skeletal diseases 15. Chronic musculo-skeletal malignancies
16. Pathological / accidental fractures 16. Malignancies of the blood and bone marrow
17. Illnesses / injuries necessitating the use of isolation room / ICU or other IC facilities 17. Hypertension, coronary artery disease / myocardial ischemia, cerebrovascular accident and other chronic cardiac diseases18. Accidental injuries
19. Second and third degree burns 18. Collagen / connective tissue diseases
20. Surgical procedures requiring application / use of prosthesis for immediate treatment 19. Diseases of the immune system
21. PEC (except congenital ones) subject to the provision on ‘PEC’ in this Agreement [waived] Dreaded & Non-Dreaded PEC are covered 100% up to MBL
8Purple Cow 2012
Benefits
3c. Medical HMO…SPECIAL PROCEDURES or NEW MODALITIES OF TREATMENT
1. Lithotripsy 11. Sclerotherapy
2. Arthroscopic procedures 12. Physical & speech therapy
3. Laparoscopic procedures 13. Angiography
4. Laser therapy (excludes use for correcting vision) 14. Nuclear technologies
5. Nuclear / radioactive isotope scans 15. Thallium scintigraphy
6. Cost of artificial limbs, joint prosthesis and heart valve prosthesis
16. CT scan / MRI
17. Pulmonary perfusion scan
7. Other new modalities of treatment for conditions with established etiologies and used as alternatives to conventional or traditional procedures
18. Endoscopy
19. Bone densitometry scan
20. Anti-nuclear anti-body (ANA)
8. Dialysis 21. C-reactive protein (rheumatic & complications)
9. Chemotherapy 22. Lupus cell exam
10. Radiation oncology / therapeutic radiology 23. Sleep therapy
Special Procedures or New Modalities of Treatment are covered 100% up to MBL
Purple Cow 2012
Benefits 9
3d. Medical HMO…EXCLUSIONS
1. Expenses that should be taken care of by any government programs such as Philhealth 13. Illnesses / injuries attributable to the plan member’s own misconduct / gross negligence / immoral habits, and willful and unnecessary exposure to danger or health hazards 2. Services rendered or supplies provided free of charge
3. Additional hospital charges and/or professional fees resulting from a plan member taking a room accommodation more than his R&B limit (excesses and/or incremental costs)
14. Self-inflicted injuries including, but not limited to, any form of suicide attempt
4. Maternity and maternity-related conditions and/or complications except those benefits that may be provided by the (optional) Maternity benefit
15. Sexually transmitted disease, AIDS, rehabilitative treatment for alcoholism and drug abuse
5. Sterilization of either sex or reversal of such, artificial insemination, sex change, consultation/confinement regarding fertility
16. Acquisition of prosthetic appliances, artificial aids, durable equipment, surgically implanted devices and external prosthetic devices except those that are explicitly covered and enumerated in the ‘Special Procedures or New Modalities of Treatment’ provision of this agreement6. Non-recommended confinement, convalescent / domiciliary / custodial care, rest cures
7. Dental-related cases except those that may be provided by the Dental Benefits and to the extent that are necessary for the repair or alleviation of damage caused solely by accidental injury sustained (and not caused by the plan member)
17. Organ transplant-expense relating to organ donation of the donating party/parties
18. Executive check-ups, unless explicitly provided in the master policy, and/or confinements purely for diagnostic purposes, as well as non-recommended confinements
8. Circumcision, cosmetic / aesthetic procedures except re-constructive surgery to treat functional defects due to a covered disease and/or accidental injury
9. Psychiatric disorders, psychosomatic conditions, treatment for any mental or nervous disorders, illness / injury / condition / complication arising from the plan member’s excessive alcohol intake and/or use of regulated/prohibited drugs
19. Take-home medicines, unless optional ‘Reimbursement of Prescribed Medicines’ benefit is provided, and vaccines, except for first doses of either anti-venom, anti-rabies or anti-tetanus used for emergency treatment
10. Illnesses and/or injuries arising from the plan member’s participation in brawls, riots, commission of a crime, violation of ordinances, or the like
20. Medico-legal fees including the cost of Medical Certificates that a plan member may require for any purpose it may serve him or her
11. Illnesses / injuries resulting from conditions of war or sustained from combat-related activities
21. Congenital disease / deformity that is evident to the plan member at birth and/or can be clinically determined to be congenital [waived]
12. Illnesses / injuries resulting from the plan member’s active participation in hazardous activities such as, but not limited to, bungee jumping, hang-gliding, scuba diving, mountain/wall climbing, and professional sports
22. Medical / surgical procedures and/or diagnostic tests that are experimental in nature and/or not generally accepted by the medical profession such as, but not limited to, iridology, chiropractic services, and acupuncture
10Purple Cow 2012
Benefits
4. Optional Dental HMO (nationwide)HP DENTAL (790 dentists, 659 clinics) EXCLUSIONS
1. (1) permanent filling 1. Dental procedures not included in the list of 10 benefits
2. (2) oral prophylaxes 2. Reimbursements for seeing your own dentist
3. Unlimited consultations
4. Simple tooth extractions if indicated
5. Temporary fillings when indicated
6. Gum treatment except for alveolectomy/gingivectomy
7. Simple adjustment of dentures1
+Access to HP Dental-accredited clinics in SM, Market2, Festival, Robinson’s, Shangrila, and ATC malls.
+Dental card and booklet provided, as well as an orientation and an annual utilization report.
+Discounts available on procedures not included in the dental HMO plan.
Optional Nationwide Dental HMO: +/- P300
8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays
9. Treatment of pain/lesions/wounds/burns
10. Emergency dental procedures if necessary
+Appointment preferred (unless emergency)
Optional Dental HMO benefits are covered on top of Medical HMO benefits
11Purple Cow 2012
Benefits
5. Optional Annual Physical ExamVARIOUS (mobile or clinic) EXCLUSIONS
1. Physical examination 1. APE procedures not included in the Basic 5 APE plan
2. Chest X-Ray
3. CBC Basic 5
4. Urinalysis
5. Fecalysis
+The Annual Physical Exam (APE) is a diagnostic tool, not a cure for sickness or accident. Results can serve as a baseline for referral to specialists who can authorize tests and/or prescribe further treatment.
+By appointment only, 30 days in advance.
+Pay as you go, so you don’t lose it if you don’t use it (don’t pay in advance, as payment is not transferable).
+Call Lala Perido at GRA to help design, source, price & schedule your APE during the year [888-0001 x835]. Optional APE: +/- P400 or P500 (for mobile or clinic APE)
Optional APE benefits are covered on top of Medical HMO benefits
12Purple Cow 2012
Benefits
6. Health & Wellness (up to 2x per year) ASIANLIFE (call 890-1758 ext. 278 to schedule) EXCLUSIONS
1. Comprehensive Wellness Program (to 2x/yr) 1. Cost of vaccines
A company’s corporate wellness program is a key component of company success. Based on a company’s health and wellness needs/wants, AsianLife has developed a CWP that can motivate and maintain good health. AsianLife brings corporate wellness programs to the client’s location and implements a wellness program that suits the client’s actual health profile to achieve their unique needs and goals.
To effectively manage healthcare costs, organizations must include programs that proactively help employees maintain and improve their health. The road to better health (and fewer preventable health claims) is paved with small decisions we make every day. The result of doing nothing is continued skyrocketing of health-care costs, rising absenteeism, and lower employee productivity.
Wellness Bottom Line: gains can include… Improved employee health;Increased workforce productivity;reduced health insurance premiums; lower workers compensation claims.
The Comprehensive Wellness Program is customized to meet your health & wellness needs through the following services:
HEALTH RISK ASSESSMENTS: Comprehensive written assessment and detailed CUR (current utilization report) are provided which gives the employee and the employer the information needed to set wellness goals.
HEALTH PROMOTION & DISEASE MANAGEMENT SEMINARS: Pooling from a wealth of resources and expertise available through the medical partners, numerous presentations and seminars are available for the client’s workforce to promote Wellness.
HEALTH SCREENINGS: Periodic onsite health screenings such as blood pressure and body fat analysis are available in the program in addition to more extensive screenings such as blood analysis.
HEALTH PROTECTION MEASURES: Scheduled vaccine administration program can be done within company premises. The vaccine may vary depending on the need/requirement of the company.
Free Health & Wellness Program benefits are covered on top of Medical HMO benefits
13Purple Cow 2012
Benefits
6. COSTS 6. COSTS
Your INVESTMENT in Financial Security Your INVESTMENT in Financial Security
2012
LEGEND:1. VIRGIN – new account that has never had group health before (medical INS or HMO)2. VIRGIN Renewal – renewing Virgin account3. NON-VIRGIN – new or renewing Non-Virgin account4. NON-VIRGIN Renewal – renewing Non-Virgin account
Purple Cow 2012
Costs: New VIRGIN Standard: Life INS / Accident INS / Medical HMO Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500)
1Cost Summary
R&B MBL ANN SEMI QTR MO R&B MBL ANN SEMI QTR MO
WARD(R&F)
10T 4,991 2,646 1,398 500 REG PVT
(Top rank Small co 50-100)
60T 12,332 6,537 3,454 1,234
20T 5,442 2,885 1,524 545 80T 13,888 7,361 3,889 1,389
30T 6,206 3,290 1,738 621 100T 15,185 8,049 4,252 1,519
SEMI PVT(Spvr)
30T 6,821 3,615 1,910 683LRG PVT
(Top rank Med co
100-200)
80T 16,277 8,627 4,558 1,628
40T 7,510 3,981 2,103 751 100T 17,422 9,234 4,879 1,743
50T 8,248 4,372 2,310 825 120T 19,116 10,132 5,353 1,912
SML PVT
(Top rank Small co 10-50)
50T 9,722 5,153 2,723 973JR
SUITE (Top rank Large co > 200)
100T 26,933 14,275 7,542 2,694
60T 10,570 5,603 2,960 1,058 150T 30,327 16,074 8,492 3,033
70T 11,394 6,039 3,191 1,140 200T 34,264 18,160 9,594 3,427
3Purple Cow 2012
Costs: New NON-VIRGIN Standard: Life INS / Accident INS / Medical HMO Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500)
Cost SummaryR&B MBL ANN SEMI QTR MO R&B MBL ANN SEMI QTR MO
WARD(R&F)
10T 6,378 3,381 1,786 638 REG PVT
(Top rank Small co 50-100)
60T 15,705 8,324 4,398 1,571
20T 6,903 3,659 1,933 691 80T 17,613 9,336 4,932 1,762
30T 7,834 4,153 2,194 784 100T 19,181 10,167 5,371 1,919
SEMI PVT(Spvr)
30T 8,646 4,583 2,421 865LRG PVT
(Top rank Med co
100-200)
80T 20,767 11,007 5,815 2,077
40T 9,483 5,026 2,656 949 100T 22,134 11,731 6,198 2,214
50T 10,385 5,504 2,908 1,039 120T 24,226 12,840 6,784 2,423
SML PVT
(Top rank Small co 10-50)
50T 12,332 6,536 3,453 1,234JR
SUITE (Top rank Large co > 200)
100T 34,689 18,386 9,713 3,469
60T 13,378 7,091 3,746 1,338 150T 38,807 20,568 10,866 3,881
70T 14,394 7,629 4,031 1,440 200T 43,644 23,132 12,221 4,365
7. COMP. ADVANTAGES 7. COMP. ADVANTAGES
Why PURPLE COW? Why PURPLE COW?
2012
1 ‘Large’ Size Fits All SME: If you are an SME, with 10 or more regular
employees (per DTI), you can join the herd, and be treated just like a large Company.
(Unlike most HMO plans)
You can enjoy the same toys as the Big Boys
1Why Purple Cow?
Purple Cow 2012
Competitive Advantages
2 Ways to Access Healthcare: You can see an HMO doctor for free,
or your own doctor for reimbursement at the HMO rate – each time you avail.
(Unlike most HMO plans)
You can see your own doctor, cheaper
2Why Purple Cow?
Purple Cow 2012
Competitive Advantages
3 Major Employee Benefits in 1 Plan: You get Group Life, Accident & Health
(medical HMO, optional dental HMO, optional APE, and Wellness) – all in 1 plan.
(Unlike most HMO plans)
You get all the Employee Benefits you will ever need
3Why Purple Cow?
Purple Cow 2012
Competitive Advantages
4 Modes of Payment: You can choose from annual, semi-annual,
quarterly, or monthly modes of payment to suit your cash flow or budget.
(Unlike most HMO plans)
You can pay Annual (60%), S.A. (5%), Qtr. (30%) or Mo. (5%)
4Why Purple Cow?
Purple Cow 2012
Competitive Advantages
5 R&B x 3 MBL Choices each: You can choose up to 5 SME Room & Board
categories x 3 Maximum Benefit Limits each, to suit your organizational needs.
(Unlike most HMO plans)
You can try new combinations to see if they are ‘sulit’
5Why Purple Cow?
Purple Cow 2012
Competitive Advantages
100% Pre-Existing Conditions: You get 100% coverage up to MBL for
Pre-Existing Conditions such as cancer, hypertension, diabetes & asthma.
(Unlike most HMO plans)
You are covered for dreaded & non-dreaded diseases
6Why Purple Cow?
Purple Cow 2012
Competitive Advantages
100% Congenital Conditions: You get 100% coverage up to MBL for
Congenital Conditions such as mitral valve prolapse, rheumatic heart disease & hernia.
(Unlike most HMO plans) You are covered for medical conditions since birth
7Why Purple Cow?
Purple Cow 2012
Competitive Advantages
100% Special Procedures: You get 100% coverage up to MBL for Special Procedures such as arthroscopy,
laparoscopy, chemotherapy, P/T & MRI.
(Unlike most HMO plans) You are covered for newer modalities of treatment
8Why Purple Cow?
Purple Cow 2012
Competitive Advantages
9
Benefits on Top of Philhealth: Your HMO limits are on top of Philhealth,
so you won’t be needing as much MBL: Benefits = Philhealth + MBL (not just MBL).
(Unlike most HMO plans)
You get full HMO benefits on top of Philhealth benefits
Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Pooled Employee Utilization: Your Employee utilization is pooled together with the employee utilization
of all other groups, to spread your risk.
(Unlike most HMO plans)
You get to enjoy the safety of a bigger group
10Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Separate Dependent Utilization: Your Employee and Dependent utilization
are separate, so you won’t have to worry about Dependents affecting Employee rates.
(Unlike most HMO plans)
You can offer Dependent coverage without fear
11Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Life Insurance: Your Life benefit covers death by any cause,
including suicide after 1 year. For example: Ward 20T = 100T; Semi 40T = 200T.
(Unlike all HMO plans)
12
Life = 5x MBL: 1 year’s worth of income replacement
Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Terminal Illness Rider: Your TIR benefit is a 50% advance on your
Life benefit, payable if you have < 12 mos. to live (50% balance payable upon death).
(Unlike all HMO plans)
13
TIR = 50% of 5x MBL, in lieu of life, for living expenses
Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Total & Perm. Disability Income: Your TPDI benefit is in lieu of your Life benefit, payable if you are unable to work
at all, due to sickness or accident.
(Unlike all HMO plans)
14
TPDI = 5x MBL, in lieu of Life, for living expenses
Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Accidental Death Insurance: Your Accidental Death benefit is a double
indemnity to your Life benefit, and covers death by accident only.
(Unlike all HMO plans)
Accidental Death = 10x MBL
15Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Murder: Your Murder benefit is in lieu of your Accidental Death benefit, and payable if you don’t die by accident, but by murder.
(Unlike all HMO plans)
Murder = 10x MBL, in lieu of Accidental Death
16Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Accidental Disablement Insurance: Your Disablement benefit is based on a long schedule of indemnities. For example: loss of hand = 50% of Disablement benefit.
(Unlike all HMO plans)Accidental Disablement = % of 5x MBL
17Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Assault: Your Assault benefit is in lieu of your
Disablement benefit, if you don’t get disabled by accident, but by Assault.
(Unlike all HMO plans)
Assault = % of 5x MBL, in lieu of Accidental Disablement
18Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Medical HMO Network: You can get inpatient, outpatient & ER treatment from 19,401 affiliated doctors,
382 hospitals, and 426 clinics nationwide.
(unlike some HMO plans)
You can go to MMC/ SLMC/ CSMC/ AHMC/ TMC/ Healthway
19Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Optional Dental HMO Network: You can get 1 permanent filling, 2 oral
prophylaxes, and 8 other benefits from 790 dentists and 659 clinics nationwide.
(Unlike some HMO plans)
You can go to SM/ Market2/ Festival/ Robinson’s/ Shangrila/ ATC
20Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Optional Annual Physical Exam: You can order a Basic 5 APE or customize
your APE; you can choose a nearby clinic for your staff or request a mobile APE.
(Unlike some HMO plans)
You can decide if you want an APE, and if so, what kind
21Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Free Health & Wellness Program: ALGA will conduct a free Comprehensive
Wellness Program for your group up to 2x per year, based on your own health issues.
(Unlike most HMO plans)Call Asianlife at 890-1758, ext. 278, to request a CWP
22Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Same Benefits for Dependents: Dependents get the same benefits, terms and conditions as Employees
(as well as the same costs in 2012).
(Unlike most HMO plans)
Your Dependents are treated like Employees
23Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Access through Social Media: You can access info and interact directly with suppliers via ‘C3’ (Command & Control Center), in www.purplecow.ph or Facebook.
(Unlike most HMO & insurance plans)
C3 enables you to proactively manage your own health
24Why Purple Cow?
Purple Cow 2012
Competitive Advantages
The Price is Right: Purple Cow rates are lowest where they matter the most: in the 2 lowest categories, where you enroll up to 90% of your staff!
(Unlike most HMO plans)
You get the greater good for the greater number
25Why Purple Cow?
Purple Cow 2012
Competitive Advantages
The Design is Right: Purple Cow provides medical necessity,
not luxury! Savings from excess R&B/MBL are reallocated to benefits of greater use.
(Unlike most HMO plans)
Your R&B/MBL combos are good up to 99% of the time
26Why Purple Cow?
Purple Cow 2012
Competitive Advantages
The Perfect Insurer: You get serviced by the biggest name in group life & medical, and the only insurance
company today that offers an HMO plan.
(Unlike all insurance companies)
You get the best of both INS & HMO worlds from ALGA
27Why Purple Cow?
Purple Cow 2012
Competitive Advantages
The Perfect Broker: You get represented by a legend in the
industry, and the only insurance broker today that treats SME like a large company.
(Unlike all insurance brokers) You get the perfect backroom support from GRA
28Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Buy Now, Pay Later: You can sign up today, get covered right away, and pay later when GRA bills you
(during your EB orientation, at the earliest).
(Unlike some HMO plans) You can take advantage of a credit float
29Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Easy Sign Up: 1) Complete/email Masterlist (Excel);
2) Sign/fax Endorsement sheet; 3) Sign/fax Letter of Guarantee (letterhead).
(Unlike some HMO plans)
Click ‘Join the Herd!’ to download on www.purplecow.ph
30Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Claims Utilization Report: You get a detailed, user-friendly report
that gives you real insights into your company’s overall utilization patterns.
(Unlike some HMO plans)
You can learn a lot about the state of your group’s health
31Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Group Renewal Rates: You get broker-negotiated group renewal rates for the calendar year, so you can plan in advance without hassling HR or FIN.
(Unlike most HMO plans)
Your renewals become semi-automatic for HR & Finance
32Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Your Employees Win: Employees can use Purple Cow to take
charge of their own health, and protect themselves from even more emergencies.
(Unlike most HMO plans)
P.Cow helps employees to become financially secure
33Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Your HR Wins: HR can use Purple Cow to recruit and
retain staff – especially if you are in a highly competitive work environment.
(Unlike some HMO plans)
P.Cow helps HR to power Recruitment & supply Benefits
34Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Your FINANCE Wins: FINANCE can use Purple Cow to cut
healthcare costs, and reduce future exposure to claims utilization risk.
(Unlike most HMO plans)
P.Cow helps FINANCE to limit all liabilities to the card
35Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Your Company Wins: When your Employees win,
and HR & Finance win, your Company wins!
(Unlike some HMO plans)
P.Cow promotes ‘Win-Win’ among all Co. stakeholders
36Why Purple Cow?
Purple Cow 2012
Competitive Advantages
SME Nation Wins: When your Company wins,
and other SME companies win, Purple Cow SME Nation wins!
(Unlike all HMO plans)
P.Cow promotes ‘Win-Win’ among all SME stakeholders
37Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Virgins can Win Even More: You get a 1st year Virgin promo rate
if your company has never had group medical insurance or HMO before.
(Unlike all HMO plans)You can renew at prevailing Virgin Renewal rates as well
38Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Purple Cow is Perfect for SME: Purple Cow is designed by SME, for SME.
It is the result of an AIM-ME business plan, and backed by years of broker experience.
(Unlike most HMO plans)
You can enjoy all the benefits of Purple Cow innovation
39Why Purple Cow?
Purple Cow 2012
Competitive Advantages
Purple Cow Grows as You Grow: If you grow BIG, you can opt to self-insure
using the same Purple Cow schedule of benefits, as well as the same HMO network.
(Unlike all TPA plans)You can transition smoothly from insured to self-insured
40Why Purple Cow?
Purple Cow 2012
Competitive Advantages
8. SUMMARY8. SUMMARY What’s in it for…ME? What’s in it for…ME?
2012
EE Features EE BenefitsA complete Employee Benefits package that can make you financially secure
You get more financial security from Purple Cow than from any other HMO
Life INS, Accident INS, Medical HMO, Optional Dental HMO & Optional APE
You won’t need to get any more insurance benefits for yourself
Nationwide Medical & Dental networks, inclusive of all major hospitals & clinics
You can use any accredited hospital or clinic for medical or dental treatment
Choice of doctor as a Private Patient for insurance reimbursement at HMO rates
You can see your own doctor and get reimbursed the rate of an HMO doctor
100% Pre-Existing, 100% congenital, & 100% Special Procedures coverage
You are covered for existing illnesses, natal conditions, & special procedures
Employee Benefits on top of Philhealth You get full HMO + Philhealth benefits
Access to benefit information through C3 on www.purplecow.ph & Facebook
You can take charge of your own health, and know before you go
1 health card for every employee You can avail anytime, anywhere
1♠ What’s in it for…Employees?
Purple Cow 2012
Summary
HR Features HR BenefitsA 3-in-1 Employee Benefits package, not just one HMO plan
You get all 3 major employee benefits in one smart employer-paid package
Instant rates, regardless of the size of your SME
You won’t need to wait or negotiate: one price fits all SME in the same pool
Multiple choices of Room & Board and Maximum Benefit Limits to pick from
You can adjust R&B and MBL combos to suit your organizational needs
3 forms to fill out (click ‘Join the Herd!’ at www.purplecow.ph to download)
You don’t need to create any forms: use ours (no utilization report required)
An opportunity to use Employee Benefits to perform critical HR functions
You can use Purple Cow to recruit and retain staff, and to supply benefits
Purple Cow-negotiated renewal rates and terms for the whole calendar year
You won’t have to spend time reviewing renewal proposals every year
Representation by a top local Broker You get broker assistance all year long
1 schedule of benefits for all employees You can promote equal treatment
2♥ What’s in it for…HR?
Purple Cow 2012
Summary
FIN Features FIN BenefitsA complete Employee Benefits package for the price of an HMO plan
You get the benefit of scale whenever you buy Purple Cow Employee Benefits
4 ways to fit Purple Cow in your budget: annually, semi, quarterly, and monthly
You can pay for your healthcare costs according to your cash flow or budget
Membership in a bigger & bigger pool of SME (Small & Medium Enterprises)
You can spread your risk in good times and bad, and establish greater viability
Separation of Employee vs. Dependent utilization for pricing purposes
You can reduce the adverse effect of dependent utilization on price increases
A chance to evaluate employee benefit costs & benefits instantly
You may be surprised over how you get more employee benefits for less cost
A chance to switch over to Purple Cow, before your next modal payment
You can upgrade your benefits, and hopefully not wait a whole year to do so
Purple Cow acts as Gatekeeper Purple Cow protects your interest
1 set of fixed costs for all employees You can limit your financial liability
♦ What’s in it for…Finance?
3Purple Cow 2012
Summary
CEO Features CEO Benefits
Happier Employees
very pogi
CEO!
Happier HR
Happier Finance
♣What’s in it for the…CEO?
4Purple Cow 2012
Summary
9. CONCLUSIONS9. CONCLUSIONS Purple Cow is the ANSWER! Purple Cow is the ANSWER!
2012
Compensation in the PH cannot provide enough financial support in emergencies, and needs extra support;
Benefits (EB) can provide that extra support, as most ‘emergencies’ in the PH are either life, accident, or health-related.
Why Employee Benefits?
1Purple Cow 2012
Conclusions
Compensation + Benefits offer the best 1-2 punch for HR
Employee Benefits are the KEY to your Financial Security – but not all benefits are created equal;
Purple Cow Employee Benefits pool all 3 major employee benefits together, and treat your SME like a large company.
Why Purple Cow Employee Benefits?
2
Purple Cow offers the best EB formula for growing SME
Purple Cow 2012
Conclusions
anxiety depression state of emergency debt desperation
A job without financial security:
3
LESS financial security = MORE worry at work
Purple Cow 2011
Conclusions
security peace of mind happiness focus productivity
A job with financial security:
4
MORE financial security = LESS worry at work
Purple Cow 2011
Conclusions
5% of Salary:that’s all you need for Purple Cow!
The Bottom Line
5Purple Cow 2012
Conclusions
5% is a small price to pay for everyone’s peace of mind
Treat PURPLE COW as:
1) a business investment (HR & FIN);
2) a social investment (CSR).
Our Broker Recommendation...
6Purple Cow 2012
Conclusions
Purple Cow makes good business and social sense