Power of Protection: Group Health Insurance in the Philippines
About Us
Employee Benefits Asia is a dedicated brand of Tenzing Pacific Services, Vietnam’s leading expat insurance broker since 2013. We have over 130+ perfect 5-star Google Reviews and have written this guide to provide you & your organization clarity on group health insurance in Vietnam.
We work with groups of all sizes, from 1 employee to 500+ from local, regional & international providers who service Vietnam. Our dedicated support to our cilents leads to exceptional user experiences in an industry full of landmines.
Group Heath Insurance Overview in Philippines
The group health insurance market in the Philippines is witnessing robust expansion, driven by rising healthcare costs, government initiatives like the Universal Healthcare Act, and an uptick in corporate culture valuing employee health. Key players in this market include giants like Sun Life, AIA Philippines, and Maxicare, offering a variety of plans that cater to both small businesses and large corporations.
How Group Health Insurance Works
Group health insurance provides collective coverage where employers secure insurance for their employees. This group approach leads to lower premiums than individual plans and typically covers hospitalization, outpatient services, and optional dental or vision care.
Perks of Group Policies
Affordability: Economies of scale mean that premiums are generally lower than individual plans.
Comprehensive Coverage: From basic medical services to specialized treatments, group policies can cover a wide array of health-related expenses.
Tax Benefits: Employers can often claim tax deductions on health insurance premiums, while employees enjoy non-taxable benefits.
Ease of Enrollment: Group policies streamline the process of getting insured, with less paperwork and fewer medical examinations required.
Health Insurance Benefits
Hospitalization: Covers inpatient care, including room charges, doctor’s fees, and surgical expenses.
Outpatient Services: Includes consultations, diagnostic tests, and medications outside hospital settings.
Maternity Benefits: Some policies offer coverage for prenatal care, childbirth, and postnatal care, helping new parents without worrying about hefty medical bills.
Dental and Vision: Often an add-on, these benefits cover routine check-ups and treatments, enhancing overall health management.
Emergency Services: Critical for providing immediate care in accidents or sudden illnesses, with coverage for ambulance services and emergency treatments.
Why Get Group Health Insurance in Philippines?
Providing group health insurance through your company in the Philippines offers numerous advantages, including:
- Coverage for employees to manage significant, unexpected medical expenses.
- Issuance of a VAT invoice.
- Health insurance is tax-exempt, eliminating additional fees.
- Reduces your income tax liability by categorizing it as a company expense.
- Access to group health insurance discounts, helping you save on premiums.
- Simplified policy management and centralized administration.
- Exclusive access to plans designed specifically for groups.
Things to Consider
When establishing group health insurance for your company in the Philippines, consider the following key points:
- What is the primary goal of your group health insurance plan?
- What would an ideal plan look like for your organization?
- What budget has been allocated for this plan?
- Which employees will be eligible for private insurance? Will it cover everyone or only specific groups?
- Will all employees be enrolled under the same insurance provider?
- What specific benefits do you intend to include?
- Will the plan extend coverage to dependents?
- Will the company cover the full premium, or will employees contribute a portion through salary deductions?
- How will you strike a balance between employee satisfaction and cost efficiency?
Any of these factors can change which providers we recommend to you. This is why it’s important to work with an experienced broker like EB Asia by Tenzing Pacific Services, who can guide you towards the ones that suit your company and steer you clear from the ones that will cause you headaches.
Using Group Health to Attract & Retain Talent
In a competitive job market, offering robust group health insurance can be a game-changer. It not only attracts top talent but also plays a crucial role in retention. Employees value health benefits as part of their compensation package, viewing it as a sign of employer care and investment in their well-being. This can translate into higher job satisfaction, lower turnover rates, and a more motivated workforce.
Consequences of Ignoring Group Health Insurance
- Higher Employee Turnover: Employees might seek companies with better benefits.
- Decreased Productivity: Health issues among employees without adequate coverage can lead to more sick days and reduced work efficiency.
- Increased Out-of-Pocket Costs: Without insurance, both employer and employee might face unexpected high medical costs, impacting financial health.
Strike the Balance
You want to have an even balance between:
- What’s good for your employees
- What’s good for your company
- What the cost is
That is a very fine line & if you don’t get it right, you’re looking at:
- Disgruntled employees (definitely not an employee benefit)
- Unsustainable premiums year-over-year
- Changing providers, processes, rules, etc. constantly
It’s critical to get it right from the beginning and build a plan that’s sustainable long-term and strikes the right balance between what’s good for your employees and what’s good for your company.
Group Health Insurance Providers
There are many insurance providers to consider in Philippines, including health insurance providers with offices in Philippines and international providers as well.
There is a growing list of insurers in Philippines with offices, local payment & who can issue VAT invoices. We group these into 3 categories:
- Budget friendly – local health insurer in Philippines with budget friendly plans with lower limits, coverage areas & stricter rules
- Best value – good value all things considered, benefits for your premium with regional direct billing
- High quality – the highest benefits limits, coverage area & global direct billing
Benefits & Coverage Area
Insurance providers in the Philippines typically offer four coverage options:
- Philippines only
- Asia excluding Singapore, Hong Kong, and China
- Worldwide excluding the USA
- Worldwide
The broader the coverage area, the higher the premiums, particularly if the plan includes access to high-cost healthcare markets like Singapore.
Benefit Options:
Inpatient care, often with emergency evacuation, is a standard benefit. Optional add-ons may include:
- Outpatient consultations
- Annual health screenings
- Routine dental care
- Maternity coverage
- Personal accident protection
Benefit Sub-limits:
Basic plans may include sub-limits, leading to potential out-of-pocket costs if expenses exceed those limits. More extensive plans offer higher benefit limits, reducing the likelihood of out-of-pocket expenses but come with increased premiums.
Pre-existing Conditions
Some private insurers in Philippines offer coverage for pre-existing conditions with Medical Health Disregarded (MHD) provisions, typically for groups starting from 5 employees. However, not many providers offer this, and it tends to be costly. Generally, to get MHD coverage, you need:
Local Style
50+ employees
International Style
10+
total people, adults or employees, depending on the exact company
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Related Articles
how to save money on your premium
Installments
• Pay monthly
• Pay quarterly
• Pay semi-annually
Reduce Benefits
• Focus on Inpatient
• Skip Outpatient
• Save 50% by doing so
Reduce Area
• Asia focused cover
• Ditch worldwide
• Save 25-30% by doing so
Direct Billing
• Pay & Claim for Outpatient
• Small hassle? Yes
• Save money by doing so
• Claims paid in <7 days
Deductible
• Pay $X out-of-pocket 1st
• Insurance kicks in after
• ex. $1K USD deductible
• Get 20% OFF
Co-pay
• Agree to pay X%
• Example 20% of OP expenses
• Save money by doing so
our services
Our service is completely free for you, it does not cost anything extra to have a professional broker on your side to help with:
1) Initial Consultation & Quotes
We need to understand your needs, then we will get quotes from suitable providers that meet your needs & budget. We will then present them to you, explain them, answer your questions & help you make an informed decision.
2) Plan Launch
We provide a training session at plan launch to help employees understand their policy, how it works, processes, who to contact, what to be careful of, etc.
3) Customer Service
We are the liaison between you, your employees, the hospital/clinic + the insurer. We have an in-house customer service team that:
- Works on behalf of you & your team, not the insurer
- Coordinate direct billing or guarantees of payment
- Process claims & reimbursements
- Resolve any matters when an issue arises
- Answering employees questions so your HR doesn’t have to
Read what real customers say about our complimentary customer service.
4) Policy Administration
Our customer service team works with your HR or main point of contact for anything related to:
- Application forms & contracts
- Distribution of policy documents, cards, getting your employees app/portal set up
- Invoices, payments & VATs
- Adding or removing employees
5) Renewal
Around 2 monts before your policy is set to renew, we’ll do an annual review with you. Get your feedback & your employees feedback about what worked, what didn’t work & look at what changes can be made at the renewal date.