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Voluntary health insurance: your employees will feel your care

Voluntary health insurance (VHI) of personnel today is an important part of the social package and corporate culture of the company. VHI is an effective tool for motivation and management. For most employees, especially key specialists, availability of health insurance is one of the important factors in choosing of a place of work.
Voluntary health insurance: your employees will feel your care

What does VHI mean?

Voluntary health insurance is a form of protection of the insurant's property interests in case of expenses occurrence related to payment for treatment of the insured.

In other words, voluntary health insurance is a type of insurance providing medical services within the chosen insurance program, the costs of which shall be compensated by the insurance company.

Under the VHI agreement, the insurance company guarantees arrangement and financing of medical services according to a certain list and quality provided to the insured within the insurance program chosen in the agreement.

 VHI is of two types:

• Individual VHI is voluntary health insurance for children, adults, expectant mothers and elderly people. It is issued individually for each person applying to the insurance company;

• Corporate VHI is the health insurance of employees of entities. It is usually included into wage supplements of an employee and serves as one of the most effective methods of motivating the staff in the company.

 What is an insured event?

As in any kind of insurance, in VHI there is also such a thing as an insured event.

The insured event in the VHI is the fact of applying by the insured person within the term of the agreement to a medical institution stipulated by the insurance agreement. The reason for treatment may be an acute illness, exacerbation of a chronic disease, trauma, poisoning, etc., requiring consultative, diagnostic, therapeutic, rehabilitation or other assistance stipulated by the insurance program.

What is included into the insurance policy?

The insurance program is formed taking into account the wishes and financial capabilities of the client and can include:

• 24-hour dispatch service

• emergency medical care

• service in medical care center of the insurance company

• out-patient and in-patient care

• laboratory and instrumental methods of tests in a polyclinic

• inpatient treatment and surgery

• advising by a dentist, therapeutic and surgical treatment within the limit set.

• medicines prescribed by the family doctor within the limit set

• vaccination against influenza

• preventive examination (for employees)

• assignment of the members of the employee's family.

Services are included upon the insurer's discretion, for example, you can extend the VHI program for additional members of the employee's family. It is acceptable to create several types of insurance programs for employees of different types.

How much does the insurance policy cost and what are the terms and conditions of the VHI policy?

As in all insurance products, there is an insurance premium in the VHI, i.e., in another words, the cost of the policy. The amount of the insurance premium and the term of its contribution is stipulated in the insurance agreement and (or) in the policy. If the insurance premium is paid late, the insurance policy expires. Under agreements of voluntary health insurance, the insurance premium may be paid on a lump-sum basis or in installments.

The value of VHI policy depends on a number of factors. Formation of the price of voluntary health insurance can be influenced by the following aspects:

• category of the program;

• number of insured persons to a specific program;

• a set of selected services;

• service region.

Insurance coverage in VHI is the amount within which the insurance company shall pay the costs of the policyholder for medical services provided under the insurance program. The insurance amount can be increased within the period of the agreement under approval by the insurance company for an additional fee.

The insurance agreement, as a rule, is entered into for a period of 1 year.

The insured persons can be both employees of the company and members of their families, at the age of 1 to 65. At the same time, people who are registered at dug-abuse, psycho-neurological, tuberculosis, skin-venereal, oncological clinics, and HIV-infected persons are not accepted for insurance.

The insurance agreement is valid within the territory of the Republic of Kazakhstan.

Upon entering into the agreement, all the insureds get a plastic card containing personal data of the insured, name of the insurance program, contacts of the 24-hour Call Center. The card is valid upon provision of the owner's identity card.

Rendering and provision of medical services under the agreement shall be performed by attracting of medical assistance, which has a staff of family doctors and a network of accredited medical and preventive institutions.

How shall medical expenses for VHI policy be compensated?

VHI policy does not provide insurance benefit payment in hand. The insurance company pays the bill for medical services rendered to the owner of VHI policy directly to medical institutions. Thus, the customer pays only once, when buying of a VHI policy and all the costs for treatment shall be covered by the insurance company.

How to enter into insurance agreement?

For drafting of VHI policies, a legal entity must provide a list of insured employees, as well as choose a list of medical services or one of the proposed insurance programs. As a rule, most insurance companies offer special programs to legal entities for different categories of employees - for key managers, basic programs for other professionals, etc.

How to choose an insurance company?

You have decided to insure employees of your company, and the question arises - how to choose an insurance company to enter into an agreement with? Our recommendation is to choose a large insurer with a stable goodwill. Perhaps, the cost of insurance will not be lower than the price offered by its small competitors, but upon choosing of an unreliable partner, you risk not having anything in the middle of the insurance term: in a crisis not every insurance company can boast of financial stability.

An insurance company offering VHI services must have a license for this type of insurance activity, i.e. the license must state that the company is entitled to perform activities for insurance in case of illness.

In addition, an insurance company must have an agreement with a medical institution having a license for medical activities. Moreover, the type of activity specified in the license must correspond to the set of services guaranteed by the VHI policy.

Why it is worth to choose VHI?

Any citizen of the Republic of Kazakhstan is entitled to a guaranteed amount of free medical care. It will be rendered in a state medical institution, the work of which is paid from the budget and mandatory health insurance funds. But it's not a secret that the funds coming from the state budget are not enough to provide patients with all the necessary medical services and maintain their quality at proper level.

The agreement of voluntary health insurance is a guarantee of providing employees of your company with timely medical assistance, increasing loyalty of employees to the company. Upon insured event occurrence for an employee, you can be sure that he will return to work quickly and really recover.

The VHI program for employers allows taking care of employees and create confidence for them that they are important for their enterprise and will not remain without help and support in a difficult situation.

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