Purple cow employee benefits for sme 2011 (long version)

1. INTRODUCTION1. INTRODUCTION The Purple Cow STORY The Purple Cow STORY

Moo!

1“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.

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.

Moo!

2Purple Cow Vision:

financial security through employee benefits.

Purple Cow Vision:

financial security through employee benefits.

Purple Cow believes that employee benefits are the keys to your financial security.

Purple Cow believes that employee benefits are the keys to your financial security.

Purple Cow Mission:

to protect more and more Employees & Dependents from financial insecurity.

Purple Cow Mission:

to protect more and more Employees & Dependents from financial insecurity.

Purple Cow stops you from losing your money to all sorts ofmedical emergencies.

Purple Cow stops you from losing your money to all sorts ofmedical emergencies.

Purple Cow Core Value:

take care of the hands that take care of you!

Purple Cow Core Value:

take care of the hands that take care of you!

Purple Cow provides the perfect complement to your compensation plan.

Purple Cow provides the perfect complement to your compensation plan.

2. VALUE PROPOSITION 2. VALUE PROPOSITION The Purple Cow USPThe Purple Cow USP

Purple Cow gives you all 3 of today’s major employee benefits in 1 package, designed to provide multiple layers of protection:

Group Life: P100,000 – P1,000,000

Group Accident: P100,000 – P1,000,000

Group Health: P20,000 – P200,000

More VALUE…

1

You get MORE benefits for all of your staff

Purple Cow 2011

Value Proposition

Purple Cow saves you up to 60% on the 2 most frequently selected Room & Board categories, when you combine them with our recommended Maximum Benefit Limits:

Ward 20T: P5,445 or P5,990

Semi-Pvt 30T: P6,756 or P7,444

+ Less PRICE…

2

You get LOWER rates for most of your staff

Purple Cow 2011

Value Proposition

(insured HMO plans apply to SME only; self-insured TPA plans apply to Large Companies [500+ employees])

Purple Cow provides Good News to each level of your organization:

Employees: More financial security

HR: Better recruitment & retention

Finance: Greater financial viability

CEO: Major ‘pogi’ points

= More HAPPINESS

3

You make EVERYONE happy – at the same time!

Purple Cow 2011

Value Proposition

3. PRIMER3. PRIMERA Whole New WORLD of Employee BenefitsA Whole New WORLD of Employee Benefits

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 2011

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

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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 2011

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 disability; (10% of inpatient & outpatient cases)

• HEALTH INSURANCE (Medical / Dental HMO and/or INS) protects you from losing money in the event of sickness or accident, and treats you as well (if HMO). (10% inpatient / 100% outpatient)

All insurance can make or save you money in multiples

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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 them from losing money to medical emergencies – the most common cause of their financial insecurity – in the most cost-effective manner;

• Because Employee life & health is not just corporate wealth, but also your Corporate Social Responsibility.

Insurance is the most cost-effective EB money can buy

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Primer

Why get the Purple Cow?

• The Purple Cow is UNIQUE: it’s not just an HMO plan, but all the 3 major Employee Benefits rolled into one plan;

• The Purple Cow is a good SELLING tool: it has all the features & benefits our Clients say they want or need;

• The Purple Cow makes a great PROPOSITION: Employee Benefits = Financial Security; therefore, More Employee Benefits = More Financial Security.

Purple Cow Employee Benefits = more financial security!

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Primer

• GRA is the #1 Filipino, Independent, Family-owned, full-line insurance brokerage in the country: it has >P1B in premiums, and has been around the Top 5 since 1965;

• GRA is your outsourced Employee Benefits expert, Insurance Broker, and risk management consultant;

• GRA’s Tom Gotuaco is the Originator of PURPLE COW: a unique Employee Benefits plan designed for SME.

Why get GRA as Broker?

GRA has your SME interest at HEART

7Purple Cow 2011

Primer

Why get AsianLife (ALGA) as Insurer?

• ALGA is the BIGGE$T NAME in group life and medical insurance today, and the only insurance co. in the market that offers an HMO plan; (ALGA clients include Globe, Ayala, Smart, PLDT)

• ALGA offers the BE$T VALUE for your money: you can get all the major Employee Benefits rolled into one plan;

• ALGA offers the LOWE$T PRICE, when you compare all insurance and HMO features and benefits.

ALGA has the biggest name, best value & lowest price

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Primer

4. BENEFITS 4. BENEFITS

Your SECRET to Financial Security Your SECRET to Financial Security

Benefits OverviewLIFE – ACCIDENT – HEALTH

LIFE

1. LIFE INSURANCE * Total & Perm. Disability Income

HEALTH

3. MEDICAL HMO * 21,519 MD, 352 hospitals, 358 clinics

4. DENTAL HMO * 775 dentists, 645 clinics

5. Opt. Annual Physical Exam * 124 hospitals, 241 clinics, 31 mobile

6. Health & Wellness Program * 2x/year; tailored to utilization report

ACCIDENT

2. ACCIDENT INSURANCE

a. Accidental Death * Murder

b. Accidental Disability * Assault

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Benefits

Benefits SummaryLIFE – ACCIDENT – HEALTH

1. Life = 5x MBL 13. 100% Pre-Existing Conditions coverage

2. Total & perm. disability income = 5x MBL 14. 100% Congenital Conditions coverage

3. Accid. death = 5x MBL 15. Benefits on top of Philhealth

4. Murder = 5x MBL 16. Special procedures = 30% or 100% of MBL

5. Accid. disability = __% of 5x MBL (long sked) 17. Opt. Outpatient Reimb. for meds, dental, vision

6. Assault = __% of 5x MBL 18. Dental = HMO (775 dentists / 645 clinics)

7. Medical = HMO (21,519 MD / 352 hospitals / 358 clinics) 19. Dental access to major malls in Metro-Manila

8. Access to Big 5 Hospitals & Healthway 20. 1 permanent filling, 2 oral prophylaxes, etc.

9. Combined inpatient & outpatient limits 21. Opt. APE = designated or mobile clinic

10. Max. Benefit Limits per disability per year 22. Health & Wellness Program (2x/year)

11. HMO patient for no-cash-out 23. Same benefits for all Employees

12. Private patient for reimbursement (HMO rate) 24. Same benefits for all Dependents

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Benefits

1. LIFE INSURANCE (worldwide)ASIANLIFE EXCLUSIONS

1. Life1 5x MBL 1. Suicide within the 1st year of coverage

2. Total & Perm Disability Income2 5x MBL

+Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo

1Life insurance = 5x MBL, for death by any cause (suicide covered after 1 year);

2Total & Permanent Disability Income (TPDI) = 5x MBL, in lieu of the Life benefit, after 6 months of TPD, whether sick or hurt. Example:

If MBL = 20T, Life or TPDI = 100,000;




If MBL = 100T, Life or TPDI = 500,000.

Life benefits are payable on top of Accident and Health benefits

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Benefits

2a. ACCIDENT INSURANCE (worldwide)ASIANLIFE

1. Accidental Death1 5x MBL 3. Disability3 _% 5x MBL

2. Murder2 5x MBL 4. Assault4 _% 5x MBL


1Accidental Death = 5x MBL, for death from any type of accident;2Murder = 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 = 100T, Accidental Death or Murder = 500,000.


3Disability = __% of 5x MBL, according to a long schedule of disabilities;

4Assault = __% of 5x MBL, in lieu of the Disability benefit, for disability not due to accident but assault (provoked or not).Example:

If MBL = 20T, Disability or Assault = __% of 100,000;




If MBL = 100T, Disability or Assault = __% of 500,000.

Accident benefits are payable on top of Life and Health benefits

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Benefits

2b. ACCIDENT INSURANCE… (LONG) SCHEDULE OF DISABILITIES

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

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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]

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Benefits

3a. MEDICAL HMO (nationwide)ASIANLIFE (21,519 MD / 352 hospitals / 358 clinics) TERMS & CONDITIONS

1. Combined inpatient & outpatient limits 1. Instant rates, regardless of size

2. Max. Benefit Limits per disability per year 2. No franchising required

3. HMO patient for no-cash-out 3. No utilization report required

4. Private patient for reimbursement (HMO rate) 4. No individual applications required

5. Access to Big 5 Hospitals and Healthway 5. Minimum group size = 10

6. 100% Pre-Existing Conditions coverage 6. Minimum mode of payment = monthly

7. 100% Congenital Conditions coverage 7. Pooled Employee utilization to spread risk

8. Benefits on top of Philhealth 8. Separate Dependent utilization to reduce cost

9. Special Procedures = 30%/100% of MBL 9. Buy now, pay later

10. Opt. Outpatient Reimb. for meds, dental, vision 10. 1st year Virgin promo rate, if applicable +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo +Same rates for Dependents in 2011

Medical HMO benefits are covered on top of Life and Accident benefits

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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] All Dreaded & Non-Dreaded PEC are covered 100% to MBL

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Benefits

3c. MEDICAL HMO…SPECIAL PROCEDURES – 30% of MBL SPECIAL PROCEDURES – 100% of MBL

1. Lithotripsy 1. Dialysis

2. Arthroscopic procedures 2. Chemotherapy

3. Laparoscopic procedures 3. Radiation oncology / therapeutic radiology

4. Laser therapy (excludes use for correcting vision) 4. Sclerotherapy

5. Nuclear / radioactive isotope scans 5. Physical & speech therapy

6. Cost of artificial limbs, joint prosthesis and heart valve prosthesis

6. Angiography

7. Nuclear technologies

7. Other new modalities of treatment for conditions with established etiologies and used as alternatives to conventional or traditional procedures

8. Thallium scintigraphy

9. CT scan / MRI

10. Pulmonary perfusion scan

For the above special procedures, the remaining 70% of your Maximum Benefit Limit per disability per year can be used for conventional treatment of the same condition (unlike other HMO’s which exclude conventional treatment after a special procedure, and limit special procedures to 1x/year).

11. Endoscopy

12. Bone densitometry scan

13. Anti-nuclear anti-body (ANA)

14. C-reactive protein (rheumatic & complications)

15. Lupus cell exam

16. Sleep therapy

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Benefits

3d. MEDICAL HMO…Optional OUTPATIENT REIMBURSEMENT EXCLUSIONS

1. Rx Medicines 1. Vitamins, supplements and/or non-BFAD approved medicines, herbal medicines, and other medicines that have no legal BFAD-approved therapeutic claims2. Dental

3. Vision 2. Dental procedures not included in the dental HMO plan

+Outpatient Reimbursement for Rx Meds, Dental & Vision benefits within 15 working days of receipt of all documents.

+Reimbursement for Rx Meds covers treatment for any covered sickness or accident.

+Reimbursement for Dental covers the same schedule of benefits as the dental HMO, but with your choice of dentist for full reimbursement up to your aggregate limit.

+Reimbursement for Vision covers tests for visual acuity and prescription lenses.

+The annual aggregate limit for all Rx meds, dental and vision benefits together = 1/10th your Max. Benefit Limit.

3. Non-prescription lenses and frames

Rx Medicines, Dental & Vision are covered on top of Medical & Dental HMO benefits

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Benefits

3e. 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

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Benefits

4. DENTAL HMO (nationwide)HP DENTAL (775 dentists / 645 clinics) EXCLUSIONS

1. (1) permanent filling 1. Dental procedures not included in the dental HMO plan

2. (2) oral prophylaxes1

+No reimbursements allowed (unless you get the optional Outpatient Reimbursement Plan for Rx Medicines, Dental & Vision).

+Discounts of up to 20% available on procedures not included in the dental HMO plan.

+Dental card and booklet provided, as well as an orientation and an annual utilization report.

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 dentures

8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays

9. Treatment of pain/lesions/wounds/burns

10. Emergency dental procedures if necessary

+By appointment only (unless emergency)

Dental HMO benefits are covered on top of Medical HMO benefits

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Benefits

5. Optional Annual Physical Exam ASIANLIFE (241 designated clinics, 31 mobile clinics) EXCLUSIONS

1. Physical examination 1. APE procedures not included in the Basic 5 APE plan

2. Chest X-Ray +You can add additional procedures to your Basic 5 APE: call GRA to help design, source, price, and schedule your APE anytime during your plan year.

+Nationwide (241 clinics, 31 mobile) or Metro Manila-wide (114 clinics, 24 mobile) APE also available to companies with multiple locations, at roughly triple or double the cost respectively (reflecting their average cost of a Basic 5 APE). Otherwise, individual clinics are best, whether designated or mobile.

3. CBC Basic 5 only

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).

Basic 5 Cost +/- P300 (for designated or mobile clinics).

Optional APE benefits are covered on top of Medical HMO benefits

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Benefits

6. Health & Wellness Program ASIANLIFE EXCLUSIONS

1. Comprehensive Wellness Program (2x/year) 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 the 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 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

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Benefits

5. COSTS 5. COSTS

Your INVESTMENT in Financial Security Your INVESTMENT in Financial Security

Cost Summary (APE & O/P Reimb. extra)

R&B MBL ANN SEMI QTR MO R&B MBL ANN SEMI QTR MO

WARD(R+F)

20T 5,445 2,886 1,525 545 REG PVT

(Top rank Small co 10-100)

60T 11,985 6,352 3,356 1,199

30T 6,176 3,273 1,729 618 70T 13,041 6,912 3,651 1,304

40T 6,795 3,601 1,903 680 80T 13,472 7,140 3,772 1,347

SEMI PVT(Spvr)

30T 6,756 3,581 1,892 676LRG PVT

(Top rank Med co

100-200)

80T 15,726 8,335 4,403 1,573

40T 7,416 3,930 2,076 742 100T 16,826 8,918 4,711 1,683

50T 8,122 4,305 2,274 812 120T 18,444 9,775 5,164 1,844

SML PVT(Mgr)

40T 8,787 4,657 2,460 879JR

SUITE (Top rank Large co

200+)

120T 26,724 14,164 7,483 2,672

50T 9,513 5,042 2,664 951 160T 30,536 16,184 8,550 3,054

60T 10,323 5,471 2,890 1,032 200T 32,813 17,391 9,188 3,281

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Costs

VIRGIN RATES

Cost Summary (APE extra)


WARD(R+F)

20T 6,709 3,556 1,879 671 REG PVT


60T 14,362 7,612 4,021 1,436

30T 7,963 4,220 2,230 796 70T 15,614 8,275 4,372 1,561

40T 8,797 4,662 2,463 880 80T 16,247 8,611 4,549 1,625

SEMI PVT(Spvr)

30T 8,543 4,528 2,392 854LRG PVT

(Top rank Med co

100-200)

80T 18,501 9,806 5,180 1,850

40T 9,418 4,992 2,637 942 100T 20,020 10,611 5,606 2,002

50T 10,309 5,464 2,887 1,031 120T 22,494 11,922 6,298 2,249

SML PVT(Mgr)

40T 10,789 5,718 3,021 1,079JR


200+)

120T 30,774 16,310 8,617 3,077

50T 11,700 6,201 3,276 1,170 160T 36,918 19,567 10,337 3,692

60T 12,700 6,731 3,556 1,270 200T 42,018 22,270 11,765 4,202

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Costs

VIRGIN RATES (+ Outpatient Reimbursement)

Cost Summary (APE & O/P Reimb. extra)


WARD(R+F)

20T 5,990 3,175 1,677 599 REG PVT


60T 13,324 7,062 3,731 1,332

30T 6,770 3,588 1,896 677 70T 14,487 7,678 4,056 1,449

40T 7,426 3,936 2,079 743 80T 14,924 7,910 4,179 1,492

SEMI PVT(Spvr)

30T 7,444 3,945 2,084 744LRG PVT

(Top rank Med co

100-200)

80T 17,540 9,296 4,911 1,754

40T 8,146 4,317 2,281 815 100T 18,691 9,906 5,233 1,869

50T 8,903 4,719 2,493 890 120T 20,444 10,835 5,724 2,044

SML PVT(Mgr)

40T 9,738 5,161 2,727 974JR


200+)

120T 30,052 15,928 8,415 3,005

50T 10,518 5,575 2,945 1,052 160T 34,225 18,139 9,583 3,423

60T 11,395 6,039 3,191 1,140 200T 36,618 19,408 10,253 3,662

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Costs

NON-VIRGIN RATES

Cost Summary (APE extra)


WARD(R+F)

20T 7,101 3,764 1,988 710 REG PVT


60T 15,414 8,169 4,316 1,541

30T 8,341 4,421 2,335 834 70T 16,749 8,877 4,690 1,675

40T 9,186 4,869 2,572 919 80T 17,364 9,203 4,862 1,736

SEMI PVT(Spvr)

30T 9,015 4,778 2,524 902LRG PVT

(Top rank Med co

100-200)

80T 19,980 10,589 5,594 1,998

40T 9,906 5,250 2,774 991 100T 21,499 11,394 6,020 2,150

50T 10,826 5,738 3,031 1,083 120T 24,004 12,722 6,721 2,400

SML PVT(Mgr)

40T 11,498 6,094 3,219 1,150JR


200+)

120T 33,613 17,815 9,412 3,361

50T 12,441 6,594 3,483 1,244 160T 39,836 21,113 11,154 3,984

60T 13,484 7,147 3,776 1,348 200T 44,710 23,696 12,519 4,471

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Costs

NON-VIRGIN RATES (+ Outpatient Reimbursement)

6. COMPETITIVE ADVANTAGES

6. COMPETITIVE ADVANTAGES

WHY Purple Cow?WHY Purple Cow?

1 ‘Large’ Size Fits All SME: If you are an SME, with 10+ employees, you can join Purple Cow, be part of a bigger group, and be treated like a large company.

(Unlike most HMO plans)

You can enjoy the same toys as the Big Boys

1Why Purple Cow?

Purple Cow 2011

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.


You can see your own doctor, cheaper

2Why Purple Cow?

Purple Cow 2011


3 Major Employee Benefits in 1 Plan: you get Life, Accident & Health (medical

HMO, dental HMO, optional APE, and Wellness program) – all in one plan.


You get all the Employee Benefits you will ever need

3Why Purple Cow?

Purple Cow 2011


4 Modes of Payment: you can choose from annual, semi-annual,

quarterly, or monthly modes of payment to suit your cash flow or budget.


You can pay Annual (60%), S.A. (5%), Qtr. (30%) or Mo. (5%)

4Why Purple Cow?

Purple Cow 2011


Up to 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 wants, needs or budget.


You can try new combinations to see if they are ‘sulit’

5Why Purple Cow?

Purple Cow 2011


100% Pre-Existing Conditions: you get 100% Pre-Existing Conditions

coverage, up to MBL, for cancer, hypertension, diabetes, asthma, etc.


You are covered for dreaded & non-dreaded diseases

6Why Purple Cow?

Purple Cow 2011


100% Congenital Conditions: you get 100% Congenital Conditions

coverage, up to MBL, for mitral valve pro-lapse, rheumatic heart disease, hernia, etc.

(Unlike most HMO plans) You are covered for medical conditions since birth

7Why Purple Cow?

Purple Cow 2011


8

Benefits on Top of Philhealth: your HMO limits are on top of Philhealth,

so you won’t need as much MBL. Your Benefits = Philhealth + MBL, not just MBL.


You get full HMO benefits on top of Philhealth benefits

Why Purple Cow?

Purple Cow 2011


Pooled Employee Utilization: your Employee utilization is pooled together with the employee utilization

of all other groups, to spread your risk.


You get to enjoy the safety of a bigger group

9Why Purple Cow?

Purple Cow 2011


Separate Dependent Utilization: your Employee and Dependent utilization

are separate, so you won’t have to worry about Dependents affecting your rates.


You can offer Dependent coverage without fear

10Why Purple Cow?

Purple Cow 2011


Life Insurance:your Life insurance benefit = 5x MBL.

Twist: if you don’t die, but you’re totally and permanently disabled, TPDI =

5x MBL.

(Unlike all HMO plans)

11

You can get 1 year’s worth of income replacement

Why Purple Cow?

Purple Cow 2011


Accidental Death Insurance: your Accidental Death benefit = 5x MBL.

Twist: if you don’t die by accident, but by Murder, you get 5x MBL.


You can get another year’s worth of income replacement

12Why Purple Cow?

Purple Cow 2011


Disability Insurance: your Disability benefit = __% of 5x MBL.

Twist: if you don’t get disabled by accident, but by Assault, you get __% of 5x

MBL.

(Unlike all HMO plans)You can get up to 1 year’s worth of income replacement

13Why Purple Cow?

Purple Cow 2011


Medical HMO Network: you can get inpatient, outpatient and

emergency treatment from 21,519 doctors, 352 hospitals, and 358 clinics nationwide.

(unlike some HMO plans)

You can go to MMC/ SLMC/ CSMC/ AHMC/ TMC/ Healthway

14Why Purple Cow?

Purple Cow 2011


Dental HMO Network: you can get 1 permanent filling, 2 oral

prophylaxes, and 8 other benefits from 775 dentists and 645 clinics nationwide.


You can go to SM/ Market2/ Festival/ Robinson’s/ Shangrila/ ATC

15Why Purple Cow?

Purple Cow 2011


Optional Annual Physical Exam: you can customize your APE and request

a designated or mobile clinic from GRA; or you can get a Basic 5 APE nationwide.


You can decide if you want an APE, and if so, what kind

16Why Purple Cow?

Purple Cow 2011


Health & Wellness Program: ALGA will conduct a Comprehensive

Wellness Program for your group 2x/year, based on your own set of health issues.


You get seminars, screenings & protection measures

17Why Purple Cow?

Purple Cow 2011


Optional Outpatient Reimbursement:

you can reimburse up to an aggregate limit of 1/10th your Max. Benefit Limit per year for Rx Medicines, Dental & Vision TOGETHER.

(Unlike all HMO plans)You can get the best perks of medical insurance as well

18Why Purple Cow?

Purple Cow 2011


Same Benefits for Dependents: Dependents can get the same benefits, terms and conditions as Employees

(as well as the same costs in 2011).

(Unlike most, if not all, HMO plans)

Your Dependents are treated like Employees

19Why Purple Cow?

Purple Cow 2011


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.


You get the greater good for the greater number

20Why Purple Cow?

Purple Cow 2011


The Design is Right: Purple Cow provides medical necessity,

not luxury. Savings from excess R&B/MBL are reallocated to benefits of greater use.


Your R&B/MBL combos are good up to 99% of the time

21Why Purple Cow?

Purple Cow 2011


The Perfect Insurer: you get the biggest name in group life and medical, and the only insurance company in the PH today that offers an HMO-type plan.

(Unlike all insurance companies)

You get the best of both INS & HMO worlds from ALGA

22Why Purple Cow?

Purple Cow 2011


The Perfect Broker: you get to retain the services of the

#1 Filipino, family-owned, full-line insurance brokerage in the PH today.

(Unlike most brokers)

You can outsource all your lines of insurance to GRA

23Why Purple Cow?

Purple Cow 2011


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 the float

24Why Purple Cow?

Purple Cow 2011


Easy Sign Up: 1) Email the completed Masterlist; 2) Fax the signed Endorsement; 3) Fax the signed Letter of Guarantee.

(Unlike some HMO plans)

Click ‘Join the Herd!’ on purplecow.ph to download

25Why Purple Cow?

Purple Cow 2011


Utilization Reports: you get a detailed, user-friendly report

that gives you insights into your own group’s utilization patterns.

(Unlike some HMO plans)

You can learn a lot about the state of your group’s health

26Why Purple Cow?

Purple Cow 2011


Group Renewal Rates: you get a group renewal rate increase or decrease at the start of every year,

so you can plan accordingly.


Your renewals become much less disruptive to your HR

27Why Purple Cow?

Purple Cow 2011


Group Experience Refund: you get to share in the excess, if any, of the group’s favorable utilization experience: ((premiums x 60%) – (YTD + IBNR claims)) x 50% = Exp. Refund


Good experience refund formulas keep Suppliers honest

28Why Purple Cow?

Purple Cow 2011


Your Company Wins: When your Employees win,

and your HR and Finance win, your Company wins!


You promote ‘Win-Win,’ the only long-term solution

29Why Purple Cow?

Purple Cow 2011


SME Nation Wins: When your Company wins,and the Purple Cow grows, the whole SME Nation wins.


You get to align with a Cause bigger than yourselves

30Why Purple Cow?

Purple Cow 2011


31

Non-Employees can Win, too: you can even cover agents, associations, and multi-purpose cooperatives, as long as certain selection & payment criteria are met.

(Unlike most HMO plans)You can offer Employee Benefits to Non-Employees

Why Purple Cow?

Purple Cow 2011


Virgins can Win Even More: you get a 1st year Virgin promo rate

if your company has never had group insurance or HMO before.


You can renew at the prevailing Non-Virgin rates in 2012

32Why Purple Cow?

Purple Cow 2011


Large Companies can do a TPA: if you become a Large Company, you can self-insure as a stand-alone account, using the same Purple Cow schedule of benefits.

(Unlike all TPA plans)You can switch from insured to self-insured plans easily

33Why Purple Cow?

Purple Cow 2011


7. SUMMARY7. SUMMARY What’s in it for…ME? What’s in it for…ME?

EE Features EE BenefitsA complete Employee Benefits package made up of insurance and HMO plans

You get to experience even more financial security from your EB plan

Life (or Disability Income) and Accident (or Murder/Assault) = 5x MBL

You won’t need any life insurance, PA insurance, or memorial plans

Medical, Dental, and opt. APE networks You have 2-3 networks for no-cash-out

Choice of doctor as a Private Patient for insurance reimbursement at HMO rates

You can see your own doctor and get reimbursed the HMO doctor’s fee

100% Pre-Existing Conditions and 100% Congenital Conditions coverage

You are covered for existing illnesses as well as for conditions since birth

Benefits on top of Philhealth You get full HMO & Philhealth benefits

Optional outpatient reimbursement for Rx medicines, dental & vision

You can add the best perks of medical insurance to your Employee Benefits

1 health card for every employee You can get treated anytime, anywhere

1♠ What’s in it for…Employees?

Purple Cow 2011

Summary

HR Features HR BenefitsA complete Employee Benefits package instead of just an HMO plan

You get life & accident to complement health in a single, integrated package

Instant rates, without utilization reports, regardless of the size of your SME

You won’t need to wait for a quote or negotiate: one price fits all SME

Multiple Room & Board as well as Maximum Benefit Limits to choose from

You can adjust your R&B/MBL combos to suit your organizational structure

3 simple forms to fill out (1 master-list, 1 endorsement, 1 letter of guarantee)

You won’t need to create any forms; you can just use ours

A chance to use Employee Benefits for recruitment & retention purposes

You can use Purple Cow as a tool to recruit and/or retain staff

Group renewal rates on New Year’s You won’t have to stress over renewals

Retention of a top insurance broker You can outsource your EB work, etc.

1 schedule of benefits for all employees You can promote equal treatment

2♥ What’s in it for…HR?

Purple Cow 2011

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 pay to suit your budget: annually, semi, quarterly, and monthly

You can budget your healthcare costs according to your cash flow

Membership in a bigger & bigger pool of SME, to maintain financial viability

You can spread your risk by joining the Purple Cow pool

Separation of Employee vs. Dependent utilization

You can pay for your employees only, and not subsidize dependents at all

A chance to compare rates instantly You can lower your EB costs instantly

A chance to switch to Purple Cow anytime, even in mid-year

You can correct your past mistakes, and not wait a whole year to do so

Your Broker acts as Gatekeeper Your Cowboy runs the Herd

1 set of fixed costs for all employees You can limit your financial liability

♦ What’s in it for…Finance?

3Purple Cow 2011

Summary

CEO Features CEO Benefits

Happier Employees

very pogi

CEO!

Happier HR

Happier Finance

♣What’s in it for the…CEO?

4Purple Cow 2011

Summary

8. CONCLUSIONS8. CONCLUSIONS Purple Cow is the ANSWER Purple Cow is the ANSWER

Compensation in the PH cannot provide enough financial security in emergencies, and must rely heavily on support;

Employee Benefits can provide that needed support, as most ‘emergencies’ are either life, accident or health-related.

The Problem… The Solution…

1Purple Cow 2011

Conclusions

Compensation + Benefits offer the best 1-2 punch for HR

“Employee Benefits = financial security”

If Purple Cow = more Employee Benefits, then Purple Cow = more financial security!

The Formula… The Brand…

2

Purple Cow offers the best EB formula for growing SME!

Purple Cow 2011

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 (Max!):

that’s all you need for Purple Cow.

The real cost of Purple Cow:

5Purple Cow 2011

Conclusions

If you can’t give more compensation, give more benefits!

Treat Purple Cow as:

1) a business investment (HR & FIN);

2) a social investment (CSR).

Our Recommendation:

6Purple Cow 2011

Conclusions

Purple Cow makes good business & social sense

For more information, please contact:

DisclaimerDisclaimerRenowned 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.”

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.”

Economy & Finance

Purple cow employee benefits for sme 2011 (long version)