Employee Benefits Programs
Our solutions seek to achieve a balance between the insurance program cost and the coverage levels, while improving service levels for employees, optimizing the program’s management and reducing cost volatility In the long term. Our servicing model is embedded with analytical tools to provide in-depth information analysis for decision making purposes and real-time measurement of service performance indicators, providing our clients with an unparalleled service experience.
Through the use of sophisticated statistical tools, “Interesse Business Intelligence” and “Interesse Biometrics”, we analyze the areas of opportunity related to claims management and trends, coverage options and service levels. Our objective is to develop cost containment and service improvement strategies, in a multiyear market benchmark analysis.
Insurance Cost
- Have you had premium increases above inflation? Above medical inflation? Above general increase in payroll?
- Does the net premium stand in reasonable parameters vs. the annual payroll?
- How has the program premium vs. inflation evolved?
- Is the average per capita net premium within reasonable parameters?
- In the case of “Group Life Insurance”, does the policy have a profit sharing mechanism installed? Is this mechanism legal according to the Mexican Insurance Laws and optimal?
- What is the evolution of the expected cost of insurance in the medium and long term?
Insurance Cost
- Have you had premium increases above inflation? Above medical inflation? Above general increase in payroll?
- Does the net premium stand in reasonable parameters vs. the annual payroll?
- How has the program premium vs. inflation evolved?
- Is the average per capita net premium within reasonable parameters?
- In the case of “Group Life Insurance”, does the policy have a profit sharing mechanism installed? Is this mechanism legal according to the Mexican Insurance Laws and optimal?
- What is the evolution of the expected cost of insurance in the medium and long term?
Socio-Demographics
Impact on the accident rate of the following variables:
- Turnover levels
- Socioeconomic levels
- Rate of dependents per main insured and multi-year projections
- Income levels
- Population geographical location
- Ages and gender (population pyramid)
- Level of use of the policy in frequency and average cost
- Insured staff size expectations
Socio-Demographics
Impact on the accident rate of the following variables:
- Turnover levels
- Socioeconomic levels
- Rate of dependents per main insured and multi-year projections
- Income levels
- Population geographical location
- Ages and gender (population pyramid)
- Level of use of the policy in frequency and average cost
- Insured staff size expectations
Eligible staff within the Program
Impact on the accident rate of the variables:
- Are there policy holders with contributory participation?
- Are there retired policy holders?
- Is there coverage for former employees?
- Are the economic dependents covered? Under what rule?
- Are all employees insured, or only a subgroup or section?
Eligible staff within the Program
Impact on the accident rate of the variables:
- Are there policy holders with contributory participation?
- Are there retired policy holders?
- Is there coverage for former employees?
- Are the economic dependents covered? Under what rule?
- Are all employees insured, or only a subgroup or section?
Medical Networks and their Proper Selection
Is there medical and hospital infrastructure within the region where the policy holders are located?
- Does the current insurer have good hospital agreements and an acceptable network?
Is the direct payment usage within reasonable levels? Is the network being used? - In case of out-of-network use, is the medical fee tab suitable for each insured subgroup?
- What is the process of audit and satisfaction assessment of users of hospital services?
- What is the process of review and adequacy with the best practices of the medical personnel who care for insured persons?
Medical Networks and their Proper Selection
Is there medical and hospital infrastructure within the region where the policy holders are located?
- Does the current insurer have good hospital agreements and an acceptable network?
Is the direct payment usage within reasonable levels? Is the network being used? - In case of out-of-network use, is the medical fee tab suitable for each insured subgroup?
- What is the process of audit and satisfaction assessment of users of hospital services?
- What is the process of review and adequacy with the best practices of the medical personnel who care for insured persons?
Coverage Level
- Is it well designed according to the socio-demographic and social needs of each subgroup within the insured population?
- Does it cover individual insurance cover conversion?
- Are the deductible and coinsurance, tabulation, hospital level and coverage with sub-limits such as maternity, nose & vision medical claims, aligned to the insured population level of income?
- Is there policy overutilization or underutilization?
- Do you have additional coverage such as vision, dental or minor medical expenses?
- Do you have optional coverages?
- About life insurance, is the level of insured sums and coverages competitive?
- The profit offer is competitive in your sector?
Coverage Level
- Is it well designed according to the socio-demographic and social needs of each subgroup within the insured population?
- Does it cover individual insurance cover conversion?
- Are the deductible and coinsurance, tabulation, hospital level and coverage with sub-limits such as maternity, nose & vision medical claims, aligned to the insured population level of income?
- Is there policy overutilization or underutilization?
- Do you have additional coverage such as vision, dental or minor medical expenses?
- Do you have optional coverages?
- About life insurance, is the level of insured sums and coverages competitive?
- The profit offer is competitive in your sector?