Transcript
We are a boutique insurance brokerage and consulting service focused on benefits programs management. With a high standard professional team, we manage benefits for over than 280 thousand lives.
Part of UIB Group (United Insurance Brokers) – world’s eightest insurance and reinsurance broker, with representatives in 17 countries, present in Europe, Middle East, North Africa, Asia and Latin America – we are one of the few brokers focused on the final user health and quality of life, always in balance with your economic reality.
Get to know more about us on uibbeneficios.com
WE ARE UIB BENEFÍCIOS
DEMOGRAPHICS
MALE POPULATION (BY AGE)
FEMALE POPULATION (BY AGE)
LEVEL OF COVERAGE MAP
TYPE OF CONTRACTS
CONTRACTS & COVERAGE
MARKET PLAYERS
SOCIAL SECURITY SYSTEM
RETIREMENT BENEFITS
WORKER COMPENSATION
CONTRIBUTION
FGTS: GOVERNMENT SEVERANCE INDEMNITY FUND
FOR EMPLOYEES
TRANSPORTATION VOUCHER
UNEMPLOYMENT INSURANCE
OTHER BENEFITS
PRIVATE BENEFITS – GENERAL MARKET PRACTICE
HEALTH CARE
NATIONAL HEALTH AGENCY
PLAN DESIGN
KEY ASPECTS
CONDITIONS FOR RENEWAL
DENTAL CARE
GROUP LIFE
PENSION
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8
9
10
11
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16
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INDEX
7
million 201+ With 201.032.714 inhabitants, Brazil is the nation with the 6th highest population worldwide.
million 43+ Sao Paulo is the most populated state with 43.663.672 in- habitants, followed by Minas Gerais and Rio de Janeiro.
million 47.9 inhabitants are covered by health plans.
million18.6 inhabitants have dental plan coverage.
yrs 71 is the men’s life expectancy.
yrs 78.3 is the women’s life expectancy.
%2.28 GDP increase.
%5.01 is 2013 inflation rate.
brl 724 is the the minimum monthly wage.
%7.7 is the unemployment percentage rate.
DEMO-GRAPHICS
8
MALE POPULATION (BY AGE)
OVERALL POPULATIONCOVERED POPULATION
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
%1.5
1.0
0.5
0100
AGE
9
FEMALE POPULATION (BY AGE)
OVERALL POPULATIONCOVERED POPULATION
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
%1.5
1.0
0.5
0100
AGE
10
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
Highest levels of coverage are concentrated in southern and southwestern states.
00 to 55 to 1010 to 2020 to 3030 and over
% (percentage)COVERAGE LEVELS(BY STATE)
11
As illustrated below (in %), most contracts are offered by employers, representing
63.6% of the market.
not informed individual collective membership corporate
TOTAL
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
63.6
13.7
20.6
2.1
COOPERATIVE
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
24.8
15.7
58.3
1.2
PHILANTROPY
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
35.5
13.3
47.7
3.5
GROUP MEDICINE
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
26.2
8.9
61.5
3.4
INSURER
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
26.2
7.1
85.7
7.2
SELF INSURED
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
66.1
30.5
3.4
12
Due to the size of the country, most
insurance contracts offer nationwide
coverage.
city state choicestate nationwidecity choice
TOTAL
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
4.5
6.4
7.3
41.9
39.9
INSURER
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
3.6
6.9
88.8
GROUP MEDICINE
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
7.1
11.8
3.1
60.6
17.4
SELF INSURED
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
13.5
14.3
16.3
55.6
COOPERATIVE
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
3.0
12.2
41.6
42.8
PHILANTROPY
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
26.4
1.1
70.2
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INSURANCE COMPANIES Mostly with nationwide coverage, reimbursement options, managing their networks through accreditation. Eg: Bradesco, Sul América and Seguros Unimed.
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
COOPERATIVESThe main feature of this system is a comprehensive network. Physicians also own the company and service is offered through cooperators agreements. Eg: Unimed.
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
GROUP MEDICINEHave their own hospitals and clinics, while coverage can be offered through accredited networks. Eg: Medial, Hapvida, Amil and Intermédica.
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
MARKET PLAYERS
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Managed by INSS – Instituto Nacional de Seguridade Social – (National Institute of Social Security), brazilian social security system assures coverage for state pensions, such as retirement, disability, maternity, family wage, illness, reclusion aid, death and elderly assistance.
ELIGIBILITY
Any INSS contributor has the right to the above mentioned benefits.
CONTRIBUTION
INSS benefits are financed by both employers and employees. For employees, contribution varies depending on monthly earnings, according to the following graph:
SOCIAL SECURITY SYSTEM
OVERALL POPULATION
COVERED POPULATION
OVERALL POPULATION
COVERED POPULATION
20002001
20022003
20042005
20062007
20082009
20102011
20122013
2%
4%
6%
8%
10%
12%
14%
16%
OVERALL POPULATION
COVERED POPULATION
OVERALL POPULATION
COVERED POPULATION
20002001
20022003
20042005
20062007
20082009
20102011
20122013
2%
4%
6%
8%
10%
12%
14%
16%
OVERALL POPULATION
COVERED POPULATION
OVERALL POPULATION
COVERED POPULATION
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2%
4%
6%
8%
10%
12%
14%
16%
15
1.317,07
8 9 11
2.195,12
4.390,24
BRL
CONTRI-BUTION %
minbrl 724
maxbrl
4.396However, the methodology to calculate benefits will vary
according to employee’s retirement option (full or proportional retirement).
MONTHLY RETIREMENT
INCOME (JAN 2014)
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RETIREMENT BENEFITS
OLD AGE RETIREMENT*
*Both with affiliation before July 24th, 1991.
MEN 65 years old and at least 15 years of contribution.
WOMEN 60 years old and at least 15 years of contribution.
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MEN 53 years old and at least 35 years of contribution.
WOMEN 48 years old and at least 30 years of contribution.
NORMAL AGE RETIREMENT
MEN AND WOMEN 15, 20 or 25 years of work in hazardous occupations.
SPECIAL RETIREMENT
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WORKER COMPENSATION
brl 724
brl 4.159
MONTHLY WAGES RANGE (JAN 2014)
Federal Government manages worker compensations and INSS guarantees the benefits in case of partial or total disability caused by a labor accident.
Any salaried employee that suffer injury at a work site, while commuting to or from work has access to this benefit.
Will be fully paid by the employer in case of temporary disability. 15
DAYS
first
Is the worker compensation starting day.
16th
DAY
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Employer contributions vary in accordance with performance rate related to accidents and diseases. Businesses may accrue a discount on their contribution or increase up to 100% of payroll as a penalty due to poor performance. These changes became effective in January 2010 and are still valid. See below:
CONTRI BUTION
1%
2%
3%
0.5% TO 2%
1% TO 4%
1.5% TO 6%
LOW
MEDIUM
HIGH
CONSULTING FIRMS
BANKING
MANUFACTURING
PAYROLL CONTRIBUTION
(JAN 2010)RISK LEVEL
INDUSTRY (EXAMPLE)
PAYROLL CONTRIBUTION
(DEC 2009)
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GOVERNMENT SEVERANCE INDEMNITY FUND FOR EMPLOYEES
Any salaried worker dismissed without just cause is entitled to this benefit. Federal Government mandates that all employers fund a severance pay plan at a contribution rate of 8% of their employee’s monthly wage.
Contribuions are deposited in a blocked account on employee’s behalf and managed by Caixa Econômica Federal. In addition to any accrued amounts, employees receive a 40% supplementary payment from the employer as a law required penalty. This is applicable to all contributions made by the employer to FGTS’s fund during the employee’s period of employment.
FGTS
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Government fully funds the Health Care System; there is no contribution by patients or companies. Health Ministry (Ministério da Saúde) is responsible for providing public health, government hospitals and medical services.
All legally established persons are able to be covered by the Health Care System which provides full coverage including: doctors visit, exams, therapies, in-patient treatments, vaccines, etc. Unfortunately, depending on the region, waiting periods can be longer than 3 months.
PUBLIC HEALTH SYSTEM
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Employer must share transportation costs with their employees related to one or more vouchers, depending on the distance to the employer’s residence.
Employers can deduct up to 6% of the total cost, while the other portion is to be fully paid. Companies who provide their own transportation are not obliged to provide these vouchers.
TRANSPORT VOUCHER
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It is provided to any legally employed worker dismissed without just cause who has contributed to social security for at least 15 months during a 2 years period.
Workers receive temporary financial assistance that ranges from 3 to 5 installments and values are calculated based on the average of at least three salaries prior to dismissal.
UNEMPLOYMENT INSURANCE
From 6 to 11 months
3INSTALLMENTS
From 12 to 23 months
4INSTALLMENTS
From 24 to 36 months
5INSTALLMENTS
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OTHER BENEFITS
VACATIONEmployees are entitled to a 30 day vacation after 12 months of service. They may trade vacations time for additional pay.
In addition, the employer must pay a vacation bonus of 1/3 of the employee’s monthly salary.
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
13th
13th SALARYEmployee receive a 13th check paid in December equivalent to their highest monthly salary.
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Historically, health plan costs have been increasing over the years. Inclusion of new procedures, new technologies and constant intervention from government are some of the ingredients that led to 11,23% increase in costs last year.
Health-related inflation has been increasing quicker than other financial indicators over the last 5 years, as shown on the next page:
HEALTH CARE
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OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
UIB BENEFÍCIOS DATABASE INPCA ANS INPC
HEALTH-RELATED INFLATION
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ANS – Agência Nacional de Saúde (National Health Agency) – is the regulatory agency for the private health system. It determines the minimum coverage for health care plans, what differs between them is the reimbursement level, accommodation offers, network level and additional coverages.
Nearly all of national and multinational companies provide a private health care system to their employees and dependents in Brazil.
NATIONAL HEALTH AGENCY
There are usually two or three plan levels. Companies usually resort to co-insurance in doctors visit and simple exams (from 10% to 30% of the total cost of procedure).
PLAN DESIGN
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INSUREDSELF INSURED
THE PROVIDER ESTABLISHES
A MONTHLY PREMIUM BASED
ON EMPLOYEES PROFILE.
ANNUALLY A CLAIM EXPERIENCE
ANALYSIS IS CARRIED OUT,
IN ORDER TO MEASURE THE
PREMIUM VS CLAIMS RATIO.
IN THEORY, THE RISK OF
INSURANCE SHOULD BE HANDLED
BY THE PROVIDER. HOWEVER, IT IS
ACTUALLY SHARED WITH THE COMPANY.
WHEN THE CLAIMS RATE EXCEEDS
A PRE-ESTABLISHED LIMIT,
ADJUSTMENTS MAY BE MADE.
IN CASE OF CANCELLATION OF THE
CONTRACT THE RUN OFF IS THE
RESPONSIBILITY OF THE INSURER.
THERE IS NO MONTHLY PREMIUM.
THE INSURER HANDS OVER TO THE COMPANY
EVERY COST OCCURRED IN A CERTAIN
PERIOD, PLUS THE TAXES APPLIED.
THE RISK IS FULLY HANDLED
BY THE COMPANY.
IN ORDER TO MANAGE THIS PROGRAM THE
INSURER SETS UP AN ADMINISTRATION FEE,
WHICH IS IN GENERAL A FIXED MONTHLY
AMOUNT PER INDIVIDUAL.
THE INSURER DOES NOT ASSUME
ANY RISKS, EXCEPT PENDING PAYMENTS.
THE EMPLOYER IS ABLE TO APPLY DIFFERENT
FORMS OF COPAYMENTS AND HAVE FULL
ACCESS TO MEDICAL COSTS.
STOP LOSS IS RECOMMENDED.
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Under the Brazilian Legislation, an employee who contributes a fixed amount to his health plan and has been laid off without just cause has the right to remain in the plan from 6 to 24 months. The remaining period will be defined by 1/3 of the contribution time. In case of retirement, the remaining period can be extended to lifetime.
In case of extension, it is important to remember that the employee must assume the plan cost.Liability calculation is mandatory for employers that share the cost with their employees in accordance to the laws as follows:
KEY ASPECTS
AMERICAN COMPANIES
EUROPEAN COMPANIES
BRAZILIANCOMPANIES
IAS 19
CVM 600
FAS 106
The policy can be readjusted once a year and depends on two aspects:
CONDITIONS FOR RENEWAL
EXPERIENCE OR TECHNICAL ADJUSTMENTExperience or technical adjustment: It is not applied to self-insured contracts.
VCMH OR FINANCIAL ADJUSTMENTStands for inflation related to medical costs and each provider has their own amount.
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Approximately 89% of national and multinational companies provide private dental care to employees and their dependents. As with medical plans, ANS also regulates dental plans and determines a minimum coverage. Usually, companies offer basic coverage (Level 1) and employees can upgrade to a higher level bearing the extra cost.
Copayment is usually applied to prosthesis and orthodontics in cases where these are offered in the program.
The guaranteed treatments vary in accordance with the following practices:
DENTAL CARE
LEVEL 1 Minimum coverage
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
LEVEL 2 Minimum coverage + orthodontics or prosthesis
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16% LEVEL 3 Minimum coverage + orthodontics + prosthesis
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
LEVEL 4 Minimum coverage + orthodontics + prosthesis + implants
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
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Approximately 91.2% of national and multinational companies offer group life insurance in their benefits packages. According to recent research from UIB, 67.9% of multinational companies bear the cost completly.
If the employer requires an employee contribution, Brazilian legislation requires approval from75% of the work force to include any changes in the policy. Levels of coverage may vary as shown below:
GROUP LIFE
PREVALENCE
100%Special Indemnity due to Accidental Death
84.6%Automatic inclusion of spouse (Death)
100%Permanent, full or partial disability caused by accident
76.9%Automatic inclusion of children (Death)
100%Death by any cause
COVERAGE
92.3%Permanent and full disability caused by disease
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% 50 to 200 The matching contribution may vary from 50% to 200% depending on the industry sector.
Usually the pension plan is offered to all employee levels, although these are not compulsory benefits.
PENSION
% 64.7of national and multinational companies offer Pension plans under the benefits packages.
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In accordance with our recent survey, vesting period may vary depending on
industry sector; however, general practice requires from 5 to 10 years to reach 100% of employer’s contribution.
INSURANCE COMPANIES
open entities
SELF-SPONSORED OR MULTI-SPONSORED PLANS
OVERALL POPULATION COVERED POPULATION OVERALL POPULATION COVERED POPULATION
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2%
4%
6%
8%
10%
12%
14%
16%
closed entities
Private pension plans are divided into two main vehicles:
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