1 Part 3 Chapter 7: Employee Benefits, Pensions, Annuities Chapter 8: Micro-insurance Chapter 9: Health Insurance.

1

Part 3

• Chapter 7: Employee Benefits, Pensions, Annuities

• Chapter 8: Micro-insurance

• Chapter 9: Health Insurance

Chapter 7

Employee Benefits, Pensions and Annuities

3

Life insurance plans for employees

Statutory Voluntary

EDLI Group Term

Group InsuranceSavings Scheme

Employer employeePayroll deduction

4

Retirement Plans for employees

Statutory Voluntary

EPF Group TermGroup TermSuperannuation

Gratuity

5

Voluntary Individual Pension Plans

• Guaranteed return Pension Plans from life insurance companies

• Unit Linked Pension Plans from life insurance companies

6

Annuity Options in Pension Plans

1. Lifetime annuity without return of purchase price

2. Annuity for life with a return of the purchase price

3. Lifetime annuity guaranteed for a certain number of years

4. Joint life/ Last survivor annuity

Chapter 8

Micro-insurance

8

Features of Micro-insurance

• low cost transactions on a voluntary basis for individuals of a group

• low-net-worth clients

• operating through networks of self help community organizations (or directly driven by government or corporate)

9

Regulations• IRDA issued the Obligations of Insurers to Rural or

Social Sectors Regulations in the year 2000.

• These regulations specify that a portion of the entire new business of a life insurance company has to belong to the rural and social sector.

10

Rural and Social Sector

• The regulations define the rural sector as a place that as per the latest census has a population of not more than five thousand, a density of population of not more than four hundred per square kilometer; and at least seventy five per cent of the male working population is engaged in agriculture.

• The social sector is defined as an unorganized sector, informal sector, economically vulnerable or backward classes and other categories of persons, both in rural and urban areas.

11

Marketing to Rural market

• Build trust and acceptance • Simple products• Simple claims process• Local language and cultural

sensitivity in marketing activities• Use of street theatre and posters

Chapter 9

Health Insurance

13

Private Health Insurance Penetration

Percentage of population covered by private health insurance

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

1991-92 1995-86 1999-00 2003-04 2005-06

Year

Per

cen

tag

e

Data from Bearing Point, Inc. for USAID, 2008

14

Types of Health Insurance

• Mediclaim type• Hospitalization Cash• Critical Illness• Specific Conditions cover• Health fund & hospitalization cover

15

Role of Third Party Administrators (TPA)

• Performs tasks related to administration of claims, managing hospital networks and maintaining records

• Manage the claims process. Collect all bills, reimburse and send documents for the consideration of claims to the insurer.

16

Benefits of TPA• A one-stop solution

to the policyholder for all requests and service

• Cash-less hospitalization through membership cards issued by the TPAs

The End