2. Disclaimer
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.”
4. “What is a Purple Cow?”
A unique product that stands out in the field. 1
“Moo!”
Gotuaco’s Purple Cow is a unique healthcare product
that stands out in the field of EMPLOYEE BENEFITS.
5. Vision 2
FINANCIAL
SECURITY…
through
PURPLE COW
Employee
Benefits.
LIKE Purple Cow Employee Benefits on Facebook
6. Mission 3
To PROTECT
Employers &
Employees...
from
FINANCIAL
INSECURITY.
LIKE Purple Cow Employee Benefits on Facebook
7. Advocacy 4
SUPPORT
SME:
SME
they are the
FUTURE
HEROES
of our economy!
LIKE Purple Cow Employee Benefits on Facebook
8. Philosophy 5
DOING
BUSINESS
with SME:
MORE FUN
in the
PHILIPPINES!
LIKE Purple Cow Employee Benefits on Facebook
10. Purple Cow 2012
Value Proposition
1
More VALUE…
Purple Cow gives you all 3 of today’s major
employee benefits in 1 package, designed
to provide multiple layers of protection:
Group Life: P50,000 – P1,000,000
Group Accident: P50,000 – P1,000,000
Group Health: P10,000 – P200,000
You can get MORE benefits for ALL of your staff
11. Purple Cow 2012
Value Proposition
2
+ Less PRICE…
Purple Cow saves you 25% - 50% on the
2 most frequently selected Room &
Board categories (Ward & Semi-Private)
when you combine them with our Max.
Benefit Limits:
Ward 10-20-30T: starts at P4,991 / P6,378/yr*
Semirates for new Virgin / new Non-Virgin accounts. See Costs section for all the rates)
*(Starting
30-40-50T: starts at P6,821 / P8,646/yr*
You can get LOWER rates for MAJORITY of your staff
12. Purple Cow 2012
Value Proposition
3
= More HAPPINESS!
Purple Cow shares the Good News with
each level of your SME organization:
Employees: More financial security
HR: Better recruitment & retention
Finance: Greater financial viability
CEO: Major ‘pogi’ points
You can make EVERYONE happy
14. Purple Cow 2012
Macro & Micro
1
The P6T Philippine Economy
Tran./Cm ./Str., 503, 8%
FIRBS, 841, 14%
Elec/Gas/Wat., 413, 7%
Manuf.
Cm .SocSv., 181, 3%
Wh/Re.Trd.
Wh/Re.Trd., 1,069, 18% Min./Quar., 103, 2% Fin/RE/BzSvc.
Constrctn., 94, 2% Tran./Cm ./Str.
Elec/Gas/Wat.
Agr/Fis/For., 76, 1%
Cm .SocSv.
Min./Quar.
Constrctn.
Agr/Fis/For.
Manuf., 2,716, 45%
(in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed.
FIRBS = Financial Services, Real Estate & Business Services
15. Purple Cow 2012
Macro & Micro
2
The P600B Financial Services Sector
21 Insurance, 104, 17%
Fin.Hold.Co., 95, 15%
Banking
PreNd.P/E/M, 12, 2% 21 L/NL. Ins.
Inv.Co./Hous., 10, 2% Fin.Hold.Co.
PreNd.P/E/M
Credit.Card, 6, 1%
Inv.Co./Hous.
3 PreNd.Hlth, 6, 1%
Credit.Card
Mutual.Fund, 3, 1% 3 PreNd.Hlth
Fin./Lease, 2, 0% Mutual.Fd.
Paw nshop, 1, 0% Fin./Lease
Paw nshop
Banking, 380, 61%
(in Billions of Pesos) BusinessWorld Top 1000 Corp. in the Phil., 2009 ed.
Insurance includes Medical INS.; Pre-Need Health = HMO
16. Purple Cow 2012
Macro & Micro
3
The Insurance vs. HMO Industries
88 Non-Lf.INS, 42, 38%
15 PreNd.HMO, 12, 11%
35 Life.INS
88 Non-Lf.INS
15 HMO
35 Life.INS, 57, 51%
HMO Figures: AHMOPI, 2009
(in Billions of Pesos) Life & Non-Life Insurance Figures: Insurance Commission, 2009
Insurance Industry (123 Co./P99B) > HMO Industry (15 Co./P12B)
17. Purple Cow 2012
Macro & Micro
4
The Medical INS. vs. HMO Markets
5/123 Med. INS, 2, 8%
15 HMO
5/123 Med.INS
15 PreNd.HMO, 12, 92%
HMO Figures: AHMOPI, 2009
(in Billions of Pesos) Medical Insurance Figures: Delphi, 2009
Medical INS. market (5 of 123 Co./P2B) < HMO market (15 Co./P12B)
18. Purple Cow 2012
Macro & Micro
5
The QUESTION:
Q: “What should you get?”
the BIGGER product (HMO)
from the smaller industry? (HMO)
(HMO is 90% of the healthcare market, but the HMO industry is 1/10th the size of the Insurance Industry);
or the smaller product (medical insurance)
from the BIGGER industry?
(insurance)
Can you get the best of both worlds?
(Medical Insurance is 10% of the healthcare market, but the INS. industry is 10x the size of the HMO Industry).
19. Purple Cow 2012
Macro & Micro
6
The ANSWER:
A: “You should get…”
the BIGGER product… (HMO)
♠ Buffet of Benefits
♥ Nationwide Network
♦ No-Cash-Out
♣ No Inner Limits
from the BIGGER industry! (insurance)
♠ More Stability
♥ More Underwriting
♦ More Regulation
♣ More Experience
An HMO plan from an INS. CO. can give you the best of both worlds!
20. Purple Cow 2012
Macro & Micro
7
The Healthcare ‘Red Ocean’
LG GROUP LG
100
2,958 HEALTH M20
0+ee
(.4%)
MEDIUM MEDIUM
2,923 (.4%) GROUP P15-100M;
HEALTH 100-199 ee
SMALL SMALL
61,762 (7.6%) P3-15M; 10-99 ee
MICRO MICRO
<P3M assets; 1 – 9
743,949 firms (91.6%)
ee
Figures: NSO 2001; DTI 2004
The top 1% of all enterprises receive all the Healthcare attention…
21. Purple Cow 2012
Macro & Micro
8
The Healthcare ‘Blue Ocean’
LG LG
100
2,958 M20
0+ee
(.4%)
MEDIUM MEDIUM
2,923 (.4%) P15-100M;
100-199 ee
SMALL GROUP SMALL
61,762 (7.6%) HEALTH P3-15M; 10-99 ee
MICRO INDIVIDUAL
MICRO
HEALTH <P3M assets; 1 – 9
743,949 firms (91.6%)
ee
Figures: NSO 2001; DTI 2004
…while 99% of all enterprises remain un-served or under-served!
22. Purple Cow 2012
Macro & Micro
9
The Healthcare ‘Purple Ocean’
LG LG
100
2,958 M20
0+ee
(.4%)
MEDIUM MEDIUM
2,923 (.4%) P15-100M;
PURPLE 100-199 ee
COW
SMALL EB 4 SME SMALL
61,762 (7.6%) P3-15M; 10-99 ee
MICRO MICRO
<P3M assets; 1 – 9
743,949 firms (91.6%)
ee
Figures: NSO 2001; DTI 2004
The GOAL: to protect more & more SME from financial insecurity
23. 2012
4. EB PRIMER
A Whole New WORLD of Employee Benefits
24. Purple Cow 2012
EB Primer
1
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
25. Purple Cow 2012
EB Primer
2
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
26. Purple Cow 2012
EB Primer
3
What are the most common EB?
• Paid vacations, 75%
• Health insurance, 61%
• Paid sick leave, 59%
• Disability insurance, 41%
• Education reimbursement, 39%
• Pension plan, 30%
• Life insurance, 29%
• Dental insurance, 24%
- Small Business Poll on Compensating Employees (NFIB, US: 2003)
All 4 insurance benefits are offered by Purple Cow
27. Purple Cow 2012
EB Primer
4
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 disablement;
(10% of inpatient & outpatient cases)
• HEALTH INSURANCE (medical insurance or HMO)
protects you from losing money in the event of sickness
or accident. (10% inpatient / 300% outpatient)
Insurance saves you from losing your money
28. Purple Cow 2012
EB Primer
5
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 your Employees from
LOSING MONEY to medical emergencies – the most
common cause of their financial insecurity;
• Because Employee health is not just Corporate wealth,
but also Corporate Social Responsibility.
Charity begins at home: give your staff the gift of health
29. Purple Cow 2012
EB Primer
6
Why get the Purple Cow?
• The Purple Cow is UNIQUE: no other insurance
company, HMO, agent, or broker offers such a plan;
• The Purple Cow is SMART: it has all the features and
benefits majority of our Customers say they want or need;
• The Purple Cow is PERFECT: the recommended R&B
and MBL are the right combination up to 99% of the time.
WhyPurple Cowyouthe right less? for your SME
pay more if is can pay choice
30. Purple Cow 2012
EB Primer
7
Why get AsianLife (ALGA) as Insurer?
• ALGA is the BIGGE$T NAME in group life & medical
insurance, and the only insurance company today that
offers an HMO plan; (ALGA clients include PLDT, Smart & Meralco)
• ALGA is the BE$T VALUE for your money, with the
most useful life, accident & health benefits rolled into one;
• ALGA offers the LOWE$T PRICE, when comparing all
its insurance & HMO features & benefits.
ALGA gives you the best of both INS and HMO worlds
31. Purple Cow 2012
EB Primer
8
Why get GRA as Broker?
• GRA is the #1 Filipino, (2) family-owned, full-line
insurance brokerage in the country today: it produces
>P1B in premiums, and has been in the Top 5 since 1965;
• GRA’s partners, Larry Gotuaco & Albert del Rosario, are
legends in the industry; the Next Generation of Meg Isleta,
Andy Gotuaco & Tom Gotuaco carry on the Tradition;
• GRA’s Tom Gotuaco is the Creator of PURPLE COW: the
only EB plan today that treats SME like a large company.
GRA offers the perfect admin backroom for Purple Cow
33. Purple Cow 2012
Benefits
1
3 Major Employee Benefits (per IC)
LIFE – ACCIDENT – HEALTH
LIFE (worldwide) HEALTH (nationwide)
1. LIFE INSURANCE 3. MEDICAL HMO
* Terminal Illness Rider * 8,205 affil. MD, 383 hospitals, 428 clinics
* Total & Perm. Disability Income
4. Opt. DENTAL HMO
ACCIDENT (worldwide) * Basic 10: 790 dentists, 659 clinics
2. PERSONAL ACCIDENT 5. Opt. Annual Physical Exam
a. Accidental Death * Basic 5: mobile or clinic
* Murder
b. Accidental Disablement
6. Health & Wellness Program
* up to 2x/yr; tailored to utilization report
* Assault
34. Purple Cow 2012
Benefits
2
Benefit Summary
LIFE – ACCIDENT – HEALTH
1. Life = 5x MBL 13. Access to Big 5 Hospitals & Healthway
2. Terminal Illness = up to 50% of 5x MBL 14. 100% Pre-Existing Conditions coverage
3. Total & Perm. Disability Income = 5x MBL 15. 100% Congenital Conditions coverage
4. Accidental Death = 5x MBL 16. 100% Special Procedures coverage
5. Murder = 5x MBL 17. Benefits on top of Philhealth
6. Accidental Disablement = __% of 5x MBL 18. Pooled Employee utilization
7. Assault = __% of 5x MBL 19. Separate Dependent utilization
8. Medical = HMO buffet of benefits 20. Opt. Dental = HMO buffet of benefits
9. Combined inpatient & outpatient limits 21. Opt. APE = choice of mobile or clinic
10. Max. Benefit Limits per disability per year 22. Health & Wellness Program (up to 2x/yr)
11. HMO patient for no-cash-out 23. Same benefits for Dependents
12. Private patient for reimbursement (HMO rate) 24. Access through Social Media
35. Purple Cow 2012
Benefits
3
1. Life Insurance (worldwide)
ASIANLIFE EXCLUSIONS
1. Life 5x MBL 1. Suicide within the 1st year of coverage
2.5x
2. Terminal Illness Rider (up to 50%)
MBL
3. Total & Perm Disability Income 5x MBL
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo Example:
If MBL = 20T, Life or TPDI = 100,000; TIR = 50,000;
1. Life benefit = 5x MBL, for death by any If MBL = 40T, Life or TPDI = 200,000; TIR = 100,000;
cause; If MBL = 60T, Life or TPDI = 300,000; TIR = 150,000;
2. TIR benefit = up to 50% of 5x MBL, as an If MBL = 80T, Life or TPDI = 400,000; TIR = 200,000;
If MBL = 100T, Life or TPDI = 500,000; TIR = 250,000.
advance on the Life benefit, if terminally ill
(< 12mos. to live); 50% balance upon death;
3. TPDI Benefit = 5x MBL, in lieu of the Life
benefit, whether sickness or accident.
Life benefits are payable on top of Accident & Medical HMO benefits
36. Purple Cow 2012
Benefits
4
2a. Accident Insurance (worldwide)
ASIANLIFE
1. Accidental Death 5x MBL 3. Disablement _% 5x MBL
2. Murder 5x MBL 4. Assault _% 5x MBL
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo
1. Accidental Death = 5x MBL, for death 3. Disablement = __% of 5x MBL, according
from any type of accident; to a long schedule of indemnities;
2. Murder = 5x MBL, in lieu of the Accidental 4. Assault = __% of 5x MBL, in lieu of the
Death benefit, for death not due to accident Disablement benefit, for disability not due
but murder (provoked or not). to accident but assault (provoked or not).
Example: Example:
If MBL = 20T, Accidental Death or Murder = 100,000; If MBL = 20T, Disability or Assault = __% of 100,000;
If MBL = 40T, Accidental Death or Murder = 200,000; If MBL = 40T, Disability or Assault = __% of 200,000;
If MBL = 60T, Accidental Death or Murder = 300,000; If MBL = 60T, Disability or Assault = __% of 300,000;
If MBL = 80T, Accidental Death or Murder = 400,000; If MBL = 80T, Disability or Assault = __% of 400,000;
If MBL = 100T, Accidental Death or Murder = 500,000. If MBL = 100T, Disability or Assault = __% of 500,000.
Accident benefits are payable on top of Life & Medical HMO benefits
37. Purple Cow 2012
Benefits
5
2b. Accident Insurance…
LONG SCHEDULE OF INDEMNITIES
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
38. Purple Cow 2012
Benefits
6
2c. Accident Insurance…
EXCLUSIONS
1. Bodily or mental infirmity, hernia, ptomaine, bacterial or 12. War, invasion, act of foreign enemy or warlike operation
viral infection (except pyogenic infection occurring with and (whether declared or undeclared), mutiny, strikes,
through an accidental cut or wound) demonstrations, riots, civil commotion, conspiracy, military
2. Disease, sickness, parasite, or disorder of the body/ takeover, state of siege, or any weapon or instrument
mind employing atomic fission or radioactive force whether in
3. Poison, gas or fumes voluntarily or involuntarily taken time of peace or war
4. Insect bites 13. Serving in the armed forces of any country, or
5. Earthquake, volcanic eruption or tidal wave international authority, whether in war or peace
6. Atomic explosion, nuclear fission, or radioactive gas 14. Entering, operating, servicing, ascending or descending
from any aerial or submarine device or conveyance, except
7. Pregnancy, childbirth, miscarriage or any complications as provided under a passenger aviation provision
8. Accident occurring while or because the Insured is under 15. Hunting, motorcycling or pillion riding, mountaineering
the influence of alcohol or any drug which necessitates the use of ropes or pitons, racing of any
9. Suicide or any attempted threat while sane or insane, or kind, other than on foot, ice or winter sports, water-ski
any intentionally self-inflicted injury jumping and tricks, yachting beyond 5 km. off a coastline,
underwater activities involving the use of underwater
10. Participation in any brawl, or committing any crime or apparatus, or using woodworking machinery driven by
felony mechanical power other than portable tools, applied by
11. Provoked murder / assault or attempted threat [waived] hand and used solely for private purposes without reward
39. Purple Cow 2012
Benefits
7
3a. Medical HMO (nationwide)
ASIANLIFE (8,205 affil. MD, 383 hospitals, 428 clinics) TERMS & CONDITIONS
1. Traditional HMO buffet of benefits 1. Instant rates, regardless of size
2. Combined inpatient & outpatient limits 2. No franchising required
3. Max. Benefit Limits per disability per year 3. No utilization report required
4. HMO patient for no-cash-out 4. No individual applications required
5. Private patient for reimbursement (HMO rate) 5. Minimum group size = 10
6. Access to Big 5 hospitals & Healthway 6. Minimum mode of payment = monthly
7. 100% Pre-Existing Conditions coverage 7. Pooled Employee utilization to spread risk
8. 100% Congenital Conditions coverage 8. Split Dependent utilization to reduce cost
9. 100% Special Procedures coverage 9. Buy now, pay later
10. Benefits on top of Philhealth 10. 1st year Virgin promo rate, if applicable
+Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo +Same rates for Dependents in 2012
Medical HMO benefits are covered on top of Life & Accident benefits
40. Purple Cow 2012
Benefits
8
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 diseases
18. 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] Dreaded & Non-Dreaded PEC are covered 100% up to MBL
41. Purple Cow 2012
Benefits
9
3c. Medical HMO…
SPECIAL PROCEDURES or NEW MODALITIES OF TREATMENT
1. Lithotripsy 11. Sclerotherapy
2. Arthroscopic procedures 12. Physical & speech therapy
3. Laparoscopic procedures 13. Angiography
4. Laser therapy (excludes use for correcting vision) 14. Nuclear technologies
5. Nuclear / radioactive isotope scans 15. Thallium scintigraphy
6. Cost of artificial limbs, joint prosthesis and heart 16. CT scan / MRI
valve prosthesis 17. Pulmonary perfusion scan
18. Endoscopy
7. Other new modalities of treatment for conditions with
established etiologies and used as alternatives to 19. Bone densitometry scan
conventional or traditional procedures
20. Anti-nuclear anti-body (ANA)
8. Dialysis 21. C-reactive protein (rheumatic & complications)
9. Chemotherapy 22. Lupus cell exam
10. Radiation oncology / therapeutic radiology 23. Sleep therapy
Special Procedures or New Modalities of Treatment are covered 100% up to MBL
42. Purple Cow 2012
Benefits
10
3d. 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
2. Services rendered or supplies provided free of charge health hazards
3. Additional hospital charges and/or professional fees resulting from a plan member taking
14. Self-inflicted injuries including, but not limited to, any form of suicide attempt
a room accommodation more than his R&B limit (excesses and/or incremental costs)
4. Maternity and maternity-related conditions and/or complications except those benefits that 15. Sexually transmitted disease, AIDS, rehabilitative treatment for alcoholism and
may be provided by the (optional) Maternity benefit drug abuse
5. Sterilization of either sex or reversal of such, artificial insemination, sex change, 16. Acquisition of prosthetic appliances, artificial aids, durable equipment, surgically
consultation/confinement regarding fertility implanted devices and external prosthetic devices except those that are explicitly
covered and enumerated in the ‘Special Procedures or New Modalities of Treatment’
6. Non-recommended confinement, convalescent / domiciliary / custodial care, rest cures provision of this agreement
7. Dental-related cases except those that may be provided by the Dental Benefits and to the 17. Organ transplant-expense relating to organ donation of the donating party/parties
extent that are necessary for the repair or alleviation of damage caused solely by accidental
injury sustained (and not caused by the plan member) 18. Executive check-ups, unless explicitly provided in the master policy, and/or
confinements purely for diagnostic purposes, as well as non-recommended
8. Circumcision, cosmetic / aesthetic procedures except re-constructive surgery to treat
confinements
functional defects due to a covered disease and/or accidental injury
9. Psychiatric disorders, psychosomatic conditions, treatment for any mental or nervous 19. Take-home medicines, unless optional ‘Reimbursement of Prescribed Medicines’
disorders, illness / injury / condition / complication arising from the plan member’s excessive benefit is provided, and vaccines, except for first doses of either anti-venom, anti-
alcohol intake and/or use of regulated/prohibited drugs rabies or anti-tetanus used for emergency treatment
10. Illnesses and/or injuries arising from the plan member’s participation in brawls, riots, 20. Medico-legal fees including the cost of Medical Certificates that a plan member
commission of a crime, violation of ordinances, or the like may require for any purpose it may serve him or her
11. Illnesses / injuries resulting from conditions of war or sustained from combat-related 21. Congenital disease / deformity that is evident to the plan member at birth and/or
activities can be clinically determined to be congenital [waived]
22. Medical / surgical procedures and/or diagnostic tests that are experimental in
12. Illnesses / injuries resulting from the plan member’s active participation in hazardous nature and/or not generally accepted by the medical profession such as, but not limited
activities such as, but not limited to, bungee jumping, hang-gliding, scuba diving, to, iridology, chiropractic services, and acupuncture
mountain/wall climbing, and professional sports
43. Purple Cow 2012
Benefits
11
4. Optional Dental HMO (nationwide)
HP DENTAL (790 dentists, 659 clinics) EXCLUSIONS
1. (1) permanent filling 1. Dental procedures not included in the list of 10 benefits
2. (2) oral prophylaxes 2. Reimbursements for seeing your own dentist
3. Unlimited consultations
4. Simple tooth extractions if indicated
5. Temporary fillings when indicated
6. Gum treatment except for alveolectomy/gingivectomy
1
7. Simple adjustment of dentures +Access to HP Dental-accredited clinics in SM, Market2,
Festival, Robinson’s, Shangrila, and ATC malls.
8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays
+Dental card and booklet provided, as well as an
9. Treatment of pain/lesions/wounds/burns orientation and an annual utilization report.
10. Emergency dental procedures if necessary +Discounts available on procedures not included in the
dental HMO plan.
+Appointment preferred (unless emergency) Optional Nationwide Dental HMO: +/- P300
Optional Dental HMO benefits are covered on top of Medical HMO benefits
44. Purple Cow 2012
Benefits
12
5. Optional Annual Physical Exam
VARIOUS (mobile or clinic) EXCLUSIONS
1. Physical examination 1. APE procedures not included in the Basic 5 APE plan
2. Chest X-Ray
3. CBC Basic 5
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).
+Call Lala Perido at GRA to help design, source, price
& schedule your APE during the year [888-0001 x835]. Optional APE: +/- P400 or P500 (for mobile or clinic APE)
Optional APE benefits are covered on top of Medical HMO benefits
45. Purple Cow 2012
Benefits
13
6. Health & Wellness (up to 2x per year)
ASIANLIFE (call 890-1758 ext. 278 to schedule) EXCLUSIONS
1. Comprehensive Wellness Program (to 2x/yr) 1. Cost of vaccines
A company’s corporate wellness program is a key component of The Comprehensive Wellness Program is customized to meet
company success. Based on a company’s health and wellness your health & wellness needs through the following services:
needs/wants, AsianLife has developed a CWP that can motivate HEALTH RISK ASSESSMENTS: Comprehensive written
and maintain good health. AsianLife brings corporate wellness assessment and detailed CUR (current utilization report) are
programs to the client’s location and implements a wellness provided which gives the employee and the employer the
program that suits the client’s actual health profile to achieve information needed to set wellness goals.
their unique needs and goals. HEALTH PROMOTION & DISEASE MANAGEMENT
To effectively manage healthcare costs, organizations must SEMINARS: Pooling from a wealth of resources and expertise
include programs that proactively help employees maintain and available through the medical partners, numerous presentations
improve their health. The road to better health (and fewer and seminars are available for the client’s workforce to promote
preventable health claims) is paved with small decisions we Wellness.
make every day. The result of doing nothing is continued HEALTH SCREENINGS: Periodic onsite health screenings such
skyrocketing of health-care costs, rising absenteeism, and lower as blood pressure and body fat analysis are available in the
employee productivity. program in addition to more extensive screenings such as blood
Wellness Bottom Line: gains can include… analysis.
Improved employee health; HEALTH PROTECTION MEASURES: Scheduled vaccine
Increased workforce productivity; administration program can be done within company premises.
reduced health insurance premiums; The vaccine may vary depending on the need/requirement of the
lower workers compensation claims. company.
Free Health & Wellness Program benefits are covered on top of Medical HMO benefits
46. 2012
6. COSTS
Your INVESTMENT in Financial Security
LEGEND:
• VIRGIN – new account that has never had group health before (medical INS or HMO)
• VIRGIN Renewal – renewing Virgin account
• NON-VIRGIN – new or renewing Non-Virgin account
• NON-VIRGIN Renewal – renewing Non-Virgin account
47. Purple Cow 2012
Costs: New VIRGIN
Standard: Life INS / Accident INS / Medical HMO
Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500)
1
Cost Summary
R&B MBL ANN SEMI QTR MO R&B MBL ANN SEMI QTR MO
10T 4,991 2,646 1,398 500 REG 60T 12,332 6,537 3,454 1,234
PVT
WARD 20T 5,442 2,885 1,524 545 80T 13,888 7,361 3,889 1,389
(R&F) (Top rank
Small co
30T 6,206 3,290 1,738 621 50-100) 100T 15,185 8,049 4,252 1,519
30T 6,821 3,615 1,910 683 80T 16,277 8,627 4,558 1,628
LRG
SEMI PVT
PVT 40T 7,510 3,981 2,103 751 (Top rank 100T 17,422 9,234 4,879 1,743
(Spvr) Med co
100-200)
50T 8,248 4,372 2,310 825 120T 19,116 10,132 5,353 1,912
50T 9,722 5,153 2,723 973 100T 26,933 14,275 7,542 2,694
SML JR
PVT SUITE
(Top rank 60T 10,570 5,603 2,960 1,058 (Top rank 150T 30,327 16,074 8,492 3,033
Small co Large co
10-50) > 200)
70T 11,394 6,039 3,191 1,140 200T 34,264 18,160 9,594 3,427
48. Purple Cow 2012
Costs: New NON-VIRGIN
Standard: Life INS / Accident INS / Medical HMO
Optional: Dental HMO (+/- P300) / APE (+/- P400 or P500)
3
Cost Summary
R&B MBL ANN SEMI QTR MO R&B MBL ANN SEMI QTR MO
10T 6,378 3,381 1,786 638 REG 60T 15,705 8,324 4,398 1,571
PVT
WARD 20T 6,903 3,659 1,933 691 80T 17,613 9,336 4,932 1,762
(R&F) (Top rank
Small co
30T 7,834 4,153 2,194 784 50-100) 100T 19,181 10,167 5,371 1,919
30T 8,646 4,583 2,421 865 80T 20,767 11,007 5,815 2,077
LRG
SEMI PVT
PVT 40T 9,483 5,026 2,656 949 (Top rank 100T 22,134 11,731 6,198 2,214
(Spvr) Med co
100-200)
50T 10,385 5,504 2,908 1,039 120T 24,226 12,840 6,784 2,423
50T 12,332 6,536 3,453 1,234 100T 34,689 18,386 9,713 3,469
SML JR
PVT SUITE
(Top rank 60T 13,378 7,091 3,746 1,338 (Top rank 150T 38,807 20,568 10,866 3,881
Small co Large co
10-50) > 200)
70T 14,394 7,629 4,031 1,440 200T 43,644 23,132 12,221 4,365
50. Purple Cow 2012
Competitive Advantages
1
Why Purple Cow?
1 ‘Large’ Size Fits All SME:
If you are an SME, with 10 or more regular
employees (per DTI), you can join the herd,
and be treated just like a large Company.
(Unlike most HMO plans)
You can enjoy the same toys as the Big Boys
51. Purple Cow 2012
Competitive Advantages
2
Why Purple Cow?
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.
(Unlike most HMO plans)
You can see your own doctor, cheaper
52. Purple Cow 2012
Competitive Advantages
3
Why Purple Cow?
3 Major Employee Benefits in 1 Plan:
You get Group Life, Accident & Health
(medical HMO, optional dental HMO,
optional APE, and Wellness) – all in 1 plan.
(Unlike most HMO plans)
You get all the Employee Benefits you will ever need
53. Purple Cow 2012
Competitive Advantages
4
Why Purple Cow?
4 Modes of Payment:
You can choose from annual, semi-annual,
quarterly, or monthly modes of payment
to suit your cash flow or budget.
(Unlike most HMO plans)
You can pay Annual (60%), S.A. (5%), Qtr. (30%) or Mo. (5%)
54. Purple Cow 2012
Competitive Advantages
5
Why Purple Cow?
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 organizational needs.
(Unlike most HMO plans)
You can try new combinations to see if they are ‘sulit’
55. Purple Cow 2012
Competitive Advantages
6
Why Purple Cow?
100% Pre-Existing Conditions:
You get 100% coverage up to MBL for
Pre-Existing Conditions such as cancer,
hypertension, diabetes & asthma.
(Unlike most HMO plans)
You are covered for dreaded & non-dreaded diseases
56. Purple Cow 2012
Competitive Advantages
7
Why Purple Cow?
100% Congenital Conditions:
You get 100% coverage up to MBL for
Congenital Conditions such as mitral valve
prolapse, rheumatic heart disease & hernia.
You are covered for most HMO plans) since birth
(Unlike medical conditions
57. Purple Cow 2012
Competitive Advantages
8
Why Purple Cow?
100% Special Procedures:
You get 100% coverage up to MBL for
Special Procedures such as arthroscopy,
laparoscopy, chemotherapy, P/T & MRI.
You are covered for most HMO plans) of treatment
(Unlike newer modalities
58. Purple Cow 2012
Competitive Advantages
9
Why Purple Cow?
Benefits on Top of Philhealth:
Your HMO limits are on top of Philhealth,
so you won’t be needing as much MBL:
Benefits = Philhealth + MBL (not just MBL).
(Unlike most HMO plans)
You get full HMO benefits on top of Philhealth benefits
59. Purple Cow 2012
Competitive Advantages
10
Why Purple Cow?
Pooled Employee Utilization:
Your Employee utilization is pooled
together with the employee utilization
of all other SME, to spread your risk.
(Unlike most HMO plans)
You get to enjoy the safety of a bigger group
60. Purple Cow 2012
Competitive Advantages
11
Why Purple Cow?
Separate Dependent Utilization:
Your Employee and Dependent utilization
are separate, so you won’t have to worry
about Dependents affecting Employee rates.
(Unlike most HMO plans)
You can offer Dependent coverage without fear
61. Purple Cow 2012
Competitive Advantages
12
Why Purple Cow?
Life Insurance:
Your Life benefit covers death by any cause,
including suicide after 1 year. For example:
Ward 20T = 100T; Semi 40T = 200T.
(Unlike all HMO plans)
Life = 5x MBL: 1 year’s worth of income replacement
62. Purple Cow 2012
Competitive Advantages
13
Why Purple Cow?
Terminal Illness Rider:
Your TIR benefit is a 50% advance on your
Life benefit, payable if you have < 12 mos.
to live (50% balance payable upon death).
TIR = 50% of 5x MBL, in all HMO plans) living expenses
(Unlike lieu of life, for
63. Purple Cow 2012
Competitive Advantages
14
Why Purple Cow?
Total & Perm. Disability Income:
Your TPDI benefit is in lieu of your Life
benefit, payable if you are unable to work
at all, due to sickness or accident.
(Unlike all HMO plans)
TPDI = 5x MBL, in lieu of Life, for living expenses
64. Purple Cow 2012
Competitive Advantages
15
Why Purple Cow?
Accidental Death Insurance:
Your Accidental Death benefit is a double
indemnity to your Life benefit, and covers
death by accident only.
(Unlike all HMO plans)
Accidental Death = 10x MBL
65. Purple Cow 2012
Competitive Advantages
16
Why Purple Cow?
Murder:
Your Murder benefit is in lieu of your
Accidental Death benefit, and payable if
you don’t die by accident, but by murder.
(Unlike all HMO plans)
Murder = 10x MBL, in lieu of Accidental Death
66. Purple Cow 2012
Competitive Advantages
17
Why Purple Cow?
Accidental Disablement Insurance:
Your Disablement benefit is based on a
long schedule of indemnities. For example:
loss of hand = 50% of Disablement benefit.
Accidental Disablement plans) 5x MBL
(Unlike all HMO = % of
67. Purple Cow 2012
Competitive Advantages
18
Why Purple Cow?
Assault:
Your Assault benefit is in lieu of your
Disablement benefit, if you don’t get
disabled by accident, but by Assault.
(Unlike all HMO plans)
Assault = % of 5x MBL, in lieu of Accidental Disablement
68. Purple Cow 2012
Competitive Advantages
19
Why Purple Cow?
Medical HMO Network:
You can get inpatient and outpatient
treatment from 8,205 affiliated doctors,
383 hospitals, and 428 clinics nationwide.
(unlike some HMO plans)
You can go to MMC/ SLMC/ CSMC/ AHMC/ TMC/ Healthway
69. Purple Cow 2012
Competitive Advantages
20
Why Purple Cow?
Optional Dental HMO Network:
You can get 1 permanent filling, 2 oral
prophylaxes, and 8 other benefits from
790 dentists and 659 clinics nationwide.
(Unlike some HMO plans)
You can go to SM/ Market2/ Festival/ Robinson’s/ Shangrila/ ATC
70. Purple Cow 2012
Competitive Advantages
21
Why Purple Cow?
Optional Annual Physical Exam:
You can order a Basic 5 APE or customize
your APE; you can choose a nearby clinic
for your staff or request a mobile APE.
(Unlike some HMO plans)
You can decide if you want an APE, and if so, what kind
71. Purple Cow 2012
Competitive Advantages
22
Why Purple Cow?
FREE Health & Wellness Program:
ALGA can conduct a Health & Wellness
program for your SME (up to 2 sessions
per year), based on your own health issues.
(Unlike most HMO plans)
You can get customized Wellness seminars & screenings
72. Purple Cow 2012
Competitive Advantages
23
Why Purple Cow?
Same Benefits for Dependents:
Dependents get the same benefits,
terms and conditions as Employees
(as well as the same costs in 2012).
(Unlike most HMO plans)
Your Dependents are treated like Employees
73. Purple Cow 2012
Competitive Advantages
24
Why Purple Cow?
Access through Social Media:
You can access info and interact directly
with suppliers via ‘C3’ (Command & Control
Center), in www.purplecow.ph or Facebook.
(Unlike most HMO & insurance plans)
C3 helps you to take charge of your own health
74. Purple Cow 2012
Competitive Advantages
25
Why Purple Cow?
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!
(Unlike most HMO plans)
You get the greater good for the greater number
75. Purple Cow 2012
Competitive Advantages
26
Why Purple Cow?
The Design is Right:
Purple Cow provides medical necessity,
not luxury! Savings from excess R&B/MBL
are reallocated to benefits of greater use.
(Unlike most HMO plans)
Your R&B/MBL combos are good up to 99% of the time
76. Purple Cow 2012
Competitive Advantages
27
Why Purple Cow?
The Perfect Insurer:
You get serviced by the biggest name in
group life & medical, and the only insurance
company today that offers an HMO plan.
(Unlike all insurance companies)
You get the best of both INS & HMO worlds from ALGA
77. Purple Cow 2012
Competitive Advantages
28
Why Purple Cow?
The Perfect Broker:
You get represented by a legend in the
industry, and the only insurance broker
today that treats SME like a large company.
You get the perfect insurance brokers) from GRA
(Unlike all backroom support
78. Purple Cow 2012
Competitive Advantages
29
Why Purple Cow?
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 a credit float
79. Purple Cow 2012
Competitive Advantages
30
Why Purple Cow?
Easy Sign Up:
1) Complete/email Masterlist (Excel);
2) Sign/fax Endorsement sheet;
3) Sign/fax Letter of Guarantee (letterhead).
(Unlike some HMO plans)
Click ‘Join the Herd!’ to download on www.purplecow.ph
80. Purple Cow 2012
Competitive Advantages
31
Why Purple Cow?
Claims Utilization Report:
You get a detailed, user-friendly report
that gives you real insights into your
company’s overall utilization patterns.
(Unlike some HMO plans)
You can learn a lot about the state of your group’s health
81. Purple Cow 2012
Competitive Advantages
32
Why Purple Cow?
Group Renewal Rates:
You get broker-negotiated group renewal
rates for the calendar year, so you can plan
in advance without hassling HR or FIN.
(Unlike most HMO plans)
Your renewals become semi-automatic for HR & Finance
82. Purple Cow 2012
Competitive Advantages
33
Why Purple Cow?
Your Employees Win:
Employees can use Purple Cow to take
charge of their own health, and protect
themselves from even more emergencies.
(Unlike most HMO plans)
P.Cow helps employees to become financially secure
83. Purple Cow 2012
Competitive Advantages
34
Why Purple Cow?
Your HR Wins:
HR can use Purple Cow to recruit and
retain staff – especially if you are in a
highly competitive work environment.
(Unlike some HMO plans)
P.Cow helps HR to power Recruitment & supply Benefits
84. Purple Cow 2012
Competitive Advantages
35
Why Purple Cow?
Your FINANCE Wins:
FINANCE can use Purple Cow to cut
healthcare costs, and reduce future
exposure to claims utilization risk.
(Unlike most HMO plans)
P.Cow helps FINANCE to limit all liabilities to the card
85. Purple Cow 2012
Competitive Advantages
36
Why Purple Cow?
Your Company Wins:
When your Employees win,
and HR & Finance win,
your Company wins!
(Unlike some HMO plans)
P.Cow promotes ‘Win-Win’ among all Co. stakeholders
86. Purple Cow 2012
Competitive Advantages
37
Why Purple Cow?
SME Nation Wins:
When your Company wins,
and other SME companies win,
Purple Cow SME Nation wins!
(Unlike all HMO plans)
P.Cow promotes ‘Win-Win’ among all SME stakeholders
87. Purple Cow 2012
Competitive Advantages
38
Why Purple Cow?
Virgins can Win Even More:
You get a 1st year Virgin promo rate
if your company has never had
group medical insurance or HMO before.
You can renew at(Unlike all HMO plans)
prevailing Virgin Renewal rates as well
88. Purple Cow 2012
Competitive Advantages
39
Why Purple Cow?
Purple Cow is Perfect for SME:
Purple Cow is designed by SME, for SME.
It is the result of an AIM-ME business plan,
and backed by years of broker experience.
(Unlike most HMO plans)
You can enjoy all the benefits of Purple Cow innovation
89. Purple Cow 2012
Competitive Advantages
40
Why Purple Cow?
Purple Cow Grows as You Grow:
If you grow BIG, you can opt to self-insure
using the same Purple Cow schedule of
benefits, as well as the same HMO
network.
You can transition smoothlyTPA plans)
(Unlike all from insured to self-insured
91. Purple Cow 2012
Summary
1
♠ What’s in it for…Employees?
EE Features EE Benefits
A complete Employee Benefits package You get more financial security from
that can make you financially secure Purple Cow than from any other HMO
Life INS, Accident INS, Medical HMO, You won’t need to get any more
Optional Dental HMO & Optional APE insurance benefits for yourself
Nationwide Medical & Dental networks, You can use any accredited hospital
inclusive of all major hospitals & clinics or clinic for medical or dental treatment
Choice of doctor as a Private Patient for You can see your own doctor and get
insurance reimbursement at HMO rates reimbursed the rate of an HMO doctor
100% Pre-Existing, 100% congenital, You are covered for existing illnesses,
& 100% Special Procedures coverage natal conditions, & special procedures
Employee Benefits on top of Philhealth You get full HMO + Philhealth benefits
Access to benefit information through You can take charge of your own
C3 on www.purplecow.ph & Facebook health, and know before you go
1 health card for every employee You can avail anytime, anywhere
92. Purple Cow 2012
Summary
2
♥ What’s in it for…HR?
HR Features HR Benefits
A 3-in-1 Employee Benefits package, You get all 3 major employee benefits
not just an HMO plan in one smart employer-paid package
A chance to compare HMO features You won’t need to wait for a proposal:
and benefits easily this presentation is your proposal
Multiple choices of Room & Board and You can adjust R&B and MBL combos
Maximum Benefit Limits to pick from to suit your organizational needs
3 forms to fill out (click ‘Join the Herd!’ You don’t need to create any forms:
at www.purplecow.ph to download) use ours (no utilization report required)
An opportunity to use Employee You can use Purple Cow to recruit &
Benefits to perform key HR functions retain staff, as well as supply benefits
Purple Cow-negotiated renewal rates You won’t need to spend time reviewing
and terms for the whole calendar year renewal proposals every year
Representation by a top local Broker You get broker assistance all year long
1 schedule of benefits for all employees You can promote equal treatment
93. Purple Cow 2012
Summary
3
♦ What’s in it for…Finance?
FIN Features FIN Benefits
A complete Employee Benefits package You get the benefit of scale whenever
for the price of an HMO plan you buy Purple Cow Employee Benefits
A chance to compare HMO rates easily, You get instant rates for the whole year:
regardless of size no need to wait or negotiate
4 ways to fit Purple Cow in your budget: You can pay for your healthcare costs
annually, semi, quarterly, and monthly according to your cash flow or budget
Membership in a bigger & bigger pool of You can spread your risk in good times
SME (Small & Medium Enterprises) and bad, and establish greater viability
Separation of Employee vs. Dependent You can reduce the adverse effect of
utilization for pricing purposes dependent utilization on price increases
An opportunity to use Employee You can use Purple Cow to limit your
Benefits to perform a key FIN function financial liability to the card
Purple Cow acts as Gatekeeper Purple Cow protects your interest
1 set of fixed costs for all employees You can eliminate variable costs
94. Purple Cow 2012
Summary
4
♣ What’s in it for the…CEO?
CEO Features CEO Benefits
Happier Employees
very pogi
Happier HR
CEO!
Happier Finance
96. Purple Cow 2012
Conclusions
1
Why Employee Benefits?
Compensation in the PH cannot provide
enough financial support in emergencies,
and needs extra support;
Benefits (EB) can provide that extra support,
as most ‘emergencies’ in the PH are either
life, accident, or health-related.
Compensation + Benefits offer the best 1-2 punch for HR
97. Purple Cow 2012
Conclusions
2
Why Purple Cow Employee Benefits?
Employee Benefits are the KEY to your
Financial Security – but not all benefits
are created equal;
Purple Cow Employee Benefits pool
all 3 major employee benefits together,
and treat your SME like a large company.
Purple Cow offers the best EB formula for growing SME
98. Purple Cow 2011
Conclusions
3
A job without financial security:
anxiety
depression
state of emergency
debt
desperation
LESS financial security = MORE worry at work
99. Purple Cow 2011
Conclusions
4
A job with financial security:
security
peace of mind
happiness
focus
productivity
MORE financial security = LESS worry at work
100. Purple Cow 2012
Conclusions
5
The Bottom Line
5% of Salary:
that’s all you need for Purple Cow!
5% is a small price to pay for everyone’s peace of mind
101. Purple Cow 2012
Conclusions
6
Our Broker Recommendation...
Treat PURPLE COW as:
a business investment (HR & FIN);
a social investment (CSR).
Purple Cow makes good business and social sense