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2012




Employee
Orientation




              51pg
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.”
“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.
Vision                                2

FINANCIAL
SECURITY…
 through
PURPLE COW
  Employee
   Benefits.
  LIKE Purple Cow Employee Benefits on Facebook
Mission                                  3

To PROTECT
   Employers &
  Employees...
      from
FINANCIAL
   INSECURITY.
   LIKE Purple Cow Employee Benefits on Facebook
Advocacy                                     4

SUPPORT
    SME:
    SME
 they are the
    FUTURE
 HEROES
of our economy!
   LIKE Purple Cow Employee Benefits on Facebook
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
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
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!
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
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
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
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
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
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
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
Purple Cow 2012
                   Benefits
                                                                                                    7
                   3a. Medical HMO (nationwide)
ASIANLIFE (8,205 affil. MD, 382 hospitals, 426 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
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
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
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
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
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
Purple Cow 2012
                       Benefits
                                                                                                                        13
        7. 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
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
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
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
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%)
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’
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Purple Cow 2011
    Conclusions
                                               3
A job without financial security:

       anxiety
       depression
       state of emergency
       debt
       desperation

LESS financial security = MORE worry at work
Purple Cow 2011
    Conclusions
                                               4
 A job with financial security:

       security
       peace of mind
       happiness
       focus
       productivity

MORE financial security = LESS worry at work
Purple Cow 2012 Employee Orientation

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Purple Cow 2012 Employee Orientation

  • 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.”
  • 3. “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.
  • 4. Vision 2 FINANCIAL SECURITY… through PURPLE COW Employee Benefits.  LIKE Purple Cow Employee Benefits on Facebook
  • 5. Mission 3 To PROTECT Employers & Employees... from FINANCIAL INSECURITY.  LIKE Purple Cow Employee Benefits on Facebook
  • 6. Advocacy 4 SUPPORT SME: SME they are the FUTURE HEROES of our economy!  LIKE Purple Cow Employee Benefits on Facebook
  • 7. 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
  • 8. 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
  • 9. 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!
  • 10. 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
  • 11. 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
  • 12. 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
  • 13. 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
  • 14. 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
  • 15. 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
  • 16. 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
  • 17. Purple Cow 2012 Benefits 7 3a. Medical HMO (nationwide) ASIANLIFE (8,205 affil. MD, 382 hospitals, 426 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
  • 18. 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
  • 19. 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
  • 20. 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
  • 21. 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
  • 22. 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
  • 23. Purple Cow 2012 Benefits 13 7. 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
  • 24. 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
  • 25. 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
  • 26. 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
  • 27. 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%)
  • 28. 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’
  • 29. 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
  • 30. 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
  • 31. 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
  • 32. 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
  • 33. 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
  • 34. 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
  • 35. 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
  • 36. 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
  • 37. 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
  • 38. 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
  • 39. 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
  • 40. 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
  • 41. 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
  • 42. 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
  • 43. 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
  • 44. 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
  • 45. 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
  • 46. 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
  • 47. 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
  • 48. 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
  • 49. Purple Cow 2011 Conclusions 3 A job without financial security:  anxiety  depression  state of emergency  debt  desperation LESS financial security = MORE worry at work
  • 50. Purple Cow 2011 Conclusions 4 A job with financial security:  security  peace of mind  happiness  focus  productivity MORE financial security = LESS worry at work