Competition in the Irish Private Health Insurance Market

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APPENDIX 7 Understanding and Comparing Health Insurance Products. The Health Insurance Authority publishes a document to assist consumers in understanding and comparing health insurance products. It outlines the prices and main features of all of the products available in the market in a consumer friendly format. This document is reproduced overleaf. 161
Understanding and Comparing Private Health Insurance Products Research carried out by The Health Insurance Authority (“the HIA”) indicates that Irish consumers have difficulty understanding and comparing health insurance products. The HIA publishes this document in order to address this difficulty by providing details of the main benefits provided by health insurance products in a simple, brief format that facilitates the comparison of these main benefits. It is a brief guide to the main costs and benefits of the private health insurance products sold by BUPA Ireland, Vhi Healthcare, and Vivas Health. This document does not purport to provide full product details and should not be confused with full contractual terms and conditions, which are available from the insurers. In particular, in order to avoid overcomplicating this document some potential differences between insurers and their products are not discussed, e.g. levels of customer service, number of hospitals in which cover is provided, number of consultants providing cover. The HIA provides this information on a necessarily summary basis in order to be of assistance but without liability on its part or that of its officers. You are advised in all circumstances to discuss your requirements with insurers and to review carefully the terms and conditions of the contracts. Furthermore, the cover referred to in this document is subject to the terms and conditions of the contracts. In particular, there are circumstances during which cover may not be provided, such as during waiting periods or where other exclusions apply. Again you are advised to discuss these matters with the insurers and to review carefully the terms and conditions of the contracts. Please note that the details and costs included in this document apply to the products as at 8 January, 2007 Contact details: The Health Insurance Authority Address: The Health Insurance Authority Canal House Canal Road Dublin 6 Telephone: (01) 4060080 Fax: (01) 4060081 Email: info@hia.ie Internet: www.hia.ie Vhi Healthcare Customer Service: 1850 44 44 44 (CallSave) Mon – Fri: 8.00am – 8.00pm Saturday: 9.00am – 2.00pm Fax: (056) 61741 Email: info@vhi.ie Internet: www.vhi.ie BUPA Ireland Customer Helpline: 1890 700 890 (lo-call) Mon – Fri: 8.00am – 8.30pm Saturday: 10.00am – 3.30pm Fax: (025) 42122 Email: betteroff@bupaireland.ie Internet: www.bupaireland.ie VIVAS Health Customer Service: 1850 717 717 (CallSave) Mon – Fri: 8.00am – 8.00pm Fax: (01) 2937995 Email: support@vivashealth.ie Internet: www.vivashealth.ie Table 1: Hospital Accommodation – BUPA Ireland, Vhi Healthcare, and VIVAS Health The main benefit of most private health insurance products in Ireland is the level of hospital accommodation/hospital treatment. For many plans, more than 90% of the value of claims relate to hospital accommodation and treatments although other products concentrate on out-patient benefits. Table 1 sets out the levels of hospital accommodation offered by BUPA Ireland, Vhi Healthcare, and Vivas Health for each of their products and the cost per month on Adult Group rate. The Adult Group rate is a 10% discount on full price and may be obtained if you take out health insurance as part of a group. Table 2: Outpatient, Overseas, Psychiatric Hospital, and Maternity Benefits – BUPA Ireland, Vhi Healthcare, and VIVAS Health Table 2 indicates which products provide significant outpatient benefits as well as the level of psychiatric hospital and maternity benefits. Of course insurers may offer more benefits than those listed and you should contact the insurers for full product details and terms and conditions. 162
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A Report to the Minister for Health
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CONTENTS TABLE OF FIGURES _________
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CONSUMER ATTITUDES TO SWITCHING ___
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EXECUTIVE SUMMARY AND RECOMMENDATIO
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As a result it does not have to sat
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Recommendation 7 The Minister for H
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indicates that consumers of PHI hav
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Recommendation 13 The Minister for
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is quite unclear, so far as the Aut
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1.4 For the next number of months t
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other insurers were to enter the ma
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2.6 Private health insurance (PHI)
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2.17 Open enrolment and lifetime co
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• 2001: The Health Insurance Auth
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Figure 2: Annual Change in PHI memb
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of medical inflation and the higher
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VIVAS Health is rising steadily. In
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• Table 1 below shows the annual
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Figure 6: PHI Products BUPA Ireland
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• Work-based group schemes where
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from year to year and also during t
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3. DEFINING THE PRIVATE HEALTH INSU
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Figure 7: Key features of Related H
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price increase unprofitable by a hy
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4.6 Aspects of the exemption from i
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and quarterly management accounts t
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Table 4: Regulation of PHI Firms 48
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4.31 This is a positive step. Just
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obliges Vhi Healthcare to seek appr
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4.41 In the regulatory approval pro
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4.50 However, the Authority is clea
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Unfunded Lifetime Community Rating
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President of the Society of Actuari
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− The main other deterrent at pre
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o The former members of the Advisor
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materially affected by any seasonal
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It may also be noted that the propo
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4.94 There are 37 health insurers i
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Interviews with Possible New Entran
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have shown that new sales and switc
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not binding on incumbents and no in
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5.33 In this context Vhi Healthcare
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5.44 As the former incumbent monopo
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5.52 Vhi Healthcare’s first mover
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• Psychological costs 6.5 Transac
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18-24 9% 13% 25-34 34% 19% 35-44 31
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6.24 The provision of renewal notic
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The HIA publishes on its website a
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Recommendation 10 Following consult
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Recommendation 11 The insurance com
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Regulations were established to aff
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transferred and the amounts require
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Buyer Power and Concentrated Market
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The Supply of Private Medical Facil
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VIVAS Health claims that Vhi Health
Page 111 and 112: approval on coverage of facilities
Page 113 and 114: Supplier-Induced Demand 7.36 The Vh
Page 115 and 116: Questions Relevant evidence Irish P
Page 117 and 118: to restrict individual choice of pr
Page 119 and 120: 8. CONCENTRATION AND MARKET POWER I
Page 121 and 122: gives us some indication of the com
Page 123 and 124: wishes to retain the flexibility to
Page 125 and 126: largest price increase that is prof
Page 127 and 128: scheme. Employees may be under the
Page 129 and 130: elevant regulatory requirements, ex
Page 131 and 132: Table 7 Vhi Healthcare Financial Re
Page 133 and 134: • There is limited buyer power fr
Page 135 and 136: Breaking up Vhi Healthcare would di
Page 137 and 138: expertise and other staff resources
Page 139 and 140: APPENDIX 1 Other forms of health re
Page 141 and 142: APPENDIX 2 Report of UK Government
Page 143 and 144: Australia Ireland Public hospital U
Page 145 and 146: Australia Ireland Risk equalisation
Page 147 and 148: 1.22 The Irish data is not split at
Page 149 and 150: Conclusion of normal claim payments
Page 151 and 152: APPENDIX 3 Consumer Attitudes to Sw
Page 153 and 154: Survey Respondent factors promoting
Page 155 and 156: APPENDIX 5 OECD Review of PHI The O
Page 157 and 158: not-for-profit insurers has posed c
Page 159 and 160: 114. Private insurers have not impl
Page 161: APPENDIX 6 List of Submissions The
Page 165 and 166: Benefits Outpatient Cover Cover for
Page 167 and 168: Dobson, P., M. Waterson and A. Chu,
Page 169: Vhi Healthcare (2005), Annual Repor
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Competition in the Irish Private Health Insurance Market

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