Welcome to this interactive guide!

A step-by-step handbook for HR professionals, business leaders and managers in Hong Kong.

Talent acquisition and retention are increasingly challenging for businesses. As it happens, competitive employee health benefits are a simple and cost-effective tool to attract and keep employees.

But how do you find a solution that makes your team happy and falls within your budget?

To answer this question, our experts have gathered all their insights in the first-ever comprehensive handbook on the topic. In it you will find useful information to choose the right group insurance and renew it at the best conditions, along with tips, downloadable checklists and answers to common questions.

Whether you’re looking for a group medical insurance plan or your company’s policy is up for renewal, this guide will help you understand your options and find the best solution.

This guide is also available as a downloadable ebook.

To help different companies with their group medical insurance, Alea has dedicated a special webinar session with Business Development Manager Louis Leung and HR Manager Yan Lau to share some common problems. Watch the webinar and read for our Key Takeaways here.

Pain points and challenges for HRs

• Insurance is too hard to understand
  

Insurance is a complicated financial product. It takes a great deal of time and effort to understand all the technicalities and maths behind group medical insurance.

• Too many choices, not sure where to start
  

There are thousands of options available on the market and you don’t know where to start and how to narrow down options that fit your needs. What should you look for when comparing different insurers and plans?

• Hard to balance costs with coverage
  

As HRs, you may find yourself often standing between the employers and the employees. When it comes to employee benefits, you have to answer the employer’s cost concerns on one side, and try to satisfy the employees’ demands for better coverage on the other.

• Not knowing who to ask when you or your employees have questions
  

How much coverage do I need? Which insurer is better? Is this surgery covered? You and your employees may stumble upon a bunch of questions throughout the policy year. Your insurer may not be able to answer each one of them. You want better advice and guidance from an independent source.

• Inefficient claim process and other claim issues
  

If your team is not satisfied with the claim process or if they face any claim issues, you may need to step in. You hope there is someone to handle the paperwork and communications with the insurer for you.

• Facing a high loss ratio and premium raise every year
  

Insurers adjust premiums every year by reviewing your claim history and inflation factors. You want to save on health insurance premiums and wonder if there are better alternatives.

If these scenarios strike a chord with you, you’re not alone. We understand your struggles with health insurance and it’s our job every day to help clients make the best insurance decision. Stay with us in the following chapters for some exclusive tips from Alea’s employee benefits specialists.

Group medical insurance: The basics

Group medical insurance is often referred to as “employee health benefits”. It is a common non-salary perk offered by employers to reimburse their employees’ healthcare costs.

Medical insurance is not the same as Employees’ Compensation Insurance. Employees’ Compensation Insurance (ECI) is required by law. Employers must take out ECI for all their employees to cover occupational disease, injury or death at work, regardless of an employee’s length of service, working hours and place of employment. Group medical insurance, on the other hand, is not required by law in Hong Kong. It covers non-work-related health conditions and is often an additional employee benefit.

A health insurance plan comprises different types of benefits. Most plans come with standard benefits, which cover inpatient care, outpatient care and worldwide evacuation. More comprehensive plans will include additional benefits such as dental, maternity, optical and more.

Standard benefits

• Inpatient / hospitalization: This is the essential benefit included in all insurance plans. It covers treatments that require an overnight stay in a hospital. Examples: Surgeries, hospital room fees, intensive care room fees and other costs incurred while you are admitted.
• Outpatient / doctor visit: Covers medical care that doesn’t require hospitalization. Can take place in a hospital, clinic / medical center, or other healthcare settings. Examples: Doctor consultations, prescribed medications, diagnostic tests, vaccinations and other alternative treatments like Chinese medicine.
• Worldwide evacuation: Should you ever require urgent care that is unavailable locally overseas, the insurer will arrange emergency transportation for evacuation or repatriation to your place of origin.

Additional benefits

• Dental: Usually covers routine items such as scaling and polishing, oral examinations, fillings, X-rays and simple extractions under a group plan. A waiting period of 6-12 months may apply. Orthodontics are rarely covered.
• Annual health checkup: Package may differ from plan to plan. Comes with monetary or time sub-limits.
• Maternity: Covers pregnancy-related costs, including prenatal and postnatal care, delivery, c-section, complications, etc.
• Optical: Covers an eye examination to screen for eye diseases and evaluate vision. High-end plans may reimburse prescribed spectacles with a fixed amount.
• Life insurance: More likely offered by large corporations and limited to executive-level staff, usually as a renewable term policy.
• Mental health: Covers consultations with psychiatrists and psychologists; almost always subject to an annual limit. Certain insurers provide more extensive coverage and virtual self-help tools.
• Other wellness programs, fitness programs, discounts and memberships, etc.