Global Benefits Management EMEA - Client Forum Day 2 7-8 November 2018 - Towers Watson
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Global Benefits Management EMEA Client Forum Day 2 7-8 November 2018 © 2018 Willis Towers Watson. All rights reserved.
Today’s Agenda
Time Session
08:00-08:30 Breakfast
08:30-09:15 Day 1 Takeaways and ask your Peers
09:15-10:30 Benefits programmes around the world:
Europe (including UK)
10:30-10:45 Break
10:45-11:30 Benefits programmes around the world: CEEMEA
11:30-12:30 Benefits programmes around the world: Asia
12:30-13:15 Lunch
13:15-14:15 Benefits programmes around the world: Latin America
and USA
14:15-15:00 The Way Forward
15:00 Conference ends
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Day 1 takeaways
and ask your Peers
Francis Coleman, Willis Towers Watson
Phil Simmance, Willis Towers Watson
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3
Ask Your Peers
Contingent
worker High-cost
Communication
benefits Medical
of savings
Expenses
Procurement Local buy in
involvement for vendor
in GBM switching
Divestitures &
Benefits equalization
Same sex,
Strategy
transgender
refresh
Benefits
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Benefits programmes
around the world:
Europe (including UK)
Shannon Boyle, Willis Towers Watson
Kevin Newman, Willis Towers Watson
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In Europe….Employee Benefits matter now more than ever before
Deutsche geben 100 Milliarden für
Wellness & Co. aus
El 58% de las empresas de Europa Occidental
no tienen una estrategia formal de salud y
bienestar
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Highlights of our research in Europe
Our research drives the agenda of Benefits Managers/HR throughout the region
Benefits matter
Employers recognise benefits as an important factor in attracting, retaining and engaging employees. Nearly one
third of employers are considering providing increased flexibility.
Costs are a growing concern
Half of employers in Western Europe identify rising benefit costs as a challenge to delivering on their benefits
strategy.
Top priorities focus on plan design changes
In WE around two thirds of employers over the next three years will revise their plan designs and strategies to better
manage costs and to drive desired employee behaviours.
Technology use gains traction
There’s growing interest in using digital approaches to engage employees around benefits. Also an urgency around
upcoming data privacy law changes that require technology solutions.
Health is a competitive advantage
Employers are recognising that the user experience is key to make their health and well-being programmes an
important differentiator to attract and retain key talent. However, employers are overestimating the impact of their
well-being initiatives and need assistance to improve employee engagement.
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The majority of employers are seeking to improve the consumer experience
Employee experience:
Enhance employee perceptions about the workplace culture, and technological and physical environment
EMEA U.S.
78%
Asia Pacific
67%
55% Latin America
67%
Note: Percentages indicate ‘very important’ or ‘important’.
Sources: 2017 Willis Towers Watson Best Practices in Health Care Employer Survey; 2017 Regional Benefits Trends Survey
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France snapshot
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Legal Trends
Upcoming changes and impact
Key trend Description Impacts for clients
Merger of mandatory pension schemes ARRCO & AGIRC as of
Potential need to adjust wording on company
1st January 2019
Retirement schemes New pension supplementary product replacing
agreements and health contracts and pensions
plans
insurance/financial products
Medical plan redesign, cost raise on lower end
Medical: Progressive roll out from 2020 to 2021 on eye care, dental care
package, possible raise of certain new benefit
zero out of pocket and audio
utilization
From 1st January 2019, employers, financial and insurance
Payroll: Major change for payroll, pensions, disability and
companies will have to collect tax directly on revenues (salary,
Income tax withholding death benefits admin managers
pensions…)
Potential redesign of CBAs with evolution of
Reduction of Industry Main government project to streamline industry representation
minimum requirements and subsequent impact on
collective representation (reduce branches from 700 to 200)
plan design
opt-in in all private data collection process (portals,
RGPD: New privacy policy reinforcing obligation on data collection
enrollment…) and specific requirements in
privacy EU law agreement and subcontractors
subcontractors and clients contracts
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.UK snapshot
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12Macro issues…
Topic How we are helping
Brexit
For companies this We provide ongoing updates on the predicted impact of Brexit via ‘Insights’ and advice on mitigating
means planning for potential cost increases, including:
change affecting
relocation and
Re-negotiation of current contracts to reflect employee relocation
unpredictable Appropriateness of local or expatriate benefit contracts
insurance costs
Re-design of existing contracts that are detached from State Benefits
Pressure on the
National Health For employers We advise on strategies such as:
Services (NHS) this results in Healthcare Concierge programs staffed with fully-qualified nurses who can ensure employees receive the
longer
right care at the right time
employee
absence from Balancing a combination of NHS and private medical options to be cost effective and the best for the employee
work. Negotiation with providers to help get your employees back to health – and the workplace – more quickly
Welfare reform
We offer services to mitigate this liability:
State disability
benefits that Re-design of existing contracts that are detached from State Benefits
are harder to Improved employee communication so that benefits are understood and appreciated
qualify for and
lower in value. Focus on ‘rehabilitation’ and early intervention
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Driving benefits issues…
Benefits co-ordination
Employers recognize benefits as an important factor in attracting, retaining and engaging employees…….but they are getting more
complex for employees to navigate effectively.
Mental health matters
More than half of employers have either introduced initiatives to reduce stress or are planning to do so in three years. Significant
attention to behavioral and emotional health.
Desire to add voluntary benefits
The number of employers offering greater choice in benefit levels, flexibility in allocating money and options to buy additional voluntary
benefits is expected to more than double across the region. Cost is the biggest barrier for employers who don’t provide flexibility.
Access primary care via virtual GP’s
Eight in ten employers over the next three years will revise their plan designs and strategies to better manage costs and to drive
desired employee behaviors.
Source: 2017 Benefits Trends Survey.
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Health & Benefits GB
Clinicians in the UK providing
230 employee health advice and
claims management via
colleagues ‘Healthcare Concierge’
Place over
£500m 30+
premium in
the market
Specialisms include
oncology, mental health, physiotherapy, Over 2,300
cardio, paediatrics, occupational health,
disease management, intensive care, CBT clients
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Healthcare Concierge… helping clients solve benefit challenges
Rising Complex benefit Effective care Internal resource
benefit costs structure pathways challenges
https://vimeo.com/293585126/f42c933eb7
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Benefits
programmes around
the world: CEEMEA
Melanie Birge, Willis Towers Watson
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17Africa:
Focus on Africa
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18The team leaders in Africa
Central &Eastern
Anglo Africa South Africa Europe Middle
Egypt West Africa
Gibson ATENG Euan DIXON SMITH East and Africa
Hassan HELMY Ahoua ASSOUAN
Melanie BIRGE
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Health & Benefits – Africa
20 200
Colleagues
160 000 000 USD
Premium under
Management
Medical doctors
04 TPAs (Third Party Administrators
Medical Claim Administration)
28
Countries
500,000+ Members
on our systems
Footprint in the region since 1965
Willis Towers Watson has deployed true integration across AFRICA
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Helping you to understand the region
Medical
Compliance
Inflation and Member
and Risk
Claim Experience
Transfert
Analysis
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Willis Towers Watson’s global database for benefits benchmarking
Our survey products and consultants can help you manage increasingly complex benefit program decisions so you can develop competitive
plans that attract the talent you need and drive employee engagement and performance.
Sample Participant Numbers
16,000+ Austria - 157 Germany - 463
EUROPE
Norway - 67 Spain - 368
Participants Globally Belgium - 265 Greece - 114 Poland - 263 Sweden - 220
Bulgaria - 97 Hungary - 146 Portugal - 137 Switzerland - 202
Croatia - 64 Ireland - 257 Romania - 156 Turkey - 238
125
countries
17
Czech Rep - 148
Denmark - 108
France - 143
Italy - 311
Kazakhstan - 67
Netherlands - 127
Russia - 307
Serbia - 83
Slovakia - 91
Ukraine - 89
UK – 1,009
languages NORTH AMERICA MIDDLE EAST AFRICA
Canada - 569 Israel - 39 Algeria – 37
represents United States - 870 Qatar - 30 Cameroun – 30
5,600 LATIN AMERICA
Saudi Arabia - 84
UAE - 160
Congo – 30
Côte d’Ivoire - 50
Ghana - 10
Companies Argentina - 238
ASIA PACIFIC
Egypt - 100
Brazil - 304 China - 634 Kenya - 50
Chile - 178
Multi-local: locally relevant Colombia - 89
Hong Kong - 375 Morocco - 50
Indonesia - 193 Nigeria – 50
and globally consistent Costa Rica - 54
Malaysia - 292 Senegal - 30
Mexico - 632
Peru - 133 Philippines - 400 South Africa – 145
Venezuela - 46 Singapore - 312 Togo - 15
Taiwan - 370 Tunisia – 24
Led by a dedicated global team supported by local country
champions
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.South Africa macro economy and statistics at a glance
33 rd Forecasted GDP
annual growth rate for
the period between
Largest economy 2013 and 2030.
of the world
(behind Nigeria) 2 %
Annual inflation rate Life expectancy is
.
4.9% down from
11% in 2008 63.6 (WHO)
26,7 % Unemployment rate
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Key Trends and Issues South Africa
Inflation and Costs Pooling
Products
Captives
Massive Financial stress • Medical market Only for Risk
on the Employees • New product as
Primary Care and Gap
Cover
• Disability benefits
trends
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Central & Eastern Europe:
Focus Turkey and Russia
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25The team leaders in CEE and Turkey :
Eastern Europe Russia Hungary Turkey
Anca MOLDOVAN Elena VOLOSHKO Andrea SZOLLOSY Sema GOKDEMIR
10
Countries
70
Colleagues
2
Nurses
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Turkey macro economy and statistics at a glance
18 th %
Largest economy of the world.
Also 16th largest domestic
5.2
Real GDP growth between 2002 and 2018,
market of the world, larger than higher than the averages in developing Europe &
4.2
Australia, Poland, Argentina,
Netherlands, Portugal, Thailand, etc.
Central Asia among EU members or OECD
members for the same period.
%
Annual inflation rate in 2018
between 19% and 25%
With a crash of the Currency in August 2018
10% Life expectancy is
16
Unemployement rates
And 43% of employees work very long hours,
by far the highest rate in the OECD where the
average is 9% (OECD) th 75,8 (WHO)
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.TURKEY
Turkey: Healthcare benefit costs have risen quickly
With little respite in sight
Benefits costs are the top challenge 73%
for organisations’ benefit programmes in Turkey (% of ‘to a very great extent’
or ‘to a great extent’)
Turkey gross medical trend, 2012-2017 How do insurers expect the medical trend in their overall book
of business to change over the next three years compared to
current rates?
12%
11.4% (Europe)
10.7%
10%
10.2%
52%
55%
9.7%
8%
38%
6%
5.3% 5.2% 5.3% 5.0%
4.3% 4.5%
4%
2%
7%
3%
0% 0%
2012 2013 2014 2015 2016 2017*
Significantly Lower About the same Higher Significantly
Turkey Europe lower higher
* Projected
Source: 2017 Benefits Trends Survey, EMEA – Turkey; 2017 Global Medical Trends Survey, Europe
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Russia macro economy and statistics at a glance
Lukewarm GDP growth expectations for 2018:
1.2% - 1.5%. Many positives (positive trade and
9 th current accounts, budget surplus) are overshadowed
by increased tension with the West, several rounds of
US and EU sanctions and threat of further escalation
Largest economy
in the world 1,5% Growth
71,9 8,9 %
2018 Average
Life Expectancy in 2018 medical trend rate is growing
8% 2018 Projected
salary increase.
4,5%
The unemployment remains at
historically low levels
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Key Trends and Issues Russia
The market Retirement Employees’
Motivation
The market is Retirement Age Trend to
dominated by will increase : Modernize the
state owned or Women 55 60 benefits with
quasi government Men 60 65 insured and non
insurance insured
companies proposition
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Benefits
programmes around
the world: Asia
Cedric Luah, Willis Towers Watson
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31The Asia Pacific Region – Setting the scene willistowerswatson.com 32 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.
Asia Pacific
Asia Pacific
General & Cultural Overview
India China
• 1.334 billion • 1.397 billion
• 7.3% • 6.6%
Thailand Japan
• 69.2 million • 126.4 million
• 4.6% • 1.1%
Malaysia South Korea
• 32.4 million • 51.7 million
• 4.7% • 2.8%
Singapore Hong Kong
• 5.7 million • 7.5 million
• 2.9% • 3.8%
Indonesia Vietnam
• 265.3 million • 94.6 million
• 5.1% • 6.6%
Australia Philippines
• 25.2 million
• 107 million
• 3.2% Source: 2018 forecast by IMF • 6.5%
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Asia Pacific
Benefit Spend is significant in Asia Pacific
And a top concern for employers
Spend on Benefits (% of payroll)
Less than 10% of payroll 10% toAsia Pacific
Top priorities for HR over the next three years
Too much on the agenda?
#3 Greater governance and oversight of our benefits programs 66%
#4 All benefits information being available in one place 65%
#5 Simplify administration across benefit programs 65%
#6 Add/enhance health and well-being programs 62%
Improve transparency to employees of total benefit costs
#7 54%
(both employer and employee costs)
Increase employee choice/flexibility regarding which benefits
#8 50%
they receive
#9 Create a digital engagement strategy for benefits programs 45%
#10 Improve financial well-being and retirement readiness 42%
Note: Percentages indicate ‘Very important’ or ‘Important’.
Source: 2017 Benefits Trends Survey, Asia Pacific.
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© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Asia Pacific
Key benefit challenges for employers
What it means today
A diverse and complex region Increased compliance and competitive issues
How to keep up with regulations?
How to develop programs effectively
across language and culture barriers? How to attract and retain staff?
How to implement policies How to increase the perceived program value while managing cost?
consistently throughout the region?
How to manage a workforce that is
increasingly mobile?
Rapidly aging workforce
How to manage benefits in a
systematic manner? Increasing medical costs
Adequacy of funds at retirement
Retirement education
How to reduce employer risk
Transferring to employees
Funding liabilities
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.China in focus willistowerswatson.com 37 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.
China
China – Looking at the broader benefits portfolio
Current local trends
Benefit
End of the single-child policy Prevalence
78%
Health
Social security contribution rates for maternity, job-related injury and
Benefits
unemployment were reduced
78%
The latest five-year program of healthcare reforms (2015 – 2020) encourages Risk
Benefits
individuals to take out private health insurance
Retirement
The government has combined urban and rural pension systems, and is now
aligning company employee and civil servant coverage Benefits 18%
Leave
The government plan to raise the retirement age to 65
Sustainability of public benefit programs remains a concern
Benefits 98%
Wellness
Base pay, health benefits and job security are what matters most when attracting
talents.
Benefits 100%
Flexible
Employers actively promote wellness programs
Individual Income Tax Deferred Pension Program is on pilot run in Shanghai,
Benefits
6%
Based on the WTW 2017 Benefit Design
Suzhou and Fujian, effective since May 1st, 2018 Practice Report for General Industry
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© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.China
China’s Macro-economy Entered into A Period of New Normal
Challenges and opportunities
Shrinking Workforce Population Pressure Challenges
Growth in China’s working-age Core working group shrinking while the • High expectation from employees
(15-64) population has slowed non-working-age population growing.
• Shrinking talent pool
• Lack of talent in high tech
industry, drawing talent from
others
• Shortage of experience worker in
traditional sector due to talent
competition
• De-centralization of workforce back
to Tier 3 and lower cities
Leading by BAT (Baidu, Alibaba, Tencent), AI/Big data/system
support related position are the most competitive occupations. • Staff turnover continue to be high
Aggressive hiring in fast-growing internet/e-commerce sector, • Knowledge gap
Talent followed by funds/securities/futures /investment。
“Unicorn companies” - Start-ups with valuation over US$1 billion, • Risk associated to potential trade
are attracting talents from the market with above market norm war
high-cash-rich-benefits packages
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.China
A framework for tactical implementation of your modernizing agenda
Analytics, Insights &
Portfolio Financing Talent Experience Administration & Operations
Reporting
Benefits in line with company culture, Create a personalized experience to
Optimized cost through scale and Administration and technology to Data-driven insights for informed
objectives, market norms and employee engage employees in selection and
efficient risk retention & transfer optimize internal and external resources decision making
needs & values utlilization of benefit programs
Core benefits Cost sharing Employee communication Administration technology Inventory of plans
(e.g. ER provided medical & risk benefits,
(e.g. co-pay, caps) (e.g. HR portal, total reward statements) (e.g. insurance placement, cloud-based) (e.g. maintenance of plan data)
integration with social benefits, expat benefits)
Flexibility & choice Risk transfer Self-service Systems interface Benchmarking / market insights
(e.g. top up/down core protection, voluntary (e.g. quantitative and qualitative
(e.g. insurance strategy) (e.g. online access via mobile device) (e.g. HRIS, payroll)
benefits) benchmarks)
Consistency within geography Risk retention Benefits enrolment process Security and fraud Legislative developments
(e.g. harmonisation) (e.g. Captive strategy) (e.g. choice optimisation, payment gateway) (e.g. fraud controls, data protection, GDPR)
(e.g. monitoring, impact
analysis)
Market competitiveness & Cost & risk management Ease of access Vendor & advisor management Participant & claims analytics
alignment (e.g. behavioural management design)
(e.g. provider network, medical facilities,
(e.g. case mgmt., preferred providers, SLA)
(e.g. participation, take up rates, loss ratio,
(e.g. portfolio alignment ER costs, trends) onsite facilities) driver of claims)
Alignment with employee needs Scale leverage Education & decision-support Legal & regulatory compliance Budgeting and planning
(e.g. education materials, external links,
(e.g. based on surveys Insights, focus groups) (e.g. pooling, purchasing)
targeted information by employee profiles)
(e.g. document maintenance, attestation) (e.g. medical cost inflation)
Eligibility & coverage Operating cost Participant queries Operational policies &
(e.g. family, parents, contract workers)
(e.g. legal, procurement, (e.g. call centres, chat bots, claims procedures
communications) advocacy & support) (e.g. policy manuals)
Wellbeing programs Tax optimization Talent Value Proposition Resource optimization
(e.g. alignment with company culture,
(e.g. physical, emotional) (e.g. ER and EE tax optimisation)
consistent branding)
(e.g. outsourcing, COE)
Diversity & Inclusion
(e.g. paternity leave)
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.India in focus willistowerswatson.com 41 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.
India
India – Looking at the broader benefits portfolio
Current local trends
Benefit
• Gratuity is still a financial obligation, government encouraging adoption of Prevalence
National Pension Scheme address future ageing population challenges.
94%
Health
• Paid maternity leave increased from 12 weeks to 26 weeks. Benefits
87%
• Mandatory Maternity leave and Crèche (Day care) facilities for every employer Risk
with 50 or more employees Benefits
• Retirement
Ayushman Bharat National Health Protection Scheme implemented in Sep 18
that would cover ultimately 500mil beneficiaries over the years for lower income
group
Benefits 100%
Leave
• In Aug 2018, the Insurance regulator asked insurers to cover Mental Illness or
related conditions in the insurance policies.
Benefits 100%
Wellness
• Section 377 decriminalized in 2018, action to promoted LGBT Inclusion is
gaining traction along with broader Inclusion & diversity policies such as Equal
Benefits 74%
Flexible
Employment Opportunity(EEO) statement, Code of Conduct amendment etc.
Benefits 34%
Based on the WTW 2017 Benefit Design
Practice Report for General Industry
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.India
India’s key benefits trend
On the rise: Remain a focus:
Health and wellbeing Life, Disability and
Pension
Increased focus: Heightened interest:
Childcare benefits 30%
Financial well-being Employee discounts 12%
Eldercare benefits 11%
Buy/sell annual leave 10%
Source: 2017 Benefits Trends Survey, Asia Pacific – India ‘Planned for 2018’ and ‘Considering for 2019’
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.India
A framework for tactical implementation of your modernizing agenda
Analytics, Insights &
Portfolio Financing Talent Experience Administration & Operations
Reporting
Benefits in line with company culture, Create a personalized experience to
Optimized cost through scale and Administration and technology to Data-driven insights for informed
objectives, market norms and employee engage employees in selection and
efficient risk retention & transfer optimize internal and external resources decision making
needs & values utlilization of benefit programs
Core benefits Cost sharing Employee communication Administration technology Inventory of plans
(e.g. ER provided medical & risk benefits,
(e.g. co-pay, caps) (e.g. HR
(e.g. HR portal,
portal, total
total reward
reward statements)
statements) (e.g. insurance
(e.g. insurance placement,
placement, cloud-based)
cloud-based) (e.g. maintenance of plan data)
integration with social benefits, expat benefits)
Flexibility & choice Risk transfer Self-service Systems interface Benchmarking / market insights
(e.g. top
(e.g. top up/down
up/down core
core protection,
protection, voluntary
voluntary (e.g. quantitative and qualitative
(e.g. insurance
(e.g. insurance strategy)
strategy) (e.g. online
(e.g. online access
access via
via mobile
mobile device)
device) (e.g. HRIS, payroll)
benefits)
benefits) benchmarks)
Consistency within geography Risk retention Benefits enrolment process Security and fraud Legislative developments
(e.g. harmonisation) (e.g. Captive strategy) (e.g. choice optimisation, payment gateway) (e.g. fraud controls, data protection, GDPR)
(e.g. monitoring, impact
analysis)
Market competitiveness & Cost & risk management Ease of access Vendor & advisor management Participant & claims analytics
alignment (e.g. behavioural
(e.g. behavioural management
management design)
design)
(e.g. provider network, medical facilities,
(e.g. case
(e.g. case mgmt.,
mgmt., preferred
preferred providers,
providers, SLA)
SLA)
(e.g. participation,
(e.g. participation, take
take up
up rates,
rates, loss
loss ratio,
ratio,
(e.g. portfolio alignment ER costs, trends) onsite facilities) driver of
driver of claims)
claims)
Alignment with employee needs Scale leverage Education & decision-support Legal & regulatory compliance Budgeting and planning
(e.g. education
(e.g. education materials,
materials, external
external links,
links,
(e.g. based on surveys Insights, focus groups) (e.g. pooling, purchasing)
(e.g.
targeted information
targeted information by
by employee
employee profiles)
profiles)
(e.g. document maintenance, attestation) (e.g. medical cost inflation)
Eligibility & coverage Operating cost Participant queries Operational policies &
(e.g. family, parents, contract workers)
(e.g. legal, procurement, (e.g. call centres, chat bots, claims procedures
communications) advocacy & support) (e.g. policy manuals)
Wellbeing programs Tax optimization Talent Value Proposition Resource optimization
(e.g. alignment with company culture,
(e.g. physical,
(e.g. physical, emotional)
emotional) (e.g. ER and EE tax optimisation)
consistent branding)
(e.g. outsourcing, COE)
Diversity & Inclusion
(e.g. paternity
(e.g. paternity leave)
leave)
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Singapore in focus willistowerswatson.com 45 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.
Singapore
Singapore – Looking at the broader benefits portfolio
Current local trends
Benefit
Desire to integrate social medical insurance into company medical benefits Prevalence
Flexibility and choice in benefits as well as work arrangement becoming Health
prevalent Benefits
94%
Portability and convertibility is gaining traction, but limited product availability Risk
Government’s focus on work – family balance
Benefits
87%
Retirement
Government raised the re-employment age from 65 to 67 years old in July 2017
There has been an increased effort from the Government to promote the
Benefits
5%
importance of readiness for retirement by supplementing CPF retirement Leave
savings Benefits
100%
High medical inflation rate drives more employers to look at various wellness Wellness
programs and promote healthy living Benefits
69%
Flexible
Benefits
29%
Based on the WTW 2017 Benefit Design
Practice Report for General Industry
willistowerswatson.com 46
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Healthcare benefit costs have risen quickly
With little respite in sight
Benefits costs are the top challenge
for organizations' benefit programs in Singapore 68%
(% of ‘to a very great extent’
or ‘to a great extent’)
How do insurers expect the medical trend in their overall
Singapore gross medical trend, 2012-2017 book of business to change over the next three years
compared to current rates?
10% (Asia Pacific)
48%
9%
8%
8.4%
8.8%
7.7%
9.0%
8.6%
41%
53%
8.1% 7.3% 7.0% 7.7%
7.3% 7.1%
7%7.1%
6%
5%
4%
3%
2%
1% 5% 5%
0% 1%
2012 2013 2014 2015 2016 2017*
Significantly Lower About the same Higher Significantly
Singapore Asia Pacific lower higher
Source: 2017 Benefits Trends Survey, Asia Pacific – Singapore; 2017 Global Medical Trends Survey – Singapore.
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© 2017 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Singapore
A framework for tactical implementation of your modernizing agenda
Analytics, Insights &
Portfolio Financing Talent Experience Administration & Operations
Reporting
Benefits in line with company culture, Create a personalized experience to
Optimized cost through scale and Administration and technology to Data-driven insights for informed
objectives, market norms and employee engage employees in selection and
efficient risk retention & transfer optimize internal and external resources decision making
needs & values utlilization of benefit programs
Core benefits Cost sharing Employee communication Administration technology Inventory of plans
(e.g. ER provided medical & risk benefits,
(e.g. co-pay, caps) (e.g. HR portal, total reward statements) (e.g. insurance placement, cloud-based) (e.g. maintenance of plan data)
integration with social benefits, expat benefits)
Flexibility & choice Risk transfer Self-service Systems interface Benchmarking / market insights
(e.g. top up/down core protection, voluntary (e.g. quantitative and qualitative
(e.g. insurance strategy) (e.g. online access via mobile device) (e.g. HRIS, payroll)
benefits) benchmarks)
Consistency within geography Risk retention Benefits enrolment process Security and fraud Legislative developments
(e.g. harmonisation) (e.g. Captive strategy) (e.g. choice optimisation, payment gateway) (e.g. fraud controls, data protection, GDPR)
(e.g. monitoring, impact
analysis)
Market competitiveness & Cost & risk management Ease of access Vendor & advisor management Participant & claims analytics
alignment (e.g. behavioural management design)
(e.g. provider network, medical facilities,
(e.g. case mgmt., preferred providers, SLA)
(e.g. participation, take up rates, loss ratio,
(e.g. portfolio alignment ER costs, trends) onsite facilities) driver of claims)
Alignment with employee needs Scale leverage Education & decision-support Legal & regulatory compliance Budgeting and planning
(e.g. education materials, external links,
(e.g. based on surveys Insights, focus groups) (e.g. pooling, purchasing)
targeted information by employee profiles)
(e.g. document maintenance, attestation) (e.g. medical cost inflation)
Eligibility & coverage Operating cost Participant queries Operational policies &
(e.g. family, parents, contract workers)
(e.g. legal, procurement, (e.g. call centres, chat bots, claims procedures
communications) advocacy & support) (e.g. policy manuals)
Wellbeing programs Tax optimization Talent Value Proposition Resource optimization
(e.g. alignment with company culture,
(e.g. physical, emotional) (e.g. ER and EE tax optimisation)
consistent branding)
(e.g. outsourcing, COE)
Diversity & Inclusion
(e.g. paternity leave)
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Asia Pacific
In closing
Benefits matter
Health and financial well-being
Costs are a growing concern
Top priorities focus on plan design changes, including choice
Local leadership and external benchmarking drive decisions
Source: 2017 Benefits Trends Survey, Asia Pacific
willistowerswatson.com 49
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Asia Pacific
Health & Benefits – Asia & Australasia Leaders
Country Leaders Regional Leaders
Royston Tan Alan Zhu Sudesh Shetty Audrey Tan Jon Gardner James Leung Jeffrey Fan Jasmine Tan
North Asia (Ex. China) China India Singapore Operations & Regional Business Advisory Services & Benefits Regional Benefits
Professional Excellence Development Technology Proposition Management
Moon Hae Ki Susan La Chica Yen Bui Thi Hoang Dewita Anggraeni David Rowell
Amitabh Deka Alice Tan Jenny Lim
Korea Philippines Vietnam Indonesia Australasia
Corporate Health & Benefits Delivery Regional Benefits
Wellbeing & Solutions Management
Andy Liu Toshimi Adachi Sudip Indani Rosalind Yu Niall Martin
Taiwan a.i. Japan Thailand Malaysia New Zealand
willistowerswatson.com 50Benefits
programmes around
the world: The
Americas
Maximo Saravi, Willis Towers Watson
Cecil Hemingway, Willis Towers Watson
willistowerswatson.com
51Regional focus:
LATAM
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 52
52Benefits
General structure in LATAM
Statutory Benefits Supplementary Benefits Other Benefits
Healthcare provided by social The most common are: The most common are:
security is not at par with Health plan, in some cases Meal and food vouchers.
private insurance programmes. including dental and vision Transportation.
In several cases there are coverage. Education.
pension, service and Life and Personal Accident Other wellbeing-oriented
termination indemnity benefits. Insurance. services.
Other benefits may include Car assignment or allowance
access to affordable housing, from managerial roles.
paid vacation time and Pension Plan.
unemployment.
Wellbeing benefits.
Funded by contributions from
employers and employees, and
in some cases taxes.
willistowerswatson.com 53
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.LANTAM Macro issues
Topic How we are helping
Brazil Healthcare committees (Comites de Saude) leveraged by claims analytics and
professional advice
Healthcare costs
Extensive work through chain of delivery to mitigate increases (hospitals/clinics,
increasing by 15% physicians, pharmacies)
Plan design: increased participation of employees in healthcare cost
Mexico Deployment of Benefits MarketPlace, supporting smart choice and relevancy of benefit
Competition for programs
talent on US border,
Design of benefit programs to support large populations of employees in “maquila” area
choice becomes
popular Nationwide presence allows for locally-relevant service standards coordinated
from center
Venezuela Hyper inflationary Monthly/quarterly reviews of healthcare benefits to ensure limits follow depreciation of
environment currency
prompts loss of Conversion of fully-insured plans to self-insured allowing for greater flexibility
healthcare and Working with some clients to “dollarize” coverage
other benefits
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Benefits matter now more than ever before willistowerswatson.com 55 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.
Health & Benefits in Latin America
716 50 health professionals
Colleagues (doctors, nurses, technicians) on staff,
(350 on-site our clients’ premises) providing employee health advice and
claims analytics
Place over
USD 1 billion +2.5 million
premium across 20+ countries Employees covered
Expertise across
First and second pillar healthcare, workers compensation, disability, absence
management and productivity, life, travel and personal accident insurance,
non-insurable benefits, wellbeing solutions, claims analitics.
Over 5,000 corporate clients
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Country deep-dives:
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57Mexico willistowerswatson.com © 2018 Willis Towers Watson. All rights reserved.
Snapshot
99.3%
of the population
124m inhabitants 3
major
urban
areas
speaks Spanish 22m in the Metropolitan area (Mexico City
and surrounding areas) Mexico City
The most Spanish speakers in the world Mexico City is the 2nd largest city in the Guadalajara
Fluent English speakers are scarce Americas, 20th urban area in the world Monterrey
Sept. 16, 1810
Mexico starts the battle for independence,
the biggest celebration in the country
83 % of the population
follow Catholic faith
Cinco de Mayo is not so popular
10% follow other Christian faiths.
CDMX
formerly D.F. (Distrito Federal), officially
renamed Mexico City in January 30, 2016
6 years for presidential
terms, no re-election
New President in December 2018
willistowerswatson.com 59
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Mexico Economic Context
Cost structure, talent competition and pressure to increase utility margins key factors to define the
compensation and benefit strategy.
Economic Talent
Increase in the level of inflation Financial uncertainty (purchasing power-
indebtedness) Impacts productivity
Instability in the exchange rate
Preference of “cash now” versus “future
Marginal GDP growth enjoyment” of benefits
Increases in real ISR (income tax rate) Trends to accept job offers for marginal
Reduction of the deductibility of taxes improvements
Incorporation of new industries into the Pressure to maintain high-cost benefits
country (health)
Labor cost still very competitive Job offer shortages with critically
internationally demanding skills – high costs
*Source: Focus Report
willistowerswatson.com
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Key Employee Benefits Market Practices
Healthcare
Many Employers provide Major Medical only
Inclusion of dependents being questioned due to cost exposure
Cost sharing through co-pays and deductibles
Rx limited to hospitalization and treatment
Federal initiative on stress may be delayed due to new Government
Pension
Defined Contribution trend
Concern over vesting schedules
Defined Benefit components still relevant due to Termination Indemnity provisions
Increasing attention to Benefit and Pension Funds governance and efficiency
willistowerswatson.com 61
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Brazil willistowerswatson.com © 2018 Willis Towers Watson. All rights reserved.
Snapshot
5th 207m
Inhabitants, is the 5th most
Portuguese
is the official language and
largest country in the world,
3rd in the America, and the populated country (1st in LA) Real
1st in LA is the local currency
2,05 Trillion
GDP as per 2017 as the 8th largest economy
64 % of the population
follow Catholic faith
Brasilia
is the capital and São Paulo is
the largest city in Brazil (2nd in LA)
4Years for Presidential terms, with re-election.
New President in January 2019
willistowerswatson.com
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Brazil Economic Context
Double-digit inter-annual increases in medical costs, talent competition in some industries, new government may boost
economy, concerns on social environment
Economic Talent
Uncertain macro-economic Companies looking at their talent pool,
environment in light of recent elections some activities with strong competition
Changes expected on Social Security for talent
and Public Healthcare System Progressive companies start to look
Medical inflation rates at 15%, into how to provide some degree of
changes considered for deductibles choice
and co-insurance limits in Private Transfer of costs to employees, with
Medical Plans caution on liabilities
*Source: Focus Report
willistowerswatson.com
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.Three in ten employers in Brazil spend 20% or more of payroll on benefits
How much did your organization spend in total on benefits in the last fiscal year?
50% 47%
39%
40%
30%
30% 26%
19%
20%
13% 14% 12%
10%
0%
Latin America Brazil
Less than 10% of payroll 10% to 20% of payroll 20% to 30% of payroll 30% of payroll and more
21% of employers in Brazil don’t know their spending on benefits
Source: 2017 Benefits Trends Survey, Latin America.
willistowerswatson.com 65What’s Top of Mind for Brazilian Employers?
Economic scenario for 2019 as much
dependent on elections results Employers still
reviewing
Benefit plans and
Employers looking to expand benefits respective cost-sharing
portfolio to add well-being programs aiming to mitigate post-
at impacts on claim experience employment benefits
Changes to medical plan legislation considering deductibles and
coinsurance is under discussion but due to Elections agenda, approvals
have been postponed.
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 66USA
Cecil Hemingway, Willis Towers Watson
willistowerswatson.com
© 2018 Willis Towers Watson. All rights reserved.Improving clinical conditions and enhancing employees’ total wellbeing are
identified as important priorities over the next three years
1 Clinical Conditions 30% 85% +55
2 Employee Wellbeing 41% 82% +41
3 Employee Experience 34% 72% +38
4 Health Culture 31% 67%
+36
Health Technology
5 Solutions 24% 56%
+32
Direct Financial
6 Incentives 39% 48%
+9
7 Onsite Services 39% 47%
+8
Note: Percentage indicates “To a very great extent” or “To a great extent” Progress made over Importance over the
Sample: Companies with at least 1,000 employees the last three years next three years
Source: 2018 Willis Towers Watson Best Practices in Health Care Employer Survey
willistowerswatson.com 68
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.The way forward
Julie Gebauer, Willis Towers Watson
Cecil Hemingway, Willis Towers Watson
willistowerswatson.com
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 69What we heard from you over the last two days
Portfolio Take broader view of benefits (workplace policies,
phones, coffee, allowances etc.)
Analytics,
Insights & Financing Address needs of contingent workers
Reporting
Align with culture and brand
Modernizing
Benefits More direct democracy; integrate with engagement
workstreams
Admin &
Operations Talent
Experience
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© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.What we heard from you over the last two days
Proactively manage the total spend
Portfolio
Capture economic value (scale, tax, underwriting)
Align cost with employee value and appreciation
Analytics,
Financing
Focus on cost sustainability
Insights &
Reporting Place risk (life, disability etc.) insurance cross-
Modernizing
country
Benefits
Admin &
Operations Talent
Experience
willistowerswatson.com 71
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.What we heard from you over the last two days
Portfolio Create awareness and appreciation
Personalize story by segment
Analytics,
Insights & Financing Integrate with talent value proposition
Reporting
Leverage technology to deliver
Modernizing
Benefits
Admin &
Operations Talent
Experience
willistowerswatson.com 72
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.What we heard from you over the last two days
Go beyond insurance
Portfolio
Integrate across functions, programs &
policies
Analytics,
Financing
Digitize and automate to optimize resources
Insights &
Reporting Help benefits team with elevator pitch
Modernizing
Gain local buy-in
Benefits
Admin &
Operations Talent
Experience
willistowerswatson.com 73
© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.What we heard from you over the last two days
Challenge the “so what”
Portfolio
Address life and disability
Analytics, Provide executives with easy access to data and
Insights & Financing
Reporting insights
Modernizing Communicate value to management
Benefits
Measure employee expectations
Admin &
Operations Talent
Experience
willistowerswatson.com 74
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