The country of Korea has developed into a modern, industrialized and technologically advanced economy that exports its products to consumers across the world. Medical care in Korea has developed alongside the other high-tech industries here and currently the medical establishment provides care that is among the best in the world. As a natural extension of the export-driven economy and the outcome-oriented medical care industries that exist here today, people from around the globe have begun to travel to Korea for quality, affordable care.
The government of Korea, specifically the Korea Health Industry Development Institute (KHIDI), has taken a leading role in creating a global awareness of Korea’s standing in the medical community. They have completed several initiatives that, taken together, create a platform for international customer satisfaction in the medical industry and a delivery framework within which medical providers must manage. This has created a standardized offering of great medical care whose message has begun to resonate with consumers in the US.
As the Medical Travel industry has matured over the past several years, many experts agree that we are on the cusp of a large scale adoption of medical travel by corporations in the form of modified or expanded employee benefit options. Patients Without Borders has worked closely with KHIDI to develop several offerings that create an easy way to integrate a Korea Medical Travel Benefit Option into any ERISA-based self-funded group health plan.
Among the offerings that have been developed is an association plan for Korean companies. In this article we will explore the self-funded group health plan model, the increasing trend of adoption of medical travel benefits by group health plans and what differentiates an association plan model from a standalone plan design.
It is important to point out that the plan designs discussed in this article have been adopted by several employers already, including large multinational corporations, and are in the process of being implemented by several more self-funded groups at this time. This experience in the industry has resulted in an offering that has been developed and then iteratively refined over time to enhance its relevance to the corporate buyer.
The ongoing work with employers from many different industry groups continues to bring innovative change to this platform creating an evolving offering that is ultimately designed by the consumer, not the supplier.
When an employer or other group that provides health care coverage to its members (union, government, etc.) evaluates its alternatives for funding that health care, they have several options. In a very general sense, the two ends of the spectrum are a “fully insured” health care plan and a “self-funded” plan. Using a fully insured plan design means that the employer pays a fixed premium to an insurance company to cover their group and that any claims made against the group are paid by the insurance company.
Electing a self-funded plan design, for all intents and purposes, means that the employer will assume the role of the insurance company and will pay any claims made against the group. This is a spectrum so there is a theoretically infinite number of ways of designing a plan that uses some aspects of both of the above, and a wide range of commercial products that use partial insurance and partial self-funding to optimize cost containment for the employer.
While insurance products are subject to state-by-state regulation, when employers elect a self-funded plan design they are subject to the federal regulations known as ERISA. This alone can make a good argument for self-funding for employers with facilities or employees located in many different states because it enables them to create a single plan to cover all of their US employees without needing to stay up-to-date, or pay a national insurance company to stay up-to-date, with the regulations of each state in which they operate.
Using a self-funded platform for providing employee benefits also allows the employer a far greater degree of control over what benefits are offered and exactly how they are offered, as well as the ability to change the availability and coverage levels of specific benefits within the plan at any time they see fit.
It is for these reasons and many more that most large employers (those with more than 1000 employees) choose to self-fund their health benefit plans. In fact, some groups as small as 30 members can comfortably self-fund their benefit plans so long as the demographics and claim history of the group make it financially attractive.
With an entire spectrum of plan designs available to employers, the development of the Korea Medical Travel Benefit Option needed to create a flexible, component-based product that was capable of being integrated into any funding platform in order to create a deliverable that would be appealing to the largest possible number of employers.
Patients Without Borders has worked closely with KHIDI to design, sell, integrate and deploy a component that has been shown to cleanly integrate into health care plans both at renewal and during the in-force plan year. This has been done without any impact or necessary change to the employer’s current broker, stop-loss carrier, TPA, claims process or any other part of the standard workflow for the employer.
As work has progressed there has been substantial effort put forth to develop products that bring maximum value to the table for the corporate client. This has led to the introduction of an association product for the Korean market. Developed in exclusive collaboration with two of the nation’s largest TPAs and with support from several of the leading reinsurance carriers, the plan has been developed to include Medical Travel as an integral component.
The plan also carries some of the most aggressive underwriting guidelines in use in the industry today, many of which are simply unavailable in a standalone plan. This association is open to any Korean company and the sponsoring nationally-recognized TPA partners can handle groups of any size.
As Korea becomes an increasingly desirable destination for employers looking to reduce their health care expenses and for employees in search of world-class medical outcomes we plan to continue to develop and market innovative products that maximize value for everyone in the complex health care equation.
What really matters, though, once a medical travel benefit has been adopted and made available to an employer group, is that it is utilized by the individual employees. In our view any medical travel benefit with which the employer does not enjoy significant savings has served only as a false promise and a failed experiment.
It is for this reason that a proprietary program for incentivizing and reaching out to the employees in the group has been developed in order to generate and then maximize utilization of the medical travel benefit. Though there has been limited use of our medical travel benefits by employees, as we deploy these new programs to our current and future groups our aim is to generate considerable savings for the employer clients.
As the global medical travel, insurance and group health benefits communities learn more about Korea and the leading medical care available here, it can be said with confidence that a considerable number of patients will seek out Korea as their destination.
The collaborative efforts between Patients Without Borders and KHIDI to educate some of the major industry stakeholders with which we work have been met with extremely positive feedback and as these efforts continue we expect Korea to continue to positively surprise not only the corporate buyer but also the traveling patient.
About the Author
With nearly 15 years of experience in corporate management, Mr. Carter has experience building international business relationships and in building global teams spanning several industries including pharmaceutical research and development, commercial software and online retail. Using his background in analytical sciences and his experience as a global business executive, he has helped bring the value of global staffing strategies to large and mid-sized companies. As the head of the medical travel facilitator Patients Without Borders, Mr. Carter has built a worldwide team of experts and continues to build a strong global network of hospitals and physicians.