Dubai – MENA Herald: Dubai businesses are advised to ensure their employees’ medical needs and requirements are covered when selecting a group insurance policy, according to the region’s largest financial advisor Nexus Group.

With the impending 30 June deadline for the third and final phase of the compulsory health insurance law set by the Dubai Health Authority (DHA), businesses across the emirate are hustling to ensure they fulfil the mandatory requirements ahead of the cut-off date.

However, experts warn that many companies are prioritizing their policy purchases based upon premium cost alone and therefore missing out on the opportunity to bring value to their organization.

“Most companies offering this benefit for the first time will focus on one thing – cost, when the reality is the cheapest policy is never going to be the best in terms of coverage and network access,” said Duncan Crerar, Head of Employee Benefits at Nexus Group.

“The basic policy, which provides a maximum of AED 150,000 worth of compensation per person per annum, gives the end user access to affordable/basic healthcare, but it will never cover someone fully if they have a very serious accident or illness. In addition, the network will be heavily restricted, so people may not be able to seek the services they might expect at the facilities they would prefer. But if companies are willing to invest in what may be a marginally more expensive policy, they can offer their employees more value and avoid the difficult situation of exhausting policy limits.”

Another factor that employers should consider when selecting a health insurance policy is the coverage for spouses and dependants.
Although it is not required by law, providing insurance for employee spouses and dependants can relieve the employee’s burden of time and cost associated with hunting in the market and signing up for private policies. By including them as part of the group insurance plan, the premium will be minimised, the coverage values will be maximised, and the employer can agree whether the employee or the company will pay for the additional amount, in part or in full. This will mean that the whole family can then have consistent coverage and access to the same network of healthcare providers.

Those worried about employees abusing or overusing the policy can implement various methods to prevent misuse. One effective method, explained Crerar, is co-pay — meaning that patients bear a part of the consultation and/or treatment cost every time they make a doctor visit. Another option is ‘gatekeeping’, where patients are required to see a general practitioner or family doctor before they go to a specialist.

“If you look at other parts of the world, this is standard practice, and most of the time the GP can treat the patient without having to refer him or her to a specialist,” said Crerar. “This is a good thing because it helps prevent uneducated users from disappearing into the healthcare system – cutting down on the costs associated with specialist care, and also protecting patients from being overly-serviced in terms of prescriptions, laboratory tests, second opinions and so forth. Employers can tailor their policies, so that members have access to the best healthcare providers, but the GP is always the first point of contact.”

Compulsory medical insurance was rolled out by the Dubai Health Authority in 2014 and is expected to provide coverage for all Dubai residents by 2016, taking the number of covered individuals in the medical insurance market from 1.5 million to 4 million, according to Alpen Capital’s 2015 regional industry report.

And as the final deadline approaches, Nexus Group is urging businesses across Dubai to comply with the requirements of the law to prevent stiff penalties – including AED 500 per employee per month of delay in providing coverage, and AED 10,000 (plus reimbursement of costs) for any employee who is forced to pay for their own insurance policy after the stipulated deadlines.

As per the DHA’s mandatory health insurance law, companies with more than 1,000 employees must have insured their employees by 31 October 2014, those between 100-999 employees by 31 July 2015, and companies with less than 100 employees by 30 June 2016.

“What employers need to realize is that investing in a group healthcare policy is not only about complying with the law, but also about creating a positive workplace environment in which the company recognizes the value of its staff, who will then in return show greater loyalty,” said Crerar. “Access to quality care also means lower sickness-related absenteeism and enhanced quality of life, which can ultimately lead to improved productivity – so it is a win-win for all concerned.”