Health insurance system in georgia teona teteloshvili aldagi bci june 2013
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Health Insurance System In Georgia Teona Teteloshvili Aldagi BCI June 2013. EXECUTIVE SUMMARY. 1. GEORGIAN ECONOMY TODAY. 2. INSURANCE MARKET IN GEORGIA. 3. ALDAGI BCI - INSURANCE MARKET LEADER . 4. FEDERAL/STATE HEALTH INSURANCE PROGRAMS. 5. FEDERAL/STATE HEALTH INSURANCE PROGRAMS

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Health Insurance System In Georgia Teona Teteloshvili Aldagi BCI June 2013

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Health insurance system in georgia teona teteloshvili aldagi bci june 2013

Health Insurance System In GeorgiaTeona TeteloshviliAldagi BCIJune 2013


Executive summary

EXECUTIVE SUMMARY

1

GEORGIAN ECONOMY TODAY

2

INSURANCE MARKET IN GEORGIA

3

ALDAGI BCI - INSURANCE MARKET LEADER

4

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

5

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

AND THEIR INFLUENCE ON INSURANCE COMPANY

BUSINESS

6

FUTURE OF THE HEALTH INSURANCE IN GEORGIA


Georgian economy today

GEORGIAN ECONOMY TODAY

2012 Estimated Real GDP Growth Rate for the Selected Countries *

*Source: IMF, World Economic Outlook (2012 April data)


Insurance market in georgia

INSURANCE MARKET IN GEORGIA

DENSITY & PENETRATION

  • Nascent state of Georgian insurance sector translates into extremely low insurance penetration and density levels

  • Market research reports reveal that majority of population does not have adequate perception of property & personal risks, thus is reluctant to pay money for risk minimization

EXCLUDING GOVERNMENTAL PROJECTS IN GEORGIA :

DENSITY

USD 22.4

PENETRATION

0.9%


Insurance market in georgia in georgia

INSURANCE MARKET IN GEORGIAIN GEORGIA

PREMIUMS BY YEAR & MARKET SHARE OF INSURANCE COMPANIES

INSURANCE MARKET (9 months)

GROSS WRITTEN PREMIUM

AMOUNTS IN '000 GEL

Y-o-Y GROWTH

74.9%

14 INSURANCE COMPANIES ON THE MARKET

5 LARGEST INSURANCE COMPANIES HOLD MORE THAN 79%OF THE MARKET

INSURANCE COMPANIES BY GPW, 9 MONTHS 2012

SOURCE: NBG – National Bank of Georgia

30%


Georgian insurance market

GEORGIAN INSURANCE MARKET

BY PRODUCT ANALYSES

Y-o-Y +106.9%

Y-o-Y +3%

SOURCE: NBG – National Bank of Georgia


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

HEALTH CARE MARKET IN GEORGIA

TOTAL HEALTH CARE EXPENDITURES

CIS COUNTRIES COMPARISON Y2009

SOURCE: WHO. World Health Statistics 2010

Georgia has one of the highest rate of Health Care expenditure as % of GDP,

among other low income countries

On the other hand, the share of Governmental expenditure in total Health Care sector is the lowest inGeorgia among European countries


Aldagi bci the leader on the insurance market

ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET

BRIEF INFO ABOUT ALDAGI BCI

ALDAGI BCI KEY DATES

ACQUISITION OF INSURANCE COMPANY IMEDI L

2012

  • FIRST INSURANCE COMPANY ON THE MARKET – SINCE 1990

ACQUISITION OF INSURANCE COMP. PARTNER

2011

ACQUISITION OF BLOCK GEORGIA ASSETS

  • VENTURE OF 6 INSURANCE COMPANIES

2010

ABCI - MEMBER OF BANK OF GEORGIA GROUP

  • WIDEST DISTRIBUTION CHANNEL

2009

  • UNDISPUTED LEADER ON THE MARKET*

    • By Revenue – 32%Market Share

    • By U/W Profit – 45%Market Share

    • By ASSETS – 37%Market Share

    • * Figures for 9 months of 2012

2008

ALDAGI BCI ENTERS INTO HEALTH CARE BUSINESS

2007

ACQUISITION OF ALDAGI BY BCI

2006

ACQUISITION OF EUROPACE BY BCI

2005

ACQUISITION OF SALBI BY ALDAGI

ACQUISITION OF BCI BY BANK OF GEORGIA

2004


Integrated business model

ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET

INTEGRATED BUSINESS MODEL

INSURANCE

HEALTHCARE

  • The first managed healthcare provider since 2006

  • The largest managed chain of clinics

  • A chain of 26 hospitals with a concentration in Western Georgia, covering approximately 40% of Georgia’s population

  • 40% of ABCI claims expense become revenue of its own healthcare business

  • Gross Profit Margin 40.6%

  • EBITDA Margin 22.4%

  • Market leading life and non-life insurance provider. 9 months of 2012 market shares of 30% Gross Premiums Written; 32% by Revenue

  • More than 607,000 corporate & retail clients;

  • Widest distribution channel

  • 99% of brand recognition

  • Largest insurer of property & casualty risk

  • Largest Banc assurance network in the country

  • Capable management team with strong acquisition & integration track record


Aldagi bci business development dyna mics

ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET

ALDAGI BCI BUSINESS DEVELOPMENT DYNAMICS

ALDAGI BCI TRENDS BY LINES

GROSS WRITTEN PREMIUM

AMOUNTS IN '000 GEL (1.62 GEL ~ 1 USD)

(3 Quarters of 2012 and 2011)

SOURCE: NBG – National Bank of Georgia


Aldagi bci in healthcare industry

ALDAGI BCI – THE LEADER ON THE INSURANCE MARKET

ALDAGI BCI IN HEALTHCARE INDUSTRY

  • ABCI ENTERED INTO HEALTH CARE BUSINESS IN 2006

  • Till 2010 Operated with 5 small outpatient Clinics

  • IN 2010 Invested 15 mln USD in Building 5 small sized and 1 middle sized hospitals

  • In YE 2011 acquired Hospital Assets -11 Operating hospitals - from the largest health care Company

ABCI HEALTH CARE CHAIN – IS THE LARGEST IN THE COUNTRY

26 HOSPITALS

1,120 BEDS

80% OF THE MARKET SHARE IN WESTERN GEORGIA

COVERED POPULATION – 1,800,000

AS A RESULT

IN 2012 By Acquisition of Imedi L, ABCI added to its hospital Chain 6 New Hospitals and 4 Under construction

* includes 4 small outpatient clinics


Federal state health insurance programs

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

HISTORY

  • In 1992 year free of charge healthcare system was abolished and till 1995 year was only out of pocket payment, what caused increase of morbidity, mortality

  • In 1995 year Insurance Fund was created. From Insurance Fund was covering only:

  • Socially Dangerous Diseases – tuberculosis, HIV etc.

  • Children from 0 till 1 years of age

  • Pregnancy Monitoring

  • Urgent hospitalization and treatment of Veterans and Socially Unprotected People

BUT, funds were insufficient and recourses were enough only for 20% of medical cases


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

HISTORY

In 2007 State Insurance Pilot program was launched which covered only People Under the Poverty Line. This program is operating till now but with some corrections.

  • WAS:

  • State was in the role of Insurer

  • Any Insurance company has right to take part in this project

  • Beneficiaries were granted with Insurance Vouchers and they have ability to choose in which Insurance Company they want to be Insured

  • Number of Insured In 2007 year - 196 000

  • NOW:

  • State is in the role of Insurer

  • Any Insurance Company has right to take part in this tender and choose region where he wants to operate

  • Country was divided into 26 conditional regions and Beneficiaries were obligated to choose concrete Insurance Company which won tender in concrete region

  • Number of Insured – 806 066


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

HISTORY

From 2007 simultaneously with State Insurance for People Under the Poverty Linewere launched other projects, where State was in the role of Insurer also.

  • Teachers State Program

  • Tbilisi City hall Program

  • Vulnerable Children Program

  • Refugees State program

  • “Cheap Insurance”

Also, for people who were not eligible for above mentioned programs, State has special programs, which covered Oncology diseases, Infectious Diseases and etc.

In 2008 nongovernmental Health Insurance Mediation Institute was launched. Role of this institute was to help beneficiaries arrange relation with Insurance Companies


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

HISTORY

In September, 2012 State launched second global program for Children and pension age adults.

  • State is in the role of Insurer also

  • In the range of this program were Insured: Children from 0 till 6 year of age and pension age people - Women from 60 years of age and Men from 65 years of age

  • Any Insurance Company has right to take part in this tender and choose region where he wants to operate

  • Country was divided into 26 conditional regions and Beneficiaries were obligated to choose concrete Insurance Company which won tender in concrete region

  • Number of Insured: Children – 251 600, Pension age – 546 996

After this project was launched all other programs were cancelled, except Tbilisi City Hall program and Under the Poverty line program


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

Coverage

Both State insurance Programs Cover the same list of Services

  • Urgent Ambulatory Fully

  • Urgent Hospital Service Fully

  • Planned hospital service, Oncology and Cardiology

  • Planned Ambulatory service with very limited list of services

  • Medicines with very limited list

  • Delivery (only for Under the Poverty Line Program)


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

GENERAL HEALTH INSURANCE PROGRAM

In March, 2013 State launched third global Project “General Health Insurance Program”.

  • In the range of this programwere Insured people who where not eligible for other State Projects and who do not have private Insurance policy.

  • Beneficiaries should apply service centers and take policy

  • Insurance Companies are not involved in this project, State has direct calculation with Hospitals. Insurance companies are only obliged to send monthly renewed policyholders data base.

  • “General Health Insurance Program” covers only Urgent Ambulatory and Hospital Services


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

INFLUENCE ON INSURANCE COMPANY

Under the Poverty Line Program

Children and Pension Age Adults Program

  • SHOCK caused by Significant Increase of health insured number

  • Necessity of new service centers and units what caused increase of administration costs

  • Expansion of Providers network

  • Obligation of involvement In healthcare system

  • No impact on Insurance Company Corporate and Retail Business business

  • Already ready for Increased number of Health Insured Number

  • NO Necessity of new service centers and units

  • Already Expanded Providers network

  • Already involved In healthcare system

  • Insignificant impact on Insurance Company Corporate and Retail Business business


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

INFLUENCE ON INSURANCE COMPANY

General Health Insurance Program

  • Does not decrease number of insured because it covered only people who where not eligible for other State Program and who do not have private Insurance policy.

  • Insurance Company itself is not involved in this program, but this program increase revenue of our second business, healthcare system

  • Does not decrease number of insured because it covered only Urgent Ambulatory and Hospital Services


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FEDERAL/STATE HEALTH INSURANCE PROGRAMS

State Insurance Policyholders Number and Total Number of Policyholders in Georgia


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

FUTURE OF THE HEALTH INSURANCE IN GEORGIA

  • As we see, in Georgia we do not have Mandatory Health Insurance, we have only Federal/State programs covering definite groups of people.

  • As we know changes are planned, but it is not yet known what projects will be launched.

  • Insurance Companies will be involved or not in this projects.

  • Existed programswill continue or not

BUT

As the leading company of the Georgia’s Insurance market, Aldagi BCI is ready for challenges and we are sure , we will deal with them and adapt quickly.


Health insurance system in georgia teona teteloshvili aldagi bci june 2013

THANK YOU FOR YOUR ATTENTION

TIME FOR QUESTIONS & ANSWERS


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