Following implementation of the Public Health Law in 1995, it was necessary for
Migdal to reevaluate the health products that were and are currently being sold.
Basically, the new law did not abrogate or change the need to continue the sale of
the old heath products. However, there is a need to reevaluate the insured
population and to present new and varied health products that cater to the
various needs of the market created by the new health law.
As described above, the kupot cholim provide a standard basket of heath services
to their members. For an additional fee, the kupot supplied supplementary
insurance which added services to those available in the standard basket. Thus,
it is possible to divide the population of subscribers of the four kupot cholim
(Klalit, Macabi, Meuchedet and Leumit) into two groups:
Those who did notacquire supplementary insurance.
Those who did acquire supplementary insurance.
Consequently, we also divided the population of insured who will acquire our
new health products into two groups, depending upon whether or not they
subscribed to the supplementary insurance of their kupa.
The new line of health products offered by the Migdal group is based on the
division of the market according to three main parameters.
Coverage possessed by the client differences between clients is dependent upon
the kupa to which he belongs and whether or not he acquires supplementary
insurance.
"Improved Health" products were developed for clients without supplementary
insurance. "Improved Kupat Cholim" products which are adaptable to each of the
specific kupot cholim were developed for clients who had supplementary
insurance. Thus, Improved Kupat Cholim Klalit, Improved Kupat Cholim Macabi, etc. were developed.
Economic status - each of the health products is also available on an
international track, specifically geared to the high income population. The
international option includes all the coverage of the regular product in
addition to full coverage of any type of surgery performed outside the country,
including organ transplants. Premiums for the international track are 23%
higher than those of the regular track.
Place of residence - All of the health products described in paragraphs 1 and 2,
are also presented without coverage for hospitalization costs in Israel. This
possibility is geared to clients from the Jerusalem area, where there aren’t any
private hospitals and who do not need coverage for hospitalization. The
international track only covers hospitalization outside of Israel. Premiums for
this track are 15-25% cheaper than those which include hospitalization
coverage in Israel.
Refer to Appendix A - Details of the New Product Line According to Market
Analysis
PRODUCT SPECIFICATIONS
"Improved Health" and "Improved Kupat Cholim"
These policies are offered by Migdal to those not insured by supplementary
insurance and cover important medical needs that are not provided in the basket
of health services provided by the Public Health Law. The table in Appendix B
shows that coverage by the "Improved Health" international track provides full
coverage for surgery and organ transplants taking place outside Israel.
The "Surgical Insurance" plan is at present, not being sold according to its
previous terms. Changes and additions have been introduced as an integral
part of the new policy.
Principal Changes
age of 65, with an option to continue the insurance.
Insurance", such as allowance for the contraction of AIDS as a result of
transfusion, cosmetic surgery, etc.
insurance points (approximately 107,000 NIS are equivalent to 7157 points),
exclusive of organ acquisition.
of the policy.
The new plan will be presented and sold as a basic plan to the group of clients who
have not acquired supplementary insurance from their kupat cholim.
In addition to the "Improved Health" policy, we will also present to this
group of clients coverage for surgery outside of Israel through John Alden, an
American insurance company. This insurance plan is called "Improved Health
International", see comments.
Premiums for the international plan are 23% higher than those of the regular
"Improved Health" policy.
It is also possible to sell "Improved Health" without hospitalization coverage.
Premiums for this type of coverage are 20 - 28% lower than those of the
"Improved Health" with hospitalization coverage.
It is possible to sell "Improved Health International" insurance covering
hospitalization outside, but not in, Israel.
The insurance premium of "Improved Health International" which does not
include hospitalization in Israel is 15 - 20% lower than those of "International
Improved Health" with coverage for hospitalization in Israel.
These plans are presented to those who are fully insured by their kupat cholim.
Since the insured has already acquired supplementary insurance, he does not
need all the services provided in the basket of health services offered by the
Migdal group. The improved kupat cholim plans complement his coverage so
that the insured’s total coverage becomes equivalent to that of the complete
basket of health services. Payment is only for those services that previously were
not covered by his kupa. The table in Appendix B details the supplementary
coverage of the various kupot cholim compared with the corresponding
"Improved Kupat Cholim" plan.
Four additional new policies were added for kupat cholim members who have
supplementary insurance, which correspond to the plans for members without
supplementary insurance. These plans are called "Improved Kupat Cholim".
Versions of "International Improved Kupat Cholim" with and without the
option of hospitalization in Israel have also been prepared.
A separate addendum for all coverage missing from each of the kupat cholim
plans has been prepared for kupat cholim members who have supplementary
insurance from their kupa. These addenda are called: Improved Klalit,
Improved Macabi, Improved Meuchedet, and Improved Leumit.
For example, members of kupat cholim Klalit who have supplementary
insurance will be presented with one of the four "Improved Kupat Cholim
Klalit" policies and the addendum, "Improved Klalit".
Policies for the other kupot will be presented in a similar fashion.
The addendum is required for those who have supplementary
insurance and it is not possible to offer it as an option. Premium for the
addenda are included in the premiums for "Improved Kupat Cholim",
and international versions with and without hospitalization options.
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