Allianz Global Assistance Simple. Safe. Smart. Green Shield – University of Windsor Information Session Presented by Allianz Global Assistance

January 14, 2014

1 Who We Are

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Our

mission Helping people, anytime, anywhere

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400,000

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Group offices

Service providers worldwide

languages

in countries

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Our Values

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A Worldwide Presence Designed to Help Group offices Branches Commercial activity

Europe Middle East Africa Countries with group offices Countries with commercial activity • Mauritius • Austria • Lithuanua • Bahrain • Poland • Belgium • Luxembourg • Bosnia/Herzegovina • Portugal • Czech Rep. • Moldova • Bulgaria • Reunion Island • Croatia • Egypt • Morocco • Russia • France • Norway • Denmark • Spain • Germany • Oman • Estonia • Switzerland • Greece • Qatar • Finland • The Netherlands • Hungary • Ireland • Romania • Turkey • Italy • Serbia • Kuwait • UAE • Saudi Arabia • Slovak Rep. • Latvia • UK • Lebanon

Americas Countries with group offices • Brazil • Canada • Mexico • USA

Countries with commercial activity • Argentina • Chile • Columbia

Asia Pacific Countries with group offices • Australia • China • India • Japan • Malaysia • New Zealand • Singapore • Thailand

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Countries with commercial activity • Indonesia • Philippines • South Korea • Taiwan • Vietnam

• Slovenia • Sweden • Ukraine • Uzbekistan

Our Canadian Operations • Established in 1988 • Head office in Kitchener, ON

• 24/7/365 emergency assistance • 280+ Employees • Over 8 million Canadians covered • Trusted by top Canadian travel and financial services brands • Employee engagement score from Global Employee Survey: 88%

• Average Net Promoter Score of over 78%

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In-House Support: Key Stats in 2012

68,181 assistance cases opened

606,348

60 call centre agents

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calls received

251,573 claims processed

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RN Case Managers

11 languages

Selected Key Partners

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Award-Winning Service • ICMI’s 2012 Call Centre of the Year Award • ICMI 2012 Silver Award for Quality • IQPC’s Best Contact Center Learning, Development & Recognition Program (2012) • 2011 Finalist in the Insurance Canada Technology Awards (ICTA) for our Online Claims Submission Tool

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2 What We Do

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Services Provided to Green Shield Members • Pre-Trip Assistance • Emergency Message Centre • Emergency Legal Referrals

• Emergency Translation Services • Referrals • Cashless Service • Medical Case Management

• Medical Transportation • Cost Containment • Claims Payment • GHIP Recovery • Coordination of Benefits

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Emergency Assistance Specialists •

25 years experience servicing Canadian travellers

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8 million+ covered by assistance services

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Experienced in-house nursing team of 23 Registered Nurses • Average over 10 years critical care experience per RN

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Exclusive partnership with five Emergency Physicians

Areas of nursing expertise include: • • • • • •

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Emergency medicine Pediatrics Coronary and medical/surgical intensive care Utilization review Rehabilitation Oncology

Our International Reach •

Local presence around the world allows us to: •

Expedite delivery of medical information

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Confirm legitimacy of facility and appropriateness of care

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Identify cultural differences in medical care

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Enable billing arrangements from providers who otherwise would require patient to pay prior to leaving hospital

International network covering all countries… • Selection, management and control of service providers by dedicated international team • 118 administrative and medical correspondents worldwide • 400,000 service providers

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Proprietary Provider Rating Tool •

Market leading quality-verification initiative

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Evaluations performed on-site by Allianz medical staff

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Results available to Canadian staff via intranet

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Regular provider re-evaluations

1,716 hospitals… 542 cities… 137 countries…

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Screen Capture: Hospital Search in Cuba

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Screen Capture: A Tale of Two Hospitals Hospital A

Hospital B

Rating: 1 out of 5 Stethoscopes

Rating: 4 out of 5 Stethoscopes

Based on the information available, Allianz Global Assistance RNs are able to select the hospital with the appropriate facilities and standards of care.

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Case Management • 24/7 in-house RN support • Real time monitoring and approval of emergent medical treatment • Advise patient / provider up front regarding terms and conditions • Pre-approval of all invasive procedures • Review patient medical history • Liaise with physician, patient and family

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Medical Transport Providers are screened through RFP process: •

Site visits to validate RFP submission

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Inspected for maintenance documentation

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Review protocols for medical transports

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Selection can be made based on availability and price

Working relationship with medical desks at commercial airlines

Advanced cardiac life support from certified physicians, paramedics and nurses for transport

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Claims Management

• $11.2M USD in averted costs (Case Management) • 80% adjudicated within 10 days • 99% financial accuracy rate

• 98% procedural accuracy rate • Require original itemized bills for GHIP submissions • Claims reviewed to ensure only preapproved treatments are paid • System Check for duplicate and repeat cases • Bills over a specific dollar limit are reviewed by RNs

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Recoveries Government Health Insurance Plan (GHIP) • Money recovered from member’s provincial insurance (e.g. OHIP)

Coordination of Benefits (COB) • Payments made up front by Allianz • Any money owed by other insurance (i.e. spouse’s coverage or purchased coverage for example) coordinated after the fact as per CHLIA guidelines

Subrogation • Pursue if possibility of third party’s liability

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3 Points of Interest

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Industry Trends

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Continue to see delays in some provinces when attempting to find receiving beds.

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Saw more willingness from Canadian physicians to accept patients prior to their surgery being done in the USA.

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Some Medical Facilities still requesting deposits, a trend that the travel insurance industry is working to combat.

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Increased presence of Collection Agencies and/or 3rd Party Audit companies acting on behalf of medical providers

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Points of Interest It is important to call when a medical emergency arises, rather than just paying for the treatment and submitting the claims. • Allianz can direct member to appropriate level of care with preferred provider • Allianz can arrange billing with medical provider • Allianz will monitor care to approve any subsequent required treatment, tests, etc. • If member does not contact Allianz for assistance within 48 hrs, the member may be subject to a managed care penalty

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Points of Interest GHIP covers Canadians while travelling.

• The Government will cover a minor portion of what is billed • The US healthcare operates as a business • Transportation, Prescriptions, Trip Interruption or Delay, Equipment, etc. are not reimbursed by GHIP • Not all provinces have interprovincial agreements and patients may be asked to pay for services up front • Transportation is not covered by GHIP

• Only covered up to certain amounts and treatments

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Points of Interest Adequate health care is available in any travel destination. • This is true, for the most part, in the US and Canada. • This is not true in many foreign countries. • We have put measures in place and have a worldwide presence to assist members in getting to the most appropriate level of care.

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Points of Interest Allianz will immediately move the patient to a medical provider of the patient’s choice. • Medical appropriateness is the first priority of Allianz • Evacuation is arranged based on medical necessity, not appearance of facility and preference of patient/family. • Cultural, geographical and economical differences impact the amenities at a medical provider, however, medical capability is highest priority. • A patient is required to be medically stable to travel before Allianz arranges repatriation for ongoing care. • If member requires ongoing care as an inpatient, a receiving bed must be available in Canada (cannot drop in ER)

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Points of Interest Does travel insurance guarantee that no expenses will be incurred if you get sick while travelling? • In most cases, Allianz can arrange for cashless service • Allianz can engage local business units to assist with billing challenges • It is the right of medical provider to request payment/deposit up front from the patient • Certain services are not available cashless (PX, equipment, etc)

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Points of Interest • All expenses will be covered in the event of a medical emergency while travelling. Reimbursement of eligible benefits for emergency services will be made only if the services were required as a result of emergency illness or injuries which occurred while you were vacationing or travelling for other than health reasons. Benefits will be eligible only if existing or pre-diagnosed conditions are completely stable and you are fit to travel (in the opinion of Green Shield Canada and/or our Assistance Medical Team) at the time of departure from your province of residence.

• If medical care is no longer emergent, continued treatment will not be covered. • Policy benefits differ. It is important to be aware of what benefits are covered. • Some benefits may fall under extended health care rather than emergency travel assistance.

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Point of Interest Travelling for the purpose of treatment.

• The policy covers pre-approved referral treatment, should all options be exhausted • Approved referral benefits would cover any charges above what the GHIP plan would cover, as long as they are eligible benefits under the plan • Transfers from a Canadian facility to a US facility are not considered eligible benefits under this plan, as those services should be covered by GHIP • Technical benefits would not be eligible under this circumstance

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Customer Feedback “Your staff & service were absolutely superb in meeting every need of my unforeseen

medical emergency. Many thanks.” “If everybody was treated the way you treated me then the world would be perfect” “The quality of the services Allianz Global Assistance has provided to my wife and me over the years has been absolutely superb. The associates have been unfailingly understanding, patient, and professional. We are happiest when we don’t need your services, and extremely grateful when we do because we know that what Allianz Global Assistance will provide will be first class.”

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Customer Feedback “The receptionist at the clinic I had to go to was very impressed with Allianz Global

Assistance. When I told her that Allianz Global Assistance would look after my case, she was really happy as she had just dealt with you the week before. They are so good to work with”

was her comment”

“It felt like I was dealing with family”

“Fantastic service provided to a frantic mother needing quick help for her newborn, every call was answered by knowledgeable staff willing to answer all my questions. Thank you for an outstanding experience.”

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During this presentation, we assisted more than 5,251 people. Thank you!

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4 Questions?

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