Developing Microinsurance for the Health Sector

“A CARD MRI Experience”

Microinsurance Learning Session Asia and Oceania Implications of the Landscape Study

Diamond Hotel, Manila July 4, 2014

CARD Mutually

Reinforcing

Institutions “Mga

Institusyon sa

iisang Misyon”

May 2014

Number of Clients: 2,388,224

(88.45% contribution in the MFI outreach in the country or

47.76% contribution to Poverty Reduction)

Number of Insured Individuals: 9,767,720

(20% contribution in the overall insured Filipinos)

Clients (incl. Savers): 2,318,121 Offices: 1,473

Loan Clients: 1,290,240 Total Assets: Php17.07B

Loan Outstanding: Php 8.7B Total Liabilities: Php13.09B

Savings: Php6.6B Total Equity: Php3.9B

Repayment Rate: 99.38% Operational Sufficiency: 118.52%

Staffing: 7,989 Financial Sufficiency: 112.21%

Products & Services

CARD MBA (Life & Credit Life)

CARD MRI Insurance Agency (Non-Life)

Basic Life Insurance Program (BLIP) CaMIA PAID Plan

CARD Crop Assistance Program

Retirement Savings Fund (RSF) CARD Care

Group Life Insurance

Loan Redemption Fund (LRF) Group Personal Accident

Health Care

Motor Insurance

Fire Insurance

Electronic Equipment Insurance

Travel Insurance

Fidelity Bond

Money Security and Payroll

Directors and Officers Liability Insurance

AVERAGE DEATH

Per Mo = 559

Per Day = 19

AVERAGE DEATH

Per Mo. = 941

Per Day = 31

AVERAGE DEATH

Per Mo. = 346

Per Day = 12

AVERAGE DEATH

Per Mo. = 79

Per Day = 3

MEMBER

2,795

SPOUSE

4,706 CHILDREN

1,731 PARENTS

396

As of

May 2014

TOTAL DEATH CLAIMS = 9,628

Average death = 1,925/Mo or 65/day

DEATH STATISTICS As of May 31, 2014

As of

April 2014 TOTAL DEATH CLAIMS = 6,846

Average death = 1,712/Mo or 56/day

Top 10 Causes of Death

Top 10 Causes of Death ( For the Last 3 months)

NO. CAUSES May 2014 April 2014 March 2014

1 Heart Related 34.30% 35.32% 35.18%

2 Cancer 7.82% 8.83% 8.99%

3 Pneumonia 7.25% 7.40% 7.53%

4 Diabetes 4.10% 4.20% 4.22%

6 Renal Failure/Disease 3.49% 3.62% 3.67%

7 Fetal Death 3.22% 3.53% 3.74%

5 Accident 3.13% 3.43% 3.57%

8 Tuberculosis 2.55% 2.70% 2.67%

9 Pulmonary Disease 2.42% 2.65% 2.53%

10 Septicemia 2.10% 2.40% 2.31%

BENEFIT DESCRIPTION AMOUNT

Personal Accident Php 5,000

Daily Sickness Hospital Benefit (DSHB) / Daily Accident Hospital Benefit (DAHB)

Php 200 per day

Maximum of 15 days per year of combined DSHB and DAHB

Premium: Php 250 annually

CARD CARE PROGRAM

Product Features

Insurer: CARD Pioneer Microinsurance Inc. (CPMI)

PARTICULARS 1st PILOT-TEST 2nd PILOT-TEST

Duration 2 months (July 1 to Aug. 31, 2013) 3 months (June 1 to Aug. 31,

2014); 12 months (June 1, 2014 to May 31, 2015)

Locations Ilocos Sur, Nueva Vizcaya, Bataan,

Tarlac, Bulacan, Palawan

Same areas with additional pilot areas (Cagayan, Manila,

Pangasinan & Benguet)

Target Enrollees 5,000 35,000

Results 5,504/Php 1.4M Premium

Claims 80/Php 66,400

Loss Ratio 4.83%

CARD CARE PROGRAM

Pilot-test

CARD CARE PROGRAM

Challenges

The product is being compared with

PAID Plan, hospitalization benefit

and PhilHealth.

Members like the product but it’s not

yet their priority.

Microfinance and Health Protection Program

• In partnership with Freedom from Hunger (FFH) based in Davis, California

• 5 FFH MAHP partners:

– RCPB- Burkina Faso (West Africa)

– PADME – Benin (West Africa)

– CRECER – Bolivia (Latin America)

– Bandhan – India (Asia)

– CARD – Philippines (Asia)

• CARD MAHP’s program is called CARD Healthy Pinoy Program

► Health Education

► CARD Health Loan

► Access to Affordable Quality

Medicine Program (AQMP)

► CARD MRI Clinic

► Preferred Provider Program (PPP)

► Laboratory Services thru CARD Inc.

Health Services

► MAHP Replication (MFIs for Health)

GEOGRAPHICAL PRESENCE OF MAHP

110 HSP

128 HSP

36 HSP

23 HSP

24 HSP

48 HSP

13 HSP 84 HSP

49 HSP

16 HSP

6 HSP

55 HSP

PHIC

PHIC

PHIC

PHIC

PHIC

PHIC

PHIC

16 HSP PHIC

PHIC

Clinic

PhilHealth areas PHIC

PPP areas

AQMP areas

24 HSP

12 HSP

17 HSP

8 HSP

20 HSP

11 HSP

22 HSP

9 HSP

7 HSP

14 HSP

3HSP

2 HSP

3 HSP

2 HSP

8 HSP

9 HSP 6 HSP

1 HSP

4 HSP

18 HSP

5 HSP

32 HSP

27 HSP 7 HSP

6 HSP

3 HSP

2 HSP

9 HSP

– Dengue Prevention Module – Plan for Better Health Module – Using Health Services Module – PhilHealth Module – Flood Related Illnesses Module – Affordable Quality Medicines Module – AH1N1 Module – Healthy Habits – Breastfeeding – Infant and Child feeding – Integrated Management of Childhood Illnesses – Family Planning – Women’s Health – Diarrhea prevention – Leptospirosis – Preventing HIV/AIDS – Confronting malaria – Health Habit for Kids – Smoking and its effects – Proper Heart Care

– Partnership with the National Health Insurance Program (PhilHealth) to provide affordable health insurance to members and their qualified dependents

KaSAPI/PhilHealth Enrollees

YEAR 2011 Enrollees

2012 Enrollees

2013 Enrollees

2014 Enrollees

TOTAL

11,127

5658

4538

4849

Access to Affordable Quality

Medicines Program (AQMP)

• In Partnership with Zuellig Family Foundation

• September 9, 2009 – formal launching

• Pilot test – Gumaca, Lopez, Calauag and Bondoc Peninsula (Quezon Province)

• Rider System tested

1. San Pablo, Laguna (Feb. 14, 2010) 2. Bay, Laguna ( Feb. 14, 2010) 3. Dolores, Quezon ( June 21, 2010) 4. Masbate City (July 17, 2010) 5. Goa, Camarines Sur ( Sept. 6, 2010) 6. Tacloban City, Leyte ( Oct 4, 2010) 7. Boronggan,Samar ( Nov. 15, 2010) 8. Roxas City, Capiz ( Dec. 3, 2010) 9. Catanauan, Quezon ( Feb. 23, 2011) 10. Sablayan, Occ. Mindoro (April 8, 2011) 11. Sampaloc, Manila (July 18, 2012 basic clinic) 12. Pinamalayan, Or. Mindoro (March 8, 2012 basic clinic) 13. Lipa City, Batangas (June 18, 2012 basic clinic) 14. Calapan City, Or. Mindoro ( September 26, 2012 basic clinic) 15. Cavite City( March 5, 2013 basic clinic) 16. Sipocot, Camarines Norte ( April 2014 basic clinic)

• Check up from the doctor. Doctor’s schedules are written on the advisory given by CARD-MAHP unit.

• Health monitoring by the nurse on duty like BP check/monitoring, weight monitoring, and other vital signs monitoring

• Health Education • Referral to other specialist, laboratory and

hospital that are partners of CARD • Regular check up for pregnant women and

newborn babies • First aid for common illness

Other services of the clinic

• Home visits: Nurses visit the home of members for health check

• Community clinics: clinics done at the unit offices, center houses or other location agreed upon by the operations staff and MaHP Unit

• Center visits: done by the nurses to check blood pressure of members and to provide health information and advise.

From February 2010 to December 2013, there are a total of 94,067 clinic visits in all CARD MRI clinics nationwide.

6,26912,012

31,625

50,430

0

10,000

20,000

30,000

40,000

50,000

60,000

1 2 3 4

CARD MRI Clinic Availment

2010 - 2013

20132010 2011 2012

– Partnership with health care providers (physicians, surgeons, dentists, optometrists, ophthalmologists, hospitals, medical technicians)

– Members and qualified dependents can avail of the services at discounted rates

TOTAL NUMBER OF HSP PARTNERS

TYPE As of April 2014

Physician

Dentist

Optometrist

Reg. Midwife

Maternity Clinic

Laboratory

X-Ray Clinic

Polyclinic

Hospital

Pharmacy Owner

675

365

140

15

31

110

2

18

56

2

TOTAL 1414

The CARD Mutually Reinforcing Institutions is composed

of CARD NGO, CARD Bank, CARD MBA, CMDI, CARD

BDSF, CaMIA, and RBST.

present this

Dr. Josephine Deveza-Briones

to

for being a CARD-MRI partner

in implementing the CARD Healthy Pinoy –Preferred Provider Program

by continuously providing medical services at affordable cost and in uplifting the health condition of CARD members

and their families.

Given on March 5, 2010 at CARD-MRI Development Institute, Inc., Tranca, Bay, Laguna, Philippines

ALLAN REY L. SARMIENTO Management Trainee, CARD MRI CARD-MRI

a Ramon Magsaysay

Awardee

CARD Inc. Health Services

CARD Inc. Health Services • CARD Inc. Health Services formally opened on

February 8, 2013 and was conferred as Secondary Laboratory status by DOH

• Manned by four (4) key personnel (Health Coordinator, Nurse, medical Technologist and Pathologist)

• Laboratory services includes hematology, microscopy, clinical chemistry and special test

• Members enrollment is on going for the CARD Inc. Health services program

MAHP Replication MFIs for Health

MAHP Replication

• In August 30-31, 2012, CARD MRI and FFH conducted a two (2) days workshop entitled “ Why add Heath Services to Microfinance?” It was attended by 15 Microfinance Institutions with 36 leaders.

• The 15 MFIs agreed to come together and signed the Memorandum of Understanding to form a Technical Working Group and to test sharing of resources.

• On February 2013, the Memorandum of Agreement signing was done at TSPI Head Office, Guadalupe Nuevo St., Makati City.

• The 18 MFIs are as follows: ASA Philippines, Alalay sa Kaunlaran (ASKi), BINHI, CARD Inc., CARD Bank, CARD SME Bank, CCT, DSPI, KMBI, NWTF, Life Bank Foundation Inc. Pag inupdanay Inc., RBT-MBA, Rizal Rural Bank, TSPI, TSKI and USWAG Development Foundation

From February 2013 to May 2014, a total of 16, 260 members and dependents of different MFIs received free Medical, dental

services and circumcision (minor surgery)

Joint Community Health Day

570

1348

568

1346404

756

14671493

742

435

1103

647

1222

1463

1956

0

200

400

600

800

1000

1200

1400

1600

1800

2000

1

Bacnotan, La Union

Dolores, Eastern Samar

Malabon City

Davao del Norte and Sur

Bicol

Cabanatuan

Zamboanga - Culianan

Iloilo

Bohol

Guiuan, Eastern Samar

Gen. McArthur, Eastern Samar

Pontevedra, Capiz

Estancia, Iloilo

Cagayan Valley

Malay, Aklan and Miag-ao

► Making a positive impact in the country’s health situation

► Making local health delivery system more affordable and

accessible

► Improving health situation of the MFI clients

► Collaboration among top MFIs in the Philippines

► Engage, nurture and promote PARTNERSHIPS to generate

SYNERGY in its efforts to improve the health situation of the

MFI clients

► Sharing of resources to provide quality, affordable,

accessible and sustainable health services to MFI clients

End Goal Healthy and vibrant community!