Health Insurance 2022 - Discovery
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Health Insurance 2022 Health insurance by Vitality Health International offers shared-value health insurance to companies operating in Africa, enabling comprehensive insurance cover for the healthcare of their employees, underpinned by incentives, tools and rewards for them to live healthier.
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Investing in your
employees’ health
and wellness is
good business
There is growing evidence Studies show that employees in good health are 17% more productive than those in poor health, experience fewer motivational
problems, are more resilient to change, and are more likely to be engaged with business priorities.
supporting the concept Ensuring that your employees have access to good, quality healthcare is essential to sustain the health and productivity of your
that focusing on the health workforce. While traditional health insurance models provide this access, it is focused on the funding of that access when it is
needed, and not necessarily on keeping your employees in good health.
and safety of a workforce The shared-value insurance model of Vitality Health International goes beyond the traditional insurance model by incentivising
is good business. employees to remain in good health, reducing the cost of their insurance and sustaining their health and productivity.
PG 2 | Investing in your employees’ health and wellness is good business
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Vitality Health International
is a pioneering insurer that
incentivises people to be
healthier, and enhances and
protects their lives by using
a shared-value approach
to insurance
PG 3 | Vitality Health International
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Making people WHEN OUR CLIENTS ARE HEALTHIER,
healthier through OUR BUSINESS IS HEALTHIER AND SOCIETY IS HEALTHIER
shared-value health
insurance EMPLOYEES
Improved health, better value through
improved price and benefits
Discovery, the owners of Vitality Health
International, pioneered shared-value insurance,
which not only provides comprehensive health
insurance, but also incentivises clients to lead
a healthier lifestyle through Vitality, the world’s s He
e al
tiv
leading behavioural science-based wellness
programme.
t
n
hy
ce
By encouraging and rewarding healthy behaviour
in
be
change, insurers experience fewer claims, improved
er
ha
lapse rates and increased profits. These profits,
generated by improved health, in turn fund further
b
vio
Mem
incentives that create ongoing behaviour change.
The result is a virtuous cycle called Shared-Value
ur
Insurance, which shares material benefits between
the insurer (more profits), clients (greater health
and financial rewards) and society (lowered
healthcare costs and a healthier, more productive
workforce).
Through the integration of Vitality with the health
insurance offered by Vitality Health International,
Pan-African employers can ensure that their
employees have access to world-class health SOCIETY INSURER
insurance with the added focus of keeping their
employees in good health. Healthier society Lower claims
Improved productivity Higher margins
Reduced healthcare Positive selection
Insur s
er saving
burden and lower lapses
PG 4 | Shared-value health insurance
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Introducing Health Insurance
by Vitality Health International
CO M P R E H E N S I V E , R E L E VA N T H E A LT H
INSUR ANCE OPTIONS
Vitality Health International will offer shared-value health insurance to employers in Africa,
enabling comprehensive cover for healthcare for their employees, underpinned by incentives
and tools to live healthier. Leveraging the key assets of the Discovery Group, employers with
operations on the African continent can offer their employees living and working in Africa
access to comprehensive, quality healthcare through Vitality Health International. Vitality
Health International provides comprehensive health insurance benefits for the full spectrum
of employees’ medical needs through a range of options. All insurance options are supported
by a full suite of leading digital technology designed to create an intuitive and accessible
healthcare system experience, and a seamless service experience for employees, employers
and financial advisers.
To incentivise engagement in healthy behaviour, employees will have access to Vitality, the
world’s leading behaviour-change programme, designed to make people healthier.
Quoting for Pan-African Health Insurance will be available from 1 November 2021, for cover effective from 1
January 2022. Cover will be initially available in four African countries, with a focus to expand into the rest of
Africa throughout 2022.
Nigeria Kenya
Zambia Ghana Vitality Health International covers all relevant healthcare services through four distinct health
insurance options that allow employers to tailor the cover to the needs of their employees.
Each option offers a different overall level of cover, and the choice of cover in-country, across
Africa, or worldwide. All options include Vitality to incentivise wellness among employees.
PG 5 | Introducing Pan-African Health Insurance
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Health insurance
product platform MAJOR MATERNITY
DISEASE BENEFIT
KEY FEATURES Cover for a defined list of major diseases, Comprehensive prenatal healthcare
subject to the overall yearly limit services for maternity
Cancer, including palliative care In-hospital procedures (birth,
HIV/AIDS complications, sterilisation), subject
to the out-patient limit
Organ transplants
Pre- and postnatal care, subject to
Kidney dialysis
the out-patient limit
Infertility treatment
IN-PATIENT Neonatal care, subject to sub-limits
BENEFIT
Cover in any private hospital, subject OUT-PATIENT
to the overall yearly limit
BENEFITS
Cover for all hospital admissions,
subject to overall plan limit Cover for a defined list of out-patient
benefits subject to a yearly out-patient
Emergency transport
benefit, limit and sub-limits
Family accommodation
GPs and specialists
Prescribed medicine
CHRONIC Diagnostic tests
ILLNESS BENEFIT Consultations with allied healthcare
Cover for a defined list of chronic conditions providers
Chronic medicine, consultations, Adult and child immunisations
pathology tests and basic radiology Prosthesis and external devices/
tests, subject to overall plan limit equipment
Second-opinion services
Evacuation services
SCREENING
AND PREVENTION
Cover for a defined list of clinically relevant VITALITY
health checks (depending on age and sex), Access to the world’s leading behavioural
subject to sub-limits science-based wellness programme,
tailored for Africa
PG 6 | Product platform
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Four cover options to choose from
Vitality Health International offers four distinct health insurance options, all benchmarked to provide best-in-category coverage across all benefits.
IN-COUNTRY AFRICA ROAMING
H EA L T HCA R E S E R V IC E S WORLDWIDE
(INCLUDING INDIA
CORE PLUS (EXCLUDING USA)
FROM EAST AFRICA)
Yearly plan limit for each person every year*
Overall plan limit $100 000 $600 000 $1 000 000 $3 000 000
In-patient benefits
Specialised radiology Cover of up to $600 for each person Cover of up to $2 000 for each person Cover of up to the overall plan limit, subject to preauthorisation
every year, subject to preauthorisation every year, subject to preauthorisation
Mental health admission Cover for up to 10 days for each person for every admission Cover for up to 20 days for each Cover for up to 50 days for each
person for every admission person for every admission
All hospital admissions are subject Cover for accommodation, the surgery, theatre and ward fees, treating specialists and nursing care
to the overall plan limit Cover for acute dialysis
Cover for all medicines, consumables and diagnostic tests that form part of an admission
Cover for devices and appliances
Cover for necessary physiotherapy, speech therapy and occupational therapy that forms part of the hospital admission
Emergency transport Cover for ambulance services to an appropriate medical facility, up to overall plan limit
Family accommodation Cover for up to 30 days of accommodation for the parents of an admitted child
Major diseases
Conditions covered up to The following major conditions are covered:
the overall plan limit Consultations and treatment of cancer
– In the case of breast cancer, treatment includes reconstructive and replacement surgery
– Cover for palliative care
HIV/AIDS
Organ transplant
Kidney dialysis
In-Country options: Access to cover only in the country in which the policy is issued.
Africa Roaming option: Access to cover in any African country and for clients who are based in East Africa, access to cover in India.
Worldwide option: Cover worldwide (excluding the United States of America).
*
All yearly limits and sub-limits are applied for each insured person for a 12-month period, calculated from the start date of the policy and subject to policy terms and conditions.
PG 7 | Cover options
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
IN-COUNTRY AFRICA ROAMING
HEA L T HCA R E S E R V IC E S WORLDWIDE
(INCLUDING INDIA
CORE PLUS (EXCLUDING USA)
FROM EAST AFRICA)
Maternity
Procedures covered up to overall The following procedures are covered up to the overall plan limit:
plan limit In-hospital birth (normal vaginal delivery and C-section)
Complications arising during maternity journey
Sterilisation
Pre- and postnatal care Covered up to the out-patient limit
Neonatal care Cover of up to $5 000 for each person Cover of up to $20 000 for each Cover of up to $75 000 for each Cover is subject to the overall
every year person every year person every year plan limit
Infertility treatment No cover Cover for diagnostic consultation and Up to $10 000 for each insurance
tests, subject to the yearly year and $5 250 for each fertilisation
out-patient limit attempt
Screening and prevention
A defined basket of clinically Cover of up to $500 every year for certain tests that can detect early warning signs of serious illnesses
relevant screening tests
Chronic Illness Benefit Cover for medicine, consultations, pathology tests and basic radiology tests for certain conditions, subject to preauthorisation, clinical protocols and
the overall plan limit
Out-patient benefits
Annual out-patient limit $1 300 $2 500 $3 000 $4 000
GP and specialist consultations Cover for in-person and virtual consultations up to the out-patient limit
Prescribed medication Cover of up to $300 every year Cover of up to $500 every year Cover of up to $1 500 every year Cover of up to $2 000 every year
Diagnostic testing Diagnostic consultations, blood tests, X-rays, scans and other diagnostic tests, such as COVID-19 PCR tests, are covered up to the out-patient limit and are subject
to specific protocols. Specialised radiology (such as MRI and CT scans) is subject to preauthorisation and the out-patient limit
Dental care $500 for each person every year $750 for each person every year $750 for each person every year $1 000 for each person every year
Optometry $150 for each person every year $200 for each person every year $300 for each person every year $500 for each person every year
Physiotherapy $100 for each person every year $200 for each person every year $500 for each person every year Cover up to the out-patient limit
Chiropractic Cover up to the out-patient limit
PG 8 | Cover options
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
IN-COUNTRY AFRICA ROAMING WORLDWIDE
HEA L T HCA R E S E R V IC E S (INCLUDING INDIA
CORE PLUS FROM EAST AFRICA) (EXCLUDING USA)
Speech and occupational therapy Cover for 50% of the consultation fee, limited to $1 500 every year
Immunisations for adults Cover for a defined list of immunisations, segmented according to appropriate age groups, subject to the out-patient limit
and children
Out-patient consultations with a Cover for up to 80% of the total fee, Cover for up to 80% of the total fee, Full cover for up to 10 consultations Full cover for consultations,
psychologist or psychiatrist limited to 5 consultations limited to 10 consultations limited to $1 000 every year
Cover for prosthetics and external Cover up to $1 200 for each person, Cover up to $3 000 for each person, Cover up to $4 500 for each person, Cover up to $5 000 for each person,
devices or equipment every year every year every year every year
Medical second-opinion services
Access to a medical second Limited to one usage for each person, every year, subject to preauthorisation, clinical protocols and the overall plan limit
opinion from the VHI South African
Specialist network or The Clinic by
Cleveland Clinic
Medical evacuation
International and cross-border Not covered Cover of up to $50 000 Cover up to the overall
emergency evacuation and plan limit
treatment
Compassionate travel Not covered An individual accompanying the Cover up to the overall
person being evacuated will have plan limit
access to up to $150 every day,
limited to 10 days
Repatriation of mortal remains Not covered Cover up to the overall plan limit
Vitality
Access to Vitality Access to the world’s leading behavioural science-based wellness programme
PG 9 | Cover options
Shared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Access to extensive healthcare
networks across Africa
Tunisia
Vitality Health International has partnered with Medical Services
Organisation International (MSOI) to deliver health insurance in
Africa, and to manage and expand healthcare networks available to Senegal
clients. MSOI, a subsidiary of Discovery Health (Pty) Ltd, is a leading
provider of integrated healthcare risk management and third-party
administration services and solutions to over a million beneficiaries Nigeria
throughout Africa.
MSOI has direct access agreements with over 6 000 healthcare Nigeria
providers (hospitals, clinics, pharmacies, laboratories and individual
DRC
doctors in 51 countries across Africa, with a dedicated network Kenya
management team who maintains relationships and assesses the
capabilities and quality of these providers, to ensure optimal service
Democratic
delivery to members. MSOI has 7 offices with 85 full-time staff
Republic of
members operating across the African continent. the Congo
51
countries with direct
provider agreements*
7
eSwatini
South Africa
MSOI offices across Africa
*
No direct provider agreements in the
Central African Republic and Guinea
PG 10 | Healthcare networksShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Vitality
Shared-value insurance that
motivates your employees
to get healthier
PG 11 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
The nature
The nature of mortality and morbidity risk Individual behaviour plays a fundamental role
is changing, with lifestyle choices increasingly in the disease burden faced by society globally.
impacting mortality and morbidity risk. Building A healthcare wellness paradox exists in that
of risk is
on research from the World Health Organization healthcare is typically over-consumed while
and Oxford Health Alliance, The Vitality Institute wellness is under-consumed. For the
has identified four modifiable behaviours – tobacco insured consumer, the benefit of healthcare
behavioural use, poor nutrition, low physical activity and
alcohol abuse – that are significant contributing
factors to the rising burden of non-
is immediate, while the price is hidden.
Conversely, the price of wellness is immediate,
while the benefit accrues over the long term.
communicable diseases (NCDs) and
The knowledge that much of the prevalence
cause 60% of deaths worldwide.
and cost of lifestyle diseases are attributable
Although the burden of disease in Africa continues to behaviours that can be modified,
to be dominated by infectious diseases, countries has resulted in international interest in
on the continent are undergoing a demographic mechanisms that can be used to alter poor
transition, leading to the increasing lifestyle behaviours and drive healthy choices.
prevalence of NCDs. NCDs are set to overtake
communicable, maternal, neonatal, and
nutritional diseases combined as the leading
cause of mortality in sub-Saharan Africa by 2030.
4
MAIN RISK Low physical Unhealthy diet Smoking Excess alcohol
FACTORS activity
4
NCDs
Respiratory
disease
Diabetes Cancer Cardiovascular
disease
60%of all deaths
worldwide
PG 12 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Vitality changes behaviour and Vitality is a behavioural wellness solution that helps
millions of people around the world get healthier by
giving them the tools, knowledge, access and incentives
improves health outcomes to improve their health. The programme is based
on sound clinical and behavioural science research,
and focuses on tackling key areas shown to stem the
rise of NCDs – early detection and health screening,
and behaviour modification. Vitality has scientifically
proven that members who actively engage in the
programme live longer and have lower healthcare
costs than non-Vitality members. Similarly, through
improving health outcomes for individuals, Vitality
positively impacts employee productivity
and performance.
IMPROVING HEALTH OUTCOMES
FOR INDIVIDUALS
IMPROVING EMPLOYEE PRODUCTIVITY
17% lower healthcare costs AND PERFORMANCE
for engaged members
Productivity Service defects
37%
˜7 days 23%
lower COVID-19 mortality risk
for engaged members
Additional time due to lower Fewer defects recorded by engaged
Average life expectancy
presenteeism for Gold and Platinum staff compared to staff without Vitality
87 yrs
status employees
81 yrs
67 yrs
63 yrs
Work engagement Sick days
35% 46%
South Africa South Africa, Vitality Gold and
Greater work engagement for engaged Lower number of sickness days for
insured members Diamond Vitality staff relative to unengaged engaged staff versus staff without Vitality
population members
PG 13 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Global success of Vitality
The World Health Organization (WHO) recognises physical inactivity as the fourth leading risk factor for premature death with physically inactive people
having a 30% higher risk of premature death due to chronic diseases of lifestyle. Vitality research also shows that an increase in physical activity leads to an
immediate increase in other healthy lifestyle behaviours. The fact that physical activity triggers a healthy lifestyle makes it essential to incentivise physical
activity in the short and long term.
VITALITY ACTIVE REWARDS: A SOLUTION TO GLOBAL GLOBAL VITALITY EXPERIENCE
PHYSICAL INACTIVITY
Vitality Active Rewards brings technology and behavioural science together to increase physical
activity. The programme tracks physical activity, including steps, heart rate, calories and gym
visits, through linked wearable devices. Participants receive varying rewards for achieving
personalised physical activity goals to encourage positive and ongoing behaviour change.
Participants on Vitality Active Rewards also have a higher likelihood of taking up other health 30 150+ 100K+ 100M
and wellness activities, such as healthier nutrition and regular preventive screenings.
VITALITY PROGRAMME NEW DEVICES HEALTHY
Since the introduction of Vitality Active Rewards, the programme has expanded globally to 30 MARKETS PARTNERS LINKED PER ACTIVITIES
markets across 6 continents, with over 20 million members globally receiving micro-rewards for MONTH PER MONTH
engaging in physical activity. A cohort analysis has shown that members’ activity levels increase
significantly after activating Vitality Active Rewards.
Exercise days per month Proportion of high-intensity workouts
+24% +9%
7 40%
5.6
37%
Before Vitality After Vitality Before Vitality After Vitality
Active Rewards Active Rewards Active Rewards Active Rewards
Source: An analysis of the impact of Vitality Active Rewards Discovery As of June 2021
PG 14 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Expanding
Vitality, the
world’s leading
VITALITY HEALTH CHECK WEEKLY PHYSICAL
The Vitality Health Check includes checks on blood ACTIVITY TARGET
behaviour-
pressure, blood glucose, cholesterol and weight, Employees receive a personalised weekly physical
to identify the risk of developing chronic lifestyle activity target in the Vitality app. They can track
diseases. their physical activity using a compatible fitness
change
device and see their progress towards the weekly
goal in the app.
VITALITY
programme,
HEALTH REVIEW
The Vitality Health Review is an online Im
th pr
al
in Africa
assessment that measures aspects
ov
e
of wellness, including exercise,
h
e
ur
nutrition and stress. It is a quick
yo
yo
u
and easy way to find out how
r he
Know
healthy employees are and
Vitality incentivises and rewards clients for helps identify lifestyle factors
a lt h
healthy living through three simple steps: that may put them at risk
of developing health problems.
1 | Know your health
2 | Improve your health
3 | Enjoy the rewards
Each step has a particular focus in getting
employees to live a healthier life, and is
Enjo s
accessed through the Vitality app. y the reward
Bronze Silver Gold Platinum WEEKLY REWARD DISCOUNTED
status status status status
FOR GETTING ACTIVE FITNESS DEVICE
0 10 000 20 000 25 000 Employees who achieve their weekly Employees can get rewarded with
points points points points physical activity goals can earn reward coins a 25% discount on a Garmin fitness
to spend in the Vitality Mall at a range of device to help them get active and
As employees engage with the Vitality programme, they earn Vitality points for
exciting reward partners. achieve personalised fitness goals.
completing specific activities. The points reflect the relative value of the activity
to the employees’ health. The Vitality points accumulate towards a Vitality status
– ranging from Bronze to Platinum – as a measure of the employees’ health.
PG 15 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Know your health
Employees can take a proactive approach to learn about their health by going
for various check-ups and assessments, and earn Vitality points when they do.
ONLINE VITALITY FURTHER
ASSESSMENTS HEALTH CHECK CHECKS
Vitality Health Review Do a Vitality Health Check at your Advanced health screenings
This assessment measures many local GP or clinic to identify chronic and vaccinations
aspects of wellness, including diseases or an elevated risk of Earn 1 000 Vitality Health points
exercise, nutrition and stress. developing a lifestyle-related disease. for completing the necessary
It provides a view of your current ....................................... 5 000 points advanced health screening tests
health and helps to identify lifestyle and vaccinations, administered by a
factors that may put you at risk Your Vitality Health Check healthcare provider.
of developing health problems. includes:
Earn up to 3 000 Vitality Health points
....................................... 2 000 points 01 | Blood pressure
when you upload confirmation via the
02 | Blood glucose
Vitality app.
Complete the non-smoker’s 03 | Cholesterol
declaration 04 | Weight assessment ....................................... 3 000 points
Earn points for declaring your
Earn an additional 2 500 points for
smoking status............. 1 000 points
each measure in the healthy range.
All Vitality Health Check points will
be allocated once you upload your
results via the Vitality app.
PG 16 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
IMPROVE YOUR HEALTH
25% OFF
Get active and get rewarded a Garmin
with Vitality fitness
Vitality encourages employees to get active and rewards them for doing so. Employees can earn weekly coins for
reaching weekly personalised exercise goals and spend them on a range of exciting products in the Vitality Mall.
device
GET ACTIVE ACHIEVE FITNESS GOAL GET REWARDED
Track your physical activity through Personalised, dynamic physical Vitality members earn weekly
linked wearable devices. activity goals are set weekly rewards for achieving their
and are delivered through the physical activity goals.
Vitality platform.
TO HELP EMPLOYEES
GET ACTIVE
Vitality members will receive an upfront
25% discount when purchasing a new
Garmin device.
Members need to follow the steps on
the Vitality app and place their order
online. The discount will be applied
at point of purchase and will be
subject to annual limits.
AVAILABLE FROM 1 FEBRUARY 2022 AVAILABLE FROM 1 APRIL 2022
PG 17 | VitalityShared-value | Health Insurance | Product platform | Cover options | Healthcare networks | Vitality | Servicing channels
Seamless servicing capability for members
To provide a seamless servicing experience, all employees will have access to 24/7 telephonic and email support in both English and French.
In addition, there will be a range of digital self-service and healthcare functionalities on both the Vitality Health International website and app
to put employees fully in touch with their healthcare cover.
View health insurance Conduct virtual
benefits, cover, consultations with
and authorisations in-network healthcare
practitioners
Submit requests for key
services such as Travel Access digital
for Treatment services membership card
Link to Vitality app
Search for healthcare
practitioners and book
virtual consultations
www.vitalityhealthinternational.com
ONBOARDING, QUOTES & CONTRACTS GENERAL QUERIES
Onboarding@vitalityhealthinternational.com HealthInsurance@vitalityhealthinternational.com
PG 18 | Servicing channelsVitality Health International Health Insurance is provided by Vitality International Health Insurance Company, registration number 134817C, and is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07,
an authorised financial services provider. Terms, conditions and limits apply.
The Clinic by Cleveland Clinic online medical second opinion programme is brought to you by Discovery Health (Pty) Ltd; registration number 1997/013480/07, an authorised financial services provider and administrator of medical schemes.
This document is only a summary of the key benefits and features of Vitality Health International, awaiting formal regulatory approval.
RCK_82721DH VHI_29/09/21_V17You can also read
