Health Insurances
Health Insurances
Health Policy is Continuous, Not Annual
The main issue in health insurance is not the first year's premium, but the third year's renewal condition. As the usage rate increases, renewal conditions become stricter; For this reason, plan design should be designed to be sustainable from the very beginning.
In group policies, we periodically report usage data and review the coverage structure and exemption options together with this data. For individual policies, we clarify the lifetime renewal and waiting periods from the beginning.
- Group and individual health plans
- Usage (damage/premium) reporting
Bargaining power in healthcare is not created by premiums, but by regularly kept usage data.
Scope
Coverage Scope
Group health insurance
Inpatient/outpatient treatment plans designed on an institutional basis for employees and their family members.
Individual and family health
Private health coverage with personalized network, limit and co-payment options.
complementary health
Cost-effective structure that covers the difference fees in private hospitals contracted with SGK.
Inpatient and outpatient treatment
Surgery, intensive care, examination, imaging and doctor's examination coverage.
Birth and dental packages
Integration of maternity, dental and eye packages offered as additional coverage into the plan.
Travel health and abroad
Medical expense, evacuation and accompaniment coverage for international travels.
Key Risks
What We Watch in This Area
Lifetime Renewal
A company change made before the renewal guarantee is obtained will reset the acquired rights.
Damage/Premium Ratio
The unmonitored usage rate returns as an unexpected premium increase during the renewal period.
Declaration and Waiting Times
Incomplete declaration and overlooked waiting periods will be grounds for rejection at the compensation stage.
How is it determined?
Data Determining the Health Plan
- Age distribution; Number of employees and dependents in group policies
- Contracted hospital network and city-based access
- Inpatient and outpatient treatment usage habits
- Participation share and limit preferences
- Compliance with existing SSI assurance and complementary structure
- Damage/premium ratio of previous years
FAQ
Frequently Asked Questions
It is the insurer's commitment to renew the policy every year if certain conditions are met. It is an acquired right and as a rule, it must be regained in case of company change.
Disorders that existed before the policy are generally evaluated with an exception or additional premium. Accurate and complete declaration eliminates the risk of future rejection.
Private health policies operate independently of Social Security; Its network and limits are wider. Complementary health, on the other hand, requires being covered by SSI and covers only the difference fee in contracted hospitals, so its premium is significantly lower.
Above a certain number of employees, acceptance may be possible without requiring a declaration and including existing illnesses. We negotiate this threshold and its conditions with the insurer based on group size.
Do You Have a Need in This Area?
Let's assess your risk together and build the coverage structure around your needs.