home Instruments

Large insurance companies dms. VMS programs for individuals. Among the advantages of buying a voluntary medical insurance policy in the company "reso-guarantee" can be identified

7722 views

The Association of Private Clinics of St. Petersburg for the third time compiled a rating of insurance companies selling VHI policies to St. Petersburg residents.

In 2015, the voluntary health insurance market formally grew, but in reality it narrowed. The volume of fees for VHI increased in St. Petersburg by 1.6%. But we must take into account the rise in prices: VMI policies have risen in price by an average of 5-15%, services in city clinics - by 10-12%.

Employers, who form at least 90% of the total voluntary health insurance budget by purchasing VHI policies for their employees, reduced these costs. Many small companies have simply excluded VHI from their social packages, large and medium-sized businesses have optimized VHI programs by reducing the choice of medical institutions or refusing to insure employees' relatives.

How these difficult conditions affected the cooperation of private medical clinics with insurance companies is demonstrated by this rating.

Payments to private clinics

The table below shows the total rating in terms of the volume of payments according to a survey of clinics and the site site.

1. RESO-Guarantee
2. Alliance
3. SOGAZ
4. Rosgosstrakh
5. VTB Insurance
6. AlphaInsurance
7. Renaissance Insurance
8. Consent
9. Ingosstrakh
10. Capital-Policy
11. Medexpress
12. MetLife
13. Hyde
14. Liberty Insurance
15. UralSib
16. VSK
17. British Insurance House
18. Energogarant, North European Branch
19. KRK Insurance
20. GSMK City medical insurance company
21. ZHASO
22. MAX
23. Energogarant, North-Western regional branch
24. Transneft
25. CapitalInsurance
26. Absolut insurance (former ISK Euro-Policy)
27. Surgutneftegaz
28. ANCHOR
29. Swiss Garant
30. Investments and Finance
31. Advanced insurance
32. Regionguarantor
33. Insurance business group
34. Support (ex. Opening insurance)
35. HELIOS
36. Spassky Gate

Payment discipline

The level of payment discipline of insurance companies reflects the presence of debts to clinics for 2015 as of April 1, 2016 and the accuracy of meeting payment deadlines in accordance with the terms of the contract throughout 2015.

1. Investment and Finance, HELIOS
2. Insurance business group
3. MetLife
4. Swiss-Garant
5. British Insurance House
6. Alliance
7. Absolut insurance (former ISK Euro-Policy), Surgutneftegaz, VSK, SOGAZ, Rosgosstrakh, Renaissance Insurance
8. RESO-Guarantee
9. Energogarant North European Branch, Medexpress
10. ANCHOR
11. ZHASO, Capital Insurance
12. AlfaStrakhovanie, Liberty Insurance
13. KRK Insurance, Transneft, Regiongarant, Energogarant North-West Regional Branch
14. Advanced insurance
15. Capital-Policy
16. Ural Sib
16. Spassky Gate
17. Support (ex. Opening Insurance)
18. Ingosstrakh, GSMK (City medical insurance company)
19. Hyde
20. Consent
21. MAX
22. VTB Insurance

The list of insurers with debts for 2015 to the clinics of the Association of Private Clinics as of March 30, 2016 included only 13 insurance companies. Note that this list has been reduced compared to last year, and in general, the financial discipline of reputable insurers has increased. This is a positive trend, it speaks of the good financial condition of the St. Petersburg insurance market.

It is also important that insurers have debts to no more than 10% of the surveyed clinics.

In general, doctors admit that insurers have begun to advance medical services noticeably more. On the one hand, this is required by clinics, trying to reduce financial risks, on the other hand, insurers themselves are ready to advance clinics, provided they are given discounts.

Availability of call centers

The quality of work of call-centers of insurance companies was assessed by their availability for doctors of clinics when it is necessary to coordinate medical services.

1. Support (ex. Opening Insurance)
2. ANCHOR
3. Regionguarantor
4. Energogarant, North European Branch
5. Energogarant, North-Western regional branch
6. KRK Insurance
7. Swiss-Garant, Capital-Policy
8. Insurance business group, VSK, Capital Insurance
9. ZHASO, Transneft
10. British Insurance House
11. Surgutneftegaz
12. Ural Sib, Gaide
13. MetLife
14. Advant insurance, Spassky gates
15. Alliance
16. GSMK City medical insurance company
17. Liberty Insurance
18. Absolut insurance (former ISK Euro-Policy)
19. Renaissance Insurance
20. Investments and Finance
21. SOGAZ
22. MAX
23. Consent
24. VTB Insurance
25. AlphaInsurance
26. Medexpress
27. HELIOS
28. Rosgosstrakh
29. RESO-Garantia
30. Ingosstrakh

The quality of VHI programs

The quality of medical programs was assessed according to such a criterion as the volume of coordination of medical services, which, in fact, reflects the volume of medical care available to patients under VHI or the level of restrictions (exceptions) under insurance programs.

Since clinics are interested in programs that do not limit the quality of treatment, companies that have full programs prevailed ranked higher in the ranking.

1. MetLife
2. AlphaInsurance
3.Capital Insurance
4. VTB Insurance
5. Alliance
6. Capital-Policy, VSK, British Insurance House, Rosgosstrakh
7. SOGAZ
8. Absolut insurance (former ISK Euro-Policy)
9. Liberty Insurance
10. Transneft
11. Medexpress
12. Renaissance Insurance
13. Consent
14. Hyde
15. GSMK City medical insurance company
16. Ural Sib
17. MAX
18. RESO-Guarantee
19. Insurance business group
20. Spassky Gate
21. Surgutneftegaz
22. Support (ex. Opening insurance)
23. Energogarant North European Branch, Swiss-Garant, Ingosstrakh
24. Advanced insurance
25. JASO
26. Regionguarantor
27. Energogarant North-West Regional Branch
28. KRK Insurance
29. Investments and Finance
30. ANCHOR
31. HELIOS

“In 2015, a trend that appeared two years ago was clearly visible: a decrease in the level of control from the call centers of insurers. Insurers want to spend less on call center maintenance and give doctors more power to make their own decisions about insurance events. In general, this trend cannot but rejoice, as it is aimed at increasing the satisfaction of the insured patient, increasing efficiency and reducing costs for both parties, teaching doctors to better understand the principles of insurance and the rules for working with VHI programs,” explained the General Director of the Association of Private Clinics of St. Petersburg Alexander Solonin.

Quality of administration of the process of medical and economic expertise

This rating was calculated according to two parameters. The first is the quality of expert opinions. The clinics assessed whether there were valid reasons for refusing to pay and how persuasive they were for the doctor (see Table 5).

The second criterion is the timing of execution and transfer of expert opinions to clinics (see Table No. 6).

1. MetLife, AlfaStrakhovanie, Capital Insurance, Capital Policy, Transneft, Insurance Business Group, Spassky Gates, Surgutneftegaz, Opora (former Otkritie Insurance), KRK Insurance, Regiongarant, Investments and Finances, YAKOR, HELIOS, ZHASO
2. Renaissance Insurance
3. Alliance
4. Ural Sib, British Insurance House
5. Medexpress
6. SOGAZ
7. MAX
8. Liberty Insurance, Advant Insurance, Energogarant North-West Regional Branch, VTB Insurance, VSK,
9. Hyde
10. Swiss-Garant
11. GSMK City medical insurance company
12. Rosgosstrakh, Absolut Insurance (former ISK Euro-Policy), Energogarant, North European Branch
13. Consent
14. RESO-Guarantee
15. Ingosstrakh

1. MetLife, AlfaStrakhovanie, Capital Insurance, Capital-Policy, Transneft, Insurance Business Group, Spassky Gates, Surgutneftegaz, Opora (formerly Otkritie insurance), Regiongarant, KRK Insurance, Investments and Finance, ANCHOR, HELIOS, Renaissance Insurance, Alliance, Ural Sib, MAKS, Liberty Insurance, Advant insurance, Energogarant North-West, Gaide regional branch, Swiss-Garant, Rosgosstrakh
2. British Insurance House, Medexpress, VTB Insurance, VSK, GSMK City Medical Insurance Company, Absolut Insurance (former ISK Euro-Policy), Energogarant North European Branch, RESO-Garantia
3. ZHASO
4. SOGAZ, Consent
5. Ingosstrakh

1. RESO-Garantia, SOGAZ
2. Renaissance Insurance
3. VTB Insurance
4. Alliance, Capital-Polis
5. Alpha Insurance, Liberty Insurance, British Insurance House
6. Medexpress, MetLife, Ingosstrakh, Rosgosstrakh
7. Absolut insurance, VSK, Gaide, Transneft, Energogarant (North-Western branch)

The sympathies of the clinics remained on the side of IC RESO-Garantia. It should be noted that Renaissance Insurance and VTB Insurance, which last year occupied positions 5 and 6 respectively in the trust rating, were also among the top three in this indicator. They managed to move such large insurers as Alliance, Capital-Policy and Rosgosstrakh. However, taking into account all other evaluation criteria, the final rating of insurance companies looks different.

In the final table, the places are distributed on the basis of a multiplicative indicator of business reputation according to the 6 criteria listed above. Thus, according to the results of 2015, IC RESO-Garantiya moved from the first place to the third one, SOGAZ remained on the second one, and Alliance became the leader of the rating.

1. Alliance
2. SOGAZ
3. RESO-Guarantee
4. Renaissance Insurance
5. AlphaInsurance
6. Capital-Policy
7. Rosgosstrakh
8. VTB Insurance
9. MetLife
10. Medexpress
11. Liberty Insurance
12. British Insurance House
13. Consent
14. VSK
15. Hyde
16. UralSib
17. Ingosstrakh
18. CapitalInsurance
19. Energogarant, North European Branch
20. Transneft
21. ZHASO
22. KRK Insurance
23. GSMK City medical insurance company
24. Absolut insurance (former ISK Euro-Policy)
25. Surgutneftegaz
26. MAX
27. Energogarant, North-Western regional branch
28. ANCHOR
29. Insurance business group
30. Swiss Garant
31. Investments and Finance
32. Regionguarantor
33. Support (ex. Opening Insurance)
34. Advanced insurance
35. Spassky Gate
36. HELIOS

This time, in addition to private clinics that are members of the SRO "Association of Private Clinics of St. Petersburg", 11 other large medical organizations actively working on the St. Petersburg VHI market were involved in the survey. As a result, the total number of respondents was 49 medical companies, which together manage more than 150 private clinics in our city. The questionnaires were filled out by heads of clinics, medical experts, heads of departments and employees of financial services.
This year, VHI market experts have developed a fundamentally new methodology for compiling the rating, which makes it possible to combine indicators according to several criteria that were previously evaluated only separately.
1) The volume of payments transferred to private clinics this year was taken into account both according to the data of clinics and according to information on payments from insurance companies (according to reports for the Central Bank from the website, see table No. 1).
2) The level of payment discipline - in the rating of 2016, two indicators were taken into account: the timeliness of payment of invoices in accordance with the contract and the absence of debt for 2015 (see Table No. 2).
3) Availability of call centers (see Table No. 3).
4) The quality of VHI programs (see Table No. 4).
5) The quality of administration of the process of medical and economic expertise - this rating took into account, on the one hand, the quality of expert opinions (see Table No. 5), and on the other hand, the timing of their provision to clinics (See Table No. 6).
6) Trust of clinics (see Table No. 7).

For each of the criteria, a rating was compiled. These ratings were subsequently combined into the final one, taking into account weight coefficients, the value of which varied from 3 to 30% (see Table No. 8). Most big weight- 30% - for the indicator "volume of payments to private clinics", the lowest weight - 3% - for the indicator "compliance with the deadlines for issuing expert opinions". The availability of the call center was assessed with a coefficient of 5%. Obviously, for private clinics, cash flow is much more important than the availability of a call center.
Real players of the VHI market participated in the rating: 36 insurance companies (last year there were 39). From the register of insurers, except for " dead souls» ICs whose license was revoked or suspended in 2015 were excluded. These are Avesta, ASK-med, Gefest, INSOTEK, Oranta, Help, as well as those with whom a significant part of the clinics terminated the contract due to financial problems in the UK.

Alexey KRYLOV, "City 812"

The quality of medical care under the CHI policy is low. VHI programs for individuals become more and more relevant every year. There are several dozen different insurance companies on the market that offer this type of service.

Voluntary health insurance for individuals

The VHI policy allows you to solve many problems related to health protection, receiving medical care. With its help it is possible:

undergo an expensive examination completely within the scope of the policy;
receive the necessary treatment, medications;
advice from specialized experts.

Thanks to the agreement, many services can be obtained free of charge in specialized clinics. It should be noted that the quality of the services provided is an order of magnitude higher than in municipal ones. To receive appropriate assistance, you will need to conclude an agreement. Payment of the insurance premium is carried out within the framework of the agreement. The cost of the VHI program for individuals can range from several hundred to several thousand rubles. The price depends on the list of insured events, other factors.

The insurance algorithm is simple. Includes the following main steps:

in the event of an insured event, the policyholder is obliged to notify his insurer - further instructions will be received;
you should contact the clinic, which is included in the list of partners of the UK - you can clarify information about the service at the front desk.

The main documents are the following:

VHI policy;
insurance contract.

What is the difference between DMS and OMS?

It is legally established that under the MHI policy it will be possible to receive free medical care in any region of the Russian Federation. But there is a list of restrictions. The scope of services received is limited. Some of their types can be provided only for an additional fee. The main legislative document regulating the provision of CHI is Federal Law No. 326-FZ dated November 29, 2010.

The VHI policy allows the client to choose a list of services, insured events - which will be included in the coverage. If they occur, the treatment will be free of charge. Separately, it is necessary to highlight the dental VHI program for individuals. Some companies allow you to independently choose a clinic in which the treatment process will be carried out.

The main advantages of voluntary health insurance:

there is no need for a long wait for a specialist, an appointment queue;
all necessary drugs are allocated under the insurance contract;
the level of services provided in private clinics is an order of magnitude higher than in municipal ones;
flexibility - the client can independently choose which services he will need.

The only negative is the need to conclude a contract every 12 months and pay an insurance premium. The amount of the premium depends on the IC itself.

How is a VHI policy issued?

The process of obtaining VHI begins with the choice of an insurance company. Preference should be given to a large and well-established insurance company. For example, Rosgosstrakh or RESO-Garantia. It's not just about the reliability of these organizations. They often give discounts to new and regular customers hold various promotions.

When the client has decided on the choice of a company, he should familiarize himself with all insurance products and choose the most suitable ones. The best solution is to visit the IC office, contact the manager directly. Looking at reviews on third-party sites will also help you make your choice. The most attention should be paid to the negative. This will reveal all the "pitfalls" of a particular service. The standard set of documents required to conclude an insurance agreement:

application in writing;
passport of a citizen of the Russian Federation;
medical documents.

The latter means medical card from the municipal institution where the specific client is observed.

Rating of insurance companies VHI

The best solution is to choose a policy from well-known and well-established companies. Rating of VHI programs for individuals:

Name of SC	Policy cost	Sum insured	Object of insurance	Advantages
SOGAZ	From 12 thousand rubles	Up to 2 million rubles	Individual / group of individuals	Possibility to choose the list of insured events independently
Alpha Insurance	From 6 thousand rubles	Up to 1 million rubles	Individual / for employees	Insurance rating - A++
Medsi	From 15 thousand rubles	Up to 1.5 million rubles or more	Individuals/children/employees	A large number of promotions, you can get a significant discount
ROSNO	From 8 thousand rubles (base rate)	Up to 2 million rubles or more		Many services, a wide range of clinics to serve
RESO	From 55.4 thousand rubles	Up to 3 million rubles or more	Individual/citizen of any age category	You can create your own insurance program
Ingosstrakh	From 1.4 thousand rubles	Up to 1 million rubles	Individuals/from 1 to 65 years old inclusive	Valid throughout the Russian Federation
SM Clinic	From 11.025 thousand rubles	Up to 1 million rubles	Individuals	Insurance available subject to availability chronic diseases(the list is limited)
Renaissance	From 7 thousand rubles	Up to 1.5 million rubles	Individuals	It is possible to choose the list of services included in the basic tariff
VTB 24	From 4 thousand rubles	Up to 2 million rubles	Individuals	The company has a high reliability rating - A++
UralSIB	From 3 thousand rubles	Up to 3 million rubles	Individuals/collective insurance

VSK Insurance House;
Ingosstrakh;
Rosgosstrakh;
Energoguarantor;
Alpha Insurance;
VTB Insurance;
Metlife;
Capital Insurance.

Less reliable are companies that have been rated A+. The list of those includes the following:

Zetta Insurance;
Agreement;
ERGO Life.

What to pay attention to?

When choosing an insurance company, you should pay attention to a number of nuances:

having a license;
agreements with medical institutions in which the treatment process will be carried out;
selection of required services;
premium calculation process.

It is important to carefully read the insurance contract. Not all health problems are covered by the policy.

For example:

if it is required to replace the seal with a better one, then such work will have to be paid;
if the client asked for help with acute toothache - such a case is just insured.

It is important to remember that there is a payout limit. Each visit to the doctor is paid accordingly - the clinic issues an invoice to the insurance company. If the limit is exceeded, the contract terminates. It is important to note that issuing a VHI policy is a right, but not an obligation, of all companies. Therefore, there may be a denial of service - without explanation.

It is difficult to choose a VHI policy on your own due to a large number products. The solution may be to contact a special broker.

General situation in the market of voluntary medical insurance

According to the results of 9 months of 2015, it grew by only 3%. Unlike other types of insurance -, or, which are pretty feverish for various reasons, VHI remains a kind of safe haven, where everything goes on as usual and without big shocks.

According to the figures, VHI for 3 quarters has changed as follows. Collections of insurance premium amounted to 108.5 billion rubles, having increased by 3.2% compared to 2014. Insurance indemnity payments grew a little faster - plus 5.8% to the mark of 73.5 billion rubles.

The overall payout rate (the ratio of payouts to fees) increased by 1.6 percentage points to 67.7%.

Market Concentration

As far as the concentration of the market in the hands of the leading players is concerned, here VHI keeps pace with all other types of insurance.

For 9 months of 2015 30 largest companies accumulated 91.7% of all fees in the country. A year earlier, this figure was 90.1%.

The main reason for the increase in concentration is the policy of the Central Bank of the Russian Federation, aimed at systematically clearing the market of unscrupulous insurers. The revocation of licenses frees up market shares, which are naturally distributed among existing players.

There is no need to talk about monopolization, because within the "thirty" fees are distributed fairly evenly. With the exception of , which, thanks to an emphasis on the needs of the oil and gas sector, holds a third of the entire VHI market. Which mirrors , where a third of the fees fall on .

Top 30 VHI insurers

Now let's take a look at how the rating of the largest insurance companies for VHI looks like.

The first is the castling of companies and , which exchanged 3rd and 5th places, respectively. Despite the fact that VHI became the main priority of the Alliance, the active restructuring of the company and the rejection of a number of types of insurance still affected medical fees (minus 11%).

The second - breaking into the top ten. After declaring a fight against auto insurance and opening its arms for VHI, the company is actively increasing its turnover - an increase of more than 70% in the volume of collections in 2014.

The most interesting, as usual, is at the bottom of the ranking.

4 newcomers appeared in the top 30 at once. Companies , Independent Insurance Group and have significantly improved their collection rates and confidently took their debut places in the "thirty" leaders.

Of the significant falls, only it left a mark, with the proviso that in 2014 the insurer took 32nd place with fees of 301 million rubles. Back in early 2015, the company completely curtailed the health insurance business, and in November the Central Bank of the Russian Federation revoked its license.

Keep for updates. Analytics on the ratings of insurers is published on a regular basis.

The share of Russians' spending on health care in the total amount of their spending has increased from 2.2% to 3.6% over the past 15 years. This is the reverse side of the state savings on free medicine. It is clear that with such a trend, no one will refuse a voluntary medical insurance policy (VHI), especially if the employer pays for it. But the macroeconomic situation of the last 2.5 years is forcing employers to save on VHI. And workers - to adapt to this savings. How does this affect the position of insurance companies? We analyze the Russian and St. Petersburg TOP-10.

On a federal scale

According to the Central Bank of Russia, the federal fee for voluntary medical insurance (VMI) for 2016 increased by 6.8% compared to the level of 2015, to RUB 137.8 billion. (against 129 billion rubles in 2015).

Detailed processing of all indicators of the insurance market has been carried out by the Insurance Today Group for many years. This time, the assessments of the VHI market were as follows:

DMS. TOP-10: largest insurance companies (Russia, 2016)

№	Company	Income, billion rubles (% of total market)	№	Company	payouts, billion rubles (% of total market)
1	SOGAZ	44,33 (32,17%)	1	SOGAZ	37,81 (37,57%)
2	RESO-Garantia	11,68 (8,47%)	2	RESO-Garantia	8,05 (8%)
3	Alliance Life	9,67 (7,02%)	3	Inogostrakh	6,46 (6,42%)
4	AlphaInsurance	8,99 (6,52%)	4	AlphaInsurance	6,30 (6,26%)
5	Rosgosstrakh	8,04 (5,83%)	5	ZHASO	5,53 (5,5%)
6	Inogostrakh	7,73 (5,61%)	6	Alliance Life	4,56 (4,53%)
7	Renaissance Insurance	5,74 (4,17%)	7	Rosgosstrakh	4,45 (4,42%)
8	ZHASO	5,27 (3,82%)	8	Renaissance Insurance	3,16 (3,15%)
9	VTB Insurance	4,58 (3,33%)	9	VTB Insurance	2,61 (2,6%)
10	VSK	4,30 (3,12%)	10	VSK	2,21 (2,19%)
Total		110, 33 (80,06%)	Total		81,14 (80,63%)
Market total			Market total

Another very important indicator performance of the insurance company (perhaps even more important than the absolute value of fees) - the share of payments from the amount of money collected by the insurer. In 2016, in the VHI market, this share in Russia averaged 73%. For comparison: in the first "crisis" year of 2015, it was 77.3%, in the last relatively "well-fed" 2014 - 76.7%, and in 2013 - 78.2%.

FROMratio of payments and fees, %(Russia, 2016)

№	Company	Payout to Fee Ratio (%)
1	ZHASO	104,98
2	SOGAZ	85,29
3	Ingosstrakh	83,52
4	AlphaInsurance	70,03
5	RESO-Garantia	68,94
6	VTB Insurance	57,07
7	Rosgosstrakh	55,36
8	Renaissance Insurance	55,12
9	VSK	51,35
10	Alliance Life	47,15
Average		73,54

Source: City 812.

As we can see, in the upper part of the TOP-10 in terms of collections, there were mainly such insurance companies, whose share of payments was noticeably lower than in the ideal variant (73-78%). But, apparently, their lack of readiness for payments was compensated by reliability, the size of branch networks and brand awareness.

Regionally

In 2016, 51 insurance companies operated on the St. Petersburg VHI market (it is calculated separately from the regional one), and 6 of the most unfortunate of them sold VHI for amounts from 2,000 to 71,000 rubles.

DMS. TOP-10: the largest insurance companies in St. Petersburg (2016)

№	Company	Income, billion rubles (% of total market)	№	Company	payouts, billion rubles (% of total market)
1	SOGAZ	2,07 (18,86%)	1	SOGAZ	1,82 (24,92%)
2	RESO-Garantia	1,33 (12,06%)	2	RESO-Garantia	0,78 (10,68%)
3	Renaissance Insurance	1,26 (11,50%)	3	Renaissance Insurance	0,68 (9,37%)
4	Rosgosstrakh	0,88 (7,98%)	4	Rosgosstrakh	0,62 (8,47%)
5	Capital-Policy	0,79 (7,20%)	5	Capital-Policy	0,60 (8,23%)
6	Alliance Life	0,78 (7,08%)	6	AlphaInsurance	0,38 (5,22%)
7	VSK	0,499 (4,54%)	7	Agreement	0,36 (4,93%)
8	AlphaInsurance	0,497 (4,52%)	8	Alliance Life	0,35 (4,84%)
9	Medexpress	0,46 (4,21%)	9	Medexpress	0,33 (4,48%)
10	Agreement	0,42 (3,79%)	10	Uralsib	0,22 (3,021%)
Total			Total		6,15 (84,16%)
Market total			Market total

Sources: CBR; MIG "Insurance Today".

As can be seen from the table, VSK, a member of the regional TOP-10 in terms of fees, is not included in the same top in terms of payments, and IG UralSib is the other way around. These two companies destroyed the complete unity of the two regional TOP-10.

It should be noted that in the St. Petersburg rating of the largest VHI insurers, there was a place for two local companies - Capital-Polis and Medexpress. At the same time, they also look quite worthy in the rating based on the ratio of fees and payments (see below).

TOP-10 in terms of the ratio of payments and fees, %(Petersburg, 2016):

Source: City 812.

Due to the discrepancy between the two top 10, we were able to rank only 9 companies out of 51 operating in the St. Petersburg market in 2016. As we can see, in St. Petersburg, IC "Consent" spent money on the treatment of its clients much more actively than in the country as a whole, and "Ingosstrakh" - on the contrary, it did not even get into the top 10 by this criterion.

The best client is a rich foreigner

In 2015–2016, the St. Petersburg VHI market actually stood still in terms of fees. But in each insurance company separately, the results differed more radically.

For example, in the St. Petersburg branch of AlfaStrakhovanie in 2016, fees decreased by 3%. The head of the VHI department of the branch, Lydia Berezka, explains this by the fact that client companies, having retained the number of their insured persons and the volume of services for them, nevertheless choose for some clients more economical options DMS programs.

It is clear that with this approach, savings can only be made by lowering the class of medical facilities.

In turn, in the larger Rosgosstrakh, VMI fees in 2016 decreased by 49.5%. Here there were also such clients who in general have ceased to be insured. Viktor Posokhov, head of VHI at Rosgosstrakh-North-West, says: “Of my clients who had been insured for 10-15 years, about 10% of enterprises stopped insuring under VHI and went nowhere. Those. not a single insurance company agreed to serve them on the terms that they set.”

Victor Posokhov gives a price guideline: the cheapest corporate program, which includes only emergency assistance and emergency hospitalization, costs for large teams 2.5-3.5 thousand rubles per person per year. That is, in 2016, enterprises decided to save on such small amounts.

However, there are insurance companies in the regional top 10 that have demonstrated growth in all criteria - both in terms of the number of insured persons and the volume of VHI programs paid for them. For example, Iphigenia Mayorova, deputy director for health insurance of the branch in St. Petersburg of IC Alliance Life, reported that in 2016 this branch collected 8% more than in 2015. (778.7 million rubles instead of 720.7 million).

“In St. Petersburg, our fees are more or less constant, there is a slight increase. New clients are, first of all, IT companies,” said Iphigenia Mayorova. “In 2016, all our insurers kept VHI for their employees at the same level, and even with an increase.”

At the end of 2016 - the beginning of 2017, renewable medical insurance contracts at Alliance Life increased in price by 5-7%. The same, according to Ms. Mayorova, will happen in 2017.

“This is inevitable, since medical inflation in 2016 was 8.2%,” Mayorova says. – Some medical institutions raised prices in the 4th quarter of 2016, and the rest in the 1st quarter of 2017. On average by 7%.

Ms Mayorova explains the reasons why the fees of this company not only remain, but also grow: “Our clients are mostly foreign enterprises. And by industry - tobacco manufacturers, automakers, programmers. Such enterprises suffer less in a crisis.”

Who is in charge in the "insurer - clinic" pair?

In the past few years, the market has been dictated by insurers. So, Viktor Posokhov (Rosgosstrakh - North-West) says: “The main trend of the past and present years is a decrease in the flow of insured people (and therefore patients) to clinics. Therefore, last year the CSG decided to terminate the contracts with those clinics with which it did not work in 2016 (although there were contracts) or worked in small volumes (5-10 thousand rubles a year is nothing, in fact). We have already terminated 150 contracts out of 480 available, and this process continues. About 50 clinics remain on the priority list. We also convinced the companies that buy VHI of this: it is better to have fewer clinics on the VHI list, but all of them are very reliable, and most importantly, the insurance company should be confident in them.”

Galina Sergeeva, deputy director for personal insurance of the northwestern branch of IC British Insurance House, says the same thing (his fees in St. Petersburg increased by 8.2% in 2016). According to Sergeeva, the outflow of clients in the branch in 2016 amounted to 15%, but the remaining programs did not decrease at all. They did not decrease, among other things, because the BSD carefully selects medical facilities personally for each of its clients.

“Each medical institution makes a decision to change the prices for its services, based on many factors. This is the profile of the medical institution, and the volume of services provided, and the volume of work on VMI, and many others, she explains. “Of course, there is a rise in prices, but not for all types of services ... And not even in all health facilities ... Therefore, we have the opportunity to choose a suitable option for everyone and remain flexible in relation to our clients.”

Small insurance companies are forced to be even more inventive. So, for example, Alexander Lazarev, vice president of IC MetLife (fees in St. Petersburg increased by 9.6% in 2016) says: “Last year, in order to help clients maintain the filling of VHI programs, we began to pay more attention to the issues of medical expertise and evaluate the work of medical institutions on the basis of the so-called medical and economic standards (MES). MEAs are based on the determination of the cost of standard treatment programs. Then, based on this cost, the price for the entire range of services provided to the patient is calculated. He never overpays at all and even saves.

This year MES expects further computerization.

“Our plans for 2017 include automating the processes for processing invoices from clinics,” says Lazarev. “This will not only increase the efficiency of our accounting department, but also allow us to eliminate the subjective human factor when working with our partners.”

Employees are involved in co-financing

According to Galina Sergeeva from the British Insurance House, in 2016 and 2017, compared to 2015, the proportion of corporate clients that offer their employees to partially pay for VHI increased compared to 2015. The employer can pay, depending on his assessment of the employee, from 30 to 100% of the cost of VHI.

Ms. Sergeeva categorically disagrees with the widespread thesis that only those who know about their illnesses in advance and 100% intend to receive VHI treatment agree to co-finance VHI.

“Not all employees refuse additional payments, because people are used to VHI (primarily to the service, as well as to the possibility of choosing a health facility and a doctor), she says. “And an additional payment of 50% of 16-20 thousand rubles (that is, from the price of a business-level program), paid during the year from the salary, is quite feasible for any employee.”