Warba Medical Insurance Services Portfolio

1. Corporate Profile
July 2013

2. About Warba Insurance
 Kuwait Shareholding Company incorporated in 1976.
 The fastest growing general insurance provider in Kuwait.
 Listed on Kuwait Stock Exchange since 1983; Stock Code: WINS
 Capital of KD 17.4/- million. (USD 62 Million)
 S&P Rating : BBB - June 2013
 Operating with the support of a wide network of branches & partners located in
Kuwait & across the globe

3. Table of contents
I. Company profile and strategy
II. Affiliates & Associates
III. Clinical Health Management
IV. WAPMED
V. Apollo
VI. Aetna
VII. Q&A
3

4. Warba Insurance Co
Corporate Profile
and Strategy

5. Vision & Mission
 Vision
an organization that formulates and implements effective policy, provides
timely and accurate insurance solutions, and is capable of providing a
modern, interoperable, sustainable model that can exceed customer
expectation whilst maintaining conservative underwriting of risk
 Mission
to provide effective insurance and risk management solutions that meet the
evolving needs of the clients.

6. Strong sustainable operations
6
 Over the past few years, WIC
has strengthened its position in
its home market.
 Earnings growth has been
satisfactorily high, driven by
strong cash flows, intensive
underwriting activities and an
underleveraged consumer
base.

7. Financial track record
7
 WIC has delivered well on its financial targets
and is committed to improve its performance
levels further whilst maintaining a conservative
risk culture and solid solvency levels.
 Collected insurance premiums on a
comparable basis up 2.5% to 26 M from 25 M
(mainly unit-linked life)
 Strong business volume growth across our
activities / geographic areas, generating strong
commission income and offsetting impact of
flattened yield curve
Gross Premiums
Shareholder Equity

8. Financial track record
8
 Profit from marking-to-markets and realised
capital gains on investments signifcantly
higher than 2011
 Very low credit-risk provisioning (loss ratio:
0.01%) / no net impairments on the
investment portfolio
 Sustained sound non-life underwriting
performance (combined ratio: 4%)
Technical Reserves
Gross Profit

9. 2013 at a glance - business developments
 Strengthening of long-term strategy
 New group management structure
along business lines (start: Mar -13)
 Share buy-back programme
 Enhancement of both cross-selling
and cost-savings projects
 Overseas expansion to further
strengthen the operations
9
 Streamlining of corporate identities of
operations (use of WIC CI)
 Integration of asset management and
investment activities
 Renewal of the long-term strategic
distribution/associative agreements
 Decision to open new branches
(organic growth)

10. Associates

11. Partners in success
Pakistan’s largest
insurance provider.
Serve: 9M clients globally
6k in Kuwait
India’s largest insurance &
investment group
Serve: 100M clients globally
8k in Kuwait
Middle East’s largest
extended warranty provider
Serve: 4M clients regionally
140k in Kuwait
Kuwait’s largest passport &
visa processer serving Indian
& Saudi embassies
Serve: 230k clients in Kuwait
Northern Europe’s largest
private healthcare
company
Serve: 10M clients globally
11k in KuwaitWorld’s leading int’l health
insurer for expats
Serve: 15M clients globally
16k in Kuwait
US’s 2nd
largest health care
management organization
Serve: 65M clients globally
24k in Kuwait
Kuwait’s leading third party
medical services administrator
Serve: 22M clients globally
80k in Kuwait
Private Healthcare provider
with 9000 hospitals.
Serve: 1.3M patients annually
India’s largest housing
finance group
Serve: 50M clients globally
6k in Kuwait

12. WAPMED
Global Quality TPA Services
within your grasp

13. WAPMED
 WAPMED is a Joint Venture between Bukhamseen Group (Kuwait) which is a very reputed
business group in GCC and Family Health Plan Ltd (Apollo Hospitals Group – India)
 First Licensed Third Party Administrator (TPA) established under the laws of Kuwait.
 Operated by qualified, well experienced leaders in the field of health insurance TPA services
 Offers a complete suite of healthcare services complementing health care plans
 Casts wider spectrum of coverage of health care benefits for members and families
 Administers medical benefits for organizations groups
 Liaison with insurance companies to best design the product suit that fits client needs

14. Worldwide Service Footprint
 Over 6000 Network Providers
 Spread Across 33+ Countries
 & 5 Continents
 & Growing…

15. Full Cycle Administration
 Coverage Customization
 Insurance provider liaising
 Enrollment & ID dispensing
 Creation of Universal Health Identification
UHID
 Access to health network providers
 Telephonic Help Desk information resources
and services
 Personalized Client Services
 Managed Care Information System for efficacy
of health plans for all stakeholders
 Case Management Services to monitor quality
of deliverable.

16. Client Oriented
Discounts on Services
through aptly
negotiated Tariffs
across the globe
•Statistical Cost Tracking
•Negotiated MoU Tariffs
•Strict risk assessment
techniques
•24 Hrs Call Centre
•Dedicated Helpline
•Personalized services
•Email services
•24 x 7 assistance
•Health Talk Shows
•Educational Mailers
•Health Checkup Camps
•Completely Personalized
Health Assistance Services

17.  M-Care application tested for
managing over 22 million lives
 Capable of handling e-claims &
capturing ICD, CPT & PCS codes
(Master driven)
 Thoroughly tested platform over 12
yrs
 Exposed to handle variety of policies
from international market especially
Middle-East
 Service Modules customized &
designed to cater policies providing
Out Patient (OP) coverage
 Supports both single currency &
multi-currency platforms to cater
local & international policies
Claims Processing

18. FHPL – Family Health Plan Limited
 Main backer of WAPMED
 Subsidiary of Apollo Group of Hospitals
 Licensed TPA with decades old experience in Indian Health Insurance
 Only ISO & CRISIL Certified TPA in India
 Offering service to over 70 million through network of 4500 hospitals
 Only TPA to design and implement HMO in India

19. Apollo
Touching Lives

20. Apollo
 54 Locations
 9000 beds
 65000 employees
 Touched 32 million lives
 7 million Preventive Health Checks
 Patients from 120 countries
 1,30,000 Cardiothoracic Surgeries
 Over 10000 Joint Replacements
 First Liver Transplant in Children and Adults & First Multi Organ Transplant
 Over 8400 Kidney Transplants
 Over 500 Bone Marrow and 1165 Liver Transplants

21. An integrated healthcare enterprise
Specialties:
Heart • Orthopedics • Spine • Cancer Care • Gastroenterology • Neurosciences • Nephrology & Urology • Critical Care • Preventive Health
Alliances :
AIG International Group • American Life Insurance Company • Vanbreda • International SOS • Seven Corners • Companion Global Health •
Emergency Assistance Japan • GMC Services • International Claims Service • Prestige International

22. Apollo InnovationApollo Innovation
andand
Quality AwardsQuality Awards
Hospital services
Clinical services
HR practices
Community service Environmental conservation
Financial management
Full Cycle Clinical Service

23. Worldwide Footprint in all Medical fields

24. Aetna
Better Health Today

25.  World leading global diversified health benefits company.
 Serves approximately 44 million people with information and resources .
 Broad range of traditional /consumer-directed health insurance products and related
services, including :
 Medical • Pharmacy • Dental • Behavioral health • Long-term care • Disability plans
 Medical management capabilities and health care management services.
 Committed to helping create a stronger, healthier global community by delivering effective
health management solutions worldwide.
 Health Management business collaborates with health care systems, government entities
and plan sponsors worldwide.
 Recently appointed by the National Health Insurance Company (NHIC) of Qatar to support
development of its capabilities for clinical case management, disease management and
advanced analytic reporting.
Aetna

26. Total Population Health Management
• Cardiac Rehab.
• Physical Therapy
• Maternity Management
• Exercise
• Healthy Eating
• Stress Management
• Nutrition Counseling
• Metabolic Syndrome
• Weight Management
• EAP
• Smoking Cessation
• Back Health
• Disease Management
• Behavioral Health
• Wellness Coaching
Improving Health and Reducing Risk
Health/low risk
At risk for
disease/injury Managing
a chronic
disease Major health
events
16% per year23% per year
Natural Risk Migration
(avoid risk save $$$$) (reduce risk save $$$)

27. Global Footprint
Core Business Operations
Compliance
Network
Support Services
Claims Processing
Multiple Languages
Multiple Currencies
24/ 7 working consultants
Health Care Management
Gov’t administrative services
Gov’t financial services
Gov’t value added services
Member Services
30 Languages
24/7/365
Professional CSR service
Dedicated Plan Sponsor Services
Plan Setup & Implementation
Billing
Ongoing account maintenance
Medical Directors
Business Strategies
International Standards
Medical Care Delivery

28. Fully Integrated Clinical Solution
Root CausesHealthcare System Problems
Data Fragmentation
 Historical claims and non-claims data
reside in multiple non-integrated
sources
Knowledge/Care Delivery Gaps
 The lag between the discovery of more
effective forms of treatment and their
incorporation into routine patient care
averages 17 years
Lifestyle Decisions
 Unhealthy behaviors lead to increased
health risk, adverse events and cost
Care Team Communication Gaps
 Patients and their provider(s) typically
make decisions with incomplete
information leading to sub-optimal
coordinated care
 Between 44,000–98,000 people die in
hospitals each year as a result of
preventable medical errors.
 Medical errors for hospitalized patients
cost roughly $2 billion annually.
 More than 50% of patients with
diabetes, hypertension, tobacco
addiction, hyperlipidemia, CHF, asthma,
depression and chronic atrial fibrillation
are currently managed inadequately.
 More than 70% of cancers, heart
disease, stroke and diabetes are
caused by poor lifestyle.

29. Key Tenets
 Actively facilitate patient, provider and
Aetna relationship to improve health care
quality and lower total costs
 Meet providers and members where they
are, at natural points of interaction
 Apply evidence base into everything we
do, to influence the way care is accessed
and delivered through our networks and
programs
 Deliver relevant information and decision
support to members and providers to
facilitate improved quality and cost
effective health care decisions
 Reduce provider complexity and improve
transparency through information sharing
and innovative payment models
 Enable and incentivize members to drive
sustainable healthy behaviors
Healthcar
e
Provider
Plan
Member
Network
Enhancements
Health
& Wellness
Informatics
Plan Design
& Incentives
Provider
Payments
Health
Information
Technology
Aetna’s Clinical Strategy: “Quality and Total Cost”

30. Clinical Health
Management

31. A Persistent Search for Value
Key Players: Wide Variation in Scope, Degree of Integration, & Geographic
Context
Health plans – wide array of benefits and variation in provider network scope
Physicians – solo practice, single specialty groups, multi-specialty groups, groups
linked with hospitals, core of integrated healthcare

Hospitals – individual and system members; various ownership structures
Pharmaceuticals – similar to manufacturers
− In contrast w/ other components, no local barriers exist
− Not addressed, for the most part

32.  Full integration: Hospitals, MDs, and
Insurance in one package:
 Warba has 3 components available
locally and a common incentive
structure
 Partial integration:
Physician/Hospital alliances
 Non integrated. Most common,
insurers contract with all health care
providers
Provider Integration
 Health Plans – national, regional &
international
o Consumer directed – national
players
 Physician Groups – mostly local,
some regional
o Multiple and single specialty local
groups
 Hospitals – mostly local and regional
o Local and regional systems are
commonplace
− Many have a business group
orientation
− Tertiary component in
regional systems
Geographic Orientation

33. Healthcare Expenditure: Recent Facts
 HC (KD) = (price/service) x (services/person) x (people served)
 1990 – 2010 growth accounting breakdown
– 33% - general inflation
– 22% - medical price rises above inflation rate
– 16% - population/ demographic change
– 29% - intensity of service
 Growth in inflation-adjusted HC (KD) per person driven by new technology
and services per person
– Average - 3.6% per year since 2001 but not smooth
 Not Unique to the GCC (1990 -2010)
– Kuwait HC (KD) growth = GDP growth + 2.7%
– Other GCC countries HC (KD) growth = GDP growth + 2.0%

34. Contracts & Risk Sharing
 Labor/Management Contract: Firm manages health benefits or shifts
burden to employees

 Company/Health Plan Contracts: Health plan defines benefit plan
design/scope as well as provider network breadth
 Provider/Health Plan Contracts:
– Prepaid (capitation or salary) or Fee-for-Service
– Fee schedules, discounts, and payment tiers are commonplace
 RX/Health Plan: tiers (typically 3), formularies, & discounts
– Few plans relate to value or benefit of intervention
– Variety of incentives for rebates and substitution
 Direct Contract: Skip health plan but not risk bearing

35. Good Contracts lead to
1. Good Relationships
You get what you pay for :
− More choice of provider, costs
more
− If procedures are rewarded, pay
twice for errors
− Improved outcomes (pay for
performance)
− Short term incentives differ from
long term ones
− Coverage of primary and
secondary prevention
− Payment related to place of
service and access
o ambulatory versus inpatient
coverage
o ER coverage vs. clinic (timely
access? 24/7)
2. Cost Containment
Target/control specific health care
components
Seek increased efficiency of the delivery
system (supply management)
Emphasize primary and secondary
prevention
Provide financial incentives for patients
to reduce their use of medical services
(demand management)
Implement administrative controls on the
use of services
Increase bargaining power by joining
purchasing coalitions

36. Total National Health Management Solution

37. Questions?
Thank you