The situation
A company had renewed its group medical scheme on price for several years. Staff complained about hospitals that were not on the network, slow pre-approvals and maternity waiting periods that reset at each renewal, while the human resources team spent much of the week chasing approvals and reimbursement files instead of doing its own work.
What we did
We sorted a year of complaints into ones the policy actually caused and ones the administrator caused, then took the staff census to the market on that basis. Offers were compared on network hospitals near where employees live, pre-approval turnaround, and how dependants and maternity are treated on transfer, with continuity of service asked for so waiting periods did not restart. Approvals and reimbursements now come through us rather than the human resources desk.
- Sector
- Employee benefits
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