Outlook for future health covers

1. Outlook for future healthcovers by Lorenz Stampfli, Chargé des assurances CERN (DGU-LS)

2. Incentives for exploring alternatives • Problemswithillness and accident cover of MPAs, Users, scientificvisitorscoming to CERN • Solutions for persons and families by local schemes not alwaysappropriate • Duty of care of employers and home institutes • Persons to insuretaken as a group attractive for collective solutions ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli

3. Parameters for an alternative approach • Due consideration to specificroles: CERN = host lab, not employer emissaryentities = employers, home institutes individuals = insurancetakers • tender for a collective insurancecontract • search for subsidiaryinsurance type ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli

4. Tentative call for tenders done • With help of CERN'sprofessionalinsurance broker • quotationaskedfromsome 15 insurancecompanies • responsefrom carriers usingsuchinsuranceproducts in IGOs, NGOs and multis • twooffers of particularinterest ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli

5. The mostinterestingoffer: • Affiliation without questionnaire - validated by insurancecertificate • World widecoverwhenneeded forillness and accident • Maximum indemnitylimit 2,25 million € p.p./p.a. • Hospitaltreatment in privatesector, 100% cover of effective costs (pharmaceuticals, surgery, doctors’ fees) • General medicine: 100% coverof generalpractitionersand specialists, medicalimaging and otheranlysis, pharmaceuticals, osteophaths and othermedicalauxiliaries; urgent dental treatments; breach of optical glasses and lenses • Cover of medicalevacuation and repatriation • Insurancecanbetaken per months, weeks, days; hotline/helpdesk services • Premium 1,55 CHF p.p./p.d. for 1 year ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli

6. Conditions for the implementation of such an insuranceproduct • The collective contract must besigned by a legalentitythataccepts to guarantee the payment of the individual premiums  to check withCERN’srules and procedures • A setof individual data must becollected and managed to operatesuchinsurance • name and first name of the insuredpersons, • date of birth, • date of entry into and • date of departurefromcontractscheme  to clarify by a feasibilitystudy • The premium collection per month, includingcontrolling and transfer, has to beorganised  to studya management project • At a later stage, simplification of rules and proceduresmaybesought (e.g. collective lump sum premium (« prime forfaitaire ») on the basis of accumulatedexperience) Most important: Allinterested parties (individuals– employers,home institutes – CERN as host) willhave to play an active role. ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli

7. Final Remark The only effective question of the dayis: Do we continue withthisproject Yesor No ? ACCU Meeting 98, 7 Dec. 2012 - L. Stampfli