What is Hollard Health?
The Hollard Health product is an internationally administered healthcare insurance solution targeted at key local management, regional expatriates and globally mobile staff. It is the ideal solution for multinationals operating across Africa, providing locally admitted (and therefore compliant) insurers as well as a value for money benefits.
We have a combination of a web-portal and an app which provides our members full visibility on their personal information, the policy benefits and our Network. They can submit and track their claims on these platforms. If they need a personal touch, they can contact us 24/7/365 on our call centre. In several countries we have toll-free and local phone numbers, as well as a call-back service if they just let the phone ring twice, but we are finding that, more and more, people prefer our digital chat functionality.
We will always have team members available who speak English, Portuguese and French. For other languages we can tap into our diverse team as well as a professional translation service. We want to be sure that your people can be assisted in the language they feel most comfortable speaking, knowing that some of the conversations that take place can be stressful.
We know that when you have paid for treatment out of your own pocket, it is important to get back what is due to you as quickly as possible. Once all the information is submitted to us, we strive to pay 90% of our members in less than five working days.
Everyone has a digital card within their app but we can also provide a physical card – you will be able to specify if you require both.
For non-emergency treatment, pre-approval must be obtained from us. Our goal is to provide 80% of the necessary approvals to the member and/or the provider within three working days and the balance within five working days. For emergency hospital admissions, we must be informed within 48 (forty-eight) hours unless there are extenuating circumstances. When there is a medical emergency our network providers know, first and foremost, to focus on providing you with the emergency care you need, and we work together in the background to provide the necessary approvals within two hours.If a member does not comply with these requirements, we will apply a penalty of 25% (twenty-five percent). This means that a reimbursement of only 75% (seventy-five percent) of the amount due will be paid.
If a group of 10 or more employees is enrolled, we may waive the requirement for medical underwriting. Our decision will be based on our assessment of the risk profile of the group. If we waive the requirement for health declarations, it means that there will be immediate and full acceptance of the employees and dependents you want enrolled.
In most cases we will give the option for an exclusion of the medical condition, that led to the loading to be applied. But there are some conditions that have a wide-spread affect on many systems in the body, in which case we will not approve the option for an exclusion. That said, we will always recommend accepting the loading, to ensure that the individual has the cover they need to take good care of their health.
If there are more than 10 employees, there should be no impact at all, we will follow through on any treatment that has already been approved by the current insurer, so long at this is in line with our policy limits, conditions and exclusions. If there are less than 10 employees, we may apply a loading or exclusion in the medical underwriting process.
The employer sets the rules for who may be included on the policy and may choose from one the following rule sets:
a) Compulsory for all employees only
b) Compulsory for all employees and their dependents
c) Compulsory for a specific category of employees
d) Compulsory for a specific category of employees and their dependentsThe category of employees will be declared in the application form.
The purpose of categorisation is to ensure that a clear group of individuals can be defined and that all employees who fit into this description will be included.
The following people, who are financially dependent on the main insured person:
a) Legal spouse or spouses (or legal partner or legal partners)
b) Unmarried children until the end of the insurance year in which the insured child turns 26 years of age6