As Integrated Shield insurers pursue profits, they must also uphold a social contract

NEARLY three million policyholders who maintain Integrated Shield Plans (IPs) have endured multiple changes over the past decade. These include the requirement for a co-payment in riders. More recently was the Cancer Drug List, where the IP base plan will cover only drugs on the list. More changes are in the offing. Just last year, the Medishield Life (MSL) review made a slew of recommendations, including enhanced benefits for MSL, higher deductibles and higher premiums. Some recommendations will have a knock-on impact on IPs which is not yet evident. MSL is the basic, compulsory plan that is activated to meet the first layer of a claim.

At what point do changes become intolerable? Put another way, what is the threshold at which policyholders begin to feel that the changes have unfairly deprived them of benefits? The most recent development, as reported in The Straits Times, is that Great Eastern Life (GE) has substantially reduced the pro-ration factor that applies when policyholders seek treatment in a higher-class ward than their plan entitlement.

For instance, a policyholder with a Class A public hospital plan, who chooses to be treated in a private hospital, will have just 35 per cent of the bill covered – down from 70 per cent. The pro-ration factor for a Class B1 policy is also being reduced from 50 per cent to 25 per cent for private hospital treatment, and from 80 per cent to 70 per cent for Class A treatment.