Overview of the health insurance sector in SouthEast Asia, presented by Susan Fanning to the mHealth Israel community, April, 2020. Sections include Challenges / opportunities in SEA, health systems for health insurance, relationship between private health insurance and public services, individual health, group life and health, medical inflation, insurer participation in healthcare innovation, future opportunities to evolve health insurance, role of digital health in transforming healthcare,

1. Webinar: mHealth Israel
Susan Fanning

2. Challenges / opportunities in SEA health systems for
health insurance
• High medical inflation, typically > 4* general inflation
• Incentives not aligned
• Poor data quality - insufficient data analytics
• Lack of integration of innovation into product design
• Regulation
• Ageing population and increase in lifestyle diseases

3. Private health insurance is interwoven with public health
payment
• This means that MediShield Life is compulsory for all Singaporeans and Permanent
Residents, with no option to opt out, and no requirement to apply.
• MediShield Life covers hospitalisation bill expenses, and not General Practitioner
visits. Coverage is also provided on a as-charged basis, so you don’t get cash
payouts for other expenses.
• MediShield Life covers everyone, regardless of any pre-existing conditions.
• Deductibles, limits and co-pays now standard features
Rebate of up to 80% at public
healthcare institutions
Personal savings scheme for
small health bills
Assistance with larger hospital
and healthcare bills
Safety net to provide help to
needy Sinagporeans
Subsidies
Medisave
Medishield Life
Medifund
Public Health System Integrated Shield Plan
Additional Private
Insurance Coverage
Medishield Life
• Provides additional coverage
(e.g. Private hospital or Class B1
or A wards in public hospitals)
• Managed by a private insurer
• Enough to cover your large
hospital bills in Class B2 or C
wards in public hospitals
• Managed by the Central
Provident Fund CPF Board
Participating private insurers
1. AlA Singapore
2. Aviva
3. AXA Insurance
4. Great Eastern Life
5. NTUC Income
6. Prudential Assurance
7. Raffles Health Insurance
Private Health Insurance

4. Singapore: Individual Health
Total Premium
New Business YTD Q4’18 YTD Q4’19 Q4’18 Q4’19
% change from
corresponding period in
2018
YTD Q4’19 Q4’19
IP and Riders $388.3m $419.7m $96.1m $112.2m 8% 17%
Other Medical
Plans and Riders
$35.7m $46.0m $9.3m $11.3m 29% 22%
Total $424.0m $465.7m $105.4m $123.5m 10% 17%
0
50
100
150
200
Q1 18 Q2 18 Q3 18 Q4 18 Q1 19 Q2 19 Q3 19 Q4 19
11.310.710.6
13.5
9.38.7
8.510.2
112.2110.2113.4
83.896.1104.192.895.5
Source: Life Insurance Industry Results Media Conference | 6 February 2020
New business premium refers to the premium due to the new business sold in the year, as well as incremental premiums from any repricing of plans and change in age-band of the insureds.
$million
IP and Riders
Other Medical Plans
and Riders
105.4
120.9
105.7 101.3
112.8
97.3
124.0 123.5
No. of Lives Covered
Q4’19
0.29m
2.79m
(3.08m)
Total Premium
$215m
$2,108m
($2,323m)

5. Singapore: Group Life & Health
In-Force
0
200
400
600
800
1,000
1,200
1,400
Q1 18 Q2 18 Q3 18 Q4 18 Q1 19 Q2 19 Q3 19 Q4 19
1,030.61,006.6968.1926.6
851.3842.4833.2806.6
347.5333.6327.5324.1320.1315.6307.4300.4
Life Accident & Health
Life
A&H
As at
$million
18%
1,140.6
1,378.1
1,107.0
1,171.41,158.0
1,250.7 1,295.6 1,340.2
Source: Life Insurance Industry Results Media Conference | 6 February 2020

6. Medical Inflation to hit 10% in Singapore 2019
For private health care
Source: Aon Asia Healthcare Trends 2017_18

7. Strong digital health ecosystem in Singapore with
different levels of insurer participation
AIA AXA Cigna Prudential Metlife
• AIA Vitality a science backed
wellness programme to make
real changes to customers
health - includes rewards
• Partners GOVTECH to launch
new digital service using
MYINFO for easier, faster and
safer transactions
• Announced that it will cover the
costs of 50,000 video medical
consultations provided by
WhiteCoat, a Singapore-based
tele-medicine provider for all its
HealthShield Gold Max
policyholders
• Building in-house health
insurance stack
• MYAXA Health app and portal
to allow customers to: check
benefits; locate nearest doctor /
provider; submit and track a
claim
• Launced an insurance-as-a-
service API to make int easier
for digital channels to integrate
their products - as a response to
MAS initiative to foster more
innovation (P&C)
• Piloting new wellness services -
TBD launch date for physical
wellbeing and mental support
• Partners with UEX a start up
focused on expat insurance
• Cigna Virtual Clinic, a digital
innovation that provides
customers with access to
licenced doctors through a
mobile app.
• Powered by Doctor Anywhere, a
tech-focused health & wellness
company
• Harness data integration,
tracking, and analytics in
identifying actionable insights
from key behaviours and trends.
• Insights generated will help
employers and insurers shape
future workplace initiatives to
improve wellness outcomes.
• Pulse an AI-powered app to
cater to your health and
wellness needs.
• Your personal health buddy that
fits in your pocket.
• No one knows you like your
Pulse - health check
• Health assistant - symptom
checker
• Accessible anywhere, anytime,
free to use - video consultation
• Partners include Babylon,
regionally and MyDoc in
Singapore
• Launched LumenLab to pioneer
disruptive innovation in Asia
• Experiment with Vitana -
Singapore’s first gestational
diabetes protection for
executing mothers by
harnessing blockchain
technology
AsiaPac HealthTech ecosystem momentum continued in 2019 despite geopolitical and domestic
headwinds to close at US$5B invested, across 340 deals * Galen Growth Asia

8. Future opportunities to
evolve health insurance
• Value based healthcare
• Consumer demand for a better experience - care navigation
• Distribution
• Role of third party administrators
• Preventative care and wellbeing - promoting health literacy
and shared decision making
• Bring together all healthcare spend
• Pricing and predicting risk using advanced data analytics

9. Digital health is a key focus - but do your due diligence
•Understand type of insurer or distributor or managed care coordinator
•Check what KPIs / metrics they use for product profitability
•Determine whether you are discussing a local / regional / global deal and who can approve what
•Be clear as to whether your product is driving engagement or enhanced profitability? Do you have data to back up your claims?
•What behavioural economics principles and behavioural psychology principles use for engagement
•Openness to using lifestyle data for mortality, but not morbidity
•For morbidity need at least 2-3, ideally 5 years of solid historical data to run analytics on and need to be able to link data
•What is your commercial model? Are you open to shared outcomes?

10. THANK YOU!
SUSAN@HEALYHUB.COM