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1、MMB Health Trends 2023Global insurer survey reportNavigating cost trends and using innovation in employer-provided healthcareMercer Marsh Benefits(MMB)surveyed 226 insurers across 56 countries1 to explore the key trends shaping employer-provided health benefits to produce our Health Trends 2023 repo

2、rt.These trends will be invaluable for employers designing healthcare plans to meet the needs of their businesses and employees.Insurers practices,policy language,flexibility,willingness to innovate and access to large pools of claims data give them a key role in shaping the future of employee benef

3、its.Although COVID-19 continues to influence employer-provided health plans,both directly and indirectly,medical trend across the globe has largely stabilized to approximate pre-pandemic rates.Meanwhile,market innovation continues to offer new opportunities for employers to consider as benefits plan

4、s are modernized.Top trends driving employer-provided health benefits1Per-person medical cost increases are back to pre-pandemic levels.2COVID-19 continues to impact claims experience.3Plan modernization has begun.4Mental health gaps persist.5Plan management requires greater rigor.1 Fielded in Augus

5、t 2022.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare2Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare 3Five key trends driving the future o

6、f employer-provided healthcare The findings of MMBs Health Trends 2023 survey show five key trends influencing employer-provided healthcare for the future.Per-person medical cost increases are back to pre-pandemic levels.68%COVID-19 continues to impact claims experience.55%Plan modernization has beg

7、un.1 in 2Mental health gaps persist.16%Plan management requires greater rigor.More than 1 in 5Plan sponsors must factor forecasted cost increases into budgets and determine how to balance empathy with economics.of insurers expect plan sponsors to prioritize improvements despite forecasted double-dig

8、it medical trend rates in some markets.Insurers say people are experiencing the effects of disrupted care alongside ongoing COVID claims.of insurers report an increase in later-stage diagnosis of illness due to deferred care.Digital health support is rapidly evolving,but there has been limited progr

9、ess on health sustainability.insurers has changed or expects to change eligibility requirements and eligible expenses to make coverage more inclusive for those who identify as LGBTQ+.Despite progress,plans continue to exclude mental health care or provide only minimal coverage.Employers are left to

10、fill the gap in other ways.of insurers report not providing plans that cover mental health services(versus 26%in 2022).Benefits managers must develop more robust strategies and prepare for more complex underwriting and plan design decisions.insurers in Asia are adjusting medical plan premiums based

11、on COVID-19 vaccination status.TrendWhat it meansKey findingPer-person medical cost increases are back to pre-pandemic levels Section 1Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare4Global insurer survey report.MMB heal

12、th trends 2023:Navigating cost trends and using innovation in employer-provided healthcare5Defining medical trendMedical trend is the year-over-year cost increase for claims under a medical plan on a per-person basis,assuming no changes to the benefits provided.This rate growth is the result of a va

13、riety of factors,including:Medical inflation(increase in per-unit costs for the same service/supply)Altered treatment mix(for example,moving to more expensive treatments)Utilization patterns(for example,people not accessing services due to COVID-19-related restrictions)Regulatory changesMedical tren

14、d rates,20192023Although the impact of COVID-19 on claims patterns varies around the world,in 2021,insurers generally saw medical trend rates return to pre-pandemic(2019)levels.This followed a drop in 2020 that resulted from lower usage of medical services because of the COVID-19 pandemic.There is e

15、xtensive geographical variation,with some regions(for example,Europe,Canada,Pacific)slightly exceeding pre-pandemic levels and others(for example,Asia,the Middle East and Africa MEA),Latin America and the Caribbean LAC)coming in just below.With the exception of the LAC region,insurers across regions

16、 also expect medical trend rates to exceed 2019 levels in 2022 and 2023,driven by factors such as increased cost of medical care,increased utilization and later-stage diagnosis of illness(which requires more costly treatment).In 2023,the rate of growth is generally expected to remain steady at 2022

17、levels.Rates for 2019,2020 and 2021 are retrospective.Rates for 2022 and 2023 are prospective.Unweighted global averages used.See Appendix A for a list of estimated medical trend rates by market and data sources.20192020202120222023Global9.7%5.7%10.1%12.7%12.6%Canada6.9%3.9%7.1%7.0%7.0%Asia10.2%3.5%

18、8.9%10.7%11.5%Pacific4.6%5.2%5.0%5.6%5.8%Europe8.0%3.5%10.9%13.9%13.8%Middle East and Africa11.1%9.6%10.2%15.0%13.8%Latin America and Caribbean13.4%8.0%11.1%10.7%11.3%Figure 1:20192023 medical trendGlobal insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in emp

19、loyer-provided healthcare6Global medical trend versus general inflation Soaring inflation rates in the general economy have been a source of concern for individuals and employers alike,with low-paid workers particularly hard-hit.As employers plan their 2023 benefits offerings,including medical insur

20、ance and well-being programs,the impact of inflation will inevitably be an important factor.Global inflation has not affected medical trend to the same extent as energy or food prices.It is likely that changes in claims utilization,such as late diagnosis as a result of the pandemic,are having a mate

21、rial impact on medical trend.Ambiguity in future cost levels abounds in many parts of the world due to economic uncertainty.Because it is particularly difficult to accurately predict medical trend rates in Argentina and Venezuela due to hyperinflation in those countries,they have been excluded from

22、this analysis.In Turkey,a nation seeing significant rates of inflation(60.5%as of July 2022),medical trend is forecasted to be 72.5%in 2022.Undoubtedly,inflation plays a key role,but other factors,such as legislative changes,claims utilization and advancements in technology,continue to drive medical

23、 claim costs.2 Mercer.National Survey of Employer-Sponsored Health Plans 2022.Available at https:/www.mercer.us/what-we-do/health-and-benefits/strategy-and-transformation/mercer-national-survey-benefit-trends.html 3 Bureau of Labor Statistics,Consumer Price Index,U.S.City Average of Annual Inflation

24、(April to April)19932022.4 Rates for 2018,2019,2020 and 2021 are retrospective.Rates for 2022 and 2023 are prospective.Unweighted global averages used for medical trend.See appendix A for additional detail including inflation data sources.US health updateTo capture developments in the US health land

25、scape,which are outside the scope of this survey,Mercer conducts an annual National Survey of Employer-Sponsored Health Plans in the US.The survey found that employers expect health benefit cost per employee to rise 5.6%on average in 2023,3 which is less than US inflation currently about 9%.4 Due to

26、 multiyear insurer contracts with providers,its likely that the full impact of inflation will not be felt immediately but rather will be phased in over the next few years as contracts are renegotiated.Even with sharper cost increases on the horizon,most employers are looking to enhance their benefit

27、s to improve attraction and retention of talent,with 84%of large employers rating this as an important strategy.In line with this sentiment,employers are also aware of how healthcare costs impact their employees and families,particularly with inflation adding financial stress for many.Only 36%of emp

28、loyers are looking to cut costs in 2023 by increasing deductibles or copays.Figure 2:Medical trend rates versus general inflation2General inflationMedical trend rate2.0%0.0%4.0%6.0%10.0%8.0%14.0%12.0%2018201920202021202320223.2%3.4%2.4%4.3%7.3%5.7%4.6%9.7%9.7%10.1%12.7%12.6%7Impact of economic trend

29、s on employer plan design When the survey was fielded in August 2022,globally,68%of insurers expected employers(over the next year)to prioritize plan improvements that address attraction,retention and engagement,as opposed to medical plan cost management/containment.Insurers believe that,globally,le

30、ss than one-third(32%)of plan sponsors will reduce coverage to manage costs.This view is likely influenced by wider workplace trends,including talent shortages,workforce transformation and changing employee expectations.Employers are wise to balance economics and empathy when reviewing plan design.T

31、hey must keep in mind the hardship felt by many employees in the face of inflation.In a tight labor market,an employer may also see an opportunity to differentiate through benefits in lieu of salary increases.On the other hand,they must acknowledge that a recession is likely on the horizon or underw

32、ay already.The focus on prioritizing competitive,valued benefits is particularly significant in Asia and Europe,where the perceived gap between anticipated plan improvements and appetite to reduce plan coverage to manage costs is widest.Figure 3:Based on your experience with recent medical plan rene

33、wals,which of the following objectives do you think most employer plan sponsors will prioritize over the next year?GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaMaking plan improvements to help address attraction,retention and engagement68%73%73%58%56%Reducing plan coverage to

34、 manage cost32%27%27%42%44%Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcareEmployer actions1Continue to engage stakeholders(including the C-suite)on whether to prioritize plan design competitiveness and differentiation to

35、 help address talent attraction,retention and engagement challenges versus cost containment.4Create an intentional strategy to manage plan costs over the long term,including recurring plan review to identify high-value solutions.3Prioritize the benefits and programs that are most favored by each seg

36、ment of employees,assessed through widespread,formal employee listening activities.2Be aware that inflation in the wider economy may further affect medical trend rates,and plan for a higher-inflation environment.Keep a close eye on medical and hospital pricing,and plan for increases in medical trend

37、 costs that reflect increased usage patterns and later diagnosis following COVID-19 lockdowns.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare8Global insurer survey report.MMB health trends 2023:Navigating cost trends and

38、 using innovation in employer-provided healthcare9Three elements of a truly effective health and benefits cost-containment strategy2Manage health risk1Design for valuethrough coverage provisions,network configuration and engagement.through a data-driven approach that promotes a healthy workforce.3Dr

39、ive efficienciesthrough smart financing and placement.Figure 4:Benefits cost-containment pillars COVID-19 continues to impact claims experienceSection 2Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare10The long-term effec

40、ts of lockdown and COVID-19The effects of COVID-19 continue to impact medical insurance claims,even though public life has reopened in most regions.Pandemic risk remains a considerable business risk.MMBs 2022 People Risk5 research highlights that the pandemic was ranked number 4 out of 25 risks by H

41、R and risk managers.The pandemic was ranked the number-one risk in Mexico and South Africa and the number-two risk in Brazil,Hong Kong,China and Malaysia.Lockdowns and infection fears during the pandemic meant that medical diagnosis and treatment for many conditions were disrupted.The after-effects

42、of those delays are being felt in both the volume and costs of claims in 2022.More than three in five insurers(61%)globally say claims patterns have changed in 2022,and 55%of insurers globally report seeing more later-stage illness diagnoses in claims due to deferred care.Global insurer survey repor

43、t.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare115 Mercer.People Risk Report 2022,available at http:/ 5:In 2022,have you experienced changes in group medical plan claims patterns due to deferred care during the pandemic?20%61%19%61%Yes19%No20%Unsu

44、reGlobal insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare12Late diagnosis increases claim costsGlobally and in every region except the Middle East and Africa(MEA),insurers reported cancer as the top cause of claim costs in 2021(

45、the most recent year for which insurers have a full years worth of claims experience)as well as one of the three most frequent causes of claims.Although the claim cost pattern is consistent with pre-pandemic years,insurers are reporting that deferred care and diagnosis has increased the volume of cl

46、aims,with more diagnoses being made at a later stage,further driving up costs.This is supported by external research as well.6,7The cost of COVID-19 claims continues to be a significant factor in Latin America and Caribbean(LAC),but this has become less prominent in all other regions.Figure 6:How ha

47、s the pandemic manifested itself in current(2022)claims experience?All regions saw similar patterns in the way the pandemic influenced claims in 2022:Higher cost per claim due to more advanced treatment as a result of deferred care58%globallyIncrease in utilization of mental health services40%global

48、lyMore later-stage illness diagnoses due to deferred care55%globallyHigher incidence of chronic conditions due to lifestyle changes37%globally6 Maringe C,Spicer J,Morris M et al.“TheImpact of the COVID-19 Pandemic on Cancer Deaths Due to Delays in Diagnosis in English,UK:a Aational,Population-Based,

49、Modelling Study,”The Lancet Oncology,Volume 21,Issue 8(August 2020),pp.10231034,available at https:/www.ncbi.nlm.nih.gov/pmc/articles/PMC7417808/.7 McGarvey N,Gitlin M,Fadli E and Chung KC.Increased Healthcare Costs by Later Stage Cancer Diagnosis,2022,available at https:/ 7:Based on(dollar)amount c

50、laimed,what were the top causes of claims cost in 2021 based on your book of group or overall business?GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaCancerCancerCancerCancerRespiratory conditionsDiseases of the circulatory system Diseases of the circulatory system Diseases of

51、the circulatory system COVID-19Diseases of the circulatory system COVID-19Respiratory conditionsOsteomuscular diseasesDiseases of the circulatory system Endocrine and metabolic diseasesRespiratory conditions Gastrointestinal diseases Gastrointestinal diseases Gastrointestinal diseases Infectious dis

52、easesGastro-intestinal diseases COVID-19Mental conditionsOsteomuscular diseasesCancer12345Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare13Frequency of claims is also shaped by care disruptionOver the last year,cancer in

53、creased from the number five spot globally to the number three spot.In Europe,the number of insurers identifying cancer as one of the top three most frequent causes of claims increased from 27%in 2020 to 41%in 2021.The LAC region experienced an increase in claims related to accidents and conditions

54、derived from violence,with 23%of insurers citing this as one of their most frequent causes of 2021 claims.GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaDiseases of the circulatory system Respiratory conditionsDiseases of the circulatory system COVID-19Respiratory conditionsRes

55、piratory conditions Diseases of the circulatory system CancerCancerDiseases of the circulatory system CancerGastrointestinal diseases Osteomuscular diseasesDiseases of the circulatory system Endocrine and metabolic diseases123Figure 8:Based on(frequency)incidence of claims,what were the top three ca

56、uses of claims in 2021 based on your book of group or overall business?Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare14Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in e

57、mployer-provided healthcare15Claims for COVID-19 continue Although vaccination has helped to reduce the severity of COVID-19 in some regions and parts of the population,the virus continues to feature in the top three causes of claims by frequency,even though prominence appears to be gradually reduci

58、ng in most regions.Figure 9:COVID-19 claims frequencyPercentage of insurers citing COVID-19 as one of their top three causes of claims202020210%10%20%30%33%34%65%23%25%33%33%50%28%22%40%50%60%70%GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaEmployer actions1Promote the importa

59、nce of early diagnosis and regular screening,especially for cancer,as medical services return to normal in some regions.3Continue to encourage working practices that minimize the spread of COVID-19.2Provide workplaces,benefits and tools that allow employees and families to manage their health and we

60、ll-being.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare16Plan modernization has begunSection 3Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthca

61、re17Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare18Insurer innovation is one silver lining of COVID-19COVID-19 has had significant short-and long-term impacts on peoples lives,health risks,costs and diagnoses.However,i

62、t has also driven insurer innovation and plan modernization.This is most evident in the increasing prevalence of new digital tools and services to support well-being and diagnosis,though the increase in 2022 was modest compared to 2021.Telemedicine services,such as video chat with a physician,became

63、 an essential part of insurers offerings during the pandemic.MMBs 2022 figures show that insurers have persisted with these services,suggesting telemedicine is here to stay.This aligns with MMBs Health on Demand 20218 findings,which showed that even among those using telemedicine for the first time

64、during the pandemic,the great majority(77%)intended to keep using the services.Figure 10:Which of the following solutions and services does your typical employer-sponsored group benefits plan cover or provide to members?A telemedicine service that allows the user to video chat or text with any suita

65、ble doctor/nurse assigned by the serviceAn app that suggests possible diagnoses for simple medical issues and recommends types of medical professionalsAn app to find the right doctor or medical care when and where the user needs itInsurance coverage or program that reduces cost of mental health trea

66、tment(counseling,medication)Apps and/or wearable technology to self-manage well-being2022202172%49%39%26%25%70%46%38%22%18%8 Mercer.Health on Demand 2021,available at http:/ insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare19Figu

67、re 11:In response to the changing benefits landscape,what actions are you taking?Building well-being into health plans.Apps and/or wearables to self-manage well-being Already offering:25%Considering it:49%Apps that suggest possible diagnoses for simple medical conditions Already offering:26%Consider

68、ing it:37%Insurers plan to extend their digital portfoliosWe expect a focus on well-being to continue.Our Global Talent Trends 20229 research showed that one in three employees would forgo a pay raise for additional well-being benefits for themselves or their family.This sentiment is shared by organ

69、izations as well,with the C-suite stating that its second-highest-ranked initiative for talent ROI is delivering on total well-being strategies(mental,social,physical,financial).Is home testing the next frontier for remote healthcare?Although digital tools have extended the scope of remote healthcar

70、e for those with access to them,insurers are currently less engaged with home testing,which also has potential to support remote treatment and diagnostics of a wider range of conditions.As employees in most regions will now be familiar with COVID-19 self-testing,they may be more accepting of home te

71、st kits for other conditions.Around one-third(32%)of insurers globally are considering use of home testing for common conditions;for 60%,this is not currently part of their future planning.It will be important to watch this space as new at-home testing product offerings emerge.Insurers are respondin

72、g to a more diverse workforceInsurers future plans show that although many are making changes to their policies and operations that reflect shifts in workplace practices,attitudes and demographics,change is not universal.More than half of insurers are either already implementing changes to communica

73、tions,offering eligibility for part-time or flexible working,and providing inclusivity training for member services teams or plan to do so in the future.9 Mercer.Global Talent Trends 2022 study,available at http:/ 12:In response to the changing benefits landscape,what actions are you taking?Inclusiv

74、e benefit practices.However,almost half(49%)of insurers have no plans to offer new benefits and products for employees who work from home full time(for example,proactive musculoskeletal programs,including ergonomic support).Ensuring member communications incorporate universal design (that is,making

75、sure content is accessible and inclusive for all,including those with disabilities)Providing regular trainings for your member services teams to increase cultural competency and inclusionChanging eligibility requirements to allow coverage for portions of the workforce who may not be permanent full t

76、imeLevelling up health insurance:Theres still work to do For some claimants,social factors,such as additional costs associated with treatment,can have a material effect on their ability to make a full recovery.The majority of insurers are not considering any change to policies for incorporating hous

77、ing,transportation and food into case management or rehabilitation or providing travel benefits that could improve claimants overall health or access to treatment.28%27%made changes in the past year or changes that will go into effect next year.are considering future changes.29%26%made changes in th

78、e past year or changes that will go into effect next year.are considering future changes.32%26%made changes in the past year or changes that will go into effect next year.are considering future changes.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in

79、 employer-provided healthcare20Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare2160%No recent or planned change in incorporating support for housing,transportation and food into case management/rehabilitation activities u

80、nder medical plans52%No recent or planned change in providing travel benefits for services if care is not accessible within a reasonable distance51%No recent or planned change in providing navigation tools to help members access social services from community-based organizationsFigure 13:In response

81、 to the changing benefits landscape,what actions are you taking?Social interventions to improve health equity.Insurers own ESG credentials are mixed Greater focus on environmental,social and governance(ESG)factors in business supply chains means many organizations are looking at how they can evolve

82、business practices to better align with nonfinancial goals that help advance prosperous and healthy societies.Marsh,assisted by Cranfield University,analyzed keywords in the risk sections of annual reports for a set of companies listed on the worlds four leading stock exchanges to gain insight into

83、how businesses evaluate ESG risks.These results point to a concentration across the listed companies analyzed on the environmental aspect of ESG evaluation and less attention to its social and governance facets.10 Given the role they can play in helping to make quality healthcare accessible and affo

84、rdable to all,insurers are in a unique position to lead by example and enhance supports for the full workforce.When it comes to insurers own employment practices,seeing strong emphasis on both employee health and safety(67%)and inclusion across the organization(54%)in our survey is promising.COVID-1

85、9s ongoing influence is evident in more than half(51%)of insurers taking steps to mitigate the effects of infectious disease and chronic conditions.Figure 14:Is your organization taking any of the following steps to advance social progress within its environmental,social and governance(ESG)goals for

86、 its own employees?(top five responses)Ensuring adequate policies and protections are in place to ensure workforce protection and safetyProviding access to paternal leaveProviding sick leaveEstablishing ways to ensure inclusion across the organizationTaking steps to mitigate effects of infectious di

87、sease and chronic conditions67%61%54%53%51%There are some key areas for improvement;for example,just 30%offer access to childcare,although 53%provide access to paternal leave.10 Marsh.Evaluating ESG and Pandemic Risk Trends,2022,available at https:/ actions1Explore insurers plans for future use of d

88、igital healthcare and how this will integrate with their wider care and well-being offerings.Understand and resolve any duplicate services offered by other providers(such as competing telemedicine services)as well as gaps in the benefits portfolio.3Seek to understand insurers ESG credentials as part

89、 of business supply chains,and provide feedback on areas where there is a mismatch between insurers values and those of the organization.2Assess whether insurers offerings are inclusive and meet the needs of all the insured workforce;for example,lower-paid workers included on policies.Global insurer

90、 survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare2223Mental health gaps persist Section 4Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcareGlobal insurer surve

91、y report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare24Mental health is now a major claims risk One of the most significant attitude shifts of recent years has been greater awareness of mental health as an organizational risk and a driver of clai

92、ms.Insurers have also increased coverage of mental health conditions.In 2021,mental conditions were one of the top five causes of claims cost in Europe the first time MMB has seen this as a top-five issue in any region.This shift could reflect the mental and emotional burden of COVID-19 as well as g

93、reater awareness in both the workplace and society of the significance of mental well-being.Also of note is that the Canadian Life and Health Insurance Association(CLHIA)reported aggregate paid claims for mental health had increased 75%between 2019 and 2021.11In addition,emotional or mental risk is

94、now one of the top three influences on employer-sponsored group medical costs in every region except Asia and MEA and the third-largest risk globally.Insurers have responded with increased support for mental health prevention,management and treatment in line with this trend.In MMBs 2021 findings,26%

95、of insurers globally offered no support for mental health.In 2022,that figure has fallen to just 16%.However,that still represents nearly one in five insurers globally with no provision for mental health support.Figure 15:On a scale from 1 to 5,with 5 being the most significant,how much do the follo

96、wing risk factors influence employer-sponsored group medical costs?GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaMetabolic and cardiovascular riskMetabolic and cardiovascular riskMetabolic and cardiovascular riskMetabolic and cardiovascular riskEndemic infectious diseasesEndem

97、ic infectious diseasesOccupational riskEmotional or mental risksEmotional or mental risksMetabolic and cardiovascular riskEmotional or mental risksEndemic infectious diseasesOccupational riskEndemic infectious diseasesEnvironmental riskOccupational riskTobacco smokeEndemic infectious diseasesTobacco

98、 smokeEmotional or mental risksTobacco smokeEmotional or mental risksTobacco smokeDietary riskChildhood and maternal undernutrition1234511 Canadian Life and Health Insurance Association Inc.“Canadians Received a Record$113 Billion in Life and Health Insurance Benefits,2021 Data Shows,”2022,available

99、 at https:/www.clhia.ca/web/CLHIA_LP4W_LND_Webstation.nsf/page/87ADD7069A39DAA7852588BB0069E21D!OpenDocument.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare25Mental health gaps persist Although the headline trend of more

100、 support for mental health is encouraging,in practice,the scope of insurers offerings is often still limited.Although two-thirds of insurers globally say they cover psychological and/or psychiatric counseling sessions,in practice,two-thirds of those cover 10 sessions or fewer.Assuming one session pe

101、r week,this means plans only cover around 20%of a years claims which will be insufficient for many claimants.Figure 16:What are you doing to provide access to mental health prevention,management and treatment as part of your insured medical plans?(top five offerings globally)Covering psychological a

102、nd/or psychiatric counseling sessionsCovering prescription medications prescribed for mental healthCovering inpatient treatment for mental healthSupplying education on mental health topics such as self-careSupplying virtual mental health counseling via video chat with a therapist to manage anxiety,s

103、adness or personal relationship issues66%53%45%44%40%66%66%59%69%50%73%47%33%27%41%73%48%44%29%46%55%54%45%47%30%GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaThere is also variance in what mental health coverage includes across regions.Just 55%of Asian insurers will cover any

104、 counseling sessions at all,compared to 73%in Europe.However,European insurers counseling provision is the most limited,with only 6%offering unlimited sessions,compared to 29%in MEA and 16%globally.Figure 17:How many one-hour counseling sessions does a typical plan cover in a year?GlobalAsiaEuropeLa

105、tin America and the CaribbeanMiddle East and AfricaLess than 532%44%39%17%10%51029%31%36%23%14%10 or fewer61%75%75%40%24%112011%6%8%9%38%More than 2012%4%11%29%10%Unlimited16%15%6%23%29%Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provid

106、ed healthcare26Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcareTechnology and mental health support We are now seeing significant use of telemedicine,including video chat,for healthcare in general,but this is still a mino

107、rity offering for mental health support.Just 40%of insurers globally offer virtual mental health counseling.72%of insurers say they use some form of telemedicine for general health.Insurers in the Middle East and Africa are most likely to use virtual counseling tools,with 50%of insurers offering it.

108、Reactive general treatment outstrips preventive support and support for special populationsAt present,mental health support is predominantly focused on reactive treatment rather than prevention or management.Around half of insurers globally cover inpatient treatment costs.Offering preventive tools t

109、o help build skills like mindfulness and resilience to cope better with pressure and preventative coaching is only supported by around one-quarter of insurers globally,although in MEA it is better supported(44%of insurers address mindfulness and resilience coaching).Substance use support is also lim

110、ited across all regions,with less than one in 10 providers covering it.This is an aspect of mental health support that will have resonance in many workforces and could be a future area of focus for insurers and employers alike.Figure 18:What are you doing to provide access to mental health preventio

111、n,management and treatment as part of your insured medical plans?Covering substance abuse treatmentSupplying content and delivery support for anti-stigma communication campaignsCovering preventive resilience or mindfulness coachingSupplying tools to help build skills like mindfulness and resilience

112、to better cope with pressure8%27%26%16%3%44%34%28%16%27%24%14%4%29%25%19%5%20%22%11%GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and Africa27Employer actions1Evaluate levels of coverage for mental health support,especially counseling sessions,to make sure they are adequate for claimant

113、s needs.3Understand whether remote telemedicine support extends to mental health services.4Consider how design and management of work impacts health.2Supplement insurer offerings with noninsured programs and supports.Explore opportunities to support mental well-being practices that can help with pre

114、vention of ill health as well as reactive treatment.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare28Plan management requires greater rigor Section 5Global insurer survey report.MMB health trends 2023:Navigating cost tre

115、nds and using innovation in employer-provided healthcare29Expectations of benefits plan managers increasing We saw in our People Risk research how administration and fiduciary risk has risen to the number-two risk out of 25 people risks globally,behind only cybersecurity/data privacy.12 This highlig

116、hts increased regulatory and ESG pressure on businesses to make sure retirement plans,benefits,executive compensation and investment funds are prudently managed.As benefits increase in strategic importance and the C-suite becomes more involved in plan design,delivery and financing,we expect the onus

117、 on benefits plan managers to create well-articulated multiyear benefits strategies linked to business objectives will be greater.In addition,other factors are driving the need for more robust plan management,as outlined below.Changes to coverage and exclusions need close attentionThe longer-term im

118、pact of COVID-19 on administrative practices is now becoming clear.Globally,around one in five insurers has made changes to its underwriting requirements due to COVID-19.There are notable differences at the regional level,with insurers in Asia putting more emphasis on altering premiums and exclusion

119、s based on vaccination status.The heavy impact of COVID-19 on mortality rates in Latin America and Caribbean(LAC)markets,such as Mexico,Brazil,Colombia and Peru,is a likely driver behind the requirement from more than a quarter(27%)of insurers in LAC that employers provide COVID-19 vaccination statu

120、s as part of census data(for example,when providing a quotation).This additional data requirement creates complexity for employers.Globally,one-fifth of insurers are now treating long COVID as a preexisting condition,potentially excluding coverage for individuals claims related to the condition.That

121、 rises to one-quarter in LAC,although there are differences within this region.12 Mercer.People Risk Report 2022,available at http:/ insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare30Figure 19:Are you making any of the following

122、 changes to your group medical insurance policies because of COVID-19?Requiring COVID-19 vaccination status data to be included in covered census dataAdding exclusions or limitations based on COVID-19 vaccination statusTreating long COVID as a preexisting conditionAltering coverage based on COVID-19

123、 vaccination statusAltering premium based on vaccination status16%12%15%13%20%6%9%3%9%22%4%8%8%8%14%27%10%13%4%25%21%16%24%22%21%GlobalAsiaEuropeLatin America and the CaribbeanMiddle East and AfricaGlobal insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in emp

124、loyer-provided healthcare31The importance of regular plan design reviewsAlthough projected trend for 2023 is close to 2022 levels,there is considerable uncertainty.Around half of insurers globally have not automatically adjusted deductibles(excesses)and co-payments in line with inflation and have no

125、 plans to do so at present.Therefore,its important for employers to work proactively with their advisors to make sure certain plan design features are kept in line with inflation.For example,the original intent of deductibles and co-pays may be eroding.Reviewing these annually helps avoid steep chan

126、ges in the future if plan cost controls become misaligned with medical trend.Expense sub-limits and annual/lifetime maximums can unintentionally shift costs onto employees,making care unaffordable.It is therefore important to review plan design annually,keeping the concept of employee affordability

127、front of mind.Figure 20:Has your company automatically adjusted deductibles/excesses and/or co-payments in line with inflation for group medical insurance?GlobalLatin America and the CaribbeanAsiaEuropeMiddle East and AfricaYesNo,and do not have plans to do soUnsureNo,but plan to in the next six mon

128、ths24%10%49%17%19%6%52%22%22%4%59%14%25%21%38%17%44%16%31%9%Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcareCOVID-19 reshapes life insurance pricingJust over half(55%)of insurers globally say they have increased their lif

129、e insurance premium rates by at least 1%,with almost one-quarter(23%)increasing it by more than 10%.This trend is particularly notable in Latin American and Middle Eastern/African markets,where 42%and 54%,respectively,say typical premium rates have increased by 10%or more.Mortality due to COVID-19 i

130、s likely the main reason for these increases.Globally,57%of insurers say higher claims rates have driven higher premium rates.About one in four insurers(26%)from the survey are also updating mortality tables as a result of COVID-19.Figure 21:As compared to pre-pandemic,how has your typical life insu

131、rance premium rate($1/$1,000 of coverage)changed?GlobalLatin America and the CaribbeanAsiaEuropeMiddle East and AfricaDecrease1%10%11%20%Greater than 20%No change42%3%32%16%7%1%53%33%10%3%33%7%43%10%7%29%6%23%26%16%15%31%46%8%3233Percentage of insurers saying higher incidence of claims drove 2022 li

132、fe insurance rate changesFigure 22:Claims incidence and life insurance rate changesGlobal 57%Europe 37%Asia 63%Middle East and Africa 100%Latin America and the Caribbean 55%Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare

133、Employer actions1Be aware of new insurer requirements for identifying COVID-19 vaccination status.Work with your advisor to make sure you have a process in place to support data collection if needed,and address the impact of insurers identifying long COVID as a preexisting condition.3Anticipate incr

134、eases in the cost of life insurance coverage as a result of COVID-19.This is particularly acute in LAC and MEA,where increases of more than 10%are expected.2Be proactive with insurers,and adjust plan details regularly to ensure they remain sufficient given the impact of year-on-year inflation.Global

135、 insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare34ConclusionCOVID-19 is still shaping health insurer policies globally,with variations at the regional level.Both global trends and local variations will affect plan sponsors,whic

136、h will also need to monitor the future impact of high inflation on medical trends.Balancing economics and empathy will be at the heart of annual benefits reviews and renewals.Here,it will be important to recognize the interconnectedness of different factors impacting both employee health and costs.D

137、elayed diagnoses of cancer and other conditions,such as endocrine and metabolic disease as a result of COVID-19 will have long-term implications,particularly as later-stage diagnosis increases treatment costs.New requirements for vaccination status to be included in census data,especially in Latin A

138、merica and the Caribbean(LAC)and Asia,will require a different approach to information-gathering from sponsors and advisors.To date,general inflation has not impacted medical trends to the same extent as energy and food prices.However,if inflation remains high,it will inevitably have an effect on me

139、dical trend values.Plan sponsors should prepare for this while expecting to retain a high-quality healthcare offering that will attract and retain staff.A more positive outcome of COVID-19 has been increased use of digital tools to support and monitor healthcare remotely,and these now look to be per

140、manently embedded in insurers offerings.Employers will need to explore how digital services dovetail with other aspects of coverage in the insurers offering and consider the quality and value digital tools provide for employees.There is still a disparity between coverage for physical and mental heal

141、th conditions globally.Plan sponsors should question insurers on the extent of services such as psychological and psychiatric counseling to ensure they offer sufficient depth to be of genuine benefit.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in e

142、mployer-provided healthcare35Neglected treatment of conditions due to COVID-19Ongoing caregiving,economic and other stressorsIncreased severity of noncommunicable diseasesGlobal insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare36

143、If you only do five things Plan for future inflation-related cost increases,but maintain a balance against the value of health insurance as an attraction and retention tool.1Ask insurers in-depth questions about the true extent of their support for mental health conditions.2Explore the functionality

144、 and quality of digital services offered by insurers,and understand how these fit within the benefits portfolio.3Promote early health screening and diagnosis for chronic conditions to help manage future claims costs.4Be aware of changing insurer requirements related to their underwriting practices(f

145、or example,COVID-19 vaccination data),and develop an effective plan to meet them.5Do you know if your benefits programs will support your workforce now and into the future?Find out what the Health Trends survey can tell you about addressing the critical gaps in your health and benefits programs in y

146、our organization.Reach out to one of our specialists to have a conversation around the actions that are right for your employees and your business.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare37Mercer Marsh Benefits 20

147、212023 estimated medical trend summary13 Appendix ACountry/Region2021 estimated medical trend rate2021 estimated inflation rate14 2022 forecast medical trend rate2022 forecast inflation rate142023 forecast medical trend rate2023 forecast inflation rate14Global with US10.0%4.3%12.5%7.3%12.5%4.6%Globa

148、l without US10.1%4.3%12.7%7.3%12.6%4.6%North America6.7%4.0%5.7%6.7%6.3%2.6%Canada7.1%3.4%7.0%5.6%7.0%2.4%United States156.3%4.7%4.4%7.7%5.6%2.9%Asia8.9%2.3%10.7%3.4%11.5%2.8%China10.4%0.9%10.0%2.1%10.0%1.8%Hong Kong5.8%1.6%6.0%1.9%7.5%2.1%India15.0%5.5%12.0%6.1%12.0%4.8%Indonesia7.7%1.6%12.3%3.3%13

149、.6%3.3%13 Important notices:This document does not constitute or form part of any offer or solicitation or invitation to sell by either Marsh or Mercer to provide any regulated services or products in any country in which either Marsh or Mercer has not been authorized or licensed to provide such reg

150、ulated services or products.You accept this document on the understanding and agreement that it does not form the basis of any contract,and Mercer and Marsh shall have no liability in respect of any reliance on,or decisions based on,the content of this document.The availability,nature and provider o

151、f any services or products,as described herein,and applicable terms and conditions may therefore vary in certain countries as a result of applicable legal and regulatory restrictions and requirements.Please consult your Marsh or Mercer consultants regarding any restrictions that may be applicable to

152、 the ability of Marsh or Mercer to provide regulated services or products to you in your country.The data reflected in the below table were gathered in August 2022 from 226 insurers.Local teams in each country peer reviewed the medical trend rates submitted by insurers using their own internal book-

153、of-business data,country-specific insurer surveys and subjective assessments.The review resulted in MMB changing some of the estimated rates from the raw insurer responses.Global trend rates are unweighted averages.14 Inflation rates are sourced from the International Monetary Fund,World Economic Ou

154、tlook Database,July 2022.Inflation rate information is strictly for general reference purpose;Marsh and Mercer give no guarantees as to their accuracy and will not accept liability for decisions based on them.15 US rates come from the National Survey of Employer Sponsored Health Plans report.Global

155、insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare38Malaysia11.0%2.5%12.0%3.0%13.0%2.4%Philippines9.0%3.9%12.0%4.3%13.0%3.7%Singapore9.0%2.3%10.0%3.5%10.0%2.0%South Korea7.0%2.5%8.0%4.0%8.0%2.4%Taiwan3.9%1.8%12.0%2.3%15.8%2.2%Thai

156、land9.6%1.2%8.9%3.5%8.5%2.8%Vietnam10.0%1.9%15.0%3.8%15.0%3.2%Pacific5.0%3.4%5.6%4.9%5.8%3.1%Australia2.7%2.8%2.7%3.9%2.5%2.7%New Zealand7.2%3.9%8.5%5.9%9.0%3.5%Europe10.9%4.1%13.9%9.7%13.8%5.0%Belgium3.5%3.2%5.0%8.0%5.0%1.3%Bulgaria9.5%2.8%19.0%11.0%25.0%3.3%Denmark15.0%1.9%13.2%3.8%10.5%2.1%France

157、12.1%2.1%1.5%4.1%2.6%1.8%Greece5.0%0.6%7.5%4.5%7.5%1.3%Hungary20.0%5.1%20.0%10.3%15.5%6.4%Ireland16.0%2.4%8.0%5.7%9.0%2.7%Italy5.0%1.9%8.0%5.3%6.0%2.5%Latvia10.0%3.2%17.5%10.0%10.0%3.9%Country/Region2021 estimated medical trend rate2021 estimated inflation rate14 2022 forecast medical trend rate2022

158、 forecast inflation rate142023 forecast medical trend rate2023 forecast inflation rate14Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare39Lithuania12.0%4.6%15.0%13.3%15.0%4.3%Netherlands0.5%2.8%4.5%5.2%6.5%2.3%Norway8.0%3

159、.5%8.0%3.5%10.0%1.8%Poland11.8%5.1%13.0%8.9%15.0%10.3%Portugal7.0%0.9%9.5%4.0%15.0%1.5%Romania16.0%5.0%21.0%9.3%21.0%4.0%Spain6.0%3.1%6.6%5.3%7.0%1.3%Sweden2.2%2.7%3.0%4.8%5.5%2.2%Turkey17.5%19.6%72.5%60.5%50.0%37.2%Ukraine12.0%9.4%17.0%26.0%United Kingdom29.2%2.6%9.0%7.4%13.9%5.3%Middle East and Af

160、rica10.2%5.9%15.0%8.0%13.8%6.2%Bahrain7.0%-0.6%8.5%3.5%9.5%2.9%Egypt19.0%4.5%20.0%7.5%20.0%11.0%Kenya10.0%6.1%16.0%7.2%12.5%7.1%Angola7.0%25.8%53.9%23.9%43.9%13.2%Ghana10.0%10.0%10.0%16.3%10.0%13.0%Mauritius7.0%4.0%12.0%8.4%8.0%5.7%Oman20.0%1.5%25.0%3.7%27.5%2.2%Uganda18.0%2.2%8.0%6.1%10.0%4.1%Count

161、ry/Region2021 estimated medical trend rate2021 estimated inflation rate14 2022 forecast medical trend rate2022 forecast inflation rate142023 forecast medical trend rate2023 forecast inflation rate14Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in emp

162、loyer-provided healthcare40Morocco2.5%1.4%2.5%4.4%2.5%2.3%Nigeria17.0%17.0%20.0%16.1%16.0%13.1%Qatar3.0%2.3%4.0%3.5%5.0%3.2%Saudi Arabia12.0%3.1%17.0%2.5%12.0%2.0%South Africa2.9%4.5%5.7%5.7%8.1%4.6%United Arab Emirates7.0%0.2%7.5%3.7%8.0%2.8%Latin America and Caribbean1611.1%4.8%10.7%6.4%11.3%4.1%B

163、razil10.4%8.3%15.3%8.2%15.8%5.1%Chile7.3%4.5%7.3%7.5%8.2%4.5%Colombia6.5%3.5%8.5%7.7%10.0%4.2%Dominican Republic15.5%8.2%11.4%8.4%12.5%5.0%Mexico16.9%5.7%15.8%6.8%16.0%3.9%Panama11.3%1.6%11.0%3.1%10.0%3.4%Peru14.5%4.0%9.8%5.5%11.1%3.6%Puerto Rico6.5%2.3%6.5%4.4%7.0%3.3%Country/Region2021 estimated m

164、edical trend rate2021 estimated inflation rate14 2022 forecast medical trend rate2022 forecast inflation rate142023 forecast medical trend rate2023 forecast inflation rate1416 Argentina and Venezuela are not included in the table due to current socioeconomic conditions.Global insurer survey report.M

165、MB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare41Based on(dollar)amount claimed,what were the top three causes of claims cost in 2021 based on your book of group or overall business?Top causes of claims by dollar amount claimed and frequencyAppendix

166、BGlobalAsia EuropeLatin America and CaribbeanMiddle East and AfricaCancer61%62%57%79%31%Diseases of the circulatory system45%46%53%44%41%COVID-1930%28%14%58%25%Respiratory conditions27%38%16%0%56%Gastrointestinal diseases24%33%22%25%6%Osteomuscular diseases20%14%35%21%9%Endocrine and metabolic disea

167、ses16%10%16%10%41%Accidents,conditions derived from violence14%21%16%6%3%Obstetrics and pregnancy11%6%10%10%28%Infectious diseases10%9%4%6%34%Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare42Based on(frequency)incidence

168、of claims,what were the top three causes of claims in 2021 based on your book of group or overall business?GlobalAsia EuropeLatin America and CaribbeanMiddle East and AfricaDiseases of the circulatory system42%41%45%40%50%Respiratory conditions34%52%18%2%59%Cancer34%30%41%42%19%COVID-1933%33%22%50%2

169、8%Gastrointestinal diseases30%39%27%31%9%Osteomuscular diseases21%13%39%21%13%Endocrine and metabolic diseases19%17%14%13%38%Accidents,conditions derived from violence17%21%12%23%6%Skin diseases15%15%20%17%3%Infectious diseases13%11%2%13%38%Global insurer survey report.MMB health trends 2023:Navigat

170、ing cost trends and using innovation in employer-provided healthcare43Participating insurers17Appendix CCountryInsurerArgentinaASEBelgiumDKV Belgium Sa/NvBrazilSeguros UnimedUnimed FespCanadaEquitable Life Of CanadaGreen Shield CanadaMedavie Blue CrossRBC Life Insurance CompanyThe Manufacturers Life

171、 Insurance Co.ChileBupaConsorcioMetlife Chile SegurosCountryInsurerChinaAIA Life Insurance CompanyGBG Insurance LimitedGenerali China Life Insurance Co.,LtdICBC-AXA Life Insurance CompanyMsh China Enterprise Services Co.,LtdPing An Annuity Insurance Company,Ltd.Pingan Health Insurance CompanyTaiping

172、 Pension Co.,LtdColombiaAllianzAXA ColpatriaColmedica Medicina PrepagadaCoomeva Medicina PrepagadaLiberty SegurosMedplus Pan American LifeDominican RepublicGrupo YunenHumano SegurosWorldwideEgyptAXA EgyptFranceGroupama Gan Vie17 Only participants that indicated on the survey that their company names

173、 could be published are listed here.Names are printed as they were reported in the survey response.We would like to thank all the insurer respondents for participating in this research.We are very grateful to them for sharing their important perspectives,insights and outlooks.Global insurer survey r

174、eport.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare44CountryInsurerCountryInsurerGhanaAcacia Health InsuranceGlico Healthcare LimitedGreeceGenerali HellasGroupama PhoinixNn Hellas IiHong KongAIA International LimitedAXA China Region Insurance Co.L

175、td.Bupa Asia LimitedCigna Worldwide General Insurance CompanyFWDManulifeSun Life Hong Kong LimitedHungaryAllianz Hungria Zrt.Groupama Biztost Zrt.Union Vienna Insurance Group Biztost Zrt.IndiaBajaj Allianz General Insurance Company LimitedICICI Lombard General Insurance Company Ltd.SBI General Insur

176、ance Co.Ltd.Tata Aig General Insurance Company LimitedIndonesiaPt Asuransi Astra BuanaIrelandLaya Healthcare LtdItalyGenerali ItaliaPoste AssicuraZurich Insurance PLCKenyaLiberty HealthLesothoLiberty HealthMalawiLiberty HealthMalaysiaAIA BHDAllianz Life Insurance Malaysia BerhadAmmetlife Insurance B

177、erhadAXA Affin General Insurance BerhadMCIS LifeSyarikat Takaful Malaysia Keluarga BerhadTokio Marine Life Insurance Malaysia BHD.MauritiusAfrican Employee BenefitsMexicoAXA SegurosGrupo Nacional ProvincialMapfreMetlife MexicoSeguros Atlas,S.A.Seguros Monterrey New York LifeZurichMozambiqueLiberty H

178、ealthNew ZealandSouthern Cross Health SocietyNigeriaAXA Mansard HealthLiberty HealthTotal Health Trust LtdNorwayIf Skadeforsikring NufTryg ForsikringOmanNational Life&General Insurance Company SaogOman Qatar Insurance Company SaogOman United Insurance CompanyPanamaAssa Compaa De Seguros,S.A.Internac

179、ional De SegurosPan-American Life Insurance De Panam S.A.Global insurer survey report.MMB health trends 2023:Navigating cost trends and using innovation in employer-provided healthcare45CountryInsurerCountryInsurerPeruHealth VpMapfre PeruPacifico SaludPhilippinesFirst Life Financial Co.,Inc.Generali

180、 Life Assurance Philippines,IncInsular Health Care IncMaxicare Healthcare CorporationMedicard Philippines IncPacific Cross PhilippinesPhilhealthcare,Inc.The Insular Life Assurance Co.,Ltd.PolandCm Enel-Med SALux Med Sp.Z O.O./Lmg Frskrings Ab S.A.Signal Iduna Polska Tu SaTowarzystwo Ubezpiecze Zdrow

181、ie SaQatarDoha Insurance Group QpscRomaniaSignal Iduna Asigurare Si Reasigurare SaSaudi ArabiaSaudi EnayaSingaporeHSBC Life(Singapore)Pte.Ltd.Raffles Health InsuranceSingapore Life LtdThe Great Eastern Life Assurance Co LtdSpainAXA Seguros GeneralesCignaSegurcaixa AdeslasTaiwan,Province of ChinaAIA

182、International Limited Taiwan BranchFubon Life Insurance Co.,Ltd.Tanzania,United Republic ofStrategis Insurance Tanzania LimitedThailandAllianz Ayudhya Assurance Pcl.Generali Life Assurance(Thailand)Public Company LimitedKrungthai-AXA Life Insurance Pcl.Muang Thai Life Assurance Pcl.Tokio Marine Life

183、 Insurance(Thailand)PclUgandaLiberty HealthPrudential Assurance UgandaUkraineJsic IngoUnited Arab EmiratesAbu Dhabi National Insurance CompanyGig Gulf B.S.C(C)Now Health InternationalOman Insurance CompanyQatar Insurance CompanyUnited KingdomAllianz Partners,HealthAviva PLCAXA HealthBritish United P

184、rovident Association LimitedVenezuelaHumanitas Administradora De Riesgos SaMercantil SegurosSeguros VenezuelaVietnamBao Long Insurance CorporationZambiaLiberty Health 2022 Marsh McLennan.All right reserved.For further information,please contact your local Mercer Marsh Benefits office.Mercer Marsh Be

185、nefits provides a range of solutions to help you manage workforce health and well-being,including:Brokerage of core employee benefits as well as plan design.Advice and support for health and well-being,including telemedicine,mental health support,diversity and inclusion,environmental/social/governan

186、ce,flexible benefits,and plan member communications.Digital solutions to engage plan members in their health and benefits.About Mercer Marsh Benefits Mercer Marsh Benefits(MMB)was born out of the unification of one of the worlds most respected consultancies,the global leader in people risk advisory

187、and the number one disruptive benefits technology firm to form one unique business.Together they have shaped some of the worlds most loved employee benefits experiences for small companies,growing enterprises and global firms.MMB is 7,000 strong,on the ground in 73 countries and servicing clients in

188、 more than 150 countries.It brings local expertise to more places and works side by side with clients and Mercer and Marsh colleagues around the world.Mercer and Marsh are two businesses of Marsh McLennan(NYSE:MMC),together with Guy Carpenter and Oliver Wyman.The Companys 81,000 colleagues advise clients in 130 countries.With annual revenue over$20 billion,through its market-leading companies,Marsh McLennan helps clients navigate an increasingly dynamic and complex environment.