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AXA looks to benefit coordination opportunities with BPJS

Reporter: Christine Novita Nababan | Editor: Sanny Cicilia

JAKARTA. AXA Indonesia is starting to look at the benefit coordination cooperation (coordination of benefits) with the Social Security Administering Body (BPJS) in the health sector. This cooperation is a strategy of harmonization between the health insurance business lines that the company operates with the National Health Insurance program that is being held by the public agency.

Emmanuel Wehry, Marketing Director of AXA Indonesia said that the AXA Group entities in Indonesia, both AXA Indonesia and AXA Mandiri, have many health insurance products. “Therefore, we also see an opportunity to cooperate with BPJS regarding the coordination of these benefits,” he said to KONTAN, Thursday (10/4).

Unfortunately, he was reluctant to explain further regarding the cooperation plan between AXA and BPJS Kesehatan. He ensured that his party was discussing the coordination of these benefits before cooperating with BPJS Kesehatan in providing health protection to customers.

For your information, BPJS Kesehatan together with the Indonesian General Insurance Association (AAUI) and the Indonesian Life Insurance Association (AAJI) have signed an agreement to coordinate benefits in early April 2014. Several points of benefit coordination include BPJS Kesehatan guaranteeing fees according to the applicable rates in the National Health Insurance program, while the difference is the responsibility of private insurance if the participant buys additional insurance.

Another point regulates the matter of the main and second guarantor at the hospital that is a provider of BPJS Kesehatan health services or cooperates with private insurance, including questions for submitting claims and health facilities. Inpatient services for BPJS participants are limited to a maximum of first class. Meanwhile, participants who want non-medical facilities above the specified class can purchase additional insurance.

However, this benefit coordination cooperation does not automatically occur between BPJS Kesehatan and private insurance. Private insurance companies are asked to apply for cooperation in a manner business to business.

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