The international private medical insurance market is a highly competitive – and cluttered – fi eld. Aetna International’s head of global distribution tells Health Insurance Editor David Sawers how he plans to stand out from the crowd
Aetna International’s new London offices don’t bear any signs of Goodhealth Worldwide, the international private medical insurance (iPMI) provider it acquired more than five years ago.
And while it remains a key acquisition for Aetna, Goodhealth is, for Nic Brown, now firmly a thing of the past.
But when Aetna International’s head of global distribution joined the Fortune 100 company in 2011 that wasn’t the case in the eyes of many – especially intermediaries.
“When I walked through the door, I joined Aetna International,” he says. “And while of course I did my research before I joined about how it had evolved, I came here with a view of ‘I’m joining Aetna International’. I couldn’t believe it when I walked through the door and brokers were still calling us ‘Aetna Goodhealth’.”
It’s not unusual, of course, for acquisitions to take some time for the market to get used to. Names and legacies do linger on and Goodhealth was no different, Brown acknowledges.
“The integration, especially from a systems perspective, was tougher than expected,” he says. “In Europe, because of the complexity of the client portfolio that it had at the time it took a bit longer.”
The rationale behind Aetna’s acquisition of Goodhealth Worldwide, however, made – and still makes – perfect sense. For a start, it enabled it to grow its non-US expatriate market share overnight and beyond. But changing things in the eyes of brokers and clients that are very familiar with a brand naturally takes some time.
“We’ve had a big challenge shedding the Goodhealth brand and the history that’s gone alongside that,” Brown says. “People are now starting to see us [Aetna International] just as part of Aetna.”
UK brokers that – until now – had not been so familiar with the Aetna brand may well have been unaware of just how large an organisation it is. At a global level, it is a member of the Fortune 100, with more than 18 million medical members. And as the organisation’s expatriate business, Aetna International itself boasts more than 500,000 members worldwide, providing medical, dental, vision, life, disability and emergencyassistance, in addition to a health management business which collaborates with healthcare systems, governments and plan sponsors around the globe.
“Globally we are at least the top three provider already in terms of the size of our organisation and we’ve got the infrastructure to match that,” Brown says. “At the beginning of last year we passed the billion dollar mark in terms of iPMI and we have an objective to grow that to $5bn over the course of the next four to five years. That’s the objective that we’ve set ourselves and the growth within the UK market and increasing penetration of that market is a key aspect of that.”
While Aetna International’s share of the UK broker market does not match that in other parts of the world, Brown sees that as an opportunity more than anything else – and one which is on the way up.
“The market penetration that we’ve got of the UK broker market in iPMI wasn’t very large when I joined,” he says. “It’s improved. We’ve probably doubled our penetration already. The profit that we get from this business is improving month on month and has done for the last five months, so we’re now on an upward trend.”
The “size, scale and reputation” of Aetna International’s parent company lies behind that growth, as well as significant investment in the business unit, Brown says.
Certainly, the organisation has invested in bringing a number of other senior figures on board to spearhead that growth in Europe, including the former chief executive of Aegon Ireland, David Healy, at a board level role, and Marco Bannerman and Michael Lewars in intermediary and partnership relationship roles.
But while Bannerman – a former head of intermediary sales at Bupa – and Lewars – formerly of Xafinity Consulting – have spent years immersed in the UK broker market, Brown himself has arrived at Aetna International via a very different route. Although he began his career in UK private medical insurance, with AXA PPP healthcare, his roles have taken him further afield, both geographically and in terms of sector. His most recent role prior to Aetna, in fact, was in banking, where he spent around two years at Citibank. And although it was a different sector, Brown says he found the experience “invaluable”.
“There was a lot of structure,” he says. “Sitting in a senior role, there was a lot of governance control and lots of review meetings, risk committee meetings, product committee meetings. It was a very product-led organisation, which was a really good discipline for me in terms of not having really done those roles before.”
But while banking was both “fantastically intellectual and a challenge” and he has been “lucky enough to work in some pretty dynamic environments”, the “cut and thrust” of a sales & marketing role also excited him – hence the decision to join Aetna International.
“The reason they brought me in here is because I’ve worked in strategic roles, I understand how P&L works, I understand how to operate within a governance structure and I know how to work in an American company,” he explains. “And within that I’m a pretty motivated guy.”
Brown’s experience of working in an American company also extends to his role prior to joining Citibank, as European sales director for Cigna’s life, accident and health division, based in Madrid.
“That was also a really big learning curve, of how to work for a US company with their international business,” Brown says.
The fact that there are undeniable similarities between Aetna and Cigna in terms of having major international aspirations diversifying out of a US business – plus his time at Citibank – meant the move to Aetna was “a bit of a no-brainer”, Brown explains.
“Cigna is the one [provider] that we would probably compare ourselves to,” he continues. “We’ve got a very similar footprint, we work in a very similar way and both our organisations are truly global in terms of our licensing capability, the regional capability in terms of office location and the number of people that we’ve got on the ground in those regions.”
A QUESTION OF SCALE
So what makes Aetna International so different from many other providers then?
The scale of Aetna, Brown argues, means it can offer clients “a lot more stability in terms of the numbers”.
“You’ve got more data, you can price more effectively, you can contain costs a bit more effectively,” he says. “So volume gives you stability from a pricing perspective and again not every one of the competitors in the market has size.” Scale in terms of customer profile is also on Brown’s mind and as part of its European market growth plans, Aetna International is ramping up its focus on the large corporate space.
In the UK, for example, Brown acknowledges that many brokers see Aetna International predominately as a provider of small corporate schemes. That focus will remain, but Brown is determined to dispel the misconception, in his eyes, that Aetna International is not the broker’s first choice for large corporate – experience-rated schemes of over 100 lives – business, or, indeed, individual business.
“We are good at SME, we are good at small corporate and we want to continue to be good at small corporate,” he says. “But that is not going to give us the growth that we need to help support the ambition of $5bn in five years.”
In the last six months, Brown explains, Aetna International has written eight large corporate schemes.
“We’ve proven our capability in this with the pieces that we’ve brought on board and now we want to be increasing the volume of business that we’re writing,” he says.
In order to do that, “hard work, quote management and broker relationship development” will be needed, Brown continues, and with this in mind the provider is building tools that he says will give brokers the kind of support that they will not have seen before.
A bespoke solution – scheduled to be launched in the coming months – should give brokers extra ammunition to build their own portfolios, as well as benefit the iPMI industry as a whole. It will be another example, Brown says, of Aetna International’s ability to draw upon its parent company’s vast global expertise.
“There are experts out there, they know this stuff inside out, but for most organisations, international is a niche,” he says.
“This tool will help them be able to make a better fist of it, just in terms of confidence. It’s not that they don’t know what they’re doing already but this tool gives them at least some validation that what they’re doing is correct, more guidance.”
Brown hopes that kind of broker support will demonstrate both Aetna International’s expertise and its commitment to the broader market – and it will in turn get the rganisation the recognition it deserves.
“I want to win the Health Insurance Award for Best iPMI Provider, voted for by brokers, because that’s an endorsement and a buy-in,” Brown says. “It’s as good as it gets.”
There’s no sign of a HI Award in the reception of Aetna International’s new London office just yet – but if Brown has his way, that might just be a matter of time.