Adviser Frequently Asked Questions
nib is making these changes to deliver enhanced protection and value to many of your clients. The changes will provide many nib members with improved cover and more easily understood cover terms, while also enabling more streamlined business processes (e.g. claims approval).
Almost all nib on-sale and legacy, retail and group health products will be changing as part of the Product Refresh, however the extent of the changes will vary between the products.
The products that will not be changing are Major Medical (ex OnePath) and some products developed for particular groups.
The product refresh comprises five interrelated parts:
1. Standardisation of benefit terms to match the equivalent Ultimate Health term* - creating simplicity and in many cases more favourable cover.
2. Alignment of benefit maximums for legacy products to match an equivalent on-sale product – providing cover levels consistent with contemporary products.
3. Refreshed policy documents and other brochures - to make it easier for you and your clients to understand and get value from their cover.
4. Streamlining and automation of business processes - setting nib up to provide faster processing times in the future.
5. Improved client self-service through the updated mynib portal and app.
More information about each is included in the following questions.
*Note that Ultimate Health Max policy terms, which include guaranteed wordings, are not being standardised to those of Ultimate Health and products that don’t have equivalent benefits to Ultimate Health are not having new benefits added.
The terms of many of your clients’ health insurance benefits are being aligned to the equivalent terms of nib’s on-sale Ultimate Health cover.
These ‘standardised’ benefit terms will in many cases result in increased benefit maximums or more favourable cover terms. This is particularly the case for your clients with legacy products.
nib will also be introducing capabilities so that your clients can log into the member portal or the mynib app to make simple changes to things like their contact details. This will be quicker than doing so through the contact centre and leave contact centre staff free to respond to more complex enquiries.
There will be six changes to the policy documents. They will be:
Incorporating the existing non-PHARMAC Plus Option in policy wordings (except Ultimate Health).
Restating the policy documents in plain English - to make them easier to understand.
Reordering the benefits - to follow a client’s typical treatment journey.
Removing, or moving online, a number of the product terms to reduce some of the more administrative information.
Changing the exclusions, to create more alignment across nib products.
Incorporating nib’s recently refreshed brand style.
The product brochures have also been refreshed at the same time.
Overall, the impact of the Product Refresh will be positive across most products through the higher benefit limits and enhanced cover terms. (A small increase in anticipated claims costs is indicative of this). However, for some product benefits there will be some narrowing of benefit terms and changes to exclusions resulting from the alignment to Ultimate Health. All the key changes will be detailed in the “Change Summary” provided to your clients.
Overall, the ‘standardisation’ of benefits should make it easier for you to remember product terms and to talk about nib health cover and the benefits it provides. It will also be easier to compare nib products and explain nib health cover using the refreshed brochures and policy wordings.
Information about the Product Refresh, including these FAQs, is available by logging into nib Adviser Access adviser.nib.co.nz, clicking the Public Documents tab and looking in the Product Refresh section.
Contact your Adviser Partner Manager for more information.
We’ve created a Member FAQs with answers to many of the questions your clients may have. These are also available in nib Adviser Access. Members can access these FAQ via www.health.nib.co.nz/policyupdate.
If there are further questions that you can’t answer, please get in touch with your nib Adviser Partner Manager.
Updated product collateral for you to use in client meetings and your advice process will be available in soft copy via adviser.nib.co.nz or nibadviser.co.nz and in printed form from Bluestar from 14th of December 2023.
If there is a pre-approval in place, nib will honour it up to its validity period. (This is typically three months).
If the treatment takes place after your client has moved to the Product Refresh policy terms, but within three months of the pre-approval issue date, then nib will stand by the original approval or re-assess in line with the Product Refresh terms, whichever provides your client with the more comprehensive cover.
If their treatment is planned more than three months after the pre-approval was issued, then the Product Refresh policy terms will apply, and your client will need to apply for a new pre-approval.
Please direct your clients to the Member FAQs.
No, your clients cannot remain on the current policy terms. When their policy renews, the Product Refresh terms and benefits will apply automatically.
It’s important you help your clients understand the benefits of the Product Refresh. The Change Summary included with their renewal pack outlines the key changes to their policy.
Any changes made to your client’s policy will apply from their next billing date and be on the policy terms that apply on that date.
No. Your clients will continue to have the same policy type as they hold today. However, where your client’s current cover has a benefit for which there is a comparable benefit in Ultimate Health, the benefit terms will be changed to be the same as those of Ultimate Health and the benefit maximums for legacy products will be matched to those for the equivalent on-sale product – this does not always mean that the benefit limits now match the Ultimate Health limits. If your client’s current policy does not have a benefit that Ultimate Health does have, this benefit is NOT being added to your client’s cover.
If your client’s current policy has a benefit that is not available under Ultimate Health, it will be compared to similar benefits in other products and upgraded (if appropriate) to match the ‘best of the best’ of these benefits.
Yes. This will follow nib’s usual migration pathways and require a new application and underwriting process. Depending on your client’s health and health history, exclusions or loadings may apply. A change to premiums should also be anticipated.
There will be no impact to your clients’ premiums this policy year as a result of the Product Refresh changes.
The Product Refresh changes will affect your current clients with nib retail health cover from their next policy renewal from 1 February 2024 onwards. nib will explain the Product Refresh in the policy renewal information sent to members at least 30 days before their renewal. This means that the Product Refresh will occur for different clients at different times, starting with clients with renewals on 1 February 2024 and ending with clients whose renewals are to occur in January 2025.
Your clients will receive:
• A Cover Letter, which will include summary information about the Product Refresh
• A Change Summary, which outlines the Product Refresh changes specific to their particular product.
• An updated Policy Document / Policy Wordings.
• A Policy Renewal Certificate relating to their policy and the people covered under it.
Members will also be able to access this information through the nib member portal and member app mynib.
Yes, nib will copy you on the same information as your clients receive. Advisers will be able to access this information by logging into the nib adviser portal and going to the Member documents tab.
The Product Refresh changes are triggered by the policy renewal, not an individual member’s join date anniversary.
No, the changes will be applied automatically.
The policy terms that will initially apply for new nib members will depend on the date you submit their application and the start date of their policy.
Applications submitted after 14 December 2023:
• With a policy start date on or after 1 February 2024 will have Product Refresh policy terms from when the policy cover begins.
• With a policy start date before 1 February 2024 will have policy cover with current policy terms until their first policy renewal, at which time the Product Refresh terms will kick in (with information sent in the pre-anniversary renewal comms).
You will need to discuss this with your clients when applying for cover for them and specifying a cover start date. (Note that irrespective of what their policy start date is, the Product Refresh terms will, in time, be applied to all new policies so your client wont ‘miss out’).
The Product Refresh will be incorporated into the current process for managing each scheme prior to its renewal. This typically commences 3 months before the group renewal date.
Once the scheme has been renewed, each of the clients covered under it will be informed about the Product Refresh with their group’s renewal (approx. 30 days prior to their policy renewal).
Each client will receive:
• A Renewal Letter, which will include summary information about the Product Refresh and the URL for the Member FAQ’s.
• A Change Summary listing the changes arising from the Product Refresh specific to their nib health insurance policy.
• An updated Policy Document.
• A policy Renewal Certificate relating to their policy and the people covered under it.
Members will also be able to access this information through the nib member portal and member app mynib.
For any clients with two or more policies, we encourage you to discuss the client’s coverage and ensure they do need all policies to remain in force.
New employees will be covered under the policy terms current at the time they join.