The system of insurance is an undertaking guarantee system that commonly runs in modern society. Today’s society always craves for security and safety in their life.

Brief History of PT Askes (Persero)

Protection ensures secured feelings. Likewise, insurance provides protection for the people in various aspects of life such as health care, old age care and education. Insurance serves as a reliable guarantee to mitigate risks.

Insurance is a guarantee or security provided by insurers (an insurance company) for an insured against risk. The loss risk provided is stated in insurance policy in the event of fire, theft, damages, illness, death or other accidents. In return to the protection provided, the insured should pay the insurer a premium every month, the amount of which is mutually agreed upon between both parties.

So far PT Askes (Persero) has provided protection for the people in terms of health care service. PT Askes (Persero) was established in 1968 by Presidential Decree No. 230/1968 on health care of civil servants and pension fund receivers along with their families. This Decree has replaced the old Decree of 1934, revised in 1938, prevailing during the Dutch colonial era, which regulated civil servants and pensioners.

Based on the above-mentioned Presidential Decree, the Minister of Health issued the Decree of Minister of Health No. 1/1968 which contained the formation of a body in the Department of Health, in charge of managing health care fund. The body was named Health Care Fund Management Body (BPDPK), which has since the beginning been known as Askes. Initially BPDPK/Askes provided health care service for civil servants/pension fund receivers along with their families based on ‘Reimbursement’ System. Based on this system, BPDPK/Askes reimbursed its members’ health care cost on the basis of service they used, but this system turned out to be disadvantageous to the Company in terms of controlling health care cost.

To improve the system, the status of BPDPK/Askes was changed, based on Government Regulation No. 22 and No. 23, 1984, from a management body under the Department of Health to a state owned enterprise known as Husada Bhakti Public Corporation (Perusahaan Umum Husada Bhakti). The change was made for the improvement of the systems and programs to be adopted by the new management body. The system applied for providing insurance service has been based on the ‘Managed Care’ concept, which is an integrated approach towards the service system and the financing in providing comprehensive health service supported by the service network and selection of health service provider as well as the implementation of service based on the principles of structured referrals, control of incentives and disincentives, quality control and service utilization. This concept is adopted to guarantee the implementation of quality health care with optimum cost. In this system, a number of renewal concepts are applied, such as

1. A list and Ceiling Price of Drugs of 1987 containing a list of drugs considered as standard remedy used by Askes in its services and the ceiling prices determined by Askes. - Family doctors, structured medical service through a referral concept, and payment using capitation system for primary care which was provided by health care centres in 1988.
2. Per-diem package tariff for hospitalized patients and the package for Secondary and Tertiary Care Outpatients.  
3. Total Capitation, which is the development of financing and health service system by integrating all health cost components and quality control service. In keeping with medical science and technology, medical treatment, health service facility and members’ awareness of service quality, the government, through Government Regulation No. 69/1991 as a revision of Government Regulation No. 22/1984, has extended the scope of compulsory membership to include veterans and independence pioneers along with their families, who have not been covered yet in the Government Regulation. Furthermore, an opportunity is wide open for employees of state-owned enterprises and private companies to become Askes members. To conduct these programs, Askes status was changed from public company to a limited liability company pursuant to Government Regulation No. 6/1992. This change of status naturally carries more responsibility for Askes to work more professionally.

In the beginning of 2005 pursuant to the Decree of Minister of Health No. 1241/Menkes/XI/2004 PT Askes (Persero) was entrusted to organize programs on health care service for the poor eff ective as of January 2005. In 2006 PT Askes (Persero) was assigned to conduct similar programs on health care service for the poor and the needy for 2006 based on Agreements between the Department of Health of the Republic of Indonesia and PT Askes (Persero) No. 124/Menkes/PK/II/2006 and No. 68/ KTR/0206, along with Addenda No. 472/Menkes/ PK/VI/2006 and No.133/KTR/0726 on Program Implementation of Health Care for The Poor and The Needy 2006.
PT Askes (Persero) organized health care service for the poor, called Program Askeskin, for the second year, with 60 million people targeted.
In 2007, PT Askes (Persero) was again entrusted to conduct similar programs for the poor and the needy for 2007 based on Agreements between the Department of Health of the Republic of Indonesia and PT Askes (Persero) Nos. 290/MENKES/KS/ III/2007 and 87/KTR/0307.
In its third year running Program Askeskin, PT Askes (Persero) had 76.400.000 people on target to participate.
In 2008, pursuant to Agreement held between the Health Department of the Republic of Indonesia and PT Askes (Persero) No. 213/MENKES/PKS/ III/2008 and No. 41/KTR/0308 dated 3rd March on Management of Participation in People’s Health Security Program (JAMKESMAS) of 2008, PT Askes (Persero) was assigned to manage JAMKESMAS Program, formerly known as ASKESKIN. 

Board of Commissioners

A Message of PT Askes (Persero) President Commissioner: Dr. Farid W. Husain. Sp,B

Let us first of all extend our highest praise and deepest gratitude to the Almighty God for His grace and blessings bestowed upon us all, particularly upon PT Askes (Persero) as a health insurance for civil servants, who strives to build its commitment in implementing Good Corporate Governance (GCG) on all business aspects.
Our company has been developed based on values, which have become the basis and reference for each employee in executing their tasks and responsibility, called code of conduct.
The demand raised by both stakeholders and public to state-owned companies to be able to give greater contribution to the country has boosted PT Askes (Persero) to make more concentrated efforts of rendering their best service to its members especially in facing greater challenges together, enabling us to make better performance in line with the dynamics of the company, both internally and externally.
On this occasion the commissioners wish to extend their appreciation and thanks to the Board of Directors and all employees who, with commitment and hard work based on integrity and ethical conduct, have done their utmost and worked hand in hand in improving company performance now and for the years to come. With continued management which is professional and transparent, PT Askes (Persero) will keep enhancing its existence as a sound and trustworthy insurance company.
In concluding the Board of Commissioners would like to give their highest appreciation to shareholders for entrusting them to execute supervisory function on PT Askes Board of Directors, with whom they have collaborated in creating added value for both shareholders and stakeholders.

A Message of PT Askes (Persero) President Director: I Gede Subawa

PT Askes (Persero) as a state-owned company has since 1968 been charged with the task of executing health insurance for Askes Sosial members namely civil servants, civil servant pension receivers, armed forces/police, veterans and independence fighters along with their families. Furthermore, in compliance with Government Regulation No. 69, 1991, the Company has extended its scope of membership to cover private institutions and other segments of society handled by its subsidiary, called Askes Komersial.
All employees have been strongly determined to implement Good Corporate Governance and undertake to make improvements and turn challenges into opportunities by enhancing company performance through various strategies stated in the Company Long Term Plans.
With continued commitment of the entire management to boost cooperation and partnership, as well as with the support of all parties particularly health providers and members, all lines of management of PT Askes (Persero) shall continue to do their best in keeping the commitment.

May the Almighty God keep guiding us in our endeavour to reach our goals for the benefit of many people.

Vision and Mission

Vision:

To be specialist in health insurance and health care security as well as a market leader in Indonesia.

Mission:

To support the government in the health sector by:

- Organizing social health insurance based on managed care system in order to provide maximum benefits for Askes social members.
- Organizing commercial health insurance for society with fixed income particularity for middle to upper class groups based on managed care and indemnity systems for the benefits of all stakeholders.

Notes:
A ‘specialist’ means an insurance company which conducts health insurance business and health care security, and undertakes this activity professionally, providing quality service for stakeholders. As a market leader, a company should obtain at least 20% of potential market shares within 5 years and become a centre of excellence in health insurance to other companies.

PT Askes (Persero) runs health insurance business as assigned by the government through Government Regulation No. 69/1991. PT Askes (Persero) basically organizes two programs: social health insurance and commercial health insurance. As a social program, it means the program is compulsory for the people to participate but it is not profit oriented for the company which means that PT Askes (Persero) should prioritize providing maximum benefits for Askes Sosial members by achieving at least 86% claim ratio and 85% customer satisfaction, while continually making every effort to maximize customer benefits through the accumulation of part of dividends gained. As a commercial program, it means the program is entirely profit-oriented, so claim ratio of Askes Komersial should reach around 67.01%. The premium rates are therefore fixed in nominal term based on actuary calculation, putting risks factor into account. Askes Komersial program is exclusively designed to meet the needs of middle-up market segment due to their potential purchasing power. To ensure the smooth-running of the program, continuous developments and improvements of products are essentially required.

Company Goals and Objectives

To participate in implementing and support government policies and programs in the economic sector and in national developments in general as well as developments of the insurance industry, particularly health insurance provided for civil servants, pension fund receivers, veterans, independence pioneers along with their families, and other members. PT Askes (Persero) provides health insurance by applying principles of a limited liability company.
To attain the above goals and objectives, PT Askes (Persero) conducts the following business activity:

1. To provide comprehensive health insurance for civil servants, pension fund receivers, veterans, and independence pioneers along with their families.
2. To provide comprehensive health insurance for employees, and companies or other bodies who are entitled to pension fund.
3. To provide health insurance in compliance with the prevailing regulations.

Corporate Culture

In the process of building corporate beliefs and values, all lines of PT Askes (Persero) employees, from management level all the way down to the lowest position, should firmly adhere to what are considered as characteristics of the company through among other cultural application, namely:

Integrity
Each and every employee must have strong personality in carrying out any tasks assigned by company with loyalty, high dedication, honesty and responsibility to God Almighty, stakeholders and to himself/herself. He or she must also be responsible to Askes members, shareholders, providers, commissioners and board of directors as well as to society.

Teamwork
Teamwork shall mean a working method by which employees should complement each other in accomplishing the tasks assigned by company. To be able to work closely together with each other, each employee should at least be prepared to accept different opinions. Any differences mustbe considered as an added value which can boost
working dynamics and intensify work outcome.

Service Excellence
The principle of ‘Customer Focused Company’ or prime service has to be applied to both external and internal customers. Such principle as illustrated below which is quite universal in nature needs to be adopted by each employee as his/her own characteristics.

1. Be proactive in giving service to customers
2. Give prompt response to criticism, inputs or complaints filed by customers
3. Show appreciation and respect to anyone

Continuous Learning
The culture of continuous learning should come from both, individual employee and the company itself.

Employee
Each employee is required

• To actively expand his or her knowledge in health insurance in general and in his/her own job in particular
• To enhance the culture of self-study through the culture of reading such articles as literatures, journals or scientific papers related to insurance, health insurance, management or other fields which are useful for him or her and for company development.
• To create the culture of having scientific and empirical discussions within the working environment on actual and current matters.
• To actively seek every opportunity to further his/her education, supported by company or by own facility.

The Company
The company is obligated to

• give support to any employee who is determined to widen his/her knowledge in an effort to support his/her job
• create conducive environment for an employee who actively and independently wishes to enhance his/her knowledge and skills to support his/her job. Should an employee be able to successfully apply the four elements of corporate culture in his/her job, he/she will come out as a true Askes employee.

Human Resources

A 40 year long experience with care-based system of health care conducted nationally has given PT Askes (Persero) strong confidence to continue running social health insurance nationally.
Supported by a wide organization network covering 12 regional offices, 12 main branch offices, 29 branch offices ranking A, 50 branch offices ranking B (91 branch offices) and 225 offices in regencies/cities spread all over Indonesia, PT Askes (Persero) is highly capable of providing its best service. Efficiencies in the organization continue to be done with a simplified and streamline organization structure. PT Askes (Persero) always maintains good relationships with its service providers, members, the regional government and other related parties through an intensive communication. This cooperation has been realized in the form of Consultation Forum and Communication Forum in provincial and regency/ city levels. PT Askes (Persero) employs professionals who are capable of handling managed-care system and who have also acquired knowledge in other disciplines, as follows :

• Health Insurance Associate (HIA) and Managed Healthcare Professional (MHP), as member of Health Insurance Association of America (HIAA).
• Adjunct Health Insurance Experts and Health Insurance Experts c. Adjunct Life Insurance Experts
• Indonesia’s Adjunct Actuary and Indonesia’s Actuary Expert.
• Scholars of various disciplines such as general practitioners, dentists, pharmacists, people’s health graduates, economic graduates and law graduates.
• Post graduates in hospital, health insurance, actuary management and business administration.

These competent human resources serve as a potential asset for PT Askes (Persero) in carrying out its function as an insurance company that manages health care security nationally. Furthermore, in its endeavour to enhance human resources quality, PT Askes (Persero) has established cooperation with such organizations as ARSADA, IRSPI, PERSI, PAMJAKI, IDI, Family Doctors Colleague and Indonesia’s Haj Health Association as well as with other institutions such as universities, cooperatives and small business, and the people’s self supportive institutions. In facing the current national economic conditions and in an effort to comply with prevailing government policies as well as to anticipate competition in this globalization era, PT Askes (Persero) focuses its business strategy on “3 E” key performance factors, namely:

1. Product Excellence

• Askes Sosial: As a maximum product, the scope of Askes Sosial is larger than that provided by any social health insurance in other countries. PT Askes (Persero) continues to improve its service quality by among others providing supplementary products and increasing health service tariff.
• Askes Komersial: Exclusively designed to meet market demands, various products for various segments of consumers under Askes Komersial have been offered in anendeavour to win competition. For this purpose PT Askes (Persero) has extended its service network to encompass a number of hospitals overseas.

2. Operational Excellence

• Non-medical service standard. PT Askes (Persero) has had several operational standards regarding services provided for both members and service providers.These standards have been continuously improved from time to time to enhance the effectiveness and efficiencies of company operational activity. A one day service to produce a member card, for example, has been reduced to a quarter of an-hour; likewise claims settlement filed by either providers or members can now be dealt with in a much shorter time.
• Company Information System. To simplify communication and data processing between the head office and branch offices in the regions as well as the communication between PT Askes (Persero) and its members, the Company has applied internet-based on line system. Furthermore, software program has beenapplied to hospitals and dispensaries in order to speed up claims processing service. Microsoft-based real time on line system has also been introduced.
• Quality Management System ISO 9002. PT Askes (Persero) has since 1997 apply ISO 9002:1994 awarded by the International Certification Institution (SGS from Switzerland). In 1997 ISO 9002 only covered the scope of Administration Membership of Insurance Service, having been applied in Membership Division, supported by Education and Training Division, Procurement Bureau and the Secretariat Office. In December 2003 PT Askes (Persero) obtained ISO 9001:2000 as a conversion of ISO9002:2004 (the Certificate was conferred on 1st March 2003). In ISO 9001:2000, which has been applied to date, it is stated that PT Askes (Persero) as a corporate and all working
• Units in the head office are covered in the Certificate, while its regional offices and branch offices are covered by the certificate extension. This makes it easier for PT Askes and its regional and branch offices to achieve quality target already determined as any matters arising can be promptly dealt with.

3. Service Excellence

• Prime Services. PT Askes (Persero) has imposed a policy for every individual in the company to render prime services to both internal and external customers.
• Hospital Integrated Administration Service Program PT Askes (Persero) has since the beginning of 2001 applied Hospital Integrated Administration Service Program starting with a pilot project in Pirngadi Hospital Medan. This service is performed by placing an employee as officer at customer desk of PT Askes. As it turned out, with this service PT Askes (Persero) has managed to simplify and speed up administration service to members and to also expedite claims processing and payment to service providers.

Askes Social Program 

Social health insurance program, which is compulsory in nature, is an assignment from the government to PT Askes (Persero), in insurance term called government captive health insurance; it therefore not a kind of monopoly. Askes members comprise civil servants, pension fund receivers, veterans, independence pioneers and their families.

Askes Komersial Program

Askes Komersial Program provided by PT Askes (Persero) has these characteristics:
1. This is a group membership, which is voluntary in nature
2. Premium rates are calculated nominally based on risk calculation
3. The benefits offered to members are based on agreements between the insured person and the insurer 

4. The government plays a minimal role in the implementation of this program

People’s Health Security Program or Jamkesmas (In Indonesian)

With a view to meeting the need of the poor and the needy for health care service as stipulated in the 1945 basic constitution, the government has drawn up health service program for these people, named Jamkesmas in Indonesia.

Company Growth

In line with the company mission and vision and in anticipation of an increasingly tight competition in the globalization era, PT Askes (Persero) has been making these endeavours to continue developing its business.

1. Enhancing service quality provided for Askes members to increase customer satisfaction
2. Investing every effort to sustain company growth
3. Developing new products under Askes Komersial program to meet with company’s potential needs.
4. To build competent human resources.
5. Human Resource Competition.