Resolution Health Insurance Products: Agent's Complete Guide
Resolution Health is a managed care specialist. They do health insurance differently — focused on wellness, preventive care, and integrated healthcare.
For agents, this means a different selling approach. Here's what you need to know.
Table of Contents
- Company Overview
- What Makes Resolution Different
- Product Portfolio
- Coverage Options
- Target Markets
- Premium Structures
- Selling Strategies
- Commission Structures
- Underwriting Approach
- Claims Process
- Hospital Network
- Competitive Positioning
- Objection Handling
- Agent Support
- The Bottom Line
- Next Steps
Company Overview
Resolution Health Insurance Company is one of Kenya's specialized health insurers, known for their managed care approach.
| Aspect | Details |
|---|---|
| Founded | 2003 |
| Focus | Managed care, wellness-focused |
| Differentiator | Disease management programs |
| Market position | Mid to premium segment |
What Makes Resolution Different
Managed Care Model
| Traditional Insurance | Resolution's Approach |
|---|---|
| Pay for sickness | Invest in wellness |
| Reactive claims | Proactive management |
| Any doctor, any time | Coordinated care pathways |
| Volume-based | Value-based |
Disease Management Programs
Resolution focuses on keeping people healthy:
| Program | What It Does |
|---|---|
| Chronic disease management | Active management of diabetes, hypertension, etc. |
| Wellness programs | Preventive screenings, health education |
| Care coordination | Guide members to right care |
| Health coaching | Support for lifestyle changes |
Product Portfolio
Individual & Family Plans
| Product | Target | Key Features |
|---|---|---|
| Resolution Personal | Individuals | Flexible, tiered options |
| Resolution Family | Families | Comprehensive family coverage |
| Resolution Senior | 55+ | Age-appropriate benefits |
SME & Corporate Plans
| Product | Target | Key Features |
|---|---|---|
| Resolution SME | Small businesses | Affordable group rates |
| Resolution Corporate | Medium-large companies | Full managed care |
| Resolution Executive | Senior management | Premium benefits |
Coverage Options
Inpatient Benefits
| Tier | Annual Limit | Key Inclusions |
|---|---|---|
| Essential | KES 1,000,000 | Core hospital coverage |
| Classic | KES 2,000,000 | Enhanced limits |
| Premier | KES 5,000,000 | Comprehensive |
| Executive | KES 10,000,000+ | Maximum coverage |
Outpatient Benefits
| Tier | Annual Limit | Key Features |
|---|---|---|
| Essential | KES 60,000 | GP, basic lab, pharmacy |
| Classic | KES 100,000 | + Specialist consultations |
| Premier | KES 150,000 | + Wellness benefits |
| Executive | KES 250,000+ | Comprehensive with executive screenings |
Wellness Benefits
| Benefit | What's Included |
|---|---|
| Annual health check | Executive checkup coverage |
| Gym benefits | Some plans include |
| Health coaching | Chronic disease support |
| Vaccination | Preventive immunizations |
Target Markets
Ideal Clients for Resolution
| Client Profile | Why Resolution Fits |
|---|---|
| Health-conscious individuals | Wellness focus appeals |
| Companies wanting wellness | Disease management programs |
| Chronic disease members | Management programs help |
| Value-driven buyers | Better outcomes, controlled costs |
| HR wanting engaged employees | Wellness programs boost engagement |
Where Resolution Shines
| Scenario | Resolution Advantage |
|---|---|
| Employee wellness initiatives | Integrated programs |
| Chronic disease management | Proactive support |
| Cost containment (long-term) | Prevention reduces claims |
| Care quality focus | Managed care protocols |
Premium Structures
Individual Premiums (Estimated)
| Cover Level | Individual (25–35) | Family (4) |
|---|---|---|
| Essential | KES 35,000–50,000 | KES 100,000–140,000 |
| Classic | KES 55,000–80,000 | KES 160,000–220,000 |
| Premier | KES 90,000–130,000 | KES 250,000–350,000 |
Group Premiums
Competitive rates especially for:
- Companies investing in wellness
- Groups with good claims experience
- Long-term partnerships
Selling Strategies
The Wellness Pitch
Don't just sell insurance. Sell better health.
| Say | Don't Say |
|---|---|
| "This keeps you healthier" | "This pays your bills" |
| "Prevention saves money long-term" | "Same as everyone else" |
| "Disease management helps control conditions" | "We cover treatment" |
The Value Pitch
Focus on outcomes, not just coverage:
| Outcome | How to Position |
|---|---|
| Lower long-term costs | "Prevention is cheaper than cure" |
| Better employee health | "Healthy employees are productive" |
| Managed chronic conditions | "Keep diabetes/BP under control" |
| Employee satisfaction | "Wellness shows you care" |
SME Pitch
For companies with 5–50 employees:
"Resolution helps keep your team healthy, not just covered. Their disease management programs mean employees with conditions like diabetes get support — which reduces severe claims and keeps your premiums sustainable."
Corporate Pitch
For larger companies:
"Looking at insurance as just a cost? Resolution's approach treats it as an investment in your workforce. Their wellness programs, health coaching, and disease management actually improve employee health — which affects productivity, absenteeism, and retention."
Commission Structures
Typical Rates
| Product Type | Commission Range |
|---|---|
| Individual health | 15–18% |
| Family health | 15–18% |
| SME group | 10–15% |
| Corporate | 8–12% |
| Renewals | 5–8% |
Production Incentives
Building a book with Resolution can unlock:
- Volume bonuses
- Retention bonuses
- Annual production awards
Underwriting Approach
Individual Applications
| Requirement | Details |
|---|---|
| Application form | Standard health questionnaire |
| Medical underwriting | Based on health history |
| Pre-existing conditions | Coverage with waiting periods typically |
| Loading | Applied for specific conditions |
Group Applications
| Requirement | Details |
|---|---|
| Census data | Age, gender, location |
| Claims history | If switching insurers |
| Industry | Risk factor |
| Group size | Minimum requirements |
Claims Process
Outpatient
| Method | Process |
|---|---|
| Network provider | Present ID, direct billing |
| Non-network | Pay, submit for reimbursement |
| Managed care | May require referral for specialists |
Inpatient
| Step | Process |
|---|---|
| Pre-authorization | Required for planned admissions |
| Emergency | Notify within 24 hours |
| Direct billing | At network hospitals |
| Case management | For complex cases |
Hospital Network
Network Characteristics
| Feature | Details |
|---|---|
| Public hospitals | Selected |
| Private hospitals | Good network |
| Premium hospitals | Some with co-pay |
| Upcountry | Growing coverage |
Managed Care Impact
| Aspect | How It Works |
|---|---|
| Primary care | Encouraged as first stop |
| Referrals | May be needed for specialists |
| Care coordination | Support for complex cases |
| Quality focus | Network based on quality, not just price |
Competitive Positioning
Resolution vs Traditional Insurers
| Factor | Resolution | Traditional |
|---|---|---|
| Wellness focus | High | Low |
| Disease management | Included | Rare |
| Premium | Similar to mid-tier | Varies |
| Care coordination | Yes | Limited |
| Long-term value | Better outcomes | Just claims |
When to Recommend Resolution
| Client Profile | Recommendation |
|---|---|
| Values wellness | Yes |
| Has chronic conditions | Yes — management programs |
| Company wanting to invest in health | Yes |
| Just wants cheapest option | Maybe not |
| Wants any hospital, any time | May not suit |
Objection Handling
"What's managed care? Sounds restrictive."
"Managed care means they actively help manage your health, not restrict it. You still choose your doctors — they just add support like disease management for chronic conditions, wellness programs, and coordinated care. It's more support, not more restrictions."
"We want freedom to go anywhere."
"You can access a wide network. The managed care approach means if you have a complex situation, you get support navigating it. It's like having a health guide, not a gatekeeper."
"How is this different from regular insurance?"
"Regular insurance pays when you're sick. Resolution also invests in keeping you healthy. Their disease management, wellness programs, and preventive care actually reduce how often you need to claim — which is better for you and keeps premiums stable."
Agent Support
What Resolution Provides
| Support | Details |
|---|---|
| Training | Product and managed care education |
| Marketing materials | Wellness-focused content |
| Quote tools | Digital quoting |
| Account support | For group business |
The Bottom Line
Resolution Health is your go-to when:
- Client values wellness, not just insurance
- Company wants to invest in employee health
- Members have chronic conditions needing management
- Long-term value matters more than lowest premium
Position Resolution as the smart choice for health-conscious clients and forward-thinking employers.
Next Steps
- Understand the managed care model
- Identify wellness-focused clients
- Learn the disease management programs
- Position as investment, not expense
- Use: BimaSasa Quote Comparison Tool
Start Generating Quotes in Minutes
Compare quotes from Kenya's leading insurers and send a client a proposal in under a minute.
No credit card required.
Get quotes from 40+ underwriters in under 30 seconds.
All quotes meet Insurance Regulatory Authority standards.
Never miss a commission payment with automatic tracking.