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sharedvisions
DIFFERENT PERSPECTIVES
2017
ANNUAL
BUSINESS R
EPORT
04Different perspectives shared viewpoints
20 Together, let’s get involved for those who commit!
22 Groupe Sham and Sham results
102017 highlights
16Local and regional authorities market
17Contributing to the development of its environment06
Sham governance
1290 years of experience, ambition and support
08Groupe Sham
14Health and social care market
Summary
How would you sum up the year for Groupe Sham?JL.C: Groupe Sham had an excellent year in an environment that was rough in France but favourable internationally. The Group expanded in its two markets, health and social care and local and regional authorities, with strong leadership thanks to the expertise and long-standing position of Sham and Sofaxis, and through four brands – Sham, Sofaxis, Ravinale and Neeria - that enable it to operate in France, Spain and Italy in its three core businesses: insurance, brokerage and services.
DGO: With €829 million in premiums collected, €54 million more than in 2016, the results are tangible. They reflect our choices, our thinking, the investments made by the Group and the day-to-day performance of the teams. In a particularly tough environment, we managed to defend our positions in our core businesses – medical liability and statutory insurance –, attract new clients in new segments – disabilities and social care – and achieve strong commercial successes in France, Spain and Italy.
In the Group’s two traditional markets – health and social care and local and regional authorities – the situation has become more complex. How do you explain this?JL.C: This situation is not new. For many years, we have observed two major phenomena in France that affect our two key markets. First of all, healthcare providers are reorganising in the public sector with the creation of regional hospital groups (GHT) and in the private sector through external growth operations of private clinics groups. They must also incorporate market trends in order to deliver high-quality
shared viewpoints
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DIFFERENT PERSPECTIVESJean-Luc ChassaniolChairman of Sham’s Board of Directors
innovative services: data-driven business, price reform and the patient’s central role in his/her care. Added to that is an extremely intense competition that continues to be characterised by strong price pressure.
DGO: This is also true in the local and regional authorities market, particularly in statutory insurance, which has been under significant regulatory and financial pressure. The strategic choices made in recent years sought to anticipate this increased complexity.
As a matter of fact, you are nearing the end of your strategic plan Crescendo2018! Are you in line with your objectives?JL.C: For the past three years, the Group has implemented an ambitious plan, the results of which are very significant. By diversifying its activities and geographic markets, making changes to its organisation, forming partnerships with leading market players, opening up to new clients and so on, the Group has evolved considerably to keep pace with the changing needs of its clients and members in France and Europe.
DGO: Sham’s success in Spain and Italy, where we have already established a strong presence in less than four years, is a good example of the Group’s mutualist and entrepreneurial spirit: we offer a long-term perspective while seizing opportunities to adapt to the needs of healthcare, social and medical-social professionals and local and regional authorities.
As Sham celebrates its 90 this year, what is your long-term view for the Group?DGO: In 90 years, Sham has become a major, solid and essential group in France, and now internationally, that covers the business risks of its clients and members. We will continue to reinvent ourselves in order to offer our clients high-value services that best meet their challenges. This means that we will continue our development in Europe with our first German members in 2018 and consolidate our position as a leading player in Spain and Italy. We will also continue to diversify our client base and risk types by drawing on our long-standing leadership positions in France.
JL.C: As we have seen, Groupe Sham has a lot of strenghts for the future. As Chairman, I am especially proud of the progress made by a mutual insurance company created in 1927 in Lyon that was conceived from the outset as a trusted partner of healthcare professionals.
I would like to underscore the constant involvement of Sham’s Board of Directors and the extraordinary quality of the work carried out by the Group’s 952 current employees, as well as those who preceded them over the past 90 years, to make Groupe Sham, today and tomorrow, a European mutual insurance group dedicated to its members and clients.
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Dominique GodetChief Executive Officer of Groupe Sham
SHAM GOVERNANCE
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SPECIALISED COMMITTEES OF THE BOARD OF DIRECTORSBureau– Mr. CHASSANIOL (Chairman)– Mr. BOSSARD– Ms. GEINDRE– Ms. HUBERT– Mr. PENAUD – Ms. RIET
Technical Committee– Ms. HUBERT (Chairwoman)– Ms. CAUCASE– Mr. CURTIS– Mr. DUCREUX– Mr. JACQUES– Mr. VIGOUROUX– 1 representative of HANNOVER RE*– 1 representative of MUNICH RE*
Financial Committee– Mr. PENAUD (Chairman)– Ms. GEINDRE– Mr. PAUTONNIER– Ms. VAUCONSANT
Audit Committee– Mr. BOSSARD (Chairman)– Ms. ANATOLE-TOUZET– Mr. BONAFINI*– Mr. COUHERT– Mr. LAFORCE*– Mr. SALAGNAC
* As a qualified individual
THE BOARD OF DIRECTORSAdministrators
– Centre Hospitalier Universitaire de Rennes, represented by Ms. Véronique ANATOLE-TOUZET [01]
– Assistance Publique Hôpitaux de Marseille, represented by Mr. Jean-Olivier ARNAUD [02]
– Centre Hospitalier de La Ciotat, represented by Mr. Walid BEN BRAHIM [03]
– Centre Hospitalier Régional et Universitaire de Lille, represented by Mr. Frédéric BOIRON [04]
– Maison de Retraite de la Loire in Saint-Just-Saint-Rambert, represented by Ms. Myriam CAUCASE [05]
– Groupement Hospitalier de la Mutualité Française in Paris, represented by Mr. Michel COUHERT [06]
– Administrator elected by employees, Mr. Bruno CURTIS [07]
– Doctor Jean-Claude DUCREUX [08]
– Works council representative in the board of directors, Mrs Pelin ERHAN [09]
– Centre Hospitalier Universitaire de Saint-Etienne, represented by Mr. Michaël GALY [10]
– Hôpitaux Universitaires de Strasbourg, represented by Mr. Christophe GAUTIER [11]
– Hospices Civils de Lyon, represented by Ms. Catherine GEINDRE [12]
– Centre Hospitalier Universitaire de Grenoble, represented by Ms. Jacqueline HUBERT [13]
– Centre Hospitalier d’Avignon, represented by Mr. Jean-Noël JACQUES [14]
– Centre Hospitalier Universitaire d’Angers, represented by Ms. Cécile Jaglin-GRIMONPREZ [15]
– Centre Hospitalier de Cornouaille in Quimper, represented by Mr. Jean-Roger PAUTONNIER [16]
– Mr. Marc PENAUD [17]
– Fédération Hospitalière de France in Paris, represented by Ms. Zaynab RIET [18]
– Centre Hospitalier Universitaire de Clermont-Ferrand, represented by Mr. André SALAGNAC [19]
– Centre Hospitalier de Gonesse, represented by Ms. Catherine VAUCONSANT [20]
– Centre Hospitalier Universitaire de Bordeaux, represented by M. Philippe VIGOUROUX [21]
ChairmanMr. Jean-Luc CHASSANIOL, GHT Paris Psychiatrie & Neurosciences [22]
Deputy ChairmanMr. Olivier BOSSARD, Centre Hospitalier du Mans [23]
CEOMr. Dominique GODET [24]
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Groupe
SHAMLeading global partner of healthcare and social care professionals and local and regional authorities involved in management, prevention and insurance of risks associated with their activities.With expertise in insurance, brokerage, consultancy and services, combined with a commitment to mutualist principles and an entrepreneurial drive, Groupe Sham offers all professionals in the healthcare, social care
and local authorities fields - whether public, para-public or private - solutions to manage, prevent and insure the risks associated with their activities, both in France and internationally.
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HEALTH AND SOCIAL CARE MARKET LOCAL & REGIONAL MARKET
LOCA
TION
S
GermanyFrance Spain Italy France
BUSI
NESS
LINE
S
Insurance Brokerage Services
BRAN
DSSE
GMEN
TS
– Public healthcare institutions– Private healthcare institutions– Healthcare professionals– Social and medical-social institutions
– Local and regional authorities– Local public and para-public
companies– Other local and regional players
MISSIONSupport our clients in managing the risks associated with their activities in order to strengthen the performance of their organisation and improve the quality of services they provide as part of their public interest mission.
A GROUP ENHANCED BY THE DIVERSITY OF ITS EMPLOYEES
MADRID
BOURGES
BARCELONA
DORTMUND
ROMA
TORINOLYON
ORLÉANS
A EUROPEAN MUTUAL GROUP
HIGH-VALUE OFFERING
INSURANCE SOLUTIONS
All branches and all risks in France
Medical risk in Italy, Spain and Germany
RISK MANAGEMENT
Risk identification, reduction and audit, third-party
management, consultancy, training and methodological
resources
BEING OUR CLIENTS’
RISK MANAGER
+ =
09
952EMPLOYEES
67% WOMEN
33% MEN
32,000
CLIENT-MEMBERS IN EUROPE
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2017
STRONG PRESENCE WITHIN ITS ENVIRONMENTJANUARY
– Sofaxis, partner of Préfon and Fonpel Sofaxis signed a partnership agreement with Préfon (French national public service welfare fund), expanding its offering to include an appropriate retirement solution for all current and former civil servants and their spouses. This agreement follows the partnership that Sofaxis entered into in 2008 with Fonpel (pension fund for local elected officials) through which it offers elected officials an effective supplemental retirement solution.
– ShamLab, serving customer innovationLaunched in early 2017, the aim of ShamLab is to provide Sham cross-functional expertise in data analysis, facilitating knowledge of clients and members for closer proximity and appropriate responses to their needs.
FEBRUARY
– Sham, associated member of LyonbiopôleSham deepened its involvement in its environment by joining Lyonbiopôle, the competitive health cluster in the Auvergne Rhône-Alpes region, as an associate member. This partnership embodies the Group’s commitment to research by supporting the emergence of innovative medical solutions while showcasing the region’s strengths at an international level.
APRIL
– Sham, partner of MGASSham formed a partnership with MGAS (Mutuelle Générale des Affaires Sociales), the leading mutual insurance company for the staff of the French Ministry of Social Affairs and Health, to help it enhance its high-value offering. This partnership, built on shared values and complementary expertise, will allow the implementation of civil liability insurance solutions and services to control the risks associated with the activity of the Ministry’s staff.
MAY
– Groupe Sham is involved in training of EHESP’s students
The Angers CHU, Angers University, the French School of Advanced Public Health Studies (EHESP) and Sham have formed a pioneering partnership to offer simulation-based management training dedicated to hospital directors to be. Very quickly after they begin working, hospital directors are faced with complex management situations.
To ensure that they are well-prepared, these four players in the education and healthcare sectors have developed an unprecedented educational programme funded by Sham.This innovative project is fully in line with Sham’s commitment to provide healthcare professionals with support, protection and risk prevention.
OCTOBER
– Sofaxis, partner of French departmental fire and emergency services
The staff at Sofaxis and Neeria took part in the 124th national firefighters’ conference, which was held this year in Ajaccio and brought together decision-makers from departmental fire and emergency services across France.
– Sham supports the IPO of biotech company Biom’up
Through its investment company, Sham Innovation Santé, Sham is a long-time partner of Biom’Up, a Lyon-based company founded in 2005 that specialises in surgical hemostasis. By acquiring a stake in Biom’up, Sham Innovation Santé is deepening its involvement in innovation and research, in line with its investment policy. Sham is proud to support this company, which was listed on Euronext Paris on 13 October 2017.
DECEMBER
– Sofaxis speaks on the user experience and public-sector performance
As part of the Strasbourg regional meetings, which attracted more than 1,000 public decision-makers over two days, and its partnership with the National Center of territorial civil services (CNFPT) and the National Institute of Regional Studies (INET), Sofaxis presented a workshop on the user experience and public-sector performance. This workshop, entitled “Users-agents: two visions, one meeting for one public service”, was a great success and was enthusiastically received by the dozens of local and regional decision-makers in attendance.
– Neeria supports Regional Hospitals Groups (GHT)
In 2017, as part of an agreement with UNIHA/DGOS, dedicated to support Regional Hospitals Groups, Neeria oversaw a consortium to run 9 consultancy tasks focus on writing shared medical projects, medical-technical activities clustering and human resources management.
HIGHLIGHTS
COMMERCIAL SUCCESSES – Groupe Sham’s first medical
analysis laboratory clientIn keeping with its objective of opening up to new types of clients, in 2017 Groupe Sham gained its first medical analysis laboratory, Groupe Bio-Access, enabling it to target new players in the healthcare, social and medical-social sectors.
– Capio Group chooses Sham for 3 years
Groupe Capio, a leader in the private hospital sector, chose Sham to provide assistance with insurance and risk management as part of a three-year collaboration. Sham offers a comprehensive risk management programme that combines insurance (civil liability of the Group’s 22 French clinics) and services.
INTERNATIONAL– A new year of growth in Europe2017 marked a turning point in Groupe Sham’s international development, which included: . the launch of operations in Germany with the
opening of an office in Dortmund, which had five employees as of 1 April 2017;
. the award of a major contract to insure Catalonia’s healthcare system, which positions Sham as Spain’s leading provider of medical liability insurance;
. further development in Italy (no. 2 ranking in medical liability) and especially in northern Italy (top ranking), particularly in terms of risk management (risk inspections) and with the second edition of the “Premio Sham – ANFCI” contest.
CLIENT RELATIONS AND RISK MANAGEMENTOCTOBER
– Sofaxis’s clients relationship service celebrates its 10th anniversary
Sofaxis’s clients relationship service opened its doors in 2007 with eight employees aiming to become a real entry point for its clients. This goal was achieved since the department, which today has 24 employees who are experts in the fields of statutory insurance, services and health - welfare and property and casualty, has grown continuously, with 100,000 incoming calls received in 2017.
– New success for Connect’daysOnce again this year, Connect’days, live online conferences presented by experts from Sofaxis and Neeria, were a resounding success, attracting hundreds of Internet users. The four topics discussed ranged from absence for health reasons to quality of life in the workplace and assistance with staff retirement.
DECEMBER
– Prix Sham contest gets a makeoverFor its 18th edition, the Prix Sham risk prevention contest underwent a transformation, becoming the Sham Risk Management contest. The goal: to go a step further in encouraging and rewarding actions that promote risk prevention. The contest was opened to all healthcare, social and medical-social institutions and not only to the Group’s members. It recognises projects that have not yet been implemented and will include a skills-based sponsorship in addition to the financial allocation awarded to winners. The categories have also been updated to reward three original and innovative initiatives in the fields of human resources/quality of life in the workplace, care of patients and residents and digital technology and new risks. As usual the winners were announced at Sham’s General Meeting.
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90 YEARS OF EXPERIENCE,
ambition and support
From the mutual hospital insurances company founded in Lyon on 10 December 1927 to an international group in 2018, Sham has reinvented itself throughout its history by offering healthcare professionals global risk management solutions to secure their business.
1 January 1928
Société Hospitalière d’Assurances Mutuelles officially launches its business, which entails handling “exclusively the coverage of Work Accidents involving lay and religious hospital staff” with products offered to 20 member hospitals.
“Sham was founded primarily to cover the risks relating to work accidents and occupational illnesses of hospital staff (doctors and employees). Particularly the risk of tuberculosis, which the market’s insurers no longer wanted to cover, or those with extremely expensive conditions. French public hospitals therefore decided to join forces and create their own mutual insurance company, which was headquartered in Lyon”-GILLES FONTANA, SHAM MISSION DIRECTOR UNTIL 2017
The 1960s
Sham, already a major player with nearly 900 members in 1969.
Everyone could relate to the risk coverage offered by THE Sham, as “hospital workers” called it – among themselves. An affectionate sign of recognition that the company would embrace by simplifying its company name, which in 1961 became “Société Hospitalière d’Assurances Mutuelles”.
“Sham evolved with its own history. At first, it was work accidents, then fire. Civil liability started developing in the 1960s. That was when Sham acquired all its expertise, its specialisation, ...it came into its own with civil liability.”-MICHEL GERMOND, SHAM DIRECTOR UNTIL 2017
The 1990s - 2000
Sham becomes the safe haven for numerous hospitals. Result of the surge in the number of lawsuits.
“... In the 2000s, the medical liability market went through a major crisis. Foreign competitors that began arriving in 1999 took advantage of the brand new Kouchner law passed in 2002 to cancel insurance policies on the grounds that they no longer had control over claims management. Many institutions found themselves without an insurer. By taking over most of the policies and gradually adjusting prices, Sham was (and still is) a stabilising factor in this specific medical liability market.”-BRUNO CURTIS, KEY ACCOUNTS SALES MANAGER
THE KEY PHASES OF SHAM’S HISTORY
1928-1938 1958-1978 1998-2005
2013
Sham acquires Sofaxis, the expert in insurance for local and regional authorities. Creation of Groupe Sham.
“With the acquisition of Sofaxis and 500 more employees, we needed to rethink Sham’s strategy, which led to the introduction of a new plan – Crescendo2018 ! It represents a diversification of Sham’s traditional model – in the sense of mutual company, insurance company... It involved a great deal of work on synergies and expertise, particularly in the services teams at the time of the creation of Neeria, the brand that encompasses all the Group’s service activities in France.”-YVES GAILLOT, HUMAN RESOURCES GROUPE SHAM DIRECTOR
2014
Sham enters the european market, opening a first office in Spain and Italy (2015), and then in Germany (2017).
“The new team (since 2010) wanted to expand Sham’s scope of activity by opening up to social and medical-social institutions, then to private institutions – first not-for-profit and then for-profit – to professionals working at these private institutions and, more recently, to the international market to export Sham’s expertise beyond France’s borders.” -OLIVIER BOSSARD, DEPUTY CHAIRMAN OF THE BOARD OF DIRECTORS OF SHAM, DIRECTOR OF CENTRE HOSPITALIER DU MANS
2018
A European mutual insurance group that employs over 950 people in four countries.
“Our international presence is a major success for Groupe Sham, which has managed to restructure itself substantially in just a short period of time. In Italy, in Spain, and now in Germany, we are moving ahead with this same idea of offering high-value products and services that combine our mutualist vision and overall risk management, from quality process to accident.”-JEAN-LUC CHASSANIOL, CHAIRMAN OF THE BOARD OF DIRECTORS OF SHAM, DIRECTOR OF GHT PARIS PSYCHIATRIE & NEUROSCIENCES
KEY FIGURES
“For several years, we have reported very good results, which justify our development and diversification strategy and underscore the relevance of Sham’s mutualist model, now also recognised internationally. We are thus realising our collective aim of positioning ourselves as a leading European mutual group for the long term.”-DOMINIQUE GODET, CHIEF EXECUTIVE OFFICER OF GROUPE SHAM
438
11 000
952
1928 19281968 19681988 19882008 20082018 2018
180
8 373
94
3 710
19900
≤ 5 20
13
Change in number of employees:
Change in number of members:
GROUPE SHAM
SHAM
Challenges Beyond the national disparities that exist in terms of healthcare organisations and legal frameworks, medical liability is essential to ensuring the reliability and performance of healthcare delivery. The safety and trust of patients, the protection of doctors and the efficiency of institutions depend on it.
In a context of sweeping reforms and major demographic and structural changes to the healthcare system, healthcare provision is inevitably being altered. Societal factors must also be taken into account, such as the expanding role of better-informed, more demanding patients, the growth of digital technology and international developments.
One of the main challenges therefore is to ensure secured operations in an intensifying risk environment, while at the same time dealing with growing complexity in terms of the financial stability of organisations, whether public or private. Lastly, the human factor is important, and the focal point of healthcare institutions, because people are the sector’s most valuable asset.
Quality, transparency and safetyThrough its day-to-day commitment to healthcare professionals for over 90 years, Groupe Sham’s ambition goes well beyond the insurance policy. Its goal is to help improve practices by offering risk management tailored to organisations’ requirements. With the objective to ensure the permanence and quality of the care provided to patients, while being mindful of the working conditions of healthcare professionals.
As a specialised mutual insurer fully involved and engaged in its ecosystem, Groupe Sham has in-depth knowledge of healthcare professionals. This allows it to offer a broad range of risk management, prevention and insurance products and services and to support all healthcare, social and medical-social professionals, whether in the public or private sector.
In recent years, the day-to-day lives of healthcare and social care professionals have been impacted by major structural, demographic and regulatory changes. They are working in a new environment that entails new risks and new requirements.
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HEALTH AND SOCIAL CARE
market
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#1 in northern Italy:
11,000CLIENTS IN EUROPE
100% AMONG ALL REGIONAL HOSPITAL GROUPS
present
LEADING PROVIDER OF MEDICAL liability insurance in France
#1 in Spain:
European presence and expertiseGroupe Sham’s teams develop their expertise across all the Group’s sites. Together with in-depth knowledge of the markets, this expertise ensures the relevance and effectiveness of the solutions offered to members.Strengthening collaboration within the Group also offers unique benchmarking and continuous improvement opportunities in terms of risk and claims management.
MADRID
BOURGES
DORTMUND
ROMA
TORINOLYON
ORLÉANS
BARCELONA
€425.6 million in premiums collected in Europe
Promoting risk management across EuropeRisk management is a key element of Groupe Sham’s development in France and internationally. Each year, Sham recognises particularly innovative and original risk prevention initiatives through the Sham Risk Management contest in France, Spain and Italy.
50PUBLIC HOSPITALSPUBLICS
150 HEALTHCARE INSTITUTIONS
1,250 HEALTHCARE CENTRES ET PRIVÉS
40,000 DOCTORS
THIRDS OF ALL DELIVERIES2HEALTHCARE INSTITUTION OUT OF EVERY INSURED FOR EMPLOYEE LIABILITY
1 3
2 HEALTHCARE INSTITUTIONS OUT OF EVERY 3 INSURED FOR CIVIL LIABILITY
Given that all these changes have not yet been finalised within local and regional authorities, the overall reduction in central government grants and the end of subsidised jobs have intensified the efforts made in recent years to pool services and achieve operational efficiency.Since the ageing workforce is also an ongoing issue for local and regional authorities, their desire to improve performance in order to continue to effectively carry out their public interest missions hinges on greater control over the long-term employability of their staff.
To achieve the transformation they are engaged in local and regional authorities must now pay close attention to the correlation between their staff’s quality of life in the workplace and the quality of public service provided to users. Concrete, coordinated actions in the area of occupational health must therefore be a part of the strategic planning of local and regional decision-makers.
For most local and regional decision-makers, 2017 was again a «post-reform» year marked by the multiple effects of the changes within the local and regional ecosystems, particularly in terms of organisation and management of human resources.
LOCAL AND
21,000 clients
€403.1million in premiums collected
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regional authorities market
956,000CLAIMS PROCESSED UNDER
STATUTORY INSURANCE POLICIES
Reference partner of local and regional players in their public interest missions
2 3OUT OF EVERY DEPARTMENTAL FIRE AND SAFETY AGENCIES
REGIONAL AUTHORITIES
1 2OUT OF EVERY
LOCAL AND
ADMINISTRATIVE CENTRESOUT OF EVERY2 3
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Groupe Sham has made a long-term commitment within its environment, alongside its partners in the healthcare, local and regional authorities and insurance sectors, with a focus on innovation and expertise, the development and sharing of best practices and value creation.Its goal is to form meaningful partnerships with organisations who share the same values. The Group is committed to maintaining constructive mutual relationships.
TO THE DEVELOPMENTCONTRIBUTING
of its environment
A MUTUALIST PLAYER THAT WORKS CLOSELY WITH ITS PARTNERS
Committed within its environmentThrough its entities, Groupe Sham plays an active role alongside major federations and players in the healthcare ecosystem and local and regional authorities. For example, since 2007 Sham has partnered with the French hospital directors association (ADH), with which it shares a commitment to developing and promoting public hospital service. The Group also works with many regional delegations of the federation of hospitals and personal assistance facilities (FEHAP), several regional inter-federal unions of private health and welfare organisations (URIOPSS) and the federation of private hospitals (FHP), thereby reaffirming its long-term commitment to private institutions.
In Italy, Sham is a partner of Federsanità, particularly in connection with the Sham Risk Management contest, with the aim to promoting a common risk prevention culture.
Sham also works with Spanish healthcare federations and professionals through its partnerships with ASPE (Alianza de la Sanidad Priva da Española), SEDISA (Sociedad Española de Directivos de la Salud) and AEGRIS (Asociación Española de Gestión de Riesgos Sanitarios).
With a focus on momentum and a strong presence in its environment, Sofaxis also implements a policy of forming partnerships with associations such as the association of General Directors of French municipalities (ADGCF) and the national syndicate of General Directors of local authorities (SNDGCT), particularly by conducting joint studies on overall management of absenteeism risk.
Since 2016, Sofaxis has also partnered with Villes de France, an association of elected officials that brings together more than 200 municipalities with 15 to 100,000 inhabitants. After an initial collaboration with this association in 2016 and the completion of a joint study with La Banque Postale presented at the «Rendez-vous de l’intelligence locale», a new Sofaxis study is under way, which will again focus on the links between quality of life in the workplace and absences for health reasons.
Involved in the insurance sectorTo share its expertise in the field of insurance for the healthcare, social and medical-social sector, Groupe Sham has developed close relationships with professional organisations in the insurance industry in France and Europe, including Europa Medica (association of European medical mutual insurance companies), the French Insurance Federation, the association of mutual insurance companies (ROAM), the association for the study of compensation for bodily injury (AREDOC), etc.In Germany, Sham is also a member of the association of German insurers (GDV).
An active player in skills development, research and innovationGroupe Sham, which is always interested in innovative projects, supports the development of expertise and new medical practices. It participates in many chairs and organisations such as CINEAS (training organisation created by the University of Milan in Italy), works with the University of Barcelona and the COMB (Barcelona college of physicians) and is involved in the health management and new technologies chair (ongoing training for healthcare professionals offered by the EHESP and the University of Compiègne).
Since 2015, the Group has also supported the Fonds FHF Recherche et Innovation, a research and innovation fund aimed at supporting innovative projects, facilitating progress made by hospitals and promoting French medical excellence.
In addition, Groupe Sham provides funding for innovative projects and promotes work carried out in key specialist areas. For instance, it has rewarded the research work carried out by CNGOF (national board of French gynaecologists and obstetricians), SOFCOT (French society of orthopaedic surgery and traumatology) and the Académie Nationale de Chirurgie (national academy of surgery) with the Sham award for surgical risk prevention. The support provided to these professional associations through the awards furthers research in medical specialisms, encourages young doctors to engage in research and enables publication of their work. Key partner to meet market requirementsIn a constant effort to find effective, innovative solutions to meet the needs of its clients and partners, Groupe Sham forms partnerships with other experts in the healthcare sector, in keeping with its strategy of diversifying its activities and developing its business with healthcare professionals.
For example, Sham helps healthcare professionals manage their business risks and meet their new requirements amid changes in the healthcare chain, in partnership with Groupe Pasteur Mutualité, a leading mutual insurance group. Sham also formed a partnership in the area of personal insurance with Apicil, France’s fifth largest social protection group, to offer complementary solutions tailored to new market requirements. Neeria, Groupe Sham’s consultancy and services company, also partners with HEVA, a recognised player in health data processing and data visualisation, to offer a solution that combines the provision of health data and advice on implementing strategic analyses.
AN ECONOMIC PLAYER AT THE CENTRE OF ITS ECOSYSTEMGroupe Sham is an economic player that works on several fronts: local economic activity, real estate, scientific and technological innovation and support for hospital development.
Support for scientific and technological innovation As part of its investment policy, Groupe Sham invests in innovative companies in the healthcare sector to help them get started or to support their growth projects. For this, the Group relies on Sham Innovation Santé, an investment entity that manages its investments in healthcare companies, in partnership with Turenne Capital.
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CONTRIBUTING TO THE DEVELOPMENT OF ITS ENVIRONMENT
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INVESTMENTS: A MEANINGFUL COMMITMENTIn keeping with its mutualist values,
Groupe Sham manages its funds by taking a professional, responsible and
results-oriented approach. In recognition of this policy, the Group was awarded the Instit Invest - Agefi Transparency Label, which highlights its transparency in the area of management and financial communication, its professionalism and its recent investment initiatives.
This allows Sham to support the digital revolution currently under way among healthcare institutions and professionals, with the aim of helping to improve the quality of care. In 2016, Sham invested in Extens, the first private equity fund dedicated to e-health in Europe. Sham has also invested in Simba Santé, a company that finances and supports innovative companies in the health sector, such as Imalink, a pioneer in the telemedicine market in France and internationally.
Partner in its clients’ economic activityGroupe Sham also finances hospitals’ investments to help them improve their structures and services. To this end, the Group has formed a partnership with Crédit Mutuel Arkea and has used a portion of its investments to finance the investments of healthcare institutions since 2016. The Group has invested a total of €90 million in 30 hospitals since the start of the partnership.Sham has also been active in the bond market since 2009, investing in bonds issued by CHUs (university hospitals)
Player in local economic activityThe Group also plays an active role in the real estate sector through an investment policy that focuses on energy performance, quality and users’ well-being. Along these lines, it is involved in the rehabilitation of properties in the Lyon metropolitan area, the Group’s historic home base.
ESG1 criteria: a high-performance playerAs in 2016, Groupe Sham continued to assess the environmental, social and governance aspects of its financial investment portfolio as part of its investment policy.
These criteria are used to assess the quality of the Corporate Social Responsibility policy (social dialogue, respect for employee rights, independence of the Board of Directors, prevention of environmental risks, etc.) and their business model.
Based on studies conducted by Ethifinance, an extra financial analysis and consultancy firm, the ESG performance analysis has a satisfactory coverage rate with nearly 83% of the issuers analysed covered. The results of the assessment are summarised using a rating scale from A (strong performance) to D (weak performance).
The average ESG rating of the financial assets held by Sham is satisfactory, with an average rating in 2017 of A compared to B the previous year. The financial investments in the portfolio perform particularly well in terms of environmental and social criteria.
NOTATION ESG GLOBALE : A
With regard to carbon footprint, the issuers in the portfolio were less carbon-intensive than in 2016 (average intensity of 333.6 tCO2e in 2017 compared to 478.3 tCO2e in 2016). Compared to its market index2, the CO2 intensity of Sham’s portfolio is lower by 53%.
Financial investments with weak ESG performance or high carbon intensity are subject to a critical review of their financial performance and a detailed analysis of their sub-par performance by Sham’s operational governance body through the issuance of half-yearly internal reports.
Groupe Sham also monitors ESG criteria closely in its other asset classes, such as real estate, infrastructure and private equity.
1 – Environment, Social and Governance2 – Merrill Lynch 1-10 years
OVERALL ESG RATING: A
ENVIRONNEMENT AMore than 90% of issuers have built environmental criteria into their purchasing and/or procurement policies.
SOCIAL AMore than 80% of issuers have incorporated highly advanced social requirements into their supplier selection criteria.
GOVERNANCE BMore than 85% of issuers have developed whistleblowing procedures to manage compliance risk in their business practices.
€100 million in healthcare institutions
43% GROWTH COMPARED TO 2016
INVESTMENTS IN 2017
For Groupe Sham, putting the individual first demonstrates a two-fold commitment to the men and women who make up its workforce: constantly seek to develop their expertise and combine enjoyment and performance.
Each day, Groupe Sham value management close to employees and strives to build on each person’s talents, develop expertise and encourage initiatives that support its collective success.
Through shared values, a comprehensive, personalised onboarding process, a significant investment in training tailored to individual and collective needs, an international reach and a diverse range of jobs, Groupe Sham gives all its employees the opportunity to play a role in their career development while continuously helping them find fulfilment.
TOGETHER,
LET’S GET INVOLVED
for those who commit!
To hear from its employees, the Group conducts an annual internal satisfaction survey called «Happymètre». The survey provides a forum through which employees can freely express
their opinions, feelings and views in order to identify areas of improvement.
Figures from Happymètre 2017
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97% of employees enjoy working with their colleagues
90% of employees like the work atmosphere
86% OF EMPLOYEES BELIEVE THAT GROUPE SHAM COMPANIES ARE GOOD PLACES TO WORK
The desire to work collaboratively and differentlyGroupe Sham is committed to developing and promoting teamwork to allow employees to share ideas and work together each day in a friendly, team-oriented environment.
Through numerous initiatives:– diversity development (intercultural and
intergenerational relations, support for disabled people in the workplace, etc.) and a commitment to gender equality,
– layout of work areas and common areas (co-working areas, sports rooms, cafeterias, training areas, etc.),
– implementation of a unified communication system (Skype) and a corporate social network (Agora)
– development of permanent and occasional tele-commuting to improve the work-life balance
21
20,000 HOURSof employee
training
Nearly
39 YEARSaverage age
10 yearsAVERAGE SENIORITY
Working areas, a unique concept within the GroupIn order to foster a transversal approach and the sharing of a common identity, several years ago the Group launched a process of lateral reflection across all our sites. In 2017, this resulted in the redesign of all our workspaces and communal areas, including the building of new premises. The aim was to facilitate collaborative working, reconciling our professional lives with more informal moments enjoyed between colleagues.
Working at Groupe Sham means taking part in an ambitious project. Get involved with healthcare and social care professionals and local and regional authorities to help them better serve citizens, patients and users as part of their public service mission.
To help its employees find meaning in their work, Groupe Sham offers each employee the opportunity to get involved with those who commit to providing healthcare and social care and local and regional authorities.
For example, as part of the 2018 Risk Management contest, in addition to a financial allocation, winners will receive help with implementing the award-winning project from the Group’s employees. Moreover, during the onboarding workshop, each new Group employee takes part in a session lasting one and a half days to discuss and solve a day-to-day issue faced by one of the Group’s clients.
The Group’s employees can also participate in various community-based initiatives and partnerships, such as the “Course des Héros” race in support of the Rêves association, the Run in Lyon in partnership with Fondation HCL, and Les Foulées Roses d’Olivet and de Bourges, marches in which a large portion of the funds collected is given to associations committed to fighting breast cancer.
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GROUPE SHAM
“ In our anniversary year, we are all extremely proud to achieve our collective aim: positioning ourselves as a leading European mutual group for the long term. ”
Dominique Godet, Chief Executive Officer of Groupe Sham
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FINANCIAL YEAR 2017 CONSOLIDATED FINANCIAL STATEMENTS*
* Beginning in 2013
REVENUEChange (€M)
Groupe Sham reported consolidated revenue of €439M in 2017, up by €55.8M (14.5%), including €373.5M in insurance premiums, €51.7M in commissions after eliminating intercompany transactions and €13.8M in services provided. The total amount of premiums collected resulting from this revenue was €829M, an increase of €53.6M and 6.9% compared to 2016 (including €448M collected by Sofaxis, the lead entity of Groupe Sham on the regional market).
Groupe Sham’s diversification strategy covers three areas:– first, client type, with continuous growth in the portfolios related to the healthcare professionnals, social and
medical-social market, for example.– the second area concerns insured risks in order to pool claims exposure and sensitivity, especially with the
expansion of personal insurance activities with the expertise of Sofaxis. – lastly, geography is now an important element of revenue given that premiums from international business
represented 17% of 2017 revenue, only three years after Sham expanded its operations outside France.
317.7
371.6 371.0 383.2
439.0
2013 2014 2015 2016 2017
REVENUE DISTRIBUTION by insurance branch(%)
2017 €439 Million
47.3%81.7%
0.5% 0.5%27.1%
2.5%
5.6%
16.5%
2010 €291.3 Million
1.7% 0.5% 6.8%1.7%
7.6%
CIVIL LIABILITY IN FRANCE
CIVIL LIABILITY OUTSIDE FRANCE
PROPERTY DAMAGE
AUTOMOBILE
PERSONAL INSURANCE
CONSTRUCTION
ACCEPTANCES
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FINANCIAL INCOME Change (€M)
NET PROFIT Change (€M)
EQUITYChange (€M)
Groupe Sham reported consolidated financial income of €52.5M. All the portfolios by main category (bonds, equities and real estate) contributed to the increase in this income in 2017. Financial expenses were also optimised and were instrumental in achieving the high financial profitability.
As in 2015, financial income drove Groupe Sham’s very high profit level, with €25.7 million in net income, a €7.6 million increase over 2016. The Group continued to become more financially independent, with equity increasing by 8.7% to €322.6M at the end of 2017.
2017
2016
2015
2014
2013
52.5
2017
2016
2015
2014
2013
322.6
296.9
278.9
255.0
238.3
38.3
49.6
32.4
36.5
25.7
2013 2014 2015 2016 2017
18.1
23.9
16.714.3
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2017 2016Gross earned premiums 373.5 316.8Cessions -155.9 -127.1
NET PREMIUMS 217.6 189.7Gross cost of claims -343.7 -275.3Claim settlement costs -18.0 -17.3Reinsurers’ share 137.8 89.6
NET COST OF CLAIMS -223.9 -203.0Policy acquisition and administration costs -34.0 -27.5Commissions received from reinsurers 24.0 25.6Other underwritting income and expenses -8.4 -7.2NET MARGIN -24.9 -22.4Portfolio income 54.8 44.9Other non-underwriting income 0.0 0.0Extraordinary income -1.1 0.5Employee profit sharing -0.2 -0.3EARNINGS BEFORE TAX 28.7 22.7Corporate income tax -9.1 -2.5NET PROFIT 19.6 20.2
INCOME STATEMENT(€M)
In 2017, Sham’s net profit was €19.6M, in line with the average for previous years excluding 2015 when earnings benefited from a lower claims rate and particularly favourable conditions in the financial markets.
The main feature of 2017 was the very high claims rate, which confirms the inflationary trend in the cost of risk over time. Claims expenses (before reinsurance) totalled €362M including claims settlement costs versus €292M in 2016, an increase of €70M (24%), at a time when premiums grew by only €57M (18%).
Sham’s reinsurance coverage helped limit the net impact on the accounts. The performance of the financial investments also helped safeguard profitability. Financial income reached €54.8M in 2017, up by €10M (22%).
Finally, in 2017 Sham was subject to the standard corporate tax rate after the tax adjustment in 2016 relating to the provisions for claims before 1992, taxation date of the mutual.
In 2017, Sham’s revenue increased by €56.7M (18%) to €373.5M. This increase came mainly from the rapid development of international activities which, at €72M, was eight times more than in 2016.
REVENUEChange (€M)
373.5
316.8
306.3311.4
304.1
20172016201520142013
*Combined scopes of Sham and Sham Vie
FINANCIAL YEAR 2017 CORPORATE FINANCIAL STATEMENTS*
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REVENUE DISTRIBUTION by insurance branch (%)
REVENUE DISTRIBUTION by client type(%)
NUMBER OF MEMBERS
1%
60%
16%
9%
14%
CIVIL LIABILITY
PROPERTY DAMAGE
AUTOMOBILE
PERSONAL INSURANCE
CONSTRUCTION
ACCEPTANCES
PUBLIC HEALTH INSTITUTIONS
PRIVATE HEALTH INSTITUTIONS
HEALTHCARE PROFESSIONALS
SOCIAL AND MEDICAL-SOCIAL INSTITUTIONS
TERRITORIAL COMMUNITY
As a result of price pressures over the past several years, the share of revenue of the civil liability branch decreased in favour of personal insurance. With the addition of the civil liability premiums in Spain and Italy, this branch saw an increase in 2017 and now accounts for three-fourths of the premiums (+6 points compared to 2016). Other property and casualty risks (property damage, automobile and construction) totalled approximately €38M (-2.5%), and personal insurance €57M (-3.8%).
The international diversification was achieved this year with the public healthcare institutions in Spain and Italy, which represented 17% of revenue. At the same time, market shares continued to grow in the private markets, both for legal entities in social and medical-social sector and for healthcare professionals. Including all risks, Sham sent €161M in premiums to French public healthcare institutions (-4%), €50M to private institutions (+4.1%), €27M to professional healthcare members (+5.4%) and €61M to social and medical-social institutions (-4.6%).
7%
74.5%0.5%0.5% 14.5%
3%
10,12710,127The total number of members rose by 1.2% compared to 2016.
4,994physical persons
5,133legal persons
(health and care institutionsand other social entities)
€373,5 Million
€373,5 Million
TOTAL COST OF CLAIMSChange (€M)
INVESTMENT INCOME Change (€M)
2017
2016
2015
2014
2013
216.8 361.7144,9
203.3 292.288,9
176.2 271.395,1
171.7 291.2119,5
147.9 262.3114,4
FINANCIAL YEAR 2017 CORPORATE FINANCIAL STATEMENTS*
The total cost of claims in 2017 was €361.7M, an increase of €70M (24%). Except for a slight decrease in 2015, the cost of risk has continued to rise since 2011 and the cost of claims before reinsurance is now double what it was then. The increase this year came from both claims settlements and the change in provisions, but mainly pertained to the French market.
Even though an increase in premiums automatically results in an increase in claims, the deterioration in the cost of risk is very significant given that, for the first time, the amount of gross claims was higher than the premiums for the year. This confirms the need to help our members manage and prevent their risks.
For the past five years, Sham’s investment strategy, which combines financial performance with management of the risks inherent in the financial markets, has generated significant financial income while reducing the sensitivity to financial crises.
There is even an upward trend thanks to optimisation of the income and expenses of the various portfolios. Each of the portfolios contributed to the improvement in performance this year, with an increase of 15% for bonds, 18% for equities and 75% for real estate.
RESERVES FOR CLAIMS AND ANNUITIES
CLAIMS PAID AND SETTLEMENT COSTS
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*Combined scopes of Sham and Sham Vie
2017
2016
2015
2014
2013
54.8
44.9
54.8
34.2
40.9
BALANCE SHEET(€M)Consolidation scopes of Sham and Sham Vie
INVESTMENTS(€M)
ASSETS 2017 2016Intangible assets 0.6 1.1
Investments 1,717.9 1,627.2
Assignees’ share of technical provisions 788.7 704.0
Receivables 196.0 90.0Including insurance or reinsurance receivables 169.3 53.2
Other assets 142.8 102.1Accruals 41.8 28.2TOTAL ASSETS 2 887.7 2 552.6
LIABILITIES 2017 2016Equity 331.4 303.0Including fiscal year income 28.4 19.9
Subordinated debt 50.0 50.0Technical reserves 2,356.7 2,112.0Provisions for risks and charges 3.4 6.3Other debts 137.7 74.1Including insurance or reinsurance debts 77 .9 33.6
Accruals 8.4 7.1
TOTAL LIABILITIES 2,887.7 2,552.6
Total consolidated assets from insurance activities stood at €2.9 billion at 31 December 2017, up 13% versus 2016. Investments represented 59.5% of assets (compared to 63.8% in 2016). On the liabilities side, the weight of technical reserves fell slightly to 81.6% compared to 83% last year. This means that investments now represent 73% of the gross technical reserves (-4 points versus end 2016).
Sham’s and Sham Vie’s investments and cash amounted to €1.8614M at the end of 2017, up 7.5% compared to 2016. In 2017, the share of bonds fell by 1.5 points in favour of equities and similar and real estate increased by 0.3 points.
29
79%
1,470.7 BONDS
14.7 %
273 EQUITIES AND SIMILARS
6.3 %
117.7REAL ESTATE
170%170%170%170%170%
FINANCIAL YEAR 2017 CORPORATE FINANCIAL STATEMENTS*
EQUITYChange (€M)Consolidation scopes of Sham and Sham Vie
TECHNICAL RESERVES(€M)
AM BEST RATING
SOLVENCY RATIO
2017
2016
2015
2014
2013
331.4
303.0
287.4
257.3
243.8
Sham’s equity and that of its Sham Vie subsidiary totalled €331.4M at the end of 2017, an increase of 9.4% compared to end 2016. Sham continued to strengthen its equity, to which it allocated all of its net profit for the year. Sham’s and Sham Vie’s equity has increased by €114M in five years (+47%).
Sham’s and Sham Vie’s technical reserves stood at €2.357M, representing 81.6% of total liabilities. These reserves were mostly for medical liability (€2.204M), which represented 93.5% of total technical reserves. As the other risks are more short-term, claims are settled much more quickly.
2017 % totalAutomobile 8.7 0.4%Personal insurance 93 3.9%Property damage 36.2 1.6%Legal protection 2.9 0.1%Civil liability 2 203.6 93.5%Construction 11.9 0.5%Acceptances 0.4 0.0%TECHNICAL RESERVES 2 356.7 100.0%
At 31 December 2017, Sham’s solvency ratio was 170%, which means that we are able to meet 170% of our commitments, far more than the minimum coverage of 100% under the Solvency 2 European directive.
The solvency ratio is calculated using Sham’s Partial Internal Model (PIM), which takes into account the specific characteristics of the risks borne by the company. In a complex environment, this high rate allows Groupe Sham to confirm its robstness, strengthen its financial independance and its ability to invest.
Sham’s financial soundness was also confirmed by AM Best, which gave it an A- rating – excellent with stable outlook – in November 2017 for the third straight year. This rating underscores our expertise in our businesses, our disciplined financial management approach and our ability to meet our commitments.
Excellent A-A-stable outlook
*Combined scopes of Sham and Sham Vie
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Groupe Sham18-20 rue Édouard Rochet69372 LYON Cedex 08FRANCETel: +33 (0)4 72 75 50 25www.groupesham.com
–
–Mutual insurance companyCompany regulated by the French Insurance Code
–Sham is ISO 9001 certified for its services(insurance, training, risk management) providedto healthcare, social and medical-social agents.
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