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Thome Group (Smartcare Entrepreneur). Employee Benefits Insurance Programme 2014. Content. Group Term Life (New Cover) Group Personal Accident Smartcare Entrepreneur with Major Medical rider Group Business Travel Claims Procedures (Smartcare Plans). Period of Insurance

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thome group smartcare entrepreneur

Thome Group (Smartcare Entrepreneur)

Employee Benefits Insurance Programme 2014

content
Content
  • Group Term Life (New Cover)
  • Group Personal Accident
  • Smartcare Entrepreneur with Major Medical rider
  • Group Business Travel
  • Claims Procedures (Smartcare Plans)

Period of Insurance

1 July 2014 to 30 June 2015

slide3

GROUP TERM LIFE

(NEW COVER)

group term life
Group Term Life

What are the benefits?

group term life1
Group Term Life

Who is covered?

All active full-time employees

How much are you covered?

36 x basic monthly salary (maximum S$2 million)

Age Limit

Age 65 (entry age), renewable up to Age 70

Geographical Limit

24 hours, Worldwide basis

Insurer

AXA Life Insurance

group term life2
Group Term Life

Non-Medical Limit

S$470,000 up to age 65

Within Non-Medical Limit:

No underwriting required – Cover up to full sum insured.

Exceed Non-Medical Limit:

Underwriting is required. Details are in the letters that would be given to the affected employees.

group personal accident
Group Personal Accident

What are the benefits?

group personal accident1
Group Personal Accident

Who is covered?

All active full-time employees

How much are you covered?

All Employees – 36 x basic monthly salary

Age Limit

No age limit.

Reduced payout for 80 years and above (insured at 50% of sum assured)

Geographical Limit

24 hours, Worldwide basis

Insurer

AIG

group personal accident2
Group Personal Accident

Major Exclusions…

  • Self inflicted injuries
  • War
  • Participation in Riot
  • Participation in competitive racing on wheels

TERRORISM IS COVERED

smartcare entrepreneur1
Smartcare Entrepreneur

Who is covered?

All active full-time employees and eligible dependents

Age Limit

Age 65 (entry age), renewable up to Age 72

Geographical Limit

24 hours, Worldwide basis

Insurer

AXA Life Insurance

smartcare entrepreneur2
Smartcare Entrepreneur

Major Exclusions..

  • Pre-existing conditions will be covered after 12 continuous months, unless you have been advised otherwise by AXA.
  • Psychological, psychiatric, alcoholism, drug addictions, abortion, birth control, infertility, impotency
  • Cosmetic, obesity, weight improvement / reduction
  • Refractive error of the eyes, correction of myopia, lasik surgery, etc
  • AIDs, VDs, STDs
  • Rest cures, special nursing care
  • Items of Non-Medical Nature, e.g. newspaper, GST etc
  • Self Inflicted or attempted suicide
  • Circumcision
  • Disabilities resulting from direct participation in a strike, riot or commotion, insurrection or any act of war
  • Annual Health Screening
group business travel
Group Business Travel

Coverage

Authorised business trip by company including personal deviation before, during and after a business trip

Duration Per Trip

183 days

Territorial Limit

Worldwide

Age Limit

Age 70 (entry age), renewable up to Age 75

Insurer

ACE

group business travel3
Group Business Travel

Major Exclusions…

  • Self inflicted injuries
  • War
  • Participation in Riot
  • Participation in competitive racing on wheels

(Please refer to policy for full listing of exclusions)

TERRORISM IS COVERED

claim process inpatient claims without log
Claim Process Inpatient Claims (Without LOG)

Patient has to sign Medisave Form upon admission and pay all charges when discharged

Private/Overseas Hospital

Govt Restr Hospital

Employee to submit to HR:

  • Group Hospital & Surgical Claim Form Part 1
  • All original final itemised medical bills
  • Copy of Inpatient Discharge Summary

Employee to submit to HR:

  • Group Hospital & Surgical Claim Form Part 1
  • All original final itemised medical bills
  • Medical Report (to be completed by the attending physician/surgeon)

Any medical report fee is to be borne by the Patient

HR to endorse on Part E and send all originals to JLT

AXA will process claim within 6 working weeks of receiving full documentation

AXA will settle claim via cheque and if medisave is used, AXA will settle directly with CPF Board

claim process inpatient claims with log
Claim ProcessInpatient Claims (With LOG)

Govt Restr Hospital

Private/Overseas Hospital

1. LOG Form

- Release of Medical Information Form (ROMIF)

- Pre-admission form (completed by the attending doctor)

2. Financial Counselling Form

3. Inpatient Admission Authorisation Form

4. Inpatient Discharge Summary (to be submitted upon discharge)

1. LOG Form

- Release of Medical Information Form (ROMIF)

- Pre-admission form (completed by the attending doctor)

The member can submit the relevant forms to AXA as follows:

Email: healthops@axa.com.sg

Copy HR Department

AXA will verify the policy coverage

Yes

No

Covered?

No LOG will be issued. Member will need to bear the full medical expenses upon discharge.

AXA will issue the LOG directly to the hospital

  • Important Note:
  • Policy Number:80018653
  • TAT for issuance of LOG is 5 working days before scheduled surgery
slide27

Thank You

This presentation is designed solely to provide an overview of the benefit. Please refer to the relevant policy contracts for detailed coverage, terms and conditions.