Beruflich Dokumente
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aaaaaaaaaaXZVCXZVBXZZXCVBCXCVF / ASD,MM L004FApril 17, 2017
Whether the economy is good or bad, one thing remains constant we all need healthy, productive
employees to help us grow our businesses. Truly, our employees are our best assets.
To ensure your employees medical needs are covered, Philam Life Corporate Solutions presents
Health Link - a comprehensive Group Medical Insurance plan that you, as their Employer, can avail of for
their benefit. This addresses the pressing need of employers to provide responsive medical insurance
coverage for their workforce, which can be customized according to your needs and budget using the
following available benefits:
BASIC BENEFITS
Basic Medical - Pays for Room & Board, Other Hospital Services, Surgical Fees and Doctors
Calls during confinement
Group Life Insurance - Provides life insurance protection anytime, anywhere and against any
cause of death except suicide on the first year of coverage
Accidental Death, Dismemberment & Disability Benefit - Provides additional benefits in case of
untimely loss of life or dismemberment due to accident
Total & Permanent Disability Income Benefit - Advances the life insurance benefit through a
monthly income in case of total and permanent disability
OPTIONAL BENEFITS
Outpatient Benefits - Pays for Outpatient Consultations and Diagnostics, X-Rays and
Laboratory Tests.
Annual Physical Exam - Covers the Basic 5 procedures: Physical Exam, Routine Urinalysis,
Routine Fecalysis, Chest X-Ray, CBC (Complete Blood Count)
Dental Benefits - Covers a specified list of dental services per year.
All the benefits above are subject to their respective maximum limits, also known Inner Limits, set in the
Schedule of Benefits.
Please note that Health Link benefits are paid on top of your PhilHealth benefits.
With Health Link, you and your employees can enjoy the following:
a. Flexibility. In terms of service availment, insured members can -
choose cashless access to medical services by using our partner, Medilinks, network of
doctors and hospitals, or
go to their preferred doctor or hospital outside Medilinks network, initially pay for these
services and have it reimbursed afterwards.
b. Comprehensive benefits. Health Link offers both health and protection benefits.
c. Convenience.
Easily avail of medical services from Medilink-accredited hospitals and doctors with Medilinks
card and swipe technology.
Get in touch with only one provider for life and health benefits Philam Life
By providing meaningful and value-laden medical benefits, you can earn your employees loyalty and
improve retention and productivity. Together, we can make a positive impact not only for your business
but also for your employees families.
The succeeding pages contain details on Health Links benefits and premiums. Should you have any
questions, please do not hesitate to reach the undersigned at 09778202712 or monge.janna@gmail.com
and we would be glad to discuss Health Link more with you.
Sincerely yours,
CCTV SUPREME
A HEALTH LINK PACKAGE FOR
CCTV SUPREME
Corporate Solutions
I. SUMMARY OF BENEFITS
BASIC BENEFITS
C. Surgical Benefit
Pays for the surgery performed, as per the Benefit Schedule but not to exceed the Schedule
of Operations. Also pays for anesthesiologists fees.
D. Doctors Calls
Pays for the consultation fees charged for daily visits per the Benefit Schedule. 1 call per day.
Notes:
If there is an intervening period of at least 30 days between confinements, the
succeeding confinement will be considered a new disability and the Basic Medical
benefits will be refreshed.
Emergency cases will be charged to:
Basic Medical
Surgical Benefit if it requires surgery
All Basic Medical Benefits are payable up to subject to an Annual Benefit Limit (ABL).
C. Renewal Bonus
Increases the original Principal Sum for Accident Insurance (up to the first P800,000) of
the Insured by 5% each year for the first five (5) consecutive years, starting on the
second year.
E. Flying Coverage
Pays a benefit if the Insured suffers an injury while a passenger boarding or alighting
from a certified passenger aircraft provided by a commercial airline on any regular,
scheduled or non-scheduled, special or chartered flight and operated by a properly
certified pilot flying between duly established and maintained airports over an established
passenger route.
Page 2
OPTIONAL BENEFITS
1. OUTPATIENT BENEFITS
Refers to all the medical services provided to an Insured without need for in-hospital confinement
which include:
a. General Physician/Specialist Consultations 1 consult per day, maximum of 20
consults per year
b. Treatment in clinic, during consultation e.g. bandaging of minor wounds
c. Diagnostics, X-Rays and Laboratory Tests recommended by a physician for the
diagnosis of a sickness or injury, subject to a maximum annual limit
The above are subject to their respective Maximum Limits set in the Benefit
Schedule.
3. DENTAL BENEFITS
Dental procedures are only available in Maxicares Dental Hub. Not reimbursable if done
elsewhere.
The final Interpretation of any specific provision or its applicability is subject to the provisions of the Master Policy
issued by the Philippine American Life & General Insurance Company, as accepted by the Assured Company.
Page 3
II. SCHEDULE OF BENEFITS
Figures in Philippine Peso
BENEFIT OPTIONS
BASIC BENEFITS Plan Plan Plan Plan Plan
500 750 1000 1250 1500
BASIC MEDICAL/INPATIENT (IP) per any one
disability*
Room and Board one/day, max 45 days 500 750 1,000 1,250 1,500
Other Hospital Services 10,000 15,000 20,000 25,000 30,000
Surgical Benefit subject to the Schedule of
15,000 22,500 30,000 37,500 45,000
Operations
Doctors Calls one call/day, max 45 calls 500 750 1,000 1,250 1,500
Annual Benefit Limit 150,000 225,000 300,000 375,000 450,000
GROUP LIFE INSURANCE (GL) 50,000 75,000 100,000 125,000 150,000
ACCIDENTAL DEATH, DISMEMBERMENT &
50,000 75,000 100,000 125,000 150,000
DISABILITY (ADD&D) BENEFIT
TOTAL & PERMANENT DISABILITY INCOME
50,000 75,000 100,000 125,000 150,000
BENEFIT (TPDIB)**
Plan Plan Plan Plan Plan
OPTIONAL BENEFITS
500 750 1000 1250 1500
OUTPATIENT BENEFITS (OP)
Consultations one consult/day, max 20
300 350 400 450 500
consults/year
Treatment in clinic, during consult, max 20/year 200 400 600 800 1,000
Diagnostic, X-rays, Lab max amount/year 6,000 9,000 12,000 15,000 18,000
Basic 5 tests
ANNUAL PHYSICAL EXAM (APE)*** 1) Routine exam 4) Chest x-ray
Requires a minimum of 50 enrolled employees 2) Urinalysis 5) Complete blood
3) Fecalysis count (CBC)
DENTAL BENEFITS*** Pls. refer to list of covered dental procedures
* Any One Disability shall mean all disabilities arising from the same cause including any and all
complications therefrom, as well as concurrent disabilities from different causes during the same hospital
confinement or confinements. However, if there is an intervening period of 30 days following the latest
discharge from hospital or the last treatment date, whichever is later, subsequent disability from the same
cause shall be treated as a new disability.
**TPDIB is not available for Dependent Children/Siblings.
*** APE and Dental Benefits are not available for Dependents.
Page 4
III. PREMIUMS
ANNUAL PREMIUMS PER HEAD (METRO MANILA)
Plan Plan Plan Plan Plan
PRINCIPALS
500 750 1000 1250 1500
Basic Benefits only (IP + GL + ADD&D + TPDIB) 2,292 3,097 3,903 4,708 5,517
Basic Benefits + OP 5,492 7,436 9,380 11,323 13,270
Basic Benefits + OP + APE 6,015 7,959 9,903 11,846 13,793
Basic Benefits + OP + Dental 5,863 7,807 9,751 11,694 13,641
Basic Benefits + OP + APE + Dental 6,386 8,330 10,274 12,217 14,164
Basic Benefits + APE 2,815 3,620 4,426 5,231 6,040
Basic Benefits + Dental 2,663 3,468 4,274 5,079 5,888
Basic Benefits + APE + Dental 3,186 3,991 4,797 5,602 6,411
Plan Plan Plan Plan Plan
EACH DEPENDENT
500 750 1000 1250 1500
Basic Benefits only (IP + GL + ADD&D + TPDIB)* 2,653 3,639 4,625 5,612 6,601
Basic Benefits + OP 6,653 9,062 11,471 13,881 16,293
*TPDIB is not available for Dependent Children/Siblings
NOTES:
A. General Guidelines
1. Premiums
a) Premiums are inclusive of the government-mandated Premium Tax and Documentary
Stamp Taxes.
b) Premiums are applicable for groups with 1) mandatory employee coverage only and
2) voluntary enrollment with at least 75% participation. If less than 75%, an escalation
factor will be applied to these premiums.
2. Eligible Principal Insureds: Regular, full-time, and actively-at-work employees, ages 18 -64.
Coverage terminates on the Employees 65th birthday.
3. Eligible Dependents
a) Of Married Employees
1) Legal spouse - Age 18 to 64, terminates at age 65, in good health and actively
performing the daily normal chores of life.
2) Dependent child/ren - Single, unemployed, in good health and actively performing
daily normal chores of life, age 15 days to 21 years old, terminates at age 22 enrolled
from oldest to youngest (hierarchy rule)
b) Of Single Employees
1) Parents up to 64 years old, terminates at age 65 in good health and actively
performing the daily normal chores of life.
2) Siblings Single, unemployed, in good health and actively performing daily normal
chores of life, age 15 days to 21 years old, terminates age 22, enrolled from oldest to
youngest (hierarchy rule)
5. General Exclusions
a) Pre-Existing Conditions for which the Member received medical treatment, diagnosis,
consultation or prescribed drugs during the ninety (90) days preceding the effective date
of his coverage, unless the Member affected by these conditions has been insured under
the Policy continuously for twelve (12) months, subject to conditions specified in the
Policy Schedule.
Pre-existing conditions are defined as illnesses or conditions that, prior to the Effective
date of members coverage:
a) any professional advice or treatment was given for such illness or condition;
b) such illness or condition was in any way evident to the Member, or
c) the development of such illness or condition started whether or not the Member is
aware of such illness or condition.
The complete list of exclusions is stated in the Group Master Policy as issued to the Assured Company.
B. ADD&D Guidelines
1. Exclusions - Any loss or expense caused by or resulting from the following will not be paid:
a) Suicide
b) War, Invasion or Act of Foreign Enemy
c) Service in the Armed Forces of any country or international authority whether in peace or war.
2. E-Benefits Portal
eBenefits is a FREE web application designed exclusively for Philam Life Corporate
Solutions clients and partners to support employee benefits administration.
The following functions can be accessed thru the portal:
Access to Forms (Policy Movement Forms, Claims Forms)
Policy Level Inquiries
Page 6
Member Level Inquiries
On-Line Transactions such as:
Member Listing Download
Bill Inquiry and Download
Member Updates (additions and deletions)
Beneficiary Updates
Philam Life reserves the right to withdraw or modify the proposal should there be any material change in the
underwriting assumptions such as the nature of business, number of lives, etc.
Page 7
CLIENTS ACCEPTANCE
I have read the Health Link benefits, premiums and guidelines as stated in this proposal. As the
authorized representative of my organization, this confirms that we are accepting the following Health Link
plan/s:
Accepted by:
________________________ ________________________
Date signed
Signature over Printed Name
Page 8
The Philippine American Life and General Insurance Company (Philam Life) is the countrys premier life
insurance company. Established on June 21, 1947, Philam Life has earned the trust of customers for its
financial strength, strong brand name, and ability to deliver on its promises.
Philam Life has P226.8 billion in total assets as of December 31, 2014 and has delivered timely pay outs
of over P9 billion in education benefits (2004-2014) and over P118 billion in insurance benefits (1950-
2014), while serving over 600,000 individual policyholders and over 1,700,000 insured group members.
Philam Life understands the real-life needs of its customers and provides the right plans and the right
solutions including life protection, health insurance, savings, education, retirement, investment, group and
credit life insurance. It also offers bancassurance and fund management products and services through
its subsidiariesBPI Philam Life Assurance Company (BPI-Philam) and Philam Asset Management Inc.
(PAMI).
Philam Life is a member of AIA Group Limited, the largest independent publicly listed pan-Asian life
insurance group.
AIA Group Limited and its subsidiaries (collectively AIA or the Group) comprise the largest
independent publicly listed pan-Asian life insurance group. It has a presence in 18 markets in Asia-Pacific
wholly-owned branches and subsidiaries in Hong Kong, Thailand, Singapore, Malaysia, China, Korea,
the Philippines, Australia, Indonesia, Taiwan, Vietnam, New Zealand, Macau, Brunei, a 97 per cent
subsidiary in Sri Lanka, a 26 per cent joint venture in India and representative offices in Myanmar and
Cambodia.
The business that is now AIA was first established in Shanghai over 90 years ago. It is a market leader in
the Asia-Pacific region (ex-Japan) based on life insurance premiums and holds leading positions across
the majority of its markets. It had total assets of US$167 billion as of 30 November 2014.
AIA meets the long-term savings and protection needs of individuals by offering a range of products and
services including life insurance, accident and health insurance and savings plans. The Group also
provides employee benefits, credit life and pension services to corporate clients. Through an extensive
network of agents, partners and employees across Asia-Pacific, AIA serves the holders of more than 28
million individual policies and over 16 million participating members of group insurance schemes.
AIA Group Limited is listed on the Main Board of The Stock Exchange of Hong Kong Limited under the
stock code 1299 with American Depositary Receipts (Level 1) traded on the over-the-counter market
(ticker symbol: AAGIY).