Employee Benefit Manual

Employee Benefits
Insurance Renewal
2019 – 2020
Introduction to Health Insurance Life & Accidental Non- Insurance Claim

FlexBen Benefits Insurance Benefits Benefits Process
Traditional  FLEX
Employee Benefits Insurance
Renewal 2019 – 2020
Introducing FlexBen
As part of our benefits strategy, Flipkart is committed to providing comprehensive benefits
choices to meet the needs and lifestyles of our diverse, multigenerational workforce.
PUROSE POLICY PERIOD PORTAL
To transition from the 10th June 2019 to Benefits Asia will offer easy
current insurance benefits 9th June 2020 online enrollment, better
plans to a flexible benefits support and guidance, and
approach including Non more convenient access
Insured Benefits, which to your benefits from
allows employees choice in anywhere, at any time
designing their own benefits
package
Your new benefits program
More flexibility Design your personal Easyonline Bettersupport and

and choice benefits package enrollment guidance
2 For any queries, please write to flipkart@marsh.com

Renewal 2019 – 2020
Why the change

You are unique, and so are your needs.
That’s why FlexBen has committed to providing comprehensive benefits choices to meet the needs and lifestyles of our
diverse, multigenerational workforce.
Through Benefit Asia, we’re able to offer a wider range of benefits ― including many of the same core benefits, plus new
benefits, that will empower employees to build a more customized benefits package that may better meet their needs.
Flex gives you
Understanding more Flexibility choose what’s Responsibility for your

information about your right for you own benefit package
benefits

Renewal 2019 – 2020
What’s Flex Points to choose…
Different? Core Benefits
New Benefits Medical Insurance Accident Insurance Life Insurance
and a new way Cover – 3L

Employee Only
Cover – 5 times CTC to a
maximum of 20 cr
Cover – 5 times
CTC
to enroll in them
Each employee is given a
core benefit & certain flex +
points by the employer.
Employees can then select Flexible Benefits
various levels of coverage
from the various options to Medical Insurance Accident Insurance Life Insurance
suit their individual needs,
using the allocated flex • Choice over 16 base Choose Top-Up cover Choose Top-Up cover
points plan coverage Buy Spouse Cover Spouse Cover
• Additional 4 Flex
Plus plans
• 3 OPD option plans
Non-Insurance Benefits
Fitness / Health & Wellness
E - Employee, S – Spouse, C – Child, Z – Siblings, P – Parents and Parents-in-law

Renewal 2019 – 2020
Current Plan vs Flex Cont..

Benefit Type Current Benefit Flex Plan(Summary)
Group Medical Top up ŭŭ Cover of INR 3L for E+S/Z+2C+2P No Change

ŭŭ Unlimited top up option ŭŭ Employee has the option to Buy back current base plan
ŭŭ Coverages remain as is with few enhancements
What is Flexed
ŭŭ Multiple sum insured options
ŭŭ Option to chose family structure
ŭŭ Additional Modules for better coverage
Group Accident ŭŭ CTC Based – 5 times CTC to a max. of No Change- Current base plan remain as in
INR 20 cr (E only)
What is Flexed
ŭŭ Top Up options
ŭŭ Spouse coverage
Group Term Life ŭŭ CTC Based – 5 times CTC (E only) No Change- Current base plan remain as in
What is Flexed
ŭŭ Top Up options
ŭŭ Spouse coverage
Optional Non-Insurance NIL What is Flexed – Fitness Reimbursement

Benefits ŭŭ Optional products / services related to Fitness and Gym Memberships
Fixed for All Flexibility to design Benefits as per your needs

Renewal 2019 – 2020
Your new benefit options under FlexBen

With the new benefit offerings, it’s time to revisit your benefits
coverage and design.
Health Insurance Benefits Death & Disability Insurance Benefits
Medical Insurance Life Insurance (E Only)

• Sixteen medical plan options • Basic Life cover
• Hospitalization coverage • Top-ups
• Day Care procedure coverage
Life Insurance – Spouse
Medical Flex Plus Plan
• Additional Plan enhancements for Personal Accident (E Only)
Robust Policy through enhanced • Basic Life cover
coverages
• Top-ups
Outpatient Plans (OPD)
• Option to purchase additional Personal Accident - Spouse
out patient covers to pay for
consultations, diagnostics, dental &
vision
Non-Insurance Benefits Fitness/ Health & Wellness

Health Insurance
Benefits
 Medical Insurance
 Flex Plus Plans
 OPD Plans
 Gym/Fitness Membership
Renewal 2019 – 2020
Flex Points Required

Medical insurance Structure 300,000 500,000 700,000 1,000,000 2,000,000 3,000,000 6,000,000
E 14,691 (Core)
The medical insurance plan ESC 16,815 20,178
provides insurance benefits EP 18,880 23,010 25,252
to pay for hospitalization ESP/EZP 22,656 26,904 33,630
care, if you or your declared ESCP 24,249 (Default) 28,202 36,344 48,380 88,736 129,210 249,570
dependent family members
• 25,075 points are being credited to each employee
become sick, or get injured and
are hospitalized for a period of • The Core Option would Employee only coverage for INR 300,000
24 hours or more. • The Default Option would be ESCP coverage for INR 300,000
• Multiple options ranging • The system will take the nearest selection from the previous policy period as the
from 3L to 60L default option, and employees can then trade their benefits
• Option to chose family • The plan selections made during enrollments will have a lock-in for 2 years, which
structure: E only, ESC, ESP/ means:
EZP, EP, ESCP • You cannot downgrade your selected plan for the next 2 enrollment years
• Additional Modules- • However, you can surely choose to upgrade to a higher option - ie. a higher top
Flex Plus plan for better Up / Sum Insured option.
coverage, Additional OPD E = Employee, S= Spouse, Z = Sibling, C = Child, P = Parents, PIL = Parent-in-law
covers
We Heard You! Dependents

covered for the
We’re making these year in case of
death of the
changes in response employee
to your input and LGBT
Coverage 2019 Insurance
ensure that we provide enhancements
you the best in class No Deduction in
case of Death of an
coverages Employee

Renewal 2019 – 2020
Flex plus Options

Additional Flex Plans will get attached to the base plan, upon selection. You can then choose to buy
this plan with your Flex points or through salary deduction.
Eligibility – Members covered in the base medical plan, except for Elder Care
Flex Plus Plan 1 - Diversity & Inclusion Flex Plus Plan 2 - Advanced Care Plan
Coverage INR 14,514 / Employee Coverage INR 11,564 / Employee
ŭŭ Cervical Cancer Vaccination – INR 10,000 (E + S) ŭŭ Coverage for Keratoconus Treatment up to INR 22,000
ŭŭ Higher maternity (additional INR 20,000) ŭŭ Age Related Macular Degeneration (ARMD)- up to INR 75,000
ŭŭ Pregnancy Care program ŭŭ Expensive Diagnostics – INR 10,000 per family
ŭŭ Additional infertility treatment – for both Male and Female members on ŭŭ Healthcare at Home- Domiciliary up to full sum insured for medical
IPD basis up to INR 50,000 within full sum insured treatment for an illness / disease / injury which in the normal course
would require care and treatment at a hospital but is actually taken while
ŭŭ Surrogacy - Cost of delivery covered within maternity limit for 1st child, confined at home
subject to medical condition
ŭŭ Adult Flu Vaccination up to INR 2,000
ŭŭ Mental well being (bi-polar disorder, anxiety, depression) / Psychiatric
treatment) – OPD – INR 50,000, IPD – INR 500,000 ŭŭ Cost of Physiotherapy sessions on OPD basis when there is no related
hospitalization, including long term physiotherapy upto 6 months –
ŭŭ Gender reassignment surgery covered for INR 300,000 per family INR 15,000
Flex Plus Plan 3 - Children Care Flex Plus Plan 4 - Elder Care
Coverage INR 8,614 / Employee Coverage INR 708 / Parent
ŭŭ Autism Care- for children ŭŭ Elder Care Facility
ŭŭ Well baby expenses – up to 5000 over maternity limit ŭŭ Wellness Platform 24X7
ŭŭ Infant and Children (14 years) Vaccinations approved by WHO up to INR ŭŭ Doctor Consultation : MBBS doctor 12 tele-consultation
2,000 per vaccination overall cap of INR 10,000 ŭŭ 24X7 Medical Assistance
ŭŭ Treatment for Genetic disorders - In-Patient Treatment (IPD) ŭŭ Elderly Care Helpline for inbound calls
ŭŭ Coverage for differently abled children without any age limit ŭŭ Storage Electronic Health records
ŭŭ Discounts on Medicines, nursing, Physiotherapy, Medical equipment
rentals, etc.
E = Employee, S= Spouse, C = Child, P = Parents

Renewal 2019 – 2020
OPD Plan
OPD Cover is a specially designed insurance cover for out-patient treatment expenses that includes
consultations, prescribed diagnostics, dental and vision expenses up to the sub-limits defined under
each plan. You can then choose to buy this plan with your Flex points or through salary deduction.
Eligibility – Employee, spouse and children
Coverages Plan 1 - 11,500 Plan 2 - 15,000 Plan 3 - 25,000

Doctor Consultations Covered Covered Covered
(General Physician, Specialist, Super Specialist) (INR 4,000) (INR 5,000) (INR 8,000)
Basic Basic Intermediate
Health Check
1 checkup 2 checkup 2 checkups
Covered Covered Covered
Prescribed diagnostics, Preventive Measures
(INR 2,000) (INR 3,000) (INR 5,000)
Dental – Dental Examination / Scaling and Polishing / X-ray / Fluoride Treatment Covered Covered Covered
/ Filling / Prophylaxis / Root Canal Treatment / Extractions / Oral Surgery / Re- (INR 2,000) (INR 2,000) (INR 4,000)
cementation / Medication / Restoration / Crowning / Implant / Braces
Covered Covered Covered
Vision – Prescription lens / Vision check-up done by optometrist / optician
(INR 2,000) (INR 2,000) (INR 3,000)
Co Payment 10% 10% 10%
Points Required INR 7,670 INR 12,331 INR 20,178
• All the above Flex Points are for an annual plan

• This plan is available only for Employee, Spouse and Children
• The above plans can be availed as cashless or reimbursement. Cashless will be applicable as per the network of the TPA

Renewal 2019 – 2020
Group Mediclaim Policy – Base Coverage
Policy Start & End Date Insurer Third Party Geographical Limits
Administrator (TPA)
10th June 2018 to The New India Assurance India (Covers treatment in
9th June 2019 Company Limited Mediassist India TPA Pvt. Ltd. India only)
Policy Benefits Policy Benefits

Family Floater (1+5) : Siblings Up to 2 Siblings covered up to 21 Years for
Employee + Spouse + Children + 2 unmarried employee only
Dependent Parents or 2 Parents In law + up
to 2 Siblings
Note : Maternity Benefits
ŭŭ Only a set of Parents or In-laws can be Policy Benefits
Scope of Coverage covered, No cross selection is allowed Maternity Coverage Covered
& siblings covered only for unmarried
INR 65,000 for Normal & INR 80,000 for
employees only Maternity Sub-Limit
Caesarian Delivery
ŭŭ Once you declare your Siblings in the policy
you will not be able to declare Spouse in 9 month waiting
Not Applicable
the same policy period. If your get married period for maternity
you will be eligible to cover your spouse in Pre & Post natal Covered within the maternity Sub-limit only for
next policy period onwards. Expenses in-patient treatment
Covered from INR 300,000 to INR 6,000,000 as Baby Day1 Cover The coverage will be up to the Floater Sum
Sum Insured
per the grid provided. Insured limit till first discharge and thereafter
Employee Covered becomes part of the family floater on specific
inclusion.
Spouse Covered
Maternity Related Covered only up to Base Family Sum Insured
Children Children covered up to 25 years Complication
Parent / In-Laws Set of Parents or In-laws can be covered up to
age 90 years, No cross selection is allowed

Renewal 2019 – 2020

Maternity If spouse of the employee is working with Genetic Disorders Exclusion of Genetic Disorders waived off
Contribution Clause another company then Flipkart policy covers for IPD hospitalisations with active line of
the uncovered portion of the other policy treatment.
subject to max sub-limit under Flipkart policy
OPD Coverage: Only for Children up to
Maternity Dual If both self and spouse are employed in Flipkart INR 75,000 (within total sum insured), provided
Coverage and covered separately as employees, then a employee opts for Sum insured cover of
single instance of maternity shall be eligible to minimum INR 5,00,000
claim together for 150% of the Maternity Sub-
Internal Congenital
Limit. Covered
Disease NEW
Standard
Covered External Congenital Covered under life threatening circumstances
Hospitalization
Disease only
Covered for 30 days pre and 60 days post
Pre & Post Terrorism related
hospitalization for all members . (Employees Covered
Hospitalization hospitalization
only – post hospitalization is covered for 90
Expenses
days and restricted to critical ailments)
Pre-existing
Covered from Day1
Room rent
Diseases
Policy Benefits
1/ 2/ 4 Year Waiting Waived off
Period Normal Room : Actual subject to a Max. of
INR 6,000 per day
30 days waiting Waived off (Room rent includes: Bed charges + Nursing
period for charges + RMO/DMO/duty doctor charges)
Non Accidental Room Rent ICU : No Capping for ICU hospitalization.
Claims (inclusive of nursing
Enhance your Room Rent Capping by Opting
Day Care No restriction of 24 hours hospitalisation charges and duty
for higher Sum insured. In the event of the
procedures for 140+ Specified treatments with / without doctor charges)
insured getting admitted in a category higher
pre-auth in network or non-network hospital.
than capped mentioned room rent per day as
Annexure Attached in Slide No. 24 to 28
per policy, the insured will bear the difference
Ambulance Charges Local Emergency Ambulance charges up to INR of all the Medical expenses as in the final
5,000 hospital bill in the same proportion.
Base Sum Insured INR 300,000 INR 500,000

Room Rent per day INR 6,000 INR 7,000

Renewal 2019 – 2020

Co-Payment Not Applicable for all relations Robotic Surgeries Approved Robotic Surgeries on Critical
Applicable for below: Ailments payable under this policy up to Base
Floater Sum Insured value
Cataract : INR 30,000 / Eye (Multifocal lens,
procedure covered up to INR 40,000 per eye) Example : In is an exclusion in the policy,
however due to medical exigency demands
Hernioplasty : INR 74,000 and increased to robotic surgery and it is an established mode
Ailment Capping INR 2 lakh for multiple hernia surgeries of treatment as per Indian medical association
Gall Bladder Stone Removal : INR 97,500 / food and drug administration. (USA) / any
other competent accreditation agent
Kidney Stone Including DJ Stent Removal :
Stem cell therapy Covered In IPD
INR 100,000. RIRS procedure is covered up to a
& Bone marrow
maximum of 1.5 lakhs
transplant
Lasik Surgery Covered subject to eye power +/- 5 and
Morbid Obesity Morbid Obesity is covered on IPD basis for
beyond.
cases where BMI is above 35
Maximum Up to INR 1.35 Lacs per Eye. Physiotherapy Physiotherapy OPD Expenses up to a
Domiciliary Not Covered maximum of INR 15,000 for Employees only in
Hospitalization respect of Accident cases duly supported by
Hospital Reports and Doctor’s Advice.Example
: If an employee met with an accident and
Special Conditions doctor asked for Physiotherapy treatment on
OPD basis, maximum INR 15,000 will be paid
Policy Benefits to employee for Physiotherapy on without
Covered up to INR 100,000 per family only for hospitalization supported by Hospital Reports
Inpatients Hospitalization and Doctor’s Advice
Cochlear Implant Up to Family Floater Sum Insured
Additional INR 15,000 as OPD basis for
Infertility treatments (subject to certification of
same being an infertility treatment, numbered
Infertility
receipt from registered hospitals only)
If both self and spouse are employed in Flipkart
and covered separately as employees, then
only a single coverage of Sub-Limit will be
applicable for both employees together.

Renewal 2019 – 2020

External Devices ŭŭ Prosthetic Implant (Capped at INR 85,000 Income Protection ŭŭ Salary Protection for employees on non-
per Implant) Benefits – Only for attendance at work because of medical
ŭŭ Continuous Positive Airway Pressure (CPAP) Employees contingency subject to exhaustion of leave
and Mandibular advancement device (MAD) as per HR certification & doctors certificate
for Obstructive Sleep Apnea (OSA) (Capped recommending medical leave.
at INR 50,000 equipment/device cost only) ŭŭ INR 40,000 per month or monthly salary
ŭŭ Bionic Ear up to FSI whichever is lower for 90 days paid once
subject to attending Doctor’s Certification duly employee exhaust all leave balance and is
supported by Medical Reports justifying the on LOP for 90 days and is medically unfit to
need for such external device. Consumables attend office.
and accessories for these devices will not be ŭŭ Applicable for the cases of medical
covered under the policy exigency not covered under Group
Personal Accident Policy.
In case of NEW ŭŭ Dependents are covered for the remaining
employee’s death period of the policy until expiry. HIV / AIDS Hospitalization arising out of HIV / AIDS is
ŭŭ No claim deductions in case of employee’s covered
death. LGBT Coverage NEW Covered
Cancer Support Payment of INR 150,000 to Employee only
Benefit – Only for once the Base Sum Insured Value is exhausted
Employees during the policy period for the Hospitalization
treatment of Cancer only.
Example : If an Employee has been diagnosed
with cancer and treatment cost has exhausted
the base sum insured offered by Flipkart,
Cancer Support benefit gets triggered and
an amount of INR 150,000 will be paid to
employee on lump sum.

Renewal 2019 – 2020
Health Insurance Service Providers

Insurer
The New India Assurance Company Limited
Third Party Administrator (TPA)
Mediassist TPA
Insurance Broker
Marsh India Insurance Brokers Pvt. Ltd.
Important contact points

For Claims Related Queries and Escalations, the Go To People would be from Mediassist
TPA (in that order):
TPA SPOC (as mentioned under Medical Insurance Coverage)

 niranjan.v@medibuddy.in
 arun.k@medibuddy.in
Note: All hospitalization claims post 10th June 2019 will be serviced under the flex
benefits. Any claims before this period will continue to be serviced under the current
insurance plan

Life, Accidental
death & Disability
Insurance Benefits
 Term Life Insurance
 Terminal Illness Insurance
 Personal Accident Insurance
Renewal 2019 – 2020
Personal Accident Insurance

Accident insurance helps protect you from unexpected financial stress if you or a covered family mem-
ber has an accident.
Insurer: New India Assurance Company Ltd.
Eligibility : Core Benefit – Employee only | Optional Benefits – Employee & spouse
Current Benefits Flex – Core / Minimum Benefit Flex – Optional Benefits

Addition to the Core / Minimum Benefit Coverage
ŭŭ 5 times of ŭŭ Continue as is - 5 times of Annual CTC (Max
Annual CTC capped at INR 20 crores, including Flex Options (E only) Premium Rate Enhanced Coverage
(Max capped at Benefit) 1 X Annual CTC 0.1770 / 1000 Sum Insured ŭŭ Adventure sports
INR 20 crores) ŭŭ Accidental Death 2 X Annual CTC 0.1770 / 1000 Sum Insured ŭŭ Animal / Insect Bite
ŭŭ Accidental ŭŭ Permanent Disablement
Death 3 X Annual CTC 0.1770 / 1000 Sum Insured
ŭŭ Temporary Total Disablement
ŭŭ Permanent
Disablement Spouse Coverage Points Required
ŭŭ Temporary Total INR 1,000,000 177
Disablement INR 2,000,000 354
INR 3,000,000 531
INR 4,000,000 708
INR 5,000,000 885
• Spouse coverage should be equivalent to / lower than employee’s coverage
• Coverage for non earning spouse will be limited to the base flex option, i.e. INR 1,000,000

Renewal 2019 – 2020
Term Life Insurance

This plan provides financial support to an employee’s family in case of an unfortunate event leading to
the demise of the covered employee
Insurer: Kotak Mahindra Life Insurance Co. Ltd
Eligibility : Core Benefit – Employee only | Optional Benefits – Employee & spouse
Current Benefits Flex – Core / Minimum Benefit Flex – Optional Benefits

Addition to the Core / Minimum Benefit Coverage
ŭŭ Sum Insured = 5 ŭŭ Sum Insured = 5 times of Annual CTC
times of Annual Options (E only) Premium Rate
ŭŭ FCL – INR 6 Crore
CTC 1 X Annual CTC ŭŭ Calculated according to the
ŭŭ FCL – INR 6 2 X Annual CTC per mille rate, as per Benefits
Crore Manual
3 X Annual CTC
Spouse Coverage Points Required

INR 1,000,000
INR 2,000,000 ŭŭ Calculated according to the
INR 3,000,000 per mille rate, as per Benefits
INR 4,000,000 Manual
INR 5,000,000
• Free cover limit & underwriting may be applicable for optional benefits
• Spouse coverage would be limited to/ equal to Employee’s Benefit amount.

Non- Insurance
Benefits
 Options available under
non-insurance benefits
Renewal 2019 – 2020
Flex Points Utilization- Non-Insurance

Non insured benefit
Gym / Fitness Centre Memberships for Employee Only
Employees can allocate the
• Membership / Subscription fees unused / left over Flex Points
• Fees for personal trainer / sports coach towards these benefits. These
• Health Club memberships points can be reimbursed
against the product / service
• S
tandalone fitness centers that offer activities like Zumba, purchased by them
Aerobics, Spinning, Cross-fit etc.
Note: Taxes as applicable

How does
FlexBen work?
 Let’s see some Scenarios
Renewal 2019 – 2020
Flex Points Utilization

• Each option within Flex Benefits has a price tag - Price Tag
is the cost that an employee needs to pay for additional
Tax Implication
coverages or to top-up your benefits.
Benefit deductions Tax treatment
• Flipkart contributes a fixed number of Flex points i.e.
25,075 Flex points to each employees’ flex account at the Medical Insurance –
beginning of the benefit year. Additional Modules/ 80D
Voluntary Top Up
• Using the flex points, an employee can purchase any
benefit he/she desires Medical Insurance
– Parents Insurance
• If employee chooses to opt for benefits that are 80D
(Not Applicable for
exceeding the available flex points balance, she would parents-in-law)
need to purchase the benefits from his salary
Personal Accident
NO TAX
Top-Up/ Spouse
advantage
Coverage
FLEX POINTS Life Insurance - Top-
=
Up/ spouse/ Critical 80C
FLEX Illness
OPTIONS
SALARY
DEDUCTIONS
• Salary contribution/ deduction from payroll will be

eligible for tax exemption as per the IT Rules

Renewal 2019 – 2020
Scenario 1– ‘I am Single with parents’
Points Balance per employee 25,075

Flex Points
Medical Plan EP (1+2) - 5L 23,010
Flexibility to Flex Plus Plan Flex Plan 2 11,564

OPD Plan -
choose from multiple
optional benefits Accident Insurance E (5 times CTC) 0
Accident Spouse Insurance -
Based on the family Term Life Insurance E (5 times CTC) 0
structure, choose to Term Life Spouse -
enhance insurance Non Insurance (Gym & Fitness) Gym Membership 7,000
cover Points Balance 0

Salary Deduction 16,499
1 point = 1 INR
E- Employee, S- Spouse, C- Child, P- Parents, P’- Parent-in-law

Renewal 2019 – 2020
Scenario 2– ‘I am Married and have Kids’

Flex Points
Medical Plan ESC- 3L 16,815
Flexibility to choose Flex Plus Plan -

OPD Plan Plan 1 - ESC 7,670
from multiple optional
benefits Accident Insurance E (5 times CTC) 0
Accident Spouse Insurance -
enhance insurance Non Insurance (Gym & Fitness) - 590

Salary Deduction 0
1 point = 1 INR

Renewal 2019 – 2020
Scenario 3– ‘I am a Parent & have Dependent

Parents & In-Laws’
Flex Points
Medical Plan ESCP - 3L 24,249
Flexibility to choose Flex Plus Plan Flex Plan 1 14,514

OPD Plan Plan 1 7,670
from multiple optional
benefits Accident Insurance E (5 times CTC) 0
Accident Spouse Insurance Plan 3 531
enhance insurance Non Insurance (Gym & Fitness) GYM 6,000

Salary Deduction 27,889
1 point = 1 INR

Claim Process
 Medical Insurance
 Cashless
 Reimbursement
 Term Life claim settlement
 Personal Accident claim settlement
 Non-insurance/Optional Benefits claim
Renewal 2019 – 2020
Claims process
Medical insurance:
The medical expenses can be claimed in 2 different ways:
• Cashless process • Reimbursement process
The below process will also be applicable for flex plus plan option.
Availing cashless facility with the network hospitals
Availing cashless Emergency

facility with the admission
Cashless: network hospitals
Cashless means the TPA may

authorize direct settlement of
Intimate TPA at Intimate within 24
the claim amount according least 1 day prior to hours of
to the charges between a hospitalisation hospitalisation
Network Hospital and the
TPA. In such case the TPA
will directly settle all eligible
amounts with the Network
Hospital as per the eligible
limit and coverage..
Produce the ID card TPA will issue Authorization At the time of On discharge, if the total amount
issued by TPA at the authorization letter amount shall be as discharge leave all the exceeds the sum insured & the
insurance desk of by mail/fax as per per policy terms & documents behind and amount which is not covered in the
network hospital the policy condition conditions sign the claim form policy has to be paid by the insured

Renewal 2019 – 2020
Member approaches
non network hospital
Reimbursement:
In case of non-network
hospital, you will be
required to clear the bills
Hospital provides necessary
and submit the claim to
treatment to the patient
TPA for reimbursement
from the insurer. Please
ensure that you collect
all necessary documents
such as – discharge Member pays hospital bills and sends the claim
summary, investigation documents/claim form and cancelled cheque to TPA
reports etc. for
submitting your claim..
ACCEPT REPUDIATION QUERY
Approval letter and Repudiation letter Query letter

settled claim cheque sent to member sent to member
sent to member
Member completes the query
requirement within 15 working days
from the receipt of the query letter
and sends to TPA
Note: Reimbursement documents should reach us within 30 days from the date of discharge

Renewal 2019 – 2020
Reimbursement document checklist

• Completed Claim form with Signature- Mandatory • A
ll original medicine bills with relevant prescriptions-
Mandatory
• Original hospital final bill-Mandatory
• Original signed claim form- Mandatory
• O
riginal numbered receipts for payments made to the
hospital- Mandatory • C
opy of the TPA ID card or current policy copy and previous
years' policy copies (if any)
• Complete breakup of the hospital bill- Mandatory
• C
overing letter stating your complete address, contact
• Original discharge summary- Mandatory
numbers and email address (if available).
• All original investigation reports
• Copy of cancelled cheque.
Note:
• Basis the valuation of the basic claim documents, any additional documents may be called for on case to case to basis
• All the claim documents must be submitted in originals within 30 days from the date of discharge
• Please do keep a copy of all the documents submitted with you for records.

Renewal 2019 – 2020
Term Life
Insurance HR team notifies about the accident, who in turn would
intimate Marsh / Insurer
The most
important aspect
for GTL claim
is Intimation of
the claim , which
has to be given Submit required claim documents to insurer within
to the HR (by 30 days of the event
the beneficiary/
nominee) within
24 hours of
Accident/Death,
irrespective
of any form of On obtaining all relevant documents, insurance company shall review
Claim. and call for any further docs and begin processing the claims
The HR in turn
shall inform the
ACCEPT REPUDIATION
same to Marsh
team/insurer
within 48 hrs.
of receiving the Approved claimed amount shall be Insurer share the repudiated letter with
information to transferred through NEFT to the a valid reason for the rejection to
get the claim nominee/employee within 15 days HR/Employee/Nominee
registered.
Note: Intimation should reach us within 24 hours from the date of such incidents.

Renewal 2019 – 2020
Document checklist: Term life – Points to remember

1. Intimation of death - Intimation to the HR team about death
Death Claims: is a must (within 48 hrs. of such event in any means of
1. Completed claim form communication- SMS, phone call or mail.
2. Attending Doctor's report 2. Educate the nominees about the coverage: Please remember to
educate your nominees about the benefits and process in case of
3. Death Certificate any unfortunate demise.
4. Post Mortem/ Coroner's report 3. Claim amount will be given only by Electronic Fund Transfer:
5. FIR ( First Information Report)if reported Please note that all reimbursement claim settlement will be
to police done by NEFT only and hence please provide your correct bank
account number, MICR code and IFSC code in the claim form
6. Police Inquest report, wherever applicable itself.
7. Employee ID card photocopy 4. Drive safely, suggest to drive safely by following traffic rules and
8. Any govt. ID proof wearing helmet/seat belt
9. Cancelled Cheque of the nominee 5. Stay healthy
NOTE:
The checklist is the basic and mandatory
documents required, further documents may be
called for on case to case basis.
How do I claim for Spouse Term Life Cover or

Critical illness Cover?
The same claim intimation process will need to
be followed for both these plans in case you opt
for them.

Renewal 2019 – 2020
Employee/Nominee notifies HR about the Accident,

Personal who in turn would intimate Marsh/Insurer
Accident
Insurance
The claim should
be intimated to Submit required claim documents within 30 days of the
the HR before event in case of death and disability claims and after
within 24hrs of resuming to work incase of weekly benefits claims
the occurrence of
the event.
The HR team
shall then inti- On obtaining all relevant documents, insurance company shall review
mate the same and call for any further docs and begin processing the claims
to Marsh/insurer
team to get the
claim registered ACCEPT REPUDIATION
with the insur-
ance company
Approved claimed amount shall be Insurer share the repudiated letter

transferred through NEFT to the with a valid reason for the rejection to
nominee/employee within HR/Employee/Nominee
21 working days
Note: Intimation should reach us within 24 hours from the date of such incidents.

Renewal 2019 – 2020
What are the coverages

• A ccidental Death: 100% of current employee sum insured
• Permanent Total Disability: 100% of current employee sum insured
• Permanent Partial Disability: As per chart
Description of Benefit Benefit (% of Description of Benefit Benefit (% of

CSI) CSI)
Death 100 Permanent rigidity of a hip joint or knee joint 100
Incurable insanity &/or alienation of mind 100 Removal of lower jaw by surgical operation
100
necessitated by bodily injury as defined in the Policy.
Complete paralysis of the body 100
Permanently impaired usefulness of leg resulting
Permanent total loss of sight of both eyes. 100 from
20
Loss of both Arms at or above the wrist or loss of ŭŭ fractured leg or foot
both legs a or above the ankle or permanent total 100 10
ŭŭ fractured knee cap
loss of use of both arms OR both legs.
ŭŭ shortening by at least five centimeters 15
Permanent total disability other than as described in
100 Physical loss or disablement not provided for
items 1 to 5 above.
above a benefit determined by reference to the
Loss of one limb or loss of sight of one eye. 50 percentages mentioned in this schedule.
Permanent total deafness of both ears. 50 All expenditure necessarily incurred for medical or
Permanent total deafness in one ear. 50 surgical fees, hospital, nursing home, physiotherapy,
pharmaceutical expenses, ambulance hire and any
Total Loss of Permanent Total loss of use of Right Left additional hotel or other expenses whatsoever
25 20 (except funeral and cremation expenses) in respect
� Thumb
of any bodily
� A Forefinger 20 15
10 8 injury caused by accident as defined in this policy,
� A Ring or middle Finger
whether or not giving rise to a claim under any other
� A Little Finger 12 8 items) of this schedule but not exceeding
� A Big Toe 10 10 INR 50,000 for any one person in respect of any one
� Any other 5 5 accident.

Renewal 2019 – 2020
Document checklist for personal accident
Weekly Benefit Claims Death Claims Disablement Claims

1. Duly filled, signed and 1. Completed claim form 1. Disability Certificate from
sealed Claim form the Doctor
2. Attending Doctor's report
2. Doctor's Medical certificate 2. Investigation/ Lab reports
3. Death Certificate
(x-ray etc.)
3. Disability Certificate from
4. Post Mortem/ Coroner's
the Doctor, if any 3. Original Admission/
report
discharge card, if
4. Investigation/ Lab reports
5. FIR ( First Information hospitalized.
(x-ray etc.)
Report)if reported to police
4. Police Inquest report,
5. Original Admission/
6. Police Inquest report, wherever applicable
discharge card, if
wherever applicable
hospitalized 5. Employee ID card photocopy
7. Employee ID card photocopy
6. Employers Leave Certificate 6. Any govt. ID proof
& Details of salary 8. Any govt. ID proof
7. Cancelled cheque of the
7. Employee ID card photocopy 9. Cancelled cheque of the employee
nominee
8. Any govt. ID proof
10. Completed claim form
9. Cancelled cheque of the
employee 11. Doctor's Report
NOTE: How do I claim for spouse personal accident cover?

Above mentioned checklist is the basic and mandatory The same claim intimation process will need to be followed
documents required, further documents may be called for on in case you opt for this plan.
case to case basis.

Renewal 2019 – 2020
Non-Insurance/ Optional Benefits
Member avails service/

purchases membership
Member registers
the claim and
uploads the
invoice
ACCEPT REPUDIATION QUERY
Automated mail to member with Rejection mail to member Member completes the
the approval details. Payment wll with clear the reasons for query requirement and
be made through Salary with Tax rejection sends to TPA
adjusted

How to enroll?
Renewal 2019 – 2020
Introducing BenefitsAsia
• BenefitsAsia, offers you a simple and

convenient online platform with a wide range
of benefit options and personalized decision-
making tools so you can easily create a
benefits package that’s just right for you.
• Convenient for member to access their
details when and where they want
• Visibility on Coverage details
• Up-to-date information
You’ll have access to personalized costs for each plan, along

with complete coverage details and comparison tools to help
you fully understand your options.

Renewal 2019 – 2020
Steps for Enrollment
Click on the Enrollment link shared

through the enrolment mailer
Verify/Edit your Dependent’s

Log in to information
BenefitsAsia
Select your benefits and Confirm
your selection
Selection can be made multiple times during open window. Selection ef-
fective on last day of enrolment will be considered
Make sure dependents are selected under each plan as required.
If you miss your enrollment deadline, your insurance coverage will be same as Default Plan

Renewal 2019 – 2020
Steps for Enrollment

Renewal 2019 – 2020
My Information – Personal Details

Renewal 2019 – 2020
My Information – Family Details

Renewal 2019 – 2020
Benefits – Summary of entitlement

Renewal 2019 – 2020
Benefits Enrollment Enrollment – Flex Points

Renewal 2019 – 2020
When can I enroll myself

At the time of Annual
Life Events Just Joined/New Employee
Enrolment
• On 10/06/2019, the Flipkart • If you’ve just got married, • You would have the option
FlexBen Plan will open to allow changed your marital status of selecting your benefits
you to select the benefits or had a baby, you may wish plan within 2 weeks from
that best suit to your current to change your benefits to your date of joining
circumstances allow for the change in your
• If you don’t make your
circumstances
• The choices made by you would benefit elections within the
be effective for the policy • You should contact your stipulated time then you’ll
period starting 10/06/2019 to HR/ Update your dependent be auto-enrolled in to:
9/06/2020 details on BenefitsAsia
• “Default” benefit for Medical
insurance, Personal Accident
& Term life
EnrolLment Period:
10/06/2019 to 21/06/2019
You must enter dependent information If you do not enroll for benefits during annual enrollment
for any family members you wish to cover • You will be automatically enrolled in the default level for each
in 2019, else Your current dependent benefit.
information will be carried forward for the • You will not be able to make any changes to these elections during
new plan year the plan year, unless you experience an eligible life event change.

Renewal 2019 – 2020
Who can I
reach out to?
For claims related queries and
escalations – Mediassist Third Party
Admistrator
 Mediassist TPA: www.medibuddy.in
For tool related issues SPOC

For any tool related issues at the time  Raj Kishore
of enrolment or questions on your
enrolment plan/status on BenefitsAsia,  +91 98862 66602
please write to flipkart@marsh.com  flipkart@marsh.com
Escalation 1
 Chethan Kumar
 Chethan.Kumar@marsh.com
Escalation 2
 Ajith Kumar
 Ajith.k@Marsh.com

Renewal 2019 – 2020
www.flipkart.com

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Employee Benefits

Introduction to Health Insurance Life & Accidental Non- Insurance Claim

PUROSE POLICY PERIOD PORTAL

Your new benefits program

More flexibility Design your personal Easyonline Bettersupport and

2 For any queries, please write to flipkart@marsh.com

Why the change

Flex gives you

Understanding more Flexibility choose what’s Responsibility for your

3 For any queries, please write to flipkart@marsh.com

What’s Flex Points to choose…

Different? Core Benefits

New Benefits Medical Insurance Accident Insurance Life Insurance

and a new way Cover – 3L

E - Employee, S – Spouse, C – Child, Z – Siblings, P – Parents and Parents-in-law

4 For any queries, please write to flipkart@marsh.com

Current Plan vs Flex Cont..

Group Medical Top up ŭŭ Cover of INR 3L for E+S/Z+2C+2P No Change

Optional Non-Insurance NIL What is Flexed – Fitness Reimbursement

Fixed for All Flexibility to design Benefits as per your needs

5 For any queries, please write to flipkart@marsh.com

Your new benefit options under FlexBen

Health Insurance Benefits Death & Disability Insurance Benefits

Medical Insurance Life Insurance (E Only)

Non-Insurance Benefits Fitness/ Health & Wellness

6 For any queries, please write to flipkart@marsh.com

Flex Points Required

We Heard You! Dependents

8 For any queries, please write to flipkart@marsh.com

Flex plus Options

E = Employee, S= Spouse, C = Child, P = Parents

9 For any queries, please write to flipkart@marsh.com

Eligibility – Employee, spouse and children

Coverages Plan 1 - 11,500 Plan 2 - 15,000 Plan 3 - 25,000

• All the above Flex Points are for an annual plan

10 For any queries, please write to flipkart@marsh.com

Group Mediclaim Policy – Base Coverage

Policy Benefits Policy Benefits

11 For any queries, please write to flipkart@marsh.com

Policy Benefits Policy Benefits

Base Sum Insured INR 300,000 INR 500,000

12 For any queries, please write to flipkart@marsh.com

Policy Benefits Policy Benefits

13 For any queries, please write to flipkart@marsh.com

Policy Benefits Policy Benefits

14 For any queries, please write to flipkart@marsh.com

Health Insurance Service Providers

Important contact points

TPA SPOC (as mentioned under Medical Insurance Coverage)

15 For any queries, please write to flipkart@marsh.com

Personal Accident Insurance

Current Benefits Flex – Core / Minimum Benefit Flex – Optional Benefits

• Spouse coverage should be equivalent to / lower than employee’s coverage

17 For any queries, please write to flipkart@marsh.com

Term Life Insurance

Current Benefits Flex – Core / Minimum Benefit Flex – Optional Benefits

Spouse Coverage Points Required

• Spouse coverage would be limited to/ equal to Employee’s Benefit amount.

18 For any queries, please write to flipkart@marsh.com

Flex Points Utilization- Non-Insurance

Note: Taxes as applicable

20 For any queries, please write to flipkart@marsh.com

Flex Points Utilization

FLEX POINTS Life Insurance - Top-