Cambodia, Indonesia, Laos, Benefits Table · 1/1/2020 · Cambodia, Indonesia, Laos, Malaysia,...
Transcript of Cambodia, Indonesia, Laos, Benefits Table · 1/1/2020 · Cambodia, Indonesia, Laos, Malaysia,...
Your Health First
AdministratorsA Plus International Services LimitedRoom 4, 17th Floor, Westlands Centre, 20 Westlands Road, Quarry Bay,Hong Kong China S.A.R.Tel: + 852 2891 3608Fax: + 852 2891 3229Email: [email protected]
Concepts and trademarksare licensed from
A Plus International Insurance Development AGCH-8032 Zurich, Switzerland
www.aplusii.com
Exclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam
Benefits Table effective 1/1/2020
Southeast Asia
Exclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam
Benefits Table - effective 1/1/2020Note: The General Conditions can be provided upon request or downloaded from
www.aplusii.com
Important notice:1) Only expenses which are ‘reasonable & customary’ can qualify for reimbursement. (for all
plans and options)2) Unless indicated otherwise, all ceilings mentioned in this table are applicable per Insured
and per Insurance Year.3) For definitions of the terms used in this table, reference is explicitly made to article 1.2.
(‘Definitions’) of Chapter I of the General Conditions.4) Pre-existing conditions are covered subject to acceptance by the medical consultant at
the time of enrolment. Level of cover is according to the limits of the plan chosen.
Essential Essential Plus Serene Serene Plus
BENEFITS a) Hospitalisation a) Hospitalisation
b) Other benefits
a) Hospitalisation b) Outpatientc) Other Benefits
a) Hospitalisation b) Outpatientc) Other Benefits
Maximum total reimbursement per Insured and per insurance year Premiums and claims shall be payable in US$, which is the same as the policy currency.
$ 500,000 $ 1,000,000 $ 1,000,000 $ 1,350,000
Essential Essential Plus Serene Serene Plus
1. Inpatient Care (with overnight stay in hospital)Important : Precertification is always required except in case of emergency (see article 2.1.3.4. ‘precertification’ in General Conditions). Failure to comply with the precertification requirement could lead to a reduction of the reimbursement.
Hospital accommodation
- Room & board (standard private room) Full Cover Full Cover Full Cover Full Cover
- Intensive Care Unit (ICU) Full Cover Full Cover Full Cover Full Cover
- One accompanying parent for child under age 16 having to stay overnight in hospital
Not Covered Full Cover up to 14 days Not Covered Full Cover
up to 14 days
Doctors' fees (including surgeon's & anaesthetist's fees) Full Cover Full Cover Full Cover Full Cover
Other medical expenses, including:- use of operating room and recovery room- lab exams / - medical imaging (X-ray, CT, MRI, etc.)- prescription drugs and dressings- physiotherapy - logopaedic treatment, speech
therapy, occupational therapy and ergo therapy
Full Cover Full Cover Full Cover Full Cover
Cancer treatment (e.g. radiotherapy, chemotherapy) and diabetes, kidney dialysis, excluding all experimental treatments
Full Cover Full Cover Full Cover Full Cover
Psychiatric inpatient hospital care Not Covered Full Cover up to $ 13,500 Not Covered Full Cover up to
$ 13,500
Accidental Damage to teeth (treatment received in an emergency ward of a hospital within 5 days of incurring an accidental damage to sound and natural teeth)
Full Cover Full Cover Full Cover Full Cover
Reconstructive Surgery following an accident Full Cover Full Cover Full Cover Full Cover
Hospital Cash Benefit: daily allowance, only when room, board & treatment costs are not claimed to the policy
Not Covered $ 67.50 per night up to 60 nights Not Covered $ 135 per night
up to 60 nights
Organ transplantWe cover doctors’ fees, hospital accommodation (standard private room) and other related medical expenses during hospital stay.Excluded from cover: costs related to the search for a donor, costs for acquisition of the organ, costs incurred for removal of organ from the donor
Full Cover (Prior approval
from the Insurer’s Medical Consultant)
Full Cover (Prior approval
from the Insurer’s Medical Consultant)
Full Cover (Prior approval
from the Insurer’s Medical Consultant)
Full Cover (Prior approval
from the Insurer’s Medical Consultant)
Rehabilitation and convalescence rest / care (when the admission immediately follows hospitalisation)
Full Cover up to 30 days
Full Cover up to 30 days
Full Cover up to 30 days
Full Cover up to 60 days
Essential Essential Plus Serene Serene Plus
2. Outpatient Care
GPFees of a GP (General Practitioner, Family Doctor)
Not Covered Not Covered Full Cover Full Cover
SpecialistFees of a Specialist Doctor
Not Covered Not Covered Full Cover Full Cover
Consultations, diagnostic tests,lab tests, medical imaging (cf. X-Ray, CT, MRI, etc.) by GP and Specialist, Prescribed Drugs, Treatments by Physiotherapists related to inpatient treatments within 15 days prior to admission and up to 30 days following hospital release.
Not Covered
Full Cover up to $ 2,000
if related to Inpatient treatment
Full Cover Full Cover
Outpatient psychiatric care, ergotherapy, logopaedics and / or speech therapy, occupational therapyOnly care prescribed by or performed by a Doctor can qualify for reimbursement. The covered amount includes fees of Doctor and / or (treatment fees of) Medical Practitioner, but does not include prescription drugs which are covered according to the provisions of paragraph below.
Not Covered Not Covered Not Covered 50% up to $1,350
Prescription drugs Only drugs that are prescribed by a Doctor and that are not available without prescription can be reimbursed.
Not Covered Not Covered Full Cover Full Cover
Diagnostic tests, lab tests, medical imaging (cf. X-ray, CT, MRI, etc.) Not Covered Not Covered Full Cover Full Cover
Cancer treatment (e.g. radiotherapy, chemotherapy) and diabetes, kidney dialysis, excluding all experimental treatments
Full Cover Full Cover Full Cover Full Cover
Physiotherapy prescribed by a Doctor Not Covered Not Covered Full Cover up to$ 1,500
Full Cover up to$ 2,700
Medical aids (including hearing aids, orthopaedic appliances & stockings, artificial limbs, wheelchair)
Not Covered Not Covered Full Cover up to$ 2,700
Full Cover up to$ 2,700
Treatments performed by Complementary Medical Practitioners: Chiropractor / Osteopath / Acupuncturist / HomeopathThese treatments must be prescribed by a registered medical Doctor.
Not Covered Not Covered Full Cover up to$ 1,500
Full Cover up to$ 2,700
Day-care treatment and Day surgeryFull Cover
(precertification required)
Full Cover(precertification
required)
Full Cover(precertification
required)
Full Cover(precertification
required)
Essential Essential Plus Serene Serene Plus
3. Other Benefits
Local ambulance to nearest hospital Full Cover up to$ 2,025
Full Cover up to$ 2,025
Full Cover up to$ 2,025
Full Cover up to$ 2,025
Dental treatment following an accident (surgical reconstruction covered under hospitalisation benefits)
Covered under Accidental Damage
to teeth
Covered under Accidental Damage
to teeth
Covered under Accidental Damage
to teeth
Covered under Accidental Damage
to teeth
Nursing at home Not Covered Not Covered80%. Annual max. reimbursement of
$ 2,700 up to 60 days
80%. Annual max. reimbursement of
$ 2,700 up to 60 days
Chronic Conditions (not pre-existing): Covered Covered Covered Covered
Complication of Pregnancy Covered Covered Covered Covered
Congenital Conditions Covered Covered Covered Covered
AIDS / HIV Treatment$60,000 Lifetime, 2 years’ waiting
periodCovered
$60,000 Lifetime, 2 years’ waiting
periodCovered
Hormone Replacement therapy Covered Covered Covered Covered
Hospice and palliative care in case of Terminal Illness
$ 50,000 per insured and per
lifetime
$ 50,000 per insured and per
lifetime
$ 50,000 per insured and per
lifetime
$ 50,000 per insured and per
lifetime
4. Medical Evacuation and Repatriation Services ^ (Included for Individuals, Optional for Companies*).Prior Approval from Insurer compulsory
Evacuation / Repatriation Emergency medical evacuation to the nearest hospital or emergency medical repatriation
Full Cover
Transportation of mortal remains or burial at the place of death Full Cover
Compassionate Visit by a relative of the Insured (Applicable when hospitalisation in excess of 5 consecutive days)
One economy class return airfare
Accommodation for compassionate visit by a relative accompanying the insured
Full Cover
$ 125 per day (Max 7 days)
Return of minor children (<19, unmarried and at school) if left alone when Insured is hospitalised. One-way economy class airfare per eligible child Full Cover
Early ReturnOne economy class return airfare Full Cover
Temporary replacement colleague (transport costs) Full Cover
For complete terms and conditions and explanation of benefits, refer to Chapter III of the General Conditions^ Covered by AXA Assistance * Conditions apply
Note: ‘Covered’ means treatment is reimbursed according to the limits of the plan chosen.
Additional Options5. Dental
Eligibility The optional dental cover is only open to persons a) who are accepted into the medical insurance plan and b) who are contracting into the Serene or Serene Plus medical plans. The choice for taking out the dental cover has to be made on per family level in the sense that all members of the same family, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the dental insurance or not (i.e. all family members or none); b) opt for the same Dental plan (Dental Standard or Dental Plus). Benefits Deductibles do not apply to Dental benefits. Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.
Dental Standard Dental Plus
Max. reimbursement per insured per year $1,500 $3,000
Basic dental careIncludes up to 2 periodic check-ups per year, prophylactic treatments, fillings, root canal treatment, extraction, paradental treatment, treatment of paradontosis, treatment of gums, etc.A waiting period of 6 months applies.
80% up to$900
Full Cover up to$2,000
Major dentistryBridges, implants, orthodontic treatment and dental prostheses (dentures, crowns, inlays). The amount covered includes the fees of the Dentist (or Dental Surgeon). Orthodontic treatment is only covered if started before age 17 (seventeen). A waiting period of 12 months applies.
80% up to$600
80% up to$1,000
6. Wellness (Only for Companies of 5 or more employees)
Eligibility The optional wellness cover is only open to employees and dependants a) who are accepted into the medical insurance plan; b) who are contracting into the Serene or Serene Plus medical plans and c) with plans without deductible.The choice for taking out the wellness cover has to be made on per company level in the sense that all members of the same company, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the wellness insurance or not (i.e. all members or none); b) opt for the same Wellness plan (Wellness Standard or Wellness Plus). Benefits Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.
Wellness Standard Wellness Plus
Max. reimbursement per insured per year
$300 $600
Preventive care & wellness benefitsA waiting period of 12 months applies- well baby care- medically required vaccinations (adults & children)- one routine eye test per insurance year- one adult physical examination every 2 years including: - one (bilateral) mammogram and one pap-smear test every 2 years (females as of age 35) - one PSA-test every 2 years (males as of age 50)
7. Routine Maternity (Only for Companies of 5 or more employees)
Eligibility The optional routine maternity cover is only open to employees and dependants a) who are accepted into the medical insurance plan; b) who are contracting into the Serene or Serene Plus medical plans and c) with plans without deductible.The choice for taking out the routine maternity cover has to be made on per company level in the sense that all members of the same company, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the routine maternity insurance or not (i.e. all members or none); b) opt for the same Routine Maternity plan (Routine Maternity Standard or Routine Maternity Plus). A waiting period of 12 months applies. Benefit limits on a per pregnancy basis.
Benefits Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.
Elective caesarean surgery is excluded from cover. Routine Maternity Standard Routine Maternity Plus
Pregnancy (pre & post natal fees)
Full Cover up to $3,000 Full Cover up to $5,000 Childbirth The covered amount includes doctors’ fees, hospital accommodation and other related medical expenses during hospital stay.
Prescribed caesarean (in addition to the above benefits) Full Cover up to $1,000 Full Cover up to $2,000
8. Currency Plans are to be subscribed in US dollars.
9. Zone of treatment
Zone A: Worldwide
Zone B: Worldwide excluding USA / Canada
Zone C: Restricted in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand & Vietnam
10. Deductible
US$
Essential Plans Serene Plans
0 0
per insured and per insurance year
300 300
675 675
1,350 1,350
11. Accidental death and dismemberment (AD&D)
This cover will guarantee the payment of a lump sum in case you die in an accident or you incur a permanent disability of at least 20% caused by an accident.
Lump Sum after accidental death- up to a maximum of $ 675,000 with a minimum of $ 67,500- cover is available for you and your adult dependants
Lump Sum after permanent disability- from at least a permanent disability degree of 20%- cash benefit = sum insured x degree of disability
12. Loss of income (TI / PD)
Temporary incapacity (TI)With the temporary incapacity plan option, you will feel more secure knowing your family will be protected financially if you are totally unable to perform your professional occupation due to illness or accident. You can choose the level of income benefit that is appropriate to you and your family:- up to 80% of pre-disability gross monthly salary;- subject to a maximum of $ 13,500 per month and a minimum of $ 1,350.
Income protection during 24 monthsWe will pay you a regular income for as long as you are unable to return to work. After a waiting period of 90 days, the income will start up to a maximum of 24 months. If you are still unable to resume work after 24 months then you will receive a lump sum through the Permanent Disability plan if the PD option below has been contracted.
Permanent disability (PD) (can be taken out only as supplement option to Temporary Incapacity)With this option, you receive a lump sum in case you are affected by a permanent disability of at least 33.33% caused by illness or accident. You can choose the level of sum insured that is appropriate to you:- up to 80% of pre-disability gross monthly salary multiplied by 48 months;- subject to a maximum of $ 648,000 and a minimum of $ 64,800;- when disability is between 33.33% and 66.67%, then cash benefit = sum insured x ((3 x n) - 1), n = degree of disability (%);- when disability is above 66.67%, then cash benefit = sum insured.
Additional payment of $ 33,750If from the start of the disability you need the assistance of a third person to perform the basic activities of daily living (such as feeding, washing yourself) and your degree of disability exceed 66.67%, then an additional sum of $ 33,750 will be paid.
Notes
AdministratorsA Plus International Services Limited
Room 4, 17th Floor, Westlands Centre, 20
Westlands Road, Quarry Bay, Hong Kong
China S.A.R.
Tel: + 852 2891 3608
Fax: + 852 2891 3229
Email: [email protected]
Concepts and trademarks
are licensed from
A Plus International Insurance Development AG
CH-8032 Zurich, Switzerland
www.aplusii.com
Your Health First
Southeast Asia PlansExclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand & Vietnam
Premium Tableeffective 1/1/2020
Zone A
Worldwide including USA/Canada
Zone B
Worldwide excluding USA/Canada
Zone C
Restricted only in Cambodia, Indonesia, Laos,
Malaysia, Philippines, Thailand & Vietnam
Deductible 0 300 675 1350 Deductible 0 300 675 1350 Deductible 0 300 675 1350
Essential
<18 2,552 2,033 1,989 1,930 <18 1,179 967 924 819 <18 973 796 783 677
18‐30 3,871 3,197 3,102 2,933 18‐30 1,792 1,501 1,433 1,184 18‐30 1,430 1,178 1,101 938
31‐40 4,515 3,775 3,694 3,481 31‐40 2,091 1,777 1,724 1,425 31‐40 1,654 1,378 1,273 1,126
41‐50 5,582 4,735 4,661 4,377 41‐50 2,584 2,237 2,169 1,821 41‐50 2,024 1,717 1,592 1,425
51 6,306 5,376 5,325 4,976 51 2,919 2,564 2,512 2,057 51 2,286 1,959 1,832 1,619
52 6,659 5,713 5,651 5,292 52 3,084 2,722 2,675 2,196 52 2,411 2,078 1,945 1,704
53 7,051 6,084 6,010 5,641 53 3,265 2,896 2,854 2,354 53 2,550 2,208 2,072 1,801
54 7,483 6,491 6,402 6,021 54 3,464 3,090 3,052 2,531 54 2,702 2,353 2,214 1,909
55 7,956 6,933 6,824 6,438 55 3,683 3,301 3,266 2,729 55 2,868 2,512 2,369 2,028
56 8,470 7,413 7,281 6,883 56 3,922 3,528 3,499 2,946 56 3,050 2,686 2,539 2,163
57 9,027 7,926 7,770 7,367 57 4,180 3,779 3,751 3,184 57 3,247 2,874 2,724 2,310
58 9,629 8,479 8,292 7,882 58 4,458 4,047 4,021 3,444 58 3,459 3,077 2,926 2,471
59 10,274 9,070 8,845 8,432 59 4,757 4,335 4,308 3,727 59 3,685 3,297 3,142 2,650
60 10,966 9,696 9,434 9,015 60 5,075 4,644 4,615 4,030 60 3,928 3,533 3,376 2,843
61 11,701 10,359 10,055 9,633 61 5,417 4,974 4,940 4,355 61 4,187 3,781 3,624 3,053
62 12,483 11,060 10,708 10,283 62 5,778 5,322 5,283 4,702 62 4,460 4,047 3,887 3,282
63 13,306 11,798 11,396 10,966 63 6,161 5,694 5,645 5,071 63 4,749 4,328 4,167 3,528
64 14,173 12,575 12,119 11,685 64 6,561 6,085 6,024 5,458 64 5,052 4,623 4,462 3,794
65 15,081 13,387 12,875 12,439 65 6,981 6,496 6,419 5,869 65 5,370 4,933 4,771 4,077
66 16,030 14,239 13,666 13,226 66 7,421 6,927 6,832 6,296 66 5,702 5,256 5,095 4,377
67 17,017 15,129 14,497 14,053 67 7,879 7,377 7,259 6,742 67 6,046 5,594 5,431 4,698
68 18,038 16,061 15,365 14,914 68 8,352 7,845 7,702 7,204 68 6,402 5,943 5,780 5,034
69 19,092 17,035 16,275 15,818 69 8,840 8,331 8,160 7,682 69 6,770 6,305 6,140 5,387
70 20,179 18,054 17,227 16,765 70 9,342 8,834 8,631 8,173 70 7,146 6,674 6,508 5,755
71 21,290 19,115 18,228 17,757 71 9,856 9,352 9,115 8,675 71 7,534 7,053 6,887 6,138
72 22,421 20,229 19,279 18,800 72 10,380 9,885 9,608 9,190 72 7,926 7,443 7,269 6,531
73 23,571 21,396 20,387 19,899 73 10,913 10,430 10,115 9,711 73 8,328 7,834 7,655 6,936
74 24,734 22,621 21,556 21,058 74 11,450 10,985 10,631 10,236 74 8,730 8,233 8,043 7,348
75 25,901 23,907 22,794 22,285 75 11,992 11,550 11,154 10,767 75 9,137 8,632 8,432 7,764
76 27,071 25,263 24,109 23,588 76 12,533 12,121 11,686 11,296 76 9,544 9,031 8,814 8,180
77 28,233 26,695 25,507 24,975 77 13,072 12,696 12,225 11,822 77 9,950 9,430 9,191 8,592
78 29,382 28,214 27,000 26,459 78 13,605 13,273 12,770 12,344 78 10,350 9,822 9,558 8,998
79 30,511 29,823 28,599 28,050 79 14,125 13,848 13,320 12,858 79 10,744 10,207 9,909 9,388
80+ 31,609 31,540 30,318 29,762 80+ 14,634 14,421 13,874 13,359 80+ 11,128 10,583 10,244 9,760
Evacuation and repatriation included
Essential Plus
<18 2,675 2,137 2,082 2,030 <18 1,239 1,013 948 856 <18 1,014 831 797 705
18‐30 4,078 3,383 3,268 3,102 18‐30 1,887 1,589 1,509 1,251 18‐30 1,503 1,240 1,124 985
31‐40 4,768 4,000 3,899 3,689 31‐40 2,207 1,885 1,818 1,509 31‐40 1,742 1,455 1,337 1,188
41‐50 5,901 5,026 4,926 4,644 41‐50 2,732 2,379 2,294 1,935 41‐50 2,137 1,821 1,679 1,509
51 6,671 5,500 5,430 5,087 51 3,089 2,720 2,651 2,178 51 2,414 2,080 1,933 1,716
52 7,047 5,862 5,785 5,428 52 3,263 2,889 2,824 2,327 52 2,546 2,205 2,055 1,808
53 7,462 6,281 6,189 5,822 53 3,455 3,076 3,015 2,497 53 2,693 2,345 2,189 1,912
54 7,920 6,754 6,642 6,265 54 3,669 3,282 3,225 2,686 54 2,856 2,499 2,337 2,025
55 8,422 7,282 7,150 6,760 55 3,900 3,508 3,455 2,898 55 3,032 2,669 2,504 2,154
56 8,971 7,867 7,707 7,307 56 4,155 3,754 3,706 3,130 56 3,225 2,854 2,684 2,297
57 9,563 8,505 8,316 7,905 57 4,428 4,022 3,974 3,387 57 3,435 3,054 2,880 2,454
58 10,203 9,201 8,973 8,552 58 4,725 4,309 4,263 3,666 58 3,659 3,272 3,092 2,626
59 10,890 9,948 9,676 9,246 59 5,042 4,618 4,570 3,969 59 3,900 3,505 3,325 2,814
60 11,626 10,744 10,425 9,989 60 5,384 4,949 4,900 4,292 60 4,158 3,754 3,572 3,021
61 12,410 11,587 11,217 10,771 61 5,745 5,303 5,246 4,641 61 4,434 4,022 3,836 3,247
62 13,240 12,474 12,048 11,595 62 6,130 5,675 5,612 5,012 62 4,725 4,304 4,116 3,489
63 14,118 13,402 12,915 12,457 63 6,536 6,070 5,997 5,404 63 5,033 4,603 4,413 3,752
64 15,041 14,366 13,818 13,350 64 6,963 6,486 6,402 5,818 64 5,356 4,918 4,728 4,035
65 16,010 15,365 14,749 14,276 65 7,413 6,925 6,822 6,253 65 5,693 5,248 5,059 4,337
66 17,020 16,395 15,709 15,229 66 7,880 7,383 7,259 6,708 66 6,046 5,594 5,403 4,658
67 18,072 17,450 16,693 16,207 67 8,367 7,859 7,713 7,182 67 6,414 5,954 5,763 4,998
68 19,162 18,529 17,702 17,207 68 8,872 8,357 8,183 7,671 68 6,793 6,325 6,133 5,357
69 20,287 19,629 18,728 18,228 69 9,394 8,872 8,668 8,179 69 7,184 6,710 6,517 5,732
70 21,442 20,747 19,775 19,269 70 9,928 9,403 9,165 8,699 70 7,587 7,106 6,910 6,126
71 22,627 21,882 20,841 20,327 71 10,476 9,953 9,676 9,231 71 8,000 7,511 7,312 6,535
72 23,836 23,033 21,926 21,408 72 11,036 10,520 10,201 9,777 72 8,420 7,924 7,720 6,955
73 25,063 24,200 23,034 22,507 73 11,603 11,098 10,740 10,331 73 8,846 8,344 8,132 7,385
74 26,302 25,387 24,167 23,633 74 12,179 11,690 11,288 10,891 74 9,277 8,768 8,546 7,825
75 27,548 26,597 25,329 24,790 75 12,753 12,293 11,849 11,458 75 9,711 9,195 8,959 8,269
76 28,793 27,832 26,530 25,985 76 13,331 12,908 12,421 12,027 76 10,144 9,621 9,367 8,712
77 30,034 29,103 27,774 27,224 77 13,905 13,531 13,004 12,598 77 10,575 10,047 9,769 9,153
78 31,258 30,414 29,075 28,522 78 14,473 14,161 13,598 13,169 78 11,002 10,464 10,160 9,584
79 32,461 31,780 30,446 29,889 79 15,030 14,797 14,204 13,734 79 11,422 10,876 10,535 10,003
80+ 33,629 33,214 31,904 31,345 80+ 15,572 15,435 14,822 14,296 80+ 11,833 11,276 10,891 10,399
Premiums (US$)
Zone A
Worldwide including USA/Canada
Zone B
Worldwide excluding USA/Canada
Zone C
Restricted only in Cambodia, Indonesia, Laos,
Malaysia, Philippines, Thailand & Vietnam
Serene
<18 4,609 4,125 3,154 2,181 <18 2,133 1,825 1,211 900 <18 1,701 1,434 901 776
18‐30 7,319 6,799 5,758 4,167 18‐30 3,390 3,027 2,304 1,356 18‐30 2,644 2,309 1,634 1,029
31‐40 8,635 8,111 7,062 5,341 31‐40 3,998 3,630 2,891 1,780 31‐40 3,102 2,748 2,038 1,267
41‐50 11,741 11,226 10,194 8,258 41‐50 5,436 5,073 4,347 2,950 41‐50 4,198 3,828 3,089 1,933
51 13,555 13,051 12,039 10,012 51 6,275 5,909 5,175 3,699 51 4,862 4,478 3,708 2,438
52 14,274 13,772 12,773 10,715 52 6,610 6,249 5,531 4,008 52 5,121 4,736 3,968 2,649
53 15,039 14,544 13,553 11,467 53 6,963 6,613 5,914 4,340 53 5,393 5,012 4,247 2,879
54 15,854 15,364 14,385 12,271 54 7,340 7,002 6,326 4,699 54 5,679 5,300 4,545 3,127
55 16,717 16,234 15,268 13,130 55 7,739 7,416 6,768 5,086 55 5,980 5,608 4,866 3,396
56 17,635 17,160 16,207 14,046 56 8,164 7,857 7,239 5,503 56 6,296 5,933 5,209 3,689
57 18,610 18,140 17,202 15,019 57 8,616 8,324 7,739 5,951 57 6,628 6,276 5,573 4,005
58 19,640 19,181 18,260 16,055 58 9,094 8,819 8,272 6,430 58 6,980 6,640 5,961 4,345
59 20,733 20,282 19,382 17,157 59 9,599 9,345 8,833 6,943 59 7,350 7,024 6,373 4,711
60 21,889 21,449 20,570 18,326 60 10,134 9,899 9,430 7,493 60 7,739 7,431 6,811 5,103
61 23,112 22,684 21,831 19,567 61 10,702 10,485 10,055 8,077 61 8,153 7,859 7,274 5,522
62 24,406 23,991 23,164 20,882 62 11,300 11,104 10,711 8,700 62 8,590 8,315 7,764 5,972
63 25,772 25,373 24,575 22,273 63 11,932 11,755 11,402 9,365 63 9,052 8,795 8,280 6,453
64 27,217 26,834 26,064 23,746 64 12,601 12,441 12,124 10,071 64 9,545 9,305 8,827 6,963
65 28,740 28,373 27,640 25,302 65 13,306 13,163 12,878 10,819 65 10,068 9,846 9,402 7,507
66 30,347 29,997 29,304 26,944 66 14,049 13,921 13,664 11,610 66 10,625 10,418 10,008 8,083
67 32,037 31,709 31,054 28,676 67 14,831 14,716 14,482 12,449 67 11,219 11,026 10,644 8,696
68 33,817 33,510 32,898 30,499 68 15,656 15,548 15,331 13,333 68 11,852 11,674 11,315 9,343
69 35,688 35,404 34,837 32,419 69 16,523 16,419 16,212 14,266 69 12,527 12,358 12,021 10,027
70 37,651 37,391 36,871 34,431 70 17,430 17,329 17,123 15,247 70 13,250 13,087 12,760 10,747
71 39,708 39,473 39,003 36,544 71 18,384 18,278 18,063 16,277 71 14,021 13,859 13,535 11,506
72 41,860 41,650 41,230 38,755 72 19,379 19,265 19,037 17,358 72 14,844 14,679 14,348 12,303
73 44,108 43,924 43,556 41,065 73 20,420 20,293 20,037 18,490 73 15,724 15,550 15,199 13,138
74 46,451 46,293 45,977 43,474 74 21,506 21,359 21,066 19,671 74 16,664 16,473 16,094 14,012
75 48,889 48,756 48,489 45,982 75 22,634 22,464 22,124 20,905 75 17,666 17,453 17,028 14,925
76 51,419 51,310 51,092 48,586 76 23,805 23,606 23,206 22,186 76 18,736 18,492 18,005 15,874
77 54,038 53,951 53,778 51,286 77 25,018 24,782 24,317 23,517 77 19,875 19,593 19,026 16,863
78 56,741 56,675 56,543 54,075 78 26,270 25,997 25,450 24,895 78 21,087 20,756 20,095 17,890
79 59,525 59,475 59,377 56,951 79 27,558 27,242 26,610 26,319 79 22,377 21,989 21,212 18,952
80+ 62,383 62,346 62,272 59,907 80+ 28,880 28,517 27,790 27,788 80+ 23,745 23,288 22,378 20,049
Serene Plus
<18 5,083 4,590 3,600 2,334 <18 2,354 2,032 1,386 962 <18 1,866 1,583 1,015 843
18‐30 8,140 7,617 6,572 4,893 18‐30 3,767 3,401 2,666 1,613 18‐30 2,930 2,580 1,882 1,074
31‐40 9,620 9,096 8,047 6,244 31‐40 4,453 4,083 3,342 2,130 31‐40 3,447 3,085 2,358 1,391
41‐50 13,108 12,598 11,580 9,577 41‐50 6,069 5,716 5,011 3,511 41‐50 4,674 4,306 3,566 2,305
51 15,334 14,836 13,836 11,770 51 7,099 6,747 6,047 4,489 51 5,518 5,134 4,367 2,984
52 16,132 15,638 14,650 12,557 52 7,468 7,131 6,458 4,841 52 5,793 5,415 4,658 3,226
53 16,968 16,480 15,505 13,387 53 7,856 7,534 6,891 5,213 53 6,078 5,706 4,963 3,487
54 17,848 17,368 16,408 14,265 54 8,262 7,959 7,350 5,610 54 6,377 6,012 5,285 3,765
55 18,776 18,305 17,363 15,191 55 8,692 8,406 7,834 6,034 55 6,687 6,334 5,629 4,062
56 19,760 19,298 18,374 16,175 56 9,147 8,880 8,345 6,488 56 7,012 6,674 5,995 4,383
57 20,802 20,351 19,450 17,224 57 9,629 9,382 8,885 6,973 57 7,361 7,034 6,384 4,728
58 21,908 21,470 20,594 18,340 58 10,141 9,912 9,454 7,496 58 7,728 7,417 6,798 5,101
59 23,088 22,663 21,816 19,535 59 10,689 10,477 10,054 8,057 59 8,124 7,829 7,242 5,503
60 24,345 23,937 23,119 20,815 60 11,272 11,077 10,685 8,662 60 8,549 8,272 7,717 5,941
61 25,690 25,298 24,514 22,182 61 11,894 11,714 11,355 9,315 61 9,007 8,745 8,226 6,411
62 27,129 26,754 26,004 23,648 62 12,560 12,394 12,060 10,017 62 9,503 9,260 8,773 6,919
63 28,665 28,308 27,596 25,219 63 13,272 13,116 12,802 10,771 63 10,041 9,813 9,358 7,470
64 30,307 29,970 29,296 26,899 64 14,032 13,883 13,585 11,585 64 10,622 10,408 9,983 8,062
65 32,056 31,739 31,106 28,691 65 14,841 14,696 14,408 12,451 65 11,251 11,053 10,654 8,697
66 33,918 33,622 33,032 30,602 66 15,705 15,560 15,273 13,381 66 11,932 11,744 11,367 9,377
67 35,893 35,618 35,073 32,631 67 16,617 16,472 16,181 14,368 67 12,663 12,483 12,122 10,103
68 37,981 37,729 37,225 34,776 68 17,584 17,435 17,133 15,417 68 13,447 13,273 12,924 10,876
69 40,180 39,949 39,489 37,039 69 18,602 18,444 18,125 16,524 69 14,283 14,111 13,769 11,691
70 42,483 42,273 41,855 39,408 70 19,669 19,499 19,159 17,686 70 15,172 14,999 14,654 12,549
71 44,884 44,695 44,315 41,881 71 20,780 20,598 20,233 18,898 71 16,107 15,931 15,578 13,446
72 47,369 47,198 46,856 44,438 72 21,932 21,734 21,342 20,155 72 17,087 16,902 16,533 14,376
73 49,925 49,769 49,460 47,067 73 23,113 22,904 22,485 21,449 73 18,103 17,909 17,517 15,332
74 52,528 52,386 52,102 49,748 74 24,319 24,097 23,655 22,768 74 19,150 18,941 18,520 16,311
75 55,155 55,022 54,758 52,451 75 25,534 25,305 24,849 24,098 75 20,214 19,986 19,534 17,298
76 57,775 57,648 57,394 55,150 76 26,746 26,516 26,056 25,428 76 21,281 21,035 20,542 18,286
77 60,350 60,223 59,970 57,799 77 27,939 27,717 27,271 26,736 77 22,336 22,070 21,538 19,257
78 62,837 62,706 62,440 60,360 78 29,092 28,886 28,480 28,000 78 23,361 23,074 22,499 20,197
79 65,189 65,042 64,750 62,781 79 30,180 30,010 29,673 29,196 79 24,329 24,023 23,409 21,087
80+ 67,343 67,176 66,840 64,998 80+ 31,176 31,062 30,834 30,294 80+ 25,215 24,892 24,247 21,906
Zone A
Worldwide including USA/Canada
Zone B
Worldwide excluding USA/Canada
Zone C
Restricted only in Cambodia, Indonesia, Laos,
Malaysia, Philippines, Thailand & Vietnam
Dental Standard
<18 1,243 <18 621 <18 468
18‐30 1,672 18‐30 837 18‐30 629
31‐40 2,092 31‐40 1,044 31‐40 785
41‐50 2,572 41‐50 1,288 41‐50 968
51‐55 2,847 51‐55 1,425 51‐55 1,070
56‐60* 3,850 56‐60* 1,927 56‐60* 1,448
61‐65* 4,193 61‐65* 2,096 61‐65* 1,576
66‐70* 4,661 66‐70* 2,327 66‐70* 1,752
71‐75* 5,824 71‐75* 2,912 71‐75* 2,190
76‐80* 7,104 76‐80* 3,550 76‐80* 2,669
Dental Plus
<18 2,211 <18 1,106 <18 832
18‐30 2,988 18‐30 1,493 18‐30 1,124
31‐40 3,728 31‐40 1,863 31‐40 1,403
41‐50 4,603 41‐50 2,302 41‐50 1,731
51‐55 5,094 51‐55 2,548 51‐55 1,914
56‐60* 6,891 56‐60* 3,444 56‐60* 2,590
61‐65* 7,495 61‐65* 3,750 61‐65* 2,817
66‐70* 8,330 66‐70* 4,166 66‐70* 3,130
71‐75* 10,408 71‐75* 5,205 71‐75* 3,912
76‐80* 12,696 76‐80* 6,348 76‐80* 4,773
Accidental death and dismemberment (AD&D)
This cover will guarantee the payment of a lump sum in case you die in an accident or you incur a permanent disability of at least 20% caused by an accident
Lump Sum after accidental death
- up to a maximum of $ 675,000 with a minimum of $ 67,500
- cover is available for you and your adult dependants
Lump Sum after permanent disability
- from at least a permanent disability degree of 20%
- cash benefit = sum insured x degree of disability
Premium
Annual Premium
0.23% of the Capital Insured
Capital Insured :
Premium :
Loss of Income (TI / PD)
Temporary incapacity (TI)
With the temporary incapacity plan option, you will feel more secure knowing your family will be protected financially if you are totally unable to perform your professional occupation due to illness or accident. You can choose the level of income benefit that is appropriate to you and your family:
- up to 80% of pre-disability gross monthly salary;
- subject to a maximum of $ 13,500 per month and a minimum of $ 1,350.
Income protection during 24 months
We will pay you a regular income for as long as you are unable to return to work. After a waiting period of 90 days, the income will start up to a maximum of 24 months. If
you are still unable to resume work after 24 months then you will receive a lump sum through the permanent disability option when PD option has been contracted.
Permanent disability (PD) (can be taken out only as supplement option to Temporary Incapacity)
With this option, you receive a lump sum in case you are affected by a permanent disability of at least 33.33% caused by illness or accident. You can choose the level of sum insured that is appropriate to you:
- up to 80% of pre-disability gross monthly salary multiplied by 48 months;
- subject to a maximum of $ 648,000 and a minimum of $ 64,800;
- when disability is between 33.33% and 66.67% then cash benefit = sum insured x ((3 x n)-1), n = degree of disability (%);
- when disability is above 66.67% then cash benefit = sum insured.
Additional payment of $ 33,750
If from the start of the disability you need the assistance of a third person to perform the basic activities of daily living (such as feeding, washing yourself) and your degree of disability exceeds 66.67%, then an additional sum of $ 33,750 will be paid.
Premium
Age
Monthly Sum InsuredAnnual Premium
US$
TI PD TI PD
18-30 11.00% 4.79%
31-40 12.00% 9.66%
41-50 19.00% 35.75%
51-60 27.00% 150.52%
61-65 29.67% 300.14%