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Ultimate kaiser health builder
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Transcript of Ultimate kaiser health builder
KAISER INTERNATIONAL HEALTHGROUP, INC.We are duly accredited with the Department of
Health (DOH). Our Company is likewise, registered with the Securities and Exchange Commission (SEC) on June 08, 2004 as a Health Care Provider with an Authorized Capital Stock of Php 160M.
Kaiser's Board of Directors are seasoned experts in the Medical field services and in the health care industry with its President and Medical Director Dr. Ramon B. Abragan, Jr., a former DOH Head Executive Assistant, a former Consultant to the DOH Secretary and a former member of Medical Board of Examiner- Philippine Regulation Commission (PRC).
KAISER INTERNATIONAL HEALTHGROUP, INC.
Kaiser International Healthgroup, Inc.,as an HMO Company caters to both corporate, group, family and individual accounts with our various short term plan packages that would suit your health care requirements.
We offer the following HMO Plans: Kaiser Healthcard Individual Kaiser Healthcard Family Kaiser Healthcard Mini- Group (10-49
members) Kaiser Healthcard Group (50-99
members) Kaiser Healthcard Corporate (100
members and above) Senior Care Plan Daily Health Plan
Kaiser International Health Group Inc. is also offering a one of a kind HMO Product, the Premium Healthcare Builder Plan (long term plan). ULTIMATE Kaiser Health Builder.
A five (5) year paying and a ten (10) year waiting plan; and a (7) year paying and (13) year waiting plan.
Designed to provide healthcare beyond that of an HMO.
Allows individuals to save during employment while still being covered by Company’s health plan
Geared to address the long term health care needs of individuals especially after employment and retirement years
Securing a more comfortable elderly life.
ULTIMATE KAISER HEALTH BUILDER
7-20
Issue Age
22
PAYMENT PERIOD:
7 YEARS ULTIMATE KAISER HEALTH BUILDER
START OF LONG-TERM CARE:
20 YEARS
POLICY FEE:
P500.00 / year for 7 years
SEVEN-YEAR PAY
BENEFITS INFORMATION PRICING INFORMATION
Long-Term Care
Benefit
Term Insuran
ce Annual Benefit Limit
Room and
Board Benefi
t
Annual Health Benefit
Total Annual Health Benefit
Additional
Health Benefit
s
Total Health Benefit
s
Long-term Care
Bonus
Long-term Care
Benefit At
Maturity
Long-term Care
Benefit At Age 60
Annual Lifetime Health Care At Age 60
Long-term Care
Benefit At Age 65
Annual Lifetime Health Care At Age 65
Contract Price
Annual Installm
ent
Semi-Annual Installm
ent
Quarterly
Installment
Monthly Installm
ent
(10% x A)
(B @ 10%)
Age (With bonus)
(With bonus)
(With bonus)
(With bonus)
A B C D(A+C+
D) E(A + C + D + E)
100,000 450,000 60,000 1,000 10,000 269,750 446,419 816,168 350,000 1,166,168 6,483,800 648,380 10,442,224 1,044,222 411,750 58,821 31,764 17,058 5,882
DURING ACCUMULATION PERIOD (1ST TO 7TH YEAR)
1. ANNUAL PHYSICAL EXAM
•To be administered by an accredited service provider.•APE Coverage ( Basic 5 )Physical Examination, Chest X-Ray, Routine Fecalysis, Routine Urinalysis, Complete Blood Count
ECG for Members above 35 and Pap Smear for Female Members above 35 years old or as required2. DENTAL BENEFITS
• Unlimited Dental Check Ups• Unlimited Simple tooth extraction• Once A year Free Dental Prophylaxis• Re cementation of jacket, crowns, inlays, on
lays and• Minor adjustment of Dentures
3.Basic Medical Health Benefits*Accredited (Physician’s Fee, Specialist’s fee, Surgeon’s Fee, Anesthesiologist’s Fee)*Operating Room*Hospital Intensive Care4. Member’s choice of Room and Board, up to Php 1,000.00/Day
5. Yearly Benefit Limit of Php 60,000/ year
8. Waiver of Installment due to Death/ Credit Life: If the member during the accumulation period and before exceeding the age of seventy, the proceeds of the credit life insurance shall be applied to the balance of this Contract Price upon approval of the claim by the insurance company, if any. The difference, if any, shall be paid to this designated beneficiaries.
9. Waiver of installment and Premiums due to Total and Permanent Disability: If the member becomes totally disabled during the accumulation period and before his 60th birthday thereby preventing him from engaging in any occupation for compensation or profit, is so disabled for life, and such disability continues for at least six (6) months, Kaiser shall waive the payment of each installment becoming due during the life, and such disability, However, pending approval of the claim, installments should be paid as at they fall due, subject to refund upon approval.
6. Term Life Insurance Coverage: If the member dies before attaining the age of seventy (70) years and prior to this entitlement to the Long-Term Care Benefit as indicated in the Schedule of Benefit (SOB), his beneficiary shall be entitled to an amount equal to the sum of Long-Term Care Benefit and Long-Term Care Bonus upon approval of the claim by the insurance company.
7. Accidental Death & Dismemberment: should the Member suffer, directly and Independently of all other causes, any bodily injury effected solely through external, violent and accidental mean, occurring prior to the Member’s 70th birthday and prior to the entitlement to the Long-Term Care Benefit, which result in any of the specified losses within 180 days after the accident causing the injury, the insurance company will pay the following:
DISMEMBERMENT
•Loss of Both Hands 100%•Loss of Both Feet 100%•Loss of One Hand and Sight of One Eye 100%•Loss of one foot and Sight of One Eye 100%•Loss of both Sight 100%•Loss of One Hand and One foot 100%
n.b.
All claims under the above insurance coverage shall be subject to contestability as provided for by law, but for a reduced period of two (2) years from the date of issue or reinstatement of this contract.
If the Member dies during the accumulation period, the Principal Beneficiary named herein shall be substituted as the new Member, but no longer with insurance benefits and subject to the provisions on Pre-existing illness of Injury.
10. Family Assistance Service Policy should be in ACTIVE status and plan should have completed
at least one (1) year payment Nominated patient must be an immediate family member of the
Policy Holder or within the 1st degree of consanguinity Policy Holder agrees to avail only of the services of Kaiser’s
Accredited Doctors and Affiliated network of Hospitals Assistance to be provided by Kaiser shall only be to the extent of
the allowable benefits due to the plan holder under his policy. Prior to discharge of the nominated patient, payment should have
been settled to Kaiser.Please note that this assistance is an accommodation and not
considered a benefit of the plan, hence approval & denial on the a ailment solely depends on Kaiser Management Evaluation.
EXTENDED PERIOD
PRE-EXISTING MEDICAL
CONDITION (covered after accumulation period)
Those illnesses/injuries considered to be in existence prior to the effective date of the contractAny professional advice or treatment was given for such illness or condition Such Illness or condition was in anyway evident to the member before the effective date of the contractThe pathogenesis of such illness or condition started whether or not the member is aware of it.
The following illnesses will be covered during extended period (8th-20th year)
Bronchial Asthma PTB COPD Diabetes Thyroid Diseases Systemic Allergies Hernias DUB Chronic Hemmoroids Anal Fistula Gastric or Duodenal Ulcers Liver Cirrhosis Kidney Diseases Blood Dyscrasia Immunologic & Collagen Diseases Endometriosis Cholecystitis Hallux Valgus Lithiasis Cancer Atherosclerosis CVD CVA
PHILHEALTHYour Philhealth benefit is integrated with
Kaiser. Once admitted, you will be advised to file
your PHILHEALTH REIMBURSEMENT FORM. The Philhealth reimbursement due shall be deducted from the total hospital bills.
Kaiser members without Philhealth membership, shall shoulder and pay the corresponding portion of Philhealth.
If payment is made after the grace period the contract shall be considered LAPSED. However, the owner shall be given a grace period of 60 days/2 month to pay the due installment benefits may be provided to the member only after the due installment is paid.
REINSTATEMENT UPDATE- member will pay the premiums due on all the missed
months + surcharge of 1.5%/months or 18%/annum from the date of each unpaid installment.
REDATE- member will only pay the premium for the month but the maturity period will be moved
Requirements: Re instatement application form Re-instatement fee of Php 300.00
Can be done within 2 years of the first unpaid due date The member shall be considered a new applicant subject to pre-
existing conditions and for purposes of contestability of insurance coverage and to any other requirements for a new applicant for membership in effect at that time
Kaiser will cancel the contract without need of notice to the owner if he fails to reinstate within the prescribed period.
All reinstated plan shall be subjected to the new price
The owner may surrender the contract for its cash value stated in the Schedule of Benefits provided the Plan is active for at least a year.
CASH VALUE SURRENDER
TRANSFER
The owner is allowed to transfer his rights under his contract at any time.
• Written request• Surrender of the agreement• Membership application signed by the transferee• Payment of processing fee (Php 300.00)
TRANSFER
UPGRADING OF PLAN & MODE OF PAYMENT
Plan can be upgraded within 30 days after its effectivity date. Filled-out amendment form Payment of processing fee- P300.00 Payment of additional installment corresponding to the updated
plan Mode of payment can be upgraded anytime after completion of its
respective cycle If within 30 days after purchase Filled-out amendment form Payment of additional installment due corresponding to the amount of
the updated mode of payment If beyond 30 days after purchase Filled-out amendment form Payment of Processing fee- P 300.00 Computation of dues based on the desired mode of payment
Downgrading of plan and mode of payment is not allowed.
ELIGIBILITY
10 - 40 years old = k 4541-50 years old = k 60
51 – 60 years old = k 75
PAYMENTKAISER INTERNATIONAL HEALTHGROUP
INC.BPI FAMILY BANK
Account #: 6251-0171-64BPI
Account #: 3711-0062-13UNION BANK
Account #: 002-03-0-00845-1BDO
Account #: 4280021263E-mail add: [email protected].# 892-9634 to 36 Fax # 811-1878 or 759-5538
For inquiry and assistance, please email or call:
[email protected] #: 0917-5838854
(02) 8929634 to 36