Purple cow 2011 (life & pa)

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  • 1. What is the purpose of EB ?
    • “ The purpose of EMPLOYEE BENEFITS is to increase the economic security of employees.”
      • Wikipedia
    EB can help your employees become financially secure 2 Purple Cow 2011 EB Primer
  • 2.
            • Paid vacations, 75%
            • Health insurance, 61%
            • Paid sick leave, 59%
            • Disability insurance, 41%
            • Education reimbursement, 39%
            • Pension plan, 30%
            • Life insurance, 29%
            • Dental insurance, 24%
    What are the most common EB ? All 4 insurance benefits are offered by Purple Cow! 3 - Small Business Poll on Compensating Employees (NFIB, US: 2003) Purple Cow 2011 EB Primer
  • 3. What makes Insurance ‘sulit?’
    • LIFE INSURANCE provides you with instant cash in the event of death or total and permanent disability; (.25% of population between 18-65)
    • ACCIDENT INSURANCE provides you with instant cash in the event of accidental death or disability; (10% of inpatient & outpatient cases)
    • HEALTH INSURANCE (Medical / Dental HMO and/or INS) protects you from losing money in the event of sickness or accident, and treats you as well (if HMO). (10% inpatient / 100% outpatient)
    All insurance can make or save you money in multiples 4 Purple Cow 2011 EB Primer
  • 4. 1 Purple Cow 2011 Benefits ACCIDENT 2. ACCIDENT INSURANCE a. Accidental Death * Murder b. Disability * Assault HEALTH 3. MEDICAL HMO * 21,519 MD, 352 hospitals, 358 clinics 4. DENTAL HMO * 775 dentists, 645 clinics 5. Opt. Annual Physical Exam * 124 hospitals, 241 clinics, 31 mobile 6. Health & Wellness Program * 2x/year; tailored to utilization report LIFE 1. LIFE INSURANCE * Total & Perm. Disability Income LIFE – ACCIDENT – HEALTH Benefits Overview
  • 5. 2 Purple Cow 2011 Benefits 18. Dental = HMO (775 dentists / 645 clinics) 6. Assault = __% of 5x MBL 24. Same benefits for all Dependents 23. Same benefits for all Employees 22. Health & Wellness Program 2x/year 21. Opt. APE = designated or mobile clinic 20. 1 permanent filling, 2 oral prophylaxes, etc. 19. Dental access to major malls in Metro-Manila 17. Opt. Outpatient Reimb. for meds, dental, vision 16. Special procedures = 30%/100% of MBL 15. Benefits on top of Philhealth 14. 100% Congenital Conditions coverage 11. HMO patient for no-cash-out 10. Max. Benefit Limits per disability per year 12. Private patient for reimbursement (HMO rate) 13. 100% Pre-Existing Conditions coverage 9. Combined inpatient & outpatient limits 8. Access to Big 5 Hospitals & Healthway 7. Medical = HMO (21,519 MD / 352 hospitals / 358 clinics) 5. Accidental disability = __% of 5x MBL 4. Murder = 5x MBL 3. Accidental death = 5x MBL 2. Total & perm. disability income = 5x MBL 1. Life = 5x MBL LIFE – ACCIDENT – HEALTH Benefits Summary
  • 6. 3 Purple Cow 2011 Benefits 1. Suicide within the 1 st year of coverage 5x MBL 1. Life 1 Life benefits are payable on top of Accident and Health benefits 5x MBL EXCLUSIONS +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 1 Life insurance = 5x MBL, for death by any cause (suicide covered after 1 year); 2 Total & Permanent Disability Income (TPDI) = 5x MBL, in lieu of the Life benefit, after 6 months of TPD, whether sick or hurt. Example : If MBL = 20T, Life or TPDI = 100,000; If MBL = 40T, Life or TPDI = 200,000; If MBL = 60T, Life or TPDI = 300,000; If MBL = 80T, Life or TPDI = 400,000; If MBL = 100T, Life or TPDI = 500,000. 2. Total & Perm Disability Income 2 ASIANLIFE 1. LIFE INSURANCE (worldwide)
  • 7. 4 Purple Cow 2011 Benefits _% 5x MBL _% 5x MBL 4. Assault 4 5x MBL 2. Murder 2 +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 1 Accidental Death = 5x MBL, for death from any type of accident; 2 Murder = 5x MBL, in lieu of the Accidental Death benefit, for death not due to accident but murder (provoked or not). Example : If MBL = 20T, Accidental Death or Murder = 100,000; If MBL = 40T, Accidental Death or Murder = 200,000; If MBL = 60T, Accidental Death or Murder = 300,000; If MBL = 80T, Accidental Death or Murder = 400,000; If MBL = 100T, Accidental Death or Murder = 500,000. +Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo 3 Disability = __% of 5x MBL, according to a long schedule of disabilities; 4 Assault = __% of 5x MBL, in lieu of the Disability benefit, for disability not due to accident but assault (provoked or not). Example : If MBL = 20T, Disability or Assault = __% of 100,000; If MBL = 40T, Disability or Assault = __% of 200,000; If MBL = 60T, Disability or Assault = __% of 300,000; If MBL = 80T, Disability or Assault = __% of 400,000; If MBL = 100T, Disability or Assault = __% of 500,000. Accident benefits are payable on top of Life and Health benefits 5x MBL 3. Disability 3 1. Accidental Death 1 ASIANLIFE 2a. ACCIDENT INSURANCE (worldwide)
  • 8. 5 Purple Cow 2011 Benefits Losses refer to total and permanent loss of use or complete severance 50% 8. Arm between elbow and wrist 100% 6. Any other injury causing Total Perm. Disab. +Multiple losses from 1 accident will be limited to the highest loss, not to exceed 100%. If a member suffered the loss of 1 hand/foot/eye prior to coverage, the benefit for a subsequent loss of the same will be ½. 19. Leg below knee 10% 13. Index finger 15% 12. Thumb 35% 11. Four fingers 50% 10. Four fingers and thumb of one hand 70% 4% 16. Little finger 100% 3. One hand and one foot 50% 5% 25% 50% 60% 3% - 2% 5% 6% 50% 25. Hearing - both ears 50% 24. Sight of one eye 7. Arm at or above elbow 22. Big toe 20. One foot 17. Metacarpals 1 st /2 nd - 3 rd/ 4 th /5 th 23. Any toe other than big toe (each) 21. All toes on one foot 18. Leg at or above knee 15. Ring finger 14. Middle finger 25% 26. Hearing - one ear 50% 100% 100% 100% 100% 5. Injuries resulting in being perm. bedridden 2. Both hands or feet or sight of both eyes 1% 9. One hand 4. Either hand or foot and sight of one eye 1. Life (same as Accidental Death) SCHEDULE OF DISABILITIES 2b. ACCIDENT INSURANCE…
  • 9. 6 Purple Cow 2011 Benefits 13. Serving in the armed forces of any country, or international authority, whether in war or peace 4. Insect bites 5. Earthquake, volcanic eruption or tidal wave 11. Provoked murder / assault or attempted threat [waived] 10. Participation in any brawl, or committing any crime or felony 3. Poison, gas or fumes voluntarily or involuntarily taken 8. Accident occurring while or because the Insured is under the influence of alcohol or any drug 6. Atomic explosion, nuclear fission, or radioactive gas 12. War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war 2. Disease, sickness, parasite, or disorder of the body/ mind 15. Hunting, motorcycling or pillion riding, mountaineering which necessitates the use of ropes or pitons, racing of any kind, other than on foot, ice or winter sports, water-ski jumping and tricks, yachting beyond 5 km. off a coastline, underwater activities involving the use of underwater apparatus, or using woodworking machinery driven by mechanical power other than portable tools, applied by hand and used solely for private purposes without reward 14. Entering, operating, servicing, ascending or descending from any aerial or submarine device or conveyance, except as provided under a passenger aviation provision 9. Suicide or any attempted threat while sane or insane, or any intentionally self-inflicted injury 7. Pregnancy, childbirth, miscarriage or any complications 1. Bodily or mental infirmity, hernia, ptomaine, bacterial or viral infection (except pyogenic infection occurring with and through an accidental cut or wound) EXCLUSIONS 2c. ACCIDENT INSURANCE…
  • 10. 3 Major Employee Benefits in 1 Plan: you get Life, Accident & Health (medical HMO, dental HMO, optional APE, and Wellness program) – all in one plan. (Unlike most HMO plans) You get all the Employee Benefits you will ever need 3 Purple Cow 2011 Why Purple Cow? Competitive Advantage #3:
  • 11. Life Insurance : your Life insurance benefit = 5x MBL. Twist: if you don’t die, but you’re totally and permanently disabled, TPDI = 5x MBL. (Unlike all HMO plans) 11 You can get 1 year’s worth of income replacement Purple Cow 2011 Why Purple Cow? Competitive Advantage #11:
  • 12. Accidental Death Insurance (PA) : your Accidental Death benefit = 5x MBL. Twist: if you don’t die by accident, but by Murder, you get 5x MBL. (Unlike all HMO plans) You can get another year’s worth of income replacement 12 Purple Cow 2011 Why Purple Cow? Competitive Advantage #12:
  • 13. Disability Insurance (PA) : your Disability benefit = __% of 5x MBL. Twist: if you don’t get disabled by accident, but by Assault, you get __% of 5x MBL. (Unlike all HMO plans) You can get up to 1 year’s worth of income replacement 13 Purple Cow 2011 Why Purple Cow? Competitive Advantage #13:
  • 14. Same Benefits for Dependents : Dependents can get the same benefits, terms and conditions as Employees (as well as the same costs in 2011). (Unlike most, if not all, HMO plans) Your Dependents are treated like Employees 19 Purple Cow 2011 Why Purple Cow? Competitive Advantage #19: