Slideshare - ONS Economic Forum Slidepack - 13 May 2024.pptx
Purple cow 2011 (dental)
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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. 12 Purple Cow 2011 Benefits 1 +No reimbursements allowed (unless you get the optional Outpatient Reimbursement Plan for Rx Medicines, Dental & Vision). +Discounts of up to 20% available on procedures not included in the dental HMO plan. +Dental card and booklet provided, as well as an orientation and an annual utilization report. 8. Re-cementation of fixed bridges/crowns/jackets/inlays/onlays Dental HMO benefits are covered on top of Medical HMO benefits EXCLUSIONS HP DENTAL (775 dentists / 645 clinics) 9. Treatment of pain/lesions/wounds/burns +By appointment only (unless emergency) 10. Emergency dental procedures if necessary 7. Simple adjustment of dentures 6. Gum treatment except for alveolectomy/gingivectomy 5. Temporary fillings when indicated 4. Simple tooth extractions if indicated 3. Unlimited consultations 2. (2) oral prophylaxes 1. Dental procedures not included in the dental HMO plan 1. (1) permanent filling 4. DENTAL HMO (nationwide)
7. 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:
8. Dental HMO Network : you can get 1 permanent filling, 2 oral prophylaxes, and 8 other benefits from 775 dentists and 645 clinics nationwide. (Unlike most HMO plans) You can go to SM/ Market 2 / Festival/ Robinson’s/ Shangrila/ ATC 15 Purple Cow 2011 Why Purple Cow? Competitive Advantage #15:
9. 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:
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