1. 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
2. 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
3. 13 Purple Cow 2011 Benefits +You can add additional procedures to your Basic 5 APE: call GRA to help design, source, price, and schedule your APE anytime during your plan year. +Nationwide (241 clinics, 31 mobile) or Metro Manila-wide (114 clinics, 24 mobile) APE also available to companies with multiple locations, at roughly triple or double the cost respectively (reflecting their average cost of a Basic 5 APE). Otherwise, individual clinics are best, whether designated or mobile. EXCLUSIONS ASIANLIFE (241 designated clinics, 31 mobile clinics) APE benefits are covered on top of Medical HMO benefits +The Annual Physical Exam (APE) is a diagnostic tool, not a cure for sickness or accident. Results can serve as a baseline for referral to specialists who can authorize tests and/or prescribe further treatment. +By appointment only, 30 days in advance. +Pay as you go, so you don’t lose it if you don’t use it (don’t pay in advance, as payment is not transferable). Basic 5 Cost +/- P300 (for designated or mobile clinics). 5. Fecalysis 4. Urinalysis 3. CBC Basic 5 only 2. Chest X-Ray 1. APE procedures not included in the Basic 5 APE plan 1. Physical examination 5. Optional Annual Physical Exam
4. 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:
5. Optional Annual Physical Exam : you can customize your APE and request a designated or mobile clinic from GRA; or you can get a Basic 5 APE nationwide. (Unlike most HMO plans) You can decide if you want an APE, and if so, what kind 16 Purple Cow 2011 Why Purple Cow? Competitive Advantage #16:
6. 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:
