WORLDWIDE HEALTH CARE

Transcription

1 WORLDWIDE HEALTH CARE Worldwide comprehensive protection and assistance for you and your family Page 1 of 7

2 In this Overview: 1. Introduction 2. Overview of the Plan 3. 24hr Emergency Assistance 4. Australian Healthcare Compliance 5. Introducing our Partners 6. Optional Benefits a 7. Obtaining a Quotation 1. INTRODUCTION Appendix: - Benefit and Compensation Tables - Guaranteed Continuity of Cover on permanent return to Australia. - Application Form 2. OVERVIEW OF THE PLAN Increasing globalisation has meant a growing number of staff are being sent on overseas assignments. Ensuring that there is appropriate health care insurance in place goes a long way to reassuring employees that their specific needs as well as any accompanying family members, are being taken care of. This becomes of increasing relevance where the intended destination is a developed country where there is potential to incur significant medical costs, or a developing country where the standard or quality of healthcare available is questionable. In order to assist Australian companies with these exposures, Willis has in conjunction with our partners QBE Australia and BUPA Australia Health Pty Ltd, developed a Worldwide Healthcare Plan [the Plan] that offers: - Comprehensive Expatriate Health cover anywhere in the world. - Emergency Support & Medical evacuation. - Option to comply with Australia s Medicare system. - Options to extend cover. for:- Income protection Corporate travel This overview is intended only to provide a summary of the coverage afforded. All of the benefits described are subject to the limits, conditions and exclusions detailed in the policy wordings, copies of which are available upon request. The Plan provides seamless cover between host and home country, with two (2) policy limits depending on region of residence, as detailed below: Policy limits in region of residence USA / Canada / Japan / Hong Kong / UK All other areas $2m policy limit $1m Policy Limit The plan provides comprehensive medical, hospital and ancillary benefits including: - Optional pregnancy & childbirth services including Routine pre-natal care, pre-natal classes and childbirth expenses including complications. Further details regarding coverage can be found in the Benefit and Compensation Tables included in the Appendix to this overview HOUR INTERNATIONAL EMERGENCY ASSISTANCE The Plan offers the best in Emergency Support services, accessed via a simple phone call to QBE Assist, a fully owned division of QBE Australia., QBE Assist provides medical evacuation and repatriation services for QBE s insurance policyholders worldwide. All cases are managed from start to finish by our experienced Insurance and Medical specialists who are available by telephone 24 hours a day for advice and assistance in the event of a medical emergency. Specific services provided for insured s under this policy who sustain an injury or suffer an illness or mishap while travelling outside their country of residence includes: - Medical transfer to an appropriate specialist hospital - Repatriation to Australia - Intra hospital transfer should specialist care be required - Road ambulance transportation services - Repatriation of mortal remains Page 2 of 7

3 4. AUSTRALIAN HEALTHCARE SYSTEM All Australian expatriates eligible for Medicare are affected by the Australian National Health Act legislation including amendments introduced with effect from 1 July The risks of Not Getting It Right in relation to Medicare eligibility, continuity of health fund membership, Lifetime Health Cover (LHC), and the Medicare Levy Surcharge (MLS), can result in costly penalties for both the employee and employer. - Lifetime health insurance premium penalties if the correct cover or correct arrangements are not made or maintained whilst on your overseas assignment. - Possible MLS Tax penalties on lodgement of a tax return in Australia. Medicare Levy Surcharge (MLS) Under Australian Taxation Law, anyone who holds a Medicare Card, or who is entitled to hold a Medicare Card, and does not have "appropriate"* Private Health Insurance, has to pay the!% to 1.5% Medicare Levy Surcharge (MLS), which is levied by the Australian Taxation Office (ATO) after assessment of an individual's tax return at the end of each financial year. This levy applies to Singles/Couples/families with an income over a nominated threshold. For the 2012/13 tax year the nominated threshold is in three tiers as below: Tier 1) 1% on income Singles $84,001 - $97,000. Families $168,001 - $194,000 Tier 2) 1.25% of income Singles $97,001 - $130,000 Families 194,001 - $260,000 Tier 3) 1.5% of income Singles > $130,001. Families > $260,001 Visit: for more information If prior to assignment an expatriate has private patient hospital cover and is considering cancelling or suspending cover while overseas, there may be Medicare Levy Surcharge implications if their income exceeds the relevant threshold and they are still required to lodge an Australian tax return. To retain or obtain an MLS exemption there are two options; - Retain membership of the existing health fund hospital table; or - Enrol into an MLS exemption table, which is specifically designed to eliminate the MLS tax. Under this arrangement, Members will be issued with a Private Health Insurance Statement to accompany their tax return. Please contact Willis to assist with this option. Personal circumstances vary and should be checked with a qualified accountant and/or the Australian Taxation Office. Further information can be found via the Australian Health Industry Association (AHIA) calculator: and, ATO website: 5. INTRODUCING OUR PARTNERS Recognising that provision of an effective and responsive medical insurance provider plays an essential role in offering high quality support to employees whilst they are on overseas assignments, Willis has teamed up with partners who offer superior products and the resources required to support these services. About QBE Australia QBE Insurance (Australia) Limited is a member of the QBE Insurance Group (ASX: QBE) and is Australia s largest international general insurance and reinsurance group. QBE are one of the top 25 insurers and reinsurers worldwide. The company has been operating in Australia since 1886 and continues to provide industry-leading insurance solutions. QBE Australia is backed by sizable assets, and well known as a strong financially secure organisation. Under the Plan QBE provide Expatriate Health Cover for the duration of an employee s assignment. BUPA Australia Health Pty Ltd is a division of the British United Provident Association Limited (BUPA), one of Australia s largest health funds with over three million insured members and has earned a reputation as an industry leader in the provision of health insurance products and customised health management solutions. Under the plan BUPA guarantees continuity of cover on permanent return to Australia. Page 3 of 7

4 EFFECTIVE ADMINISTRATIVE SUPPORT We provide dedicated administrators to ensure the smooth administration of the Plan. As part of the service, Individual members will be provided with a member kit containing: - A member booklet detailing information on Medicare eligibility and continuity of cover etc - Claims procedures and Claim forms - Emergency Assistance cards - Willis Contact details to respond on any specific query relating to the Plan Where a number of staff is on assignment, we can help develop procedures and billing arrangements that will help streamline and cut out unnecessary administration at Head Office. CLAIMS SERVICE TO MEMBERS With particular emphasis having been given to quick and efficient claims settlement, systems are in place to achieve settlement within 10 working days of receiving all necessary documentation. Hospital in-patient treatment QBE Assist is able to arrange admission, guarantee of payment and direct settlement on discharge thereby avoiding out-of- pocket expenses. Outpatient treatment and services Options exist to arrange reimbursement in foreign currency and/or direct credit to foreign bank accounts (subject to domestic regulations) at no charge. 6. OPTIONAL EXTRAS Depending on individual s specific needs, the following optional extras can easily be included to the core expatriate health cover Authorised Business and related leisure Travel Insurance - Intended to compliment the benefits already received under the Expatriate Health Cover, cover applies whilst an insured is travelling on business and leisure travel. AGE LIMIT Benefits cease at age OBTAINING A QUOTATION Companies To provide a quotation we will need the following: - Name of Company - Nationalities of lives to be insured - Locations of lives to be insured - Gender - Occupations - Salary if salary related benefit - Cover required - 3 years claims experience The premiums on page 6 are for individual expatriates. Individuals Premiums for individuals are on page 6. Claims are not payable unless premium has been received. GUARANTEED CONTINUITY OF COVER ON PERMANENT RETURN TO AUSTRALIA We have an arrangement in place with BUPA Australia to provided members with guaranteed continuity of cover. Personal Injury and Illness benefits: Accidental Death Disablement Benefits - If within 12 consecutive months of an injury which results in death or specified events such as paraplegia/quadriplegia, loss of sight or loss of use of limbs etc, this cover will pay lump sum cash benefits. Income Replacement Benefits In event of injury or sickness preventing an Insured Person from engaging in his/her usual occupation, the policy provides income replacement support for up to two years. Page 4 of 7

5 PREMIUM SCHEDULE The indicative premiums below are based on the following conditions: White Collar occupations including Sales & Administration No pre-existing conditions No previous claims reported under a current or previous policy Country of Employment as identified below Premiums for Death and Capital Benefits and Income Protection require additional underwriting information and no benefits are available if aged 65 & over. IINDIVIDUAL EXPATRIATE PREMIUM RATES REGION OF RESIDENCE Pregnancy included 12 month waiting period SINGLE COUPLE FAMILY USA / CANADA $10,400 $15,600 $20,800 UK /JAPAN/HONG KONG $6,240 $9,360 $12,480 SINGAPORE $5,460 $8,190 $10,920 REST OF THE WORLD $5,200 $7,800 $10,400 IINDIVIDUAL EXPATRIATE PREMIUM RATES Pregnancy Excluded SINGLE COUPLE FAMILY USA / CANADA $9,400 $14,100 $18,800 REGION OF UK /JAPAN/HONG KONG $5,640 $8,460 $11,280 RESIDENCE SINGAPORE $4,935 $7,400 $9,870 REST OF THE WORLD $4,700 $7,050 $9,400 Annual excess or Deductible SINGLE $250 COUPLE /FAMILY $500 Options Lump Sum Death & Disablement Weekly Benefits Accident Only Weekly Benefits Accident & Illness Corporate Travel Medicare Compliance ** Medical Levy Surcharge (MLS) Elimination Single, cost per annum Couple / Family, cost per annum Optional Benefits Sum Insured Additional Premium (AUD) Expatriate $250,000 $295 Spouse / Partner $100,000 $95 Children $30,000 $28 30 day excess 85% up to $3,500 per week. $ day excess 156 week benefit period $ day excess $ day excess 85% up to $3,500 per week. $1, day excess 104 week benefit period $1, day excess $1,124 Single As per policy wording $278 Couple / Family $555 $ per annum or $67.05 per month $1, per annum or $ per month ** BUPA Australia Medicare Levy Surcharge application form required to be completed. RENEWAL PREMIUMS it is important to note that there are several l factors that may affect the premium of this insurance at the expiry of the policy, being: 1- Claims during the policy period 2- The number of people to be covered under the policy 3- The level of benefits selected 4 - Change in Occupations 5 - Change in Country Page 5 of 7

6 BENEFIT & COMPENSATION TABLES The maximum amounts payable in any one period of insurance (less the deductible if applicable) is: Residence in USA/Canada/Japan/Hong Kong/UK: AUD 2,000,000 per per annum Residence in all other areas: AUD 1,000,000 per per annum MEDICAL EXPENSES $1,000,000 $2,000,000 HOSPITAL SERVICES - 100% REIMBURSEMENT OF ACTUAL COSTS Accommodation and ancillary charges, Intensive Care, Full refund to policy limit Full refund to policy limit Theatre, Medical Supplies, Surgically Implanted Prosthetics Doctors services, Anaesthetic services, Nursing care Full refund to policy limit Full refund to policy limit services and Diagnostic procedures Parenting Accommodation Full refund for reasonable cost of a parent staying in the same hospital with the child under the age of 12 OUTPATIENT DOCTOR SERVICES - 100% REIMBURSEMENT OF ACTUAL COSTS DOCTOR SERVICES charges for outpatient services - includes specialist consultations Full refund to policy limit Full refund to policy limit OTHER OUTPATIENT SERVICES 100% REIMBURSEMENT OF ACTUAL COSTS Home nursing limits of $3,000 any one Insured limits of $3,000 any one Insured Radiation therapy Full refund to policy limit Full refund to policy limit X-ray and laboratory examinations Full refund to policy limit Full refund to policy limit PREGNANCY AND CHILDBIRTH SERVICES - 100% REIMBURSEMENT OF ACTUAL COSTS Routine care $10,000 $20,000 Childbirth (Hospital In-patient up to 6 months ) $10,000 $20,000 Pregnancy and childbirth emergency and complications $10,000 $20,000 ANCILLARY SERVICES - 100% REIMBURSEMENT OF ACTUAL COSTS Acupuncture $500 per $1,000 per Chiropody / Podiatry $500 per $1,000 per Chiropractor / Osteopathy $120 per visit to a maximum of $1,200 per $240 per visit to a maximum of $2,400per Dietician $500 per $1,000 per Hearing Aids / Prosthesis (one appliance every 2 years) $600 any one appliance, annual sub limit $1,200 per $1,200 any one appliance, annual sub limit $2,400 per Homoeopath $250 per $500 per Naturopath $250 per $500 per Optical $500 any one insured $1,000 any one insured Pharmaceutical Supplies Physiotherapist Psychology, Psychiatry, Psychotherapy, Hypnotherapy, Personal, Family or Marital Counselling limits of $2,000 any one Insured $150 per visit to a maximum of $1,250 per limits of $4,000 any one Insured $150 per visit to a maximum of $2,500 per $2,500 per $5,000 per Page 6 of 7

7 MEDICAL EXPENSES $1,000,000 $2,000,000 Rehabilitation and Occupational Therapy $10,000 per $10,000 per Speech Therapy $500 per $1,000 per DENTAL SERVICES - costs, subject to annual sub limits shown below Dental Services - charges made by a qualified dentist or oral surgeon $2,400 per $4,800 per Emergency Dental - as a result of an injury to sound and natural teeth Full refund to policy limit Full refund to policy limit ADDITIONAL BENEFITS Compassionate travel - Additional Travel Expenses - following unexpected death or life threatening injury or illness of your spouse, parent, step-parent, parent-in-law, brother, sister, child or grandchild, who is not over 80 years. Airline costs must be incurred within 14 days of first becoming aware of the condition. Cost of economy class return tickets to travel to your country of residence up to a maximum $10,000 per or family Personal legal Liability $1,000,000 SECTION B EMERGENCY TRAVEL ASSISTANCE - cost Medical Transfer & Emergency Evacuation/Repatriation The maximum amount payable is $1,000,000 Including Return transportation. Unlimited usage Repatriation of Mortal Remains or local burial: charges incurred for the return of your body or ashes to your place of residence in your country of All regions residence Full refund to policy limit of $10,000 the cost of a burial overseas provided it does not exceed the cost of repatriation of your body to your place of residence CORPORATE & LEISURE TRAVEL The Event Benefit amount $ Baggage and Personal effects 7,500 3,000 any one item Personal computers 7,000 Money/travellers cheques/documents/credit cards 2,000 Loss of travel deposits 10,000 Waiver of car hire excess 5,000 Kidnap & Ransom 500,000 Page 7 of 7