Supporting your people at work, wherever they are Global health cover for NGO workers

Transcription

1 For non-governmental organisations Supporting your people at work, wherever they are Global health cover for NGO workers

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3 A health plan that suits your unique needs NGO workers venture to unfamiliar locations and are often faced with critical situations. Your employees and their families can be located in remote areas or near conflict zones, thus increasing their risk of injury. Therefore, apart from the challenge of being in a foreign country, they require access to quality health care or medical/security evacuation to immediately take them to a safe location should alarming incidents occur. Vanbreda International has more than 50 years of market leadership in providing worldwide medical insurance to workers from international organisations. Our INGO members are based in virtually every country in the world and as a result, we have acquired unmatched experience and knowledge of this industry. Due to the increase in targeted violence against development and aid workers, CoverN GO has been specifically designed to offer your employees and their families peace of mind. Your employees deserve a fully integrated solution that prepares them for all eventualities, whether they are on short-term or longterm assignment. The success of your NGO and your employee s assignment depends on the well-being and safety of your employees. CoverN GO is committed to supporting their work by providing the appropriate cover. CoverN GO is a product of Cigna Global Health Benefits, serviced by Vanbreda International. 3

4 Our trusted service promise: we ve got your employees covered Make the most of Vanbreda International s first rate services and specialist local knowledge with the CoverN GO plan. Easy access to health care When you sign up to CoverN GO your employees can access the most extensive client-driven global network of health care providers. Whether your workers are active in populated cities or in remote field areas, they will always have easy access to health care through our global proprietary network in combination with local provider partnerships. With a simple click, members can look for their preferred provider online or call our 24/7 Contact Centre for further local advice. All-in-one medical and security evacuation Emergency situations and hostile environments are often an integral part of an NGO s day-to-day work. Thanks to our partnership with a renowned assistance company we can lessen the worry with respect to the safety of your employees. One single call is sufficient for us to organise a safe return if there is a medical emergency or safety risk. Throughout the entire process, our representatives will remain in contact with your teams either in the field or at home to continuously update you as the situation unfolds. Whenever your employees have experienced severe trauma on assignment, their family and friends may not be present to offer them first-hand support to comfort them. That is why CoverN GO includes two counselling sessions by phone for psychological support. Expert local teams for reassurance We recognise that it is difficult being far away from your home environment, and understanding local practices can be time consuming. Our local representatives worldwide can visit our clients offices to ensure their employees receive one-on-one support and advice. They are close to your employees and can assist them on the spot in case of hospitalisation or emergency repatriation and perform on-site case management. Making a member s life easier through direct payment With a single phone call, we will assist your employees whenever they need us most. We will arrange for the administration and payment of the invoices, leaving your employees to concentrate on a speedy recovery. 24/7 assistance Your employees are fully supported 24/7 in their preferred language by our in-house Contact Centres located in 3 time zones. Whether a plan member calls about an emergency, or simply to enquire about their benefits, our supportive and empathic staff are there to help. 4

5 Case study Our case manager based in Kenya, arranged home care for a 7-year old patient Better quality of life for the patient and family Avoided subsequent admissions Cost savings 500 USD per day A 7-year old boy, whose family is based in Kenya, suffers from recurrent left parietal cavernous angioma and requires constant monitoring and treatment which can involve very long admission periods. Our senior case manager based in Nairobi assisted the family and patient by answering their medical and non-medical questions. She suggested the alternative of home care to the family, the patient and the treating physician, which they preferred over the prolonged hospital stay. Our case manager then arranged for the boy to be transferred home to receive nursing care and physiotherapy and coordinated the rental of necessary supplies, thus guaranteeing continuous high-quality medical care. The total cost of home care amounted to 150 USD per day (nursing care, doctors visits, medication, physiotherapy and the cost of the medical equipment) whereas the average price per day for inpatient admission would have been 650 USD, saving 500 USD a day. Also, other inpatient admissions were avoided thanks to the home care alternative. But above all, the quality of life of the entire family improved, saving the parents the daily travel to the hospital and having their son treated by professionals within the comfort of their own home. 5

6 Our expertise makes managing your health plan easy We go the extra mile for you. Sector specific benchmarked plans We re in a league of our own when it comes to setting the perfect benchmarks for suitable plan designs for your NGO. Our product structure 3 core plans, 7 optional covers, 5 deductible options and 5 territories of coverage - offers you the possibility of tailoring the plan to the requirements of your organisation, aligned with your budget capabilities. All of you in Vanbreda International have been a source of immense strength to the family throughout the last three months. We could not have asked for more, thank you so much. Keeping your plan affordable through exceptional cost management practices In response to rising health care costs, Vanbreda International has implemented a number of cost management measures to safeguard the viability of your plan while keeping your budget in mind. We make it one of our top priorities to ensure that our members are not overcharged in medical facilities worldwide. Our goal is to make sure that they are charged reasonable and customary rates in order to protect their own copayment, and to secure the stable evolution of your insurance premium at year-end. Thanks to our unrivalled hospital network, local experience and infrastructure, we are proud of achieving this goal on a continuous basis. Smooth implementation Flexible payment methods and invoicing procedures are available at no extra cost, supported by a tailored communication plan to suit both you and your employees. Online services for easy plan management First-rate online services, including online claims submission, access to our database of health care providers, a health library and much more are available to your employee through a dedicated client website. The online service is also customised for the plan manager enabling top quality reporting mechanisms, such as: real time membership management and reports per cost center, a complete overview of the plan structure, safe data exchange etc. We put your employees first Your employees count on us, no matter how major or minor their needs are. Our market leading position in the INGO market and our members positive feedback testify that we live up to our promises. I would like to thank you all for your great support during my medical evacuation in Johannesburg. Thank you very much for your help and great professionalism; it was not easy but I had a very good team [supporting me] that I could always count on. 6

7 Case study A medical evacuation from Benin to France optimises the patient s well-being Arranged for overseas treatment and accommodation Took away administrative and financial burden Saved approx 20,000 EUR on total invoice A 22-year old woman was involved in a motorbike crash in Benin, West Africa. Inevitably, she was admitted to a local hospital for emergency treatment. As a result of her injuries, she needed a medical evacuation to the Georges Pompidou hospital in Paris a few weeks later. As soon as we were informed of the evacuation, we sent a guarantee of payment to the hospital. As the patient needed further care, we were able to extend her stay by 15 days, until her place became available in the rehab facility in Paris. We negotiated a 10% discount on the hospital invoice which led to a saving of approximately 8,500 EUR. Our case manager contacted a Paris-based doctor specialising in medical evacuation cases to countries in Europe to help negotiate a guarantee of payment instead of an advance payment with the rehabilitation facility. With his on-site support, and the support of the hospital administration, we negotiated with the facility and saved approximately 20,000 EUR on the final bill for the client. We took care of all of the administrative aspects of the patient s treatment which was helpful, as she did not have family with her in France. She was discharged from the rehab facility after a 3 month stay and transferred to a special apartment with meals and visits from a nurse every 2 days and 20 sessions of ambulatory rehab treatment were arranged for her. The patient continued to receive excellent medical care up until the end of her recovery. 7

8 Design your CoverN GO plan CoverN GO is a flexible insurance product that allows your NGO to build a versatile plan tailor-made for its specific needs. Choose your core plan You can choose from 3 plans: Phoenix Orion Pegasus Your core plan automatically includes health, accidental dental and medical evacuation and repatriation insurance. + You can choose from 5 areas of cover: Africa Asia* and the Middle East Central and South America/Caribbean/Canada/Europe Worldwide excluding the USA Worldwide Choose your additional cover Dental Care Life Cover Accidental Death and Invalidity Temporary Incapacity Permanent Disability Travel Insurance Security evacuation, including kidnap and ransom services * excluding Hong Kong, China, Singapore and Japan You can select your deductible: 0, 0, $ 0 and CHF 0 100, 65, $ 125 and CHF 150 (Phoenix and Orion only) 300, 200, $ 375 and CHF , 325, $ 625 and CHF 750 (Pegasus only) 1,000, 650, $ 1,250 and CHF 1,500 8

9 Core plan 1 Maximum reimbursement per insured and per insurance year Area of cover 2 Deductible for Outpatient Treatment per insured and per insurance year phoenix orion pegasus 1,000, ,000 $ 1,250,000 CHF 1,500,000 Africa Asia 3 and the Middle East 1,500,000 1,000,000 $ 1,875,000 CHF 2,250,000 Central and South America/Caribbean/Canada/Europe Worldwide excluding the USA Worldwide $ 0 - CHF $ CHF $ CHF 450 1, $ 1,250 - CHF 1, $ 0 - CHF $ CHF $ CHF 450 1, $ 1,250 - CHF 1,500 3,000,000 2,000,000 $ 3,750,000 CHF 4,500, $ 0 - CHF $ CHF $ CHF 750 1, $ 1,250 - CHF 1, Inpatient treatment (day-patient and treatment with overnight stay in hospital) Hospital room & board (pre-certification required) of semi-private or 80% of standard private room of standard private room of standard private room Doctor s fees (surgeon, anaesthesist) Other medical expenses (medical imaging, drugs and dressings and use of operating room) Hospital accommodation in intensive care unit (ICU) Rehabilitation and convalescence rest/care (when the admission immediately follows Not covered hospitalisation) Parent accommodation of one parent for child < 16 up to 1,500 up to 1,000 up to $ 1,875 up to CHF 2, Outpatient treatment Not covered up to 1,500 up to 1,000 up to $ 1,875 up to CHF 2,250 Doctor s fees (generalist, specialist) 80% 90% Diagnostic tests, lab tests, medical imaging 80% 90% (x-ray, MRI- and CT-scans) Prescribed drugs 80% 90% Physiotherapy 80% up to 1,000 80% up to % up to $ 1,250 80% up to CHF 1,500 90% up to 2,000 90% up to 1,300 90% up to $ 2,500 90% up to CHF 3,000 (max. 28 days) up to 1,500 up to 1,000 up to $ 1,875 up to CHF 2,250 up to 3,000 up to 2,000 up to $ 3,750 up to CHF 4,500 1 All benefits are valid per insurance person, per insurance year (unless specifically stated). For full benefit details and definitions, please consult the General Conditions. 2 In case of accident and emergency treatment outside your region of cover you are covered up to 90 days during each insurance year. 3 Excluding Hong Kong, China, Singapore and Japan 9

10 Preventive care Yearly check-up Eye test Mammogram Pap-smear test PSA-test phoenix orion pegasus up to 600 up to 400 up to $ 750 up to CHF 900 Vaccinations up to 200 up to 130 up to $ 250 up to CHF 300 Alternative medicines such as homeopathy, acupuncture, chiropraxis and osteopathy Therapies Ergotherapy Logopaedics and speech therapy Psychiatric outpatient care 3. Other medical treatment Pregnancy and childbirth (a waiting period of 10 months is applied 4 ) Pregnancy 80% up to 1,000 80% up to % up to $ 1,250 80% up to CHF 1,500 up to 800 up to 535 up to $ 1,000 up to CHF 1,200 up to 400 up to 270 up to $ 500 up to CHF % up to 2,000 90% up to 1,300 90% up to $ 2,500 90% up to CHF 3,000 Not covered 50% up to 1,000 50% up to % up to $ 1,250 50% up to CHF 1,500 Reimbursement according to type of Outpatient Treatment Reimbursement according to type of Outpatient Treatment up to 1,000 up to 650 up to $ 1,250 up to CHF 1,500 up to 600 up to 400 up to $ 750 up to CHF 900 up to 3,000 up to 2,000 up to $ 3,750 up to CHF 4,500 50% up to 2,000 50% up to 1,300 50% up to $ 2,500 50% up to CHF 3,000 Reimbursement according to type of Outpatient Treatment Infertility treatment and sterilisation (IVF, ICSI, AI and all similar treatments) (limit per lifetime) Not covered Not covered up to 16,800 (4x 4,200) up to 11,200 (4x 2,800) up to $ 21,000 (4x $ 5,250) up to CHF 25,200 (4x CHF 6,300) Childbirth (without complications) 80% up to 5,000 80% up to 3,250 80% up to $ 6,250 80% up to CHF 7,500 ( if home confinement) up to 7,500 up to 5,000 up to $ 9,375 up to CHF 11,250 up to 10,000 up to 6,500 up to $ 12,500 up to CHF 15,000 Childbirth (with complications) Cancer treatment (excluding experimental treatments) Hospitalisation and chemo- or radiotherapy Other costs see 1. Inpatient Treatment see 2. Outpatient Treatment see 1. Inpatient Treatment see 2. Outpatient Treatment see 1. Inpatient Treatment see 2. Outpatient Treatment 10 4 For organisations with full medical underwriting.

11 phoenix orion pegasus Chronic and pre-existing conditions 5 Covered Covered Covered AIDS / HIV Treatment Inpatient Treatment Outpatient Treatment 80% 90% Nursing at home 80% up to 160 / day 80% up to 110 / day 80% up to $ 200 / day 80% up to CHF 240 / day (max. 60 days) 90% up to 180 / day 90% up to 120 / day 90% up to $ 225 / day 90% up to CHF 270 / day (max. 60 days) up to 200 / day up to 135 / day up to $ 250 / day up to CHF 300 / day (max. 100 days) Organ transplant (excluding costs for donor prior approval required) up to 100,000 up to 65,000 up to $ 125,000 up to CHF 150,000 up to 125,000 up to 83,500 up to $ 156,250 up to CHF 187,500 up to 150,000 up to 100,000 up to $ 187,500 up to CHF 225,000 Kidney dialysis (excluding experimental treatments) Local ambulance (to nearest hospital) up to 1,500 up to 975 up to $ 1,875 up to CHF 2,250 up to 3,000 up to 1,950 up to $ 3,750 up to CHF 4,500 up to 4,500 up to 3,000 up to $ 5,625 up to CHF 6,750 Accident related dental treatment Emergency dental treatment up to 750 up to 500 up to $ 950 up to CHF 1,125 up to 1,000 up to 650 up to $ 1,250 up to CHF 1,500 up to 1,250 up to 850 up to $ 1,575 up to CHF 1,875 Dental surgery Psychiatric care Inpatient Treatment up to 2,000 up to 1,300 up to $ 2,500 up to CHF 3,000 Not covered Outpatient Treatment see 2. Outpatient Treatment: Therapies Vision care (glasses, frames, contact lenses) 80% up to % up to 65 80% up to $ % up to CHF 150 Medical aids (hearing aids and orthopaedic appliances) 80% up to 1,500 80% up to 1,000 80% up to $ 1,875 80% up to CHF 2,250 Palliative care 80% up to 40,000 80% up to 26,600 80% up to $ 50,000 80% up to CHF 60,000 up to 2,500 up to 1,625 up to $ 3,125 up to CHF 3,750 90% up to 10,000 90% up to 6,500 90% up to $ 12,500 90% up to CHF 15,000 see 2. Outpatient Treatment: Therapies 90% up to % up to % up to $ % up to CHF % up to 2,500 90% up to 1,650 90% up to $ 3,125 90% up to CHF 3,750 90% up to 45,000 90% up to 30,000 90% up to $ 56,000 90% up to CHF 67,000 up to 3,000 up to 2,000 up to $ 3,750 up to CHF 4,500 up to 20,000 up to 13,500 up to $ 25,000 up to CHF 30,000 see 2. Outpatient Treatment: Therapies up to 300 up to 200 up to $ 375 up to CHF 450 up to 3,000 up to 2,000 up to $ 3,750 up to CHF 4,500 up to 50,000 up to 33,300 up to $ 62,500 up to CHF 75,000 5 For organisations with full medical underwriting, acceptance of your application is subject to a medical questionnaire and approval by the medical consultant. Pre-existing and chronic conditions are covered within the limits of your plan if accepted by the medical consultant at the time of your enrolment. 11

12 4. Medical evacuation and assistance services 6 Repatriation Assistance organising and paying the cost of your return or transportation to a hospital organising and paying the cost of the return of an insured travel companion and minor children reimbursement of your accommodation costs and those incurred by the insured members of your family or an insured person travelling with you Hospitalisation in situ: paying the costs that enable a member of your family to get to you in hospital: outward/return journey cost of accommodation locally until you are repatriated phoenix orion pegasus up to 100 / 65 / $ 125 / CHF 150 / day for a maximum of 10 days up to 100 / 65 / $ 125 / CHF 150 / day for a maximum of 10 days Search and/or Rescue costs 1,500 / 1,000 / $ 1,875 / CHF 2,250 Early return assistance Organising and paying transportation costs Assistance in the event of your organisation assignment being curtailed: paying the travel costs of your replacement colleague Despatch of medicines unavailable locally Unforeseen assistance communication with your family or your company up to 400 / 260 / $ 500 / CHF 600 theft of your identity documents, credit cards, travel tickets or business documents: advance of funds abroad Psychological support: in the event of severe trauma as a result of a covered two telephone calls per insured person and per insurance year illness or accident Assistance in the event of an insured person s death transporting the body funeral costs necessary for transportation additional costs for the transportation of the insured members of the deceased s family or an insured person burial at the location funeral costs necessary for transportation 3,000 / 2,000 / $ 3,750 / CHF 5,500 3,000 / 2,000 / $ 3,750 / CHF 5, The benefits of Medical Evacuation and Assistance Services apply per insured person / per claim and per insurance year, unless mentioned otherwise.

13 Additional cover Your CoverN GO core plan, which includes health, accidental dental and medical evacuation and repatriation insurance can be supplemented with 7 additional covers, enabling you to create the insurance plan that best suits the specific needs of your employees. Dental Care You can take out an additional insurance for Dental Care. Select from 2 formulas: Basic or Comprehensive. BASIC Maximum annual reimbursement per insured 3,000 2,000 $ 3,750 CHF 4,500 Basic dental care (check-ups, basic treatments) Major dentistry (orthodontic, prostheses, bridges, implants) Orthodontic treatment is only covered if started before age 15. A waiting period of 12 months applies to all major dentistry 7. 80% up to 1,500 80% up to 1,000 80% up to $ 1,875 80% up to CHF 2,250 60% up to 1,500 60% up to 1,000 60% up to $ 1,875 60% up to CHF 2,250 COMPREHENSIVE 5,000 3,250 $ 6,250 CHF 7,500 up to 2,500 up to 1,625 up to $ 3,125 up to CHF 3,750 80% up to 2,500 80% up to 1,625 80% up to $ 3,125 80% up to CHF 3,750 Life Cover The Life Cover benefit offers financial protection to your employee s dependants in the unfortunate event of your employee s death (or his/her spouse s death). You can choose a sum to protect their financial future up to a maximum of 500,000 / 325,000 / $ 625,000 / CHF 750, For organisations with full medical underwriting. 13

14 Accidental Death and Invalidity The Accidental Death and Invalidity cover protects your expats and their family from the financial implications of an accident, by paying out a lump sum. You define the amount of this sum, but it is subject to a minimum of 50,000 / 32,500 / $ 62,500 / CHF 75,000 and a maximum of 500,000 / 325,000 / $ 625,000 / CHF 750,000. In case of death caused by an accident, the beneficiaries will be paid an amount that is equal to the sum insured. In case of permanent invalidity of at least 20% caused by an accident, the employee will receive an amount that is equal to the sum insured, multiplied by the degree of invalidity. Temporary Incapacity If your employee is unable to work for a period of time due to an illness or an accident, the Temporary Incapacity cover can guarantee a fixed monthly allowance. After a waiting period of 90 days, the employee will receive a monthly allowance of maximum 10,000 / 6,500 / $ 12,500 / CHF 15,000 and minimum 500 / 325 / $ 625 / CHF 750. The maximum monthly allowance is 80% of the gross monthly salary. The monthly allowance will be paid out during a maximum period of 24 months. If the employee is still unable to resume work after 2 years, the Permanent Disability insurance can offer a solution. Permanent Disability The Permanent Disability insurance guarantees a monthly allowance if your employee is unable to resume work due to an accident or illness (after two years of Temporary Incapacity). You can choose the level of the monthly allowance that is appropriate for your employee. This amount may not exceed a maximum of 80% of the gross monthly salary, with a minimum of 500 / 325 / $ 625 / CHF 750 and a maximum of 10,000 / 6,500 / $ 12,500 / CHF 15,000. If the degree of disability is lower than 33.33%, no allowance will be paid. If the degree of disability lies between 33.33% and 66.67%, the allowance will be calculated proportional to the actual disability. If the degree of disability is 66.67% or more, the full allowance will be paid. Furthermore, an additional one-off sum of 25,000 / 16,250 / $ 31,250 / CHF 37,500 will be paid on top of the monthly allowance, in case your employee needs the assistance from a third party to perform the basic activities of daily living. The allowance will be paid to your employee for as long as he/she is unable to resume his/ her activities, and at the latest until he/she becomes 65 years old. Travel Insurance The worldwide Travel Insurance protects your employees against adverse events such as loss or damage of property and compensates for luggage delay and delay of flight or train. The premium covers any number of trips and all insured can travel independently. Access to security evacuation services When your employees face critical situations, such as sudden waves of political instability, natural disasters or even kidnapping, you have no better partnership than Vanbreda International and its specialist security partner. Our partner s operations are supported by rapid response medical teams and security specialists who facilitate evacuations using essential equipment. Your workers will have access to country risk assessments and expert security advice before and during their mission through daily alerts. 14

15 Join CoverN GO now: it s quick and easy Contact us today info@coverngo.com

16 Vanbreda International ( is the market leader with over 50 years of experience in managing cross-border health insurance programmes for intergovernmental organisations. The company s claims processing offices, located in Belgium, Malaysia and the US, operate on a global platform and serve clients in all major languages across all time zones. With expert knowledge of local social security systems, cost levels and billing practices, their ISO certified services are focused on accessibility, speed and quality of customer services. Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in 30 countries and jurisdictions, and has approximately 70 million customer relationships throughout the world. is a product of administered by Chief editor: Wouter Reggers Vanbreda International NV Plantin en Moretuslei Antwerpen Belgium RPR Antwerpen VAT BE FSMA A-R (0812) This brochure was printed on reclycled and FSC certified paper.