ENGLISH INSTRUCTION FOR PREMIUM CALCULATION AND APPLICATION THROUGH ONLINE FUNNEL 42390_1216
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1 ENGLISH INSTRUCTION FOR PREMIUM CALCULATION AND APPLICATION THROUGH ONLINE FUNNEL 42390_1216
2 English instruction for premium calculation and application through online funnel Step 1: 1. Effective date 2. Date of birth 3. Choose your health insurance with excess. Every insured person from 18 years and older has to pay a mandatory excess of 385,-. You may choose to raise the excess in order to receive a discount on your premium. 4. Choose your supplementary insurance. If you choose the Aanvulling Optimaal, you have to fill in health questions: a. Is it to be expected that you will need more than 10 treatments at an alternative medicine practitioner next year? Yes No b. Is it to be expected that you will need to buy a hearing aid, wig or hairpiece next year? Yes No c. Is it to be expected that you will purchase a pair of glasses next year? Yes No d. Is it to be expected that you will need more than 21 treatments at a physiotherapist next year? Yes No e. Is it to be expected that you will need a laser treatment for your eyes or a lens implant next year? Yes No 5. Choose your dental insurance If you choose Tandarts Extra, Uitgebreid of Optimaal, you have to fill in health questions: a. Did you visit the dentist for periodic preventive examination (checkup) at least once a year in the past 2 years? b. Did you receive periodontal (gums) treatment in the past year? Or does your dentist expect you to need periodontal (gums) treatment within a year? c. Do you have any extracted or missing teeth and/or molars which will be replaced by crowns and bridges, implants or a partial plate prosthesis or frame prosthesis within a year? d. Does your dentist expect you to need treatment involving crowns, bridges and/or implants within a year? 6. Do you want to add another person? a. Volwassene (adult) b. Kind <18 jr (child under 18 years) 7. Choose your preferred term of premium payment a. Maand 0% korting (monthly 0% discount) b. Kwartaal 0% korting (quarterly 0% discount) c. Halfjaar 0% korting (half-yearly 0% discount) d. Jaar 2% korting (annually 0% discount) 8. Reset 9. Print 10. Proceed 11. Change your current insurance 12. Information about your selected insurance 13. Coverage overview health insurance and terms and policy health insurance. 2
3 Step 2: 1. Initials 2. Insertion 3. Surname 4. Sex a. Man (Male) b. Vrouw (Female) 5. Citizen service number (BSN) 6. Nationality (click at Anders, namelijk to select a different nationality) 7. Country of residence 8. Postal code 9. House number and addition to house number 10. You receive salary or social benefits from (select one of the following options): a. Nederland (The Netherlands) b. Buitenland (Abroad) c. Nederland & Buitenland (The Netherlands & Abroad) d. Niet van toepassing (Does not apply to you) 3
4 Step 3: 1. How do you want to receive information? a. Digitaal: in het postvak van Mijn Amersfoortse (Digitally: in the mailbox of Mijn Amersfoortse) b. Op papier: on paper 2. You can log on with your DigiD in the secured online environment of De Amersfoortse: Mijn Amersfoortse. Here you can find all the correspondence with De Amersfoortse and you can organize your insurance matters. You will receive an if a new document is added in your mailbox. 3. address 4. Confirm address 5. Phone number 6. Second phone number 7. Method of payment a. Automatische incasso (automatic collection) b. Betaalmail ( payment) c. Overboeking via uw bank (manual transfer by bank account) 8. Giro or bank account number for automatic collection (IBAN) 9. By signing this application form, you are authorising De Amersfoortse to debit the owed premium (including costs) from your account on a regular basis. 10. You can choose to pay your mandatory excess ( 385,- in 2017) in advance by spread payments in 10 equal terms paid monthly. The health care costs you have made which are part of the excess will be settled subsequently with the paid terms. Do you want to participate in spread payment? a. Ja (Yes) b. Nee (No) 11. Select the persons who want to participate in spread payment 12. Based on your citizen service number (BSN) we can see where you have your current health insurance. We can terminate your current health insurance. You do not have to do anything. Do you want to use the termination service? a. Yes, terminate my basic and supplementary health insurance at my current insurer b. Yes, terminate only my basic health insurance at my current insurer c. No, I will terminate my basic health insurance myself 4
5 Step 4: 1. Here you can check if all your information is correct 2. You declare that you filled in the data correctly and that you agree with the terms and conditions of the policy. 3. If you click on Indienen ->, your information will be sent and your application is finished. 5
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