IntegraGlobal. IntegraGlobal Group Proposal for the UAE. Our Life is Your Life. Group Health options for the UAE. Healthcare you deserve

Transcription

1 IntegraGlobal Group Proposal for the UAE Our Life is Your Life. Underwritten by SALAMA-Islamic Arab Insurance Co. (P.S.C.) Group Health options for the UAE IntegraGlobal

2 Group Health Plans Group Health Options from Integra Global offers your company, Flexibility, core Protection, unequaled Service, and all at an outstanding Value. We give your organisation the Flexibility to meet your international employee benefits needs through our five flexible s. Each gives not just essential but superlative benefits to your staff. Our health plans offer your staff excellent Protection no matter what (s) you choose. Each plan has at its core a strong foundation of cover. All plans include Inpatient & Hospitalisation Outpatient & Specialist Fees Prescription Drugs Emergency Medical Evacuation 2/ Medical Emergency Assistance Hotline Your staff will always feel fully protected with an Integra Global Health Plan. Both your staff and organisaton require a specialised international health plan for your expat staff. Our unequaled Service means happier staff members and less involvement with your HR department. We offer direct billing in many countries which of course gives tremendous convenience to your staff. Yet, through our local arrangements with country based direct bill providers we also manage to keep costs down and abuse low. Always important to your bottom line is the cost of your employee benefits. We recognise how important this can be. With this in mind, the lowest cost policy is not always the best deal for your organisation. Likewise, the most expensive health plan doesn't necessarily guarantee you and your organisation receiving the most value from your health plan. Integra Global Health Plans have the rare ability of offering you Flexibilty and choice, outstanding Protection, unequaled Service at a cost that is un-paralleled in Value to your organisation.

3 Full Comprehensive Cover in all of our Global s Integra Global Group Health Options offers superlative benefits and is naturally comprehensive in scope. It covers your everyday needs as well as serious medical issues. Quality health protection when and where you need it the most - 2/. Hospitalisation/Inpatient Services/Emergency Room Full cover for hospitalisation, surgery, inpatient services, intensive care, emergency room and out-patient surgery. Organ Transplants Excellent organ transplant benefits through our Managed Transplant Program. Outpatient No specific limits on outpatient services such as General Physician office visits and Specialist fees. Prescription Drugs Plan provides complete cover for prescription drugs with no specific annual or lifetime limits. Chronic Conditions Cover If you develop a chronic condition once under our plan you have the peace of mind to know that we treat a chronic condition as any other illness. You need not worry about specific limitations that can effect your well-being and lifestyle.

4 Diagnostic and Therapeutic Services All types of imaging and lab services as well as full therapeutic services. Physical Therapy Generous physical and occupational therapy benefits. Simplified Geographical Cover We keep things simple for you by having only two different regions of Cover: Cover 1 - Worldwide including U.S./ Cover 2 - Worldwide but excluding U.S./ Medical Evacuation and Emergency Assistance 2/ protection and assistance around the clock. E-health Records and Storage Each staff member will receive a completely private and secure e-health Records Acccount. Allowing your staff to store all their health records in one secure location accessible 2/. Each account holder chooses what records are public for an emergency situation. All insurance documentation including ID card, Table of Benefits and Claim Forms are stored there as well for your convenience. *For a complete listing of benefits, please consult the Table of Benefits.

5 Worldwide Access to your Health Benefits The Integra Global Member ID Card is a powerful tool for your staff to access benefits in a time of need. It contains all the necessary information for both the medical provider and staff member to guarantee medical care is received and medical costs are guaranteed. The Member ID card provides for 2/ Medical Assistance Hotline and can provide for payment guarantees worldwide in case of hospitalisation. All the staff member or medical provider needs to do is call the number on the back of the card. Integra Global also has select local networks in many countries of the world. For these countries we give your staff an extra local network card that gives them access to a large network with top rated medical providers. Local convenience with international protection and service. Your staff member couldn t ask for more convenience. And for Cover 1 members who need access to U.S. medical care Integra Global gives your staff access to over 650,000 medical providers in the United States through our network provider UnitedHealthcare (UHC). By presenting your Integra Global Member ID Card to a medical provider or hospital in the UHC Network all your claim filings, pre-authorisations and payments are done for you. You only need to pay your deductible and co-insurance (if any). All relevant policy information that verifies your cover to medical providers is included here. On the right side of your Member ID Card you will find the logos of our network partners. These logos "steer" trained medical providers to submit claims through the network. Important contact numbers both for emergencies and preauthorizations. These numbers are listed both for your use and medical providers. Contact numbers for medical providers only in the U.S. who will need to contact our network in the States.

6 A Word About Our Flexible Plan Design Integra Global offers 5 choices. You have the flexibility to choose one of the 5 s for your staff. Or, set up different choices for various staff categories. This gives you the opportunity to offer various plan options to meet different levels of your organisation at a cost that is easy on your bottom line. To discuss how to set up different s for different staff categories contact Integra Global or your Insurance Consultant. Integra Global Group Health Options Benefits Plan BA Plan BM Plan BW Plan BC Premier Inpatient/Daypatient Outpatient Evacuation/Repatriation Maternity Wellness Dental Vision Care Best Possible Outcome Programme Advanced Health Screening Complimentary Medicine AD&D Benefit $100k

7 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Policy Year Maximum Plan Benefit $USD $1,500,000 $1,500,000 $1,500,000 $1,500,000 $2,000,000 Hospitalisation Benefits Accommodation Inpatient treatment, daypatient, operating theatre and recovery room, prescribed medicines, drugs and dressing for inpatient or daypatient treatment Intensive Care Unit Inpatient Ancillary Services including Physical and Occupational Therapy as day-or inpatient Surgeons and anaesthetists fees Inpatient consultation by Specialist Emergency Room Pathology, radiology, and diagnostic tests MRI, CT and PET scans Private Duty Nursing (Policy Year maximum) Skilled Nursing Facility (Policy Year maximum) Home Health Care (Policy Year maximum) Hospice Care Services (Policy Year maximum) Emergency Dental Treatment as a result of accident Cancer Treatment Semi-Private Room Semi-Private Room Semi-Private Room Semi-Private Room Private Room $,500 $,500 $,500 $,500 $15,000 $,500 $,500 $,500 $,500 $15,000 $,500 $,500 $,500 $,500 $15,000 $10,000 $10,000 $10,000 $10,000 $20,000

8 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Child Accompaniment If the Insured Person is a child under 16 who requires Hospitalisation: we will pay for necessary overnight accommodation for one parent in the same Hospital, or when no such accommodation is available, for necessary bed and breakfast accommodation in a nearby hotel. Pre-approval is necessary. Managed Transplant Program Organ Transplants Policy Year Maximum,000,000,000,000,000 Tissue Transplants (as part of the overall Organ max.) Transplant must be pre-certified and approved by us. Failure to comply will result in treatment not being covered by your policy. $250,000 $250,000 $250,000 $250,000 $250,000 Outpatient Benefits Surgery as Outpatient Physician Office Visits & Specialist Fees Individual Deductible applies Diagnostic & Therapeutic Services (as outpatient) Physical Therapy (as outpatient, per visit) Occupational Therapy (as outpatient, per visit) Chiropractic Services Policy Year Maximum for Chiropractic Services Referral letter required from medical physician Prescription Program $5 $5 $5 $5 $5 $5 $5 $5 $5 max 50 visits $5 max 50 visits $50 $50 $50 $50 $1500 In US (no deductible applies) 90% generic 80% brand 90% generic 80% brand 90% generic 80% brand 90% generic 80% brand generic 90% brand All other countries Complementary Medicine Including TCM, Bonesetting, Acupuncture, Herbal Medicine, Homeopathy & Osteopathy available at benefits below) available at benefits below) available at benefits below) available at benefits below) $1,500

9 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Maternity & Newborn Cover (per pregnancy) Pregnancy Normal Delivery Complicated Pregnancy Routine Nursery, included under Maternity Benefits as any other treatment including room and board, physician charges and circumcision for males prior to discharge. New Born Cover Included in New Born Cover are Premature Births, Congenital Conditions and Birth Anomalies. New Born Cover is only available for a covered pregnancy. A 12-month waiting period applies to all Maternity & Newborn Care Benefits unless Maternity Waiting Period Waiver Option is chosen. $10,000 $12,000 $10,000 $12,000 $20,000 $30,000 $25,000 $25,000 $30,000 Wellness & Routine Services Adults $50 Routine physical exams in connection with overall health and wellbeing. 90% 90% Pap Smear 90% 90% Mammograms Ages one baseline exam Ages 0-9 one exam every one or two years for asymptomatic women, but no sooner than two years after baseline Age 50 & over one exam annually Any age whenever prescribed by a physician Prostate Cancer Screening One test per for males age 50 or over 90% 90% 90% 90% Immunisations & Vaccinations 90% 90% Child(ren) Maximum per birth to age 12 months $300 $300 Maximum per 13 months and over $200 $200 $300 Routine medical exams and immunisations & vaccinations Child Preventive Care Services Hearing Tests 6 month waiting period applies to all Wellness Benefits but waits are waived for policies that are paid annually. Overall Wellness Benefit Maximums apply to all routine and wellness benefits for Adults and Children. Individual Deductible does not apply for Wellness Benefits.

10 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Vision Care Cover Maximum per 2 month period 6 month waiting period applies to Vision Care Cover but waits are waived for policies that are paid annually. $300 $300 $300 Dental Plan Class I Expenses No deductible applies Diagnostic General Preventive Class II Expenses Elected deductible applies Restorative (Basic); Endodontics; Periodontics; Prosthodontics Removable (Maintenance; Fixed Bridge (Maintenance); Oral Surgery 80% 80% 90% Class III Expenses Elected deductible applies Restorative (Major); Prosthodontics Removable (Installation); Fixed Bridge (Installation) Orthodontic and Class III services are available after 6 months of continuous enrollment in the Dental Plan. Orthodontic services are only available for children under 18 years of age. 50% 50% 60% Policy Year Maximum (per Insured Person) $1,500 $1,500 $3,000 Emergency Evacuation, Repatriation and Ambulance Services Medical Evacuation & Assistance 2/ Emergency Medical Assistance Hotline Repatriation of Mortal Remains Family Emergency Travel $5,000 Repatriation Accompaniment $2,500 $2,500 $2,500 $2,500 $5,000 Repatriation Family Accompaniment $3,000 Medical Concierge Services Best Possible Outcome Programme A dedicated Diagnosis Verification and Treatment Planning care management programme. In the event that you are diagnosed with a specified critical illness, the programme provides access to an appropriate specialist from a top rated US hospital who will remotely review your medical reports to confirm your diagnosis and advise, in conjunction with your treating physician on your treatment options, to provide the best outcome. Advanced Health Screening Programme Ages 0-50 one high level physical examination every 3 years $1,000 Ages 50+ one high level physical examination every 3 years $1,500

11 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Blood Care Programme A blood care programme that delivers screened blood, in an emergency, to its members in any part of the world. ehealth Records Account Mental Health Benefits Policy Year Maximum for Mental Health Benefits (inpatient & outpatient) Policy Year Mental Illness, Maximum (Out-of-Hospital) 15 visits $25,000 $25,000 $25,000 $25,000 $25,000 $2,500 per $2,500 per $2,500 per $2,500 per $2,500 per Accidental Death & Dismemberment Also available as an optional benefit on all plans $100,000 HIV/AIDS Treatment Policy Year Maximum $25,000 $25,000 $25,000 $25,000 $25,000 Durable Medical Equipment Policy Year Maximum $15,000 $15,000 $15,000 $15,000 $20,000 Chronic Conditions Chronic conditions are treated like any other condition under the Policy. Pre-Existing Conditions Policy Year Maximum Plan Benefit Pre-existing Conditions are covered after a 12-month waiting period and subject to maximums above unless otherwise stated on your Certificate of Insurance. $5,000 waived for MHD underwriting $5,000 waived for MHD underwriting $5,000 waived for MHD underwriting $5,000 waived for MHD underwriting $5,000 waived for MHD underwriting Deductible Options Individual Deductible All deductibles in local currency AED. Individual deductible applies to each Out-patient Physician or Specialist consultation unless to same Physician or Specialist within days of first consultation for same condition. AED 0; AED 50; AED 5; AED 100 AED 0; AED 50; AED 5; AED 100 AED 0; AED 50; AED 5; AED 100 AED 0; AED 50; AED 5; AED 100 AED 0; AED 50; AED 5; AED 100

12 IntegraGlobal Group Health Options for UAE BA BM BW BC Premier Group Optional Add-Ons Blood Care Programme A blood care programme that delivers screened blood, in an emergency, to its members in any part of the world. Complementary Medicine Including TCM, Bonesetting, Acupuncture, Herbal Medicine, Homeopathy & Osteopathy No Wait on Maternity Benefits 12-month wait on maternity benefits waived and maternity benefit immediately available to staff and eligible dependents. Private Room Upgrade (not applicable) (not applicable) included in cover included in cover included in cover Emergency Cover for US/ Emergency non-elective treatment only Accidental Death & Dismemberment $50,000 $50,000 $50,000 $50,000 $50,000 $100,000 included in cover additional cover available Geographical Cover Region Options Cover Region 1 Worldwide including U.S. and and their territories For Cover Region 1 please note that benefits listed above are only applicable when using our Preferred Provider Network UHC. The UHC Network is one of the largest in the U.S. with over 650,000 medical providers. Benefits outside of network are reduced to 0%. Please note that Cover Region 1 is limited to 180 days in the U.S. in any 12 month period. For Cover 1 policy start dates are 1st, 11th and 21st of each month only. Cover Region 2 Worldwide but excluding U.S. and and their territories Cover Region 2 does not include any cover for U.S. and and their territories. Direct Billing Network Options Choice of three different network options. Each network is extensive with over 1,000 medical providers in the UAE. Access to other MedNet networks within the Gulf region is included. Gold Silver Premium Silver Classic Accidental Death and Dismemberment (AD&D) Option In the event of an Accidental Death or Dismemberment of the Primary Insured the Insurer pays a lump sum benefit equal to the Principal Sum subject to a Maximum benefit multiplied by a percentage as shown below. loss of life loss of sight of both eyes loss of both hands or arms loss of both feet or both legs loss of one arm and one leg loss of sight of one eye 50% 50% 50% 50% 50% loss of one foot or one leg 50% 50% 50% 50% 50% loss of one hand or arm 50% 50% 50% 50% 50% N.B. Benefits cannot exceed 2 times annual salary.

13 About Integra Global Integra Global is an international health plan provider since Integra Global is a UK company that has service offices strategically placed worldwide in Europe, North America and Asia. We specialise in providing health plans to organisations and individuals with unique heath protection needs, such as expatriates, marine professionals and specialised risks. In creating our health plans, we consider the unique needs of our members and design health plans to suit these requirements. Providing extraordinary health plans to unique markets is our specialty. Our approach enables us to offer outstanding protection, excellent value and a superlative level of personal service to all of our members worldwide. Our Life is Your Life.

14 This Policy is underwritten by SALAMA-Islamic Arab Insurance Co. (P.S.C) For further questions and information contact us by phone, or visit the website International: U.K: (free phone in UK) North America: (toll-free) member-care@integraglobal.com IntegraGlobal