TheOne. Underwritten by. Appointed Insurance Agency (PMH055BE1407)

Transcription

1 TheOne (PMH055BE1407) Appointed Insurance Agency Underwritten by

2 TheOne Medical Solution Health is the most precious treasure in life which deserves the greatest defence. Your current peaceful, enjoyable life can be disturbed by unexpected illnesses. Despite the ever-increasing medical costs, we all want to ensure we can enjoy high quality medical services at different life stages without impact to our quality of life. TheOne Medical Solution (the "Plan") offers you comprehensive medical coverage that gives you a peace of mind. Comprehensive protection throughout life To ensure you have an all-round protection during your life s journey, the Plan provides a Lifetime Limit of up to HK$100 million 1, including a range of hospitalization and surgical benefits, as well as providing First-dollar Coverage Deductible Waived for Designated Critical Illness 2. What s more, it provides reimbursement for your regular health screen 3. Hospitalization and surgical benefits include daily hospital accommodation in a Standard Private Room 4, surgery fees, physician s visit and specialist s fees, etc. 9 different plan options to fit your specific needs The Plan provides 3 different types of plans that cover 3 different geographic areas. Furthermore, 3 5 options (HK$0, HK$40,000 and HK$80,000) could be chosen to tailor your most ideal life protection. For example, with HK$0 deductible could provide a worldwide full medical coverage to you. If you have employer-sponsored medical coverage and are looking for additional medical coverage in Asia, our with 5 of HK$40,000 or HK$80,000 may satisfy your needs. First-dollar Coverage Deductible Waived for Designated Critical Illness Benefit 2 Heavy stress and unhealthy habits raise the risk of suffering from critical illnesses. In Hong Kong, 1 out of every 4 men or 5 women is diagnosed with cancer before the age of Critical illnesses may cause an unexpected financial burden on you and your family. The Plan is focused around your concerns and needs, offering First-dollar Coverage Deductible Waived for Designated Critical Illness 2 to ease your and your family s financial stress due to related medical expenses (The amount of benefit is subject to applicable Annual Limit, Lifetime Limit and limits for specific benefit items). The Plan provides protection for your family as well as your health.

3 Tailored extra benefits In the event that the insured needs specific treatments and organ transplantation to receive better medical services, on top of its original Annual Limit, the Plan provides additional Annual Limit of up to HK$2 million to cover medical expenses of organ and bone marrow transplantation, chemotherapy and radiotherapy, and kidney dialysis 7. Guaranteed lifetime renewal privilege for peace of mind 8 The guaranteed lifetime renewal privilege of the Plan takes away your concern over policy discontinuity due to old age and changes in health conditions. Regardless of any significant changes in your health, financial condition or claim history, FWD guarantees that your policy will be renewable until the age of 100 (Age Next Birthday) 8, subject to the continual availability of the Plan, terms and conditions applicable, the benefits and the prevailing premium rates of the Plan at the time of renewal. Benefits and premium are not guaranteed and subject to change by FWD. Flexible protection aligned to your future needs Your needs vary as you go through different life stages. The Plan enables you to switch to a lower 5 option once (per lifetime) when you turn 50, 55, 60 or 65 (Age Next Birthday) without the need to provide proof of insurability 9, meeting any changing needs in the future for protection. Worldwide support service If you meet an accident or suffer an illness whilst abroad, your needs will be well taken care of with our Worldwide Emergency Assistance. All you need to do is call our 24-hour emergency assistance hotline to enjoy round-the-clock worldwide support and assistance provided by International SOS hour Worldwide Assistance Services that includes phone medical advice, emergency medical evacuation and repatriation of mortal remains, etc.

4 Major Exclusions Despite anything stated in this Policy and/or supplementary benefits (if any), FWD shall not be liable to pay any benefits under this Policy if: 1. the Insured s illness or injury is a Pre-existing Condition or results from the complications of a Pre-existing Condition; 2. in case of medical treatment in Mainland China, the subject Hospital is not a designated Hospital approved by FWD; 3. the Insured s sickness, disease or illness occurs during the first 30 days from the Policy Date or the date of reinstatement of the Policy; 4. the Confinement, treatment or charges incurred relate to or arise as a direct or indirect result of: (1) the Insured s pregnancy, surrogacy, childbirth or termination of pregnancy (except for the Pregnancy Complications Treatment), birth control, infertility or human assisted reproduction, or sterilisation of either sexes; (2) war, hostilities (whether war is declared or not), rebellion, insurrection, riot, strike, civil commotion, terrorist act, nuclear contamination, biological contamination or chemical contamination; (3) naval, military or air-force services, or any operation or combat duty with any armed force of any country, territory, or organization; (4) the Insured s participation in any criminal offence or illegal acts; (5) attempted suicide or self-inflicted injuries while sane or insane, or any condition caused by chronic alcoholism or drug addiction; (6) cosmetic or plastic surgery, dental treatment or surgery of any kind, oral or oro-surgical care, eye refraction, eye tests or fitting of glasses, or surgical correction of nearsightedness (such as but not limited to radial keratomoty and keratectomy), unless such a treatment is explicitly covered by this Policy; (7) procurement or use of medical appliances and medical devices for the benefit of the Insured including but not limited to spectacles, contact lenses, hearing aids or wheelchairs (unless such medical appliances and medical devices are explicitly covered by this Policy); (8) preventive treatments, preventive medicines, convalescence, physical examinations, or health checks (with or without any positive finding) on the Insured; vaccination and immunisation received by the Insured; genetic testing or counselling on the Insured; or any treatment which is not deemed Medically Necessary by FWD; (9) treatment or tests carried out in relation to the Insured s illness or injury are not consistent with customary medical treatment or diagnosis in Hong Kong; (10) narcotics used by the Insured unless taken as prescribed by a Physician, or the Insured s abuse of drugs or alcohol; (11) health supplements and all specialized Chinese herbs and / or tonic medicine including bird s nest, lingzhi, gingseng, agaricus blazei murill, antelope horn powder, antler, cordyceps sinensis, donkey-hide gelatin, hippocampus, moschus, pearl powder, placenta hominis and any other Chinese herbs and / or tonic medicine determined by FWD in its absolute discretion from time to time; (12) scuba diving or engaging in or taking part in any kind of race other than on foot, mountaineering involving the use of ropes or guides by the Insured or other professional or hazardous sports or pastimes including but not limited to skydiving, parachuting, hang-gliding, parasailing, hunting, aviation or aeronautics (other than as fare paying passenger on a duly licensed commercial aircraft), ice or water ski-jumping, show jumping; (13) AIDS or any complications associated with HIV Infection except for the HIV / AIDS Treatment Benefit; (14) transplant service for which the cost incurred in connection with identifying service and procuring a replacement organ or any costs incurred for removal of the organ from the donor, all associated transportation costs and administrative costs; (15) donation of organ; (16) mental disorder, psychological or psychiatric conditions, behavioural problems or personality disorder of the Insured unless such occurrence is covered by the Psychiatric Treatment Benefit; (17) birth defects, genetic disorders, Congenital Conditions, or inherited disorders or developmental conditions (only applicable if the disorder gives rise to signs or symptoms or was diagnosed before the Insured attains 16th years of age ) of the Insured; (18) any Confinement primarily for physiotherapy or for the investigation of signs and / or symptoms with diagnostic imaging, laboratory investigation or other diagnostic procedures as determined by FWD; (19) rest cures and services or treatment received in any home, spa, health hydro, nature cure clinic, sanatorium or long term care facility that is not a registered acute treatment hospital; (20) any treatment, investigation, services or supplies which are not Medically Necessary; any charges which exceed the Reasonable and Customary Charges as determined by FWD; (21) non-medical services, including but not limited to guest meals, radio, telephone, television, photocopy, telex, personal items, and medical report charges; (22) experimental and / or unconventional medical technology / procedure / therapy performed on the Insured; novel drugs / medicines / stem cell therapy not yet approved by the government, relevant authorities and recognised medical association in the locality, or treatment and procedures carried out by a facility not recognized as an acute treatment hospital, or services performed by a relative of the insured or a person who ordinarily resides in the insured s home; (23) sleep disorders (except for the treatment of sleep apnoea which is life-threatening as confirmed by a Specialist and approved by FWD in advance), treatment for learning difficulties in children, such as dyslexia or behavioural problems, attention deficit hyperactivity disorder, or development problems such as shortness of stature; (24) treatment of obesity (including morbid obesity), weight control programmes or bariatric surgery (except when bariatric surgery is necessary as confirmed by a Specialist after failure of conventional treatments and approved by FWD in advance); (25) treatment of sexually transmitted diseases; venereal diseases, sexual problems, such as impotence, whatever the cause, gender issues or gender re-assignment except for the HIV/AIDS Treatment Benefit; (26) treatment whilst staying in Hospital for more than 90 consecutive days if the Insured is in a persistent vegetative state characterized by wakefulness without awareness for more than 4 weeks; (27) expenses that are recoverable from any other source; (28) any activity or disease which falls under the exclusion(s) as shown on the endorsement(s) (if any) of this Policy. Please refer to the Policy Provision for the exclusions of Accidental Death Benefit and services provided by International SOS.

5 TheOne Medical Solution Issue Age (Age Next Birthday) 1 (15 days) 70 Policy Term Guaranteed yearly renewable 8 to age 100 Premium Payment Period To age 100 Premium Payment Mode Currency Annually / Semi-annually / Monthly USD / HKD Schedule of Benefit Benefit Schedule Maximum Benefit Limit Plan Level Area of Cover Asia 11 Worldwide ex USA 12 Worldwide 13 Annual Limit Lifetime Limit 1 HK$8,000,000 / US$1,000,000 HK$40,000,000 / US$5,000,000 HK$12,000,000 / US$1,500,000 HK$60,000,000 / US$7,500,000 HK$16,000,000 / US$2,000,000 HK$100,000,000 / US$12,500,000 5 options (Only available for item 1 5 of this Schedule of Benefit) HK$0 / 40,000 / 80,000 US$0 / 5,000 / 10, Hospitalization Benefits Room and Board (Standard Private Room 4 ) Companion Bed Private Nursing Care s Fee 14 (up to a max. of 30 days per policy year) (up to a max. of 60 days per policy year) (up to a max. of 90 days per policy year) (maximum 180 days per lifetime) Specialist s Fee Physician s Hospital Visit Charges for Intensive Care Miscellaneous Hospital Charges 15 Daily Hospital Cash 16 (for Confinement in general ward of public hospital in Hong Kong) Daily Hospital Cash for Voluntary Room and Board Stay Below Private Room 16 (Stay in private hospital in Hong Kong) HK$1,500 / US$187.5 (up to a max. of 30 days per policy year) HK$1,500 / US$187.5 (up to a max. of 30 days per policy year) Psychiatric Treatment 2. Surgical Benefits Surgery Fee (including Surgeon Fee, Operation Theatre Fee, Anaesthetist s Fee and Outpatient Surgery Fee) Organ and Bone Marrow Transplantation Not Applicable (up to 30 days per policy year and 180 days per lifetime) Medical Appliances Specified Items 17 : Other Items: HK$96,000 / US$12,000 per item per life 3. Pre- and Post-Hospitalization Benefits Pre-Hospitalization Outpatient 18 Post-Hospitalization Outpatient Post-Hospitalization Home Nursing 14 (within 31 days before hospitalization and maximum 1 visit per day) (within 60 days immediately after discharge from hospitalization and maximum 1 visit per day) (up to a maximum of 31 days per policy year within 31 days after discharge from hospitalization)

6 4. Extended Benefits First-dollar coverage - Waive 2, 5 Designated Critical Illnesses First-dollar Coverage Deductible waived for Designated Critical Illness 2 (Only applicable to policies) Fulminant Hepatitis Cardiomyopathy Coronary Artery Disease Surgery Surgery to Aorta Heart Attack Chronic Liver Disease Heart Valve Surgery Stroke Major Organ Transplantation Parkinson s Disease Chemotherapy and Radiotherapy Kidney Dialysis Additional Annual Limit for Organ and Bone Marrow Transplantation, Chemotherapy and Radiotherapy and Kidney Dialysis 7 HK$1,000,000 / US$125,000 HK$1,500,000 / US$187,500 HK$2,000,000 / US$250,000 HIV / AIDS Treatment 19 HK$800,000 / US$100,000 (per lifetime) Pregnancy Complications 20 Traditional Chinese Medicine 5. Emergency Dental Treatment Benefit Emergency Dental Treatment Health Screening Benefit Not Applicable (Due to Accident) HK$350 / US$43.75 per visit (within 60 days after discharge from hospitalization. Maximum 1 visit per day and up to 10 visits per policy year) Health Screen 21 Not Applicable Once and up to HK$4,000 / US$500 for every 2 policy years (For policies with 5, once and up to HK$2,000 / US$250 per 2 policy years) Once and up to HK$6,000 / US$750 for every 2 policy years (For policies with 5, once and up to HK$3,000 / US$375 per 2 policy years) 7. Life Protection Death Benefit HK$80,000 / US$10,000 HK$80,000 / US$10,000 Accidental Death Benefit 8. Other Guaranteed Convertibility to Reduce s 5 at Specified Ages 24-Hour Worldwide Assistance Services 10 Second Medical Opinion 10 Privilege to reduce 5 within 31 days before or after the Policy Anniversary at age 50 / 55 / 60 / 65 (Age Next Birthday) without providing proof of insurability. The premium would be based on factors, including but not limited to new 5, Plan Level and age of the Insured and the premium table applicable at that time. This right can only be exercised once by lifetime. Service Program Service Program Reasonable and Customary charges for the above benefits will be paid by FWD. Reasonable and Customary shall mean: (i) in relation to a fee, a charge or an expense, shall mean any fee or expense which (a) is actually charged for treatment, supplies or medical services that are Medically Necessary and in accordance with standards of good medical practice for the care of an ill or injured person under the care, supervision or order of a Physician; (b) does not exceed the usual or reasonable average level of charges for similar treatment, supplies or medical services in the location where the expense is incurred; (c) does not include charges that would not have been made if no insurance existed; and (d) does not exceed the actual fee, charge or expense incurred. FWD reserves the right to determine whether any particular charge is Reasonable and Customary with reference but not limited to, any relevant publication or information made available, such as schedule of fees, by the government, relevant authorities and recognized medical association at the location where the Eligible Expense is incurred. FWD reserves the right to adjust any and all benefits payable under this Policy which in our opinion is not Reasonable and Customary; (ii) in relation to a Confinement shall mean the admission and length of a Confinement, and medical services and treatment received during which, are in accordance with generally accepted professional standards of medical practice, and do not exceed the usual standard for the treatment of similar illness or injury at the location where such Confinement is made. FWD reserves the right to revise the benefits payable, terms and conditions and the premium at any time. A 30-day waiting period is applicable for the above benefits, except the specific waiting periods stated above, Life Protection and the treatment due to accident. The above information is for reference only and is indicative of the key features of the basic plan and the riders. For a complete explanation of the terms and conditions, please refer to the relevant Policy Provisions. In the event of any ambiguity or inconsistency between the terms of this leaflet and the Policy Provisions, the Policy Provisions in English shall prevail. In the event of any discrepancy between the English and Chinese version of this leaflet, the English version shall prevail.

7 Remarks 1. Lifetime Limit refers to the maximum aggregate amount of benefits payable under all insurance policies and supplemental benefits (if any) issued by FWD Life Insurance Company (Bermuda) Limited ( FWD ) covering the insured during his/her lifetime, regardless whether the insurance policies are still in force. 2. Only applicable to policies with and subject to the Annual Limit and Lifetime Limit. FWD shall not waive the payment of any balance of Annual Deductible if the confinement is related to a designated crises whose symptoms appear or relevant diagnosis or surgery occurs within the first 90 days from the policy date or the last policy reinstatement date. Please refer to the Schedule of Benefit of this brochure, Policy Provisions, and Policy Schedule for the details and definition of Designated Critical Illness. 3. Only applicable to designated Plan Level and up to the relevant limit. Please refer to Schedule of Benefit of this brochure and Policy Provisions for details. 4. Standard Private Room means a single occupancy room with adjoining bathroom for the insured s use during his/her confinement, but excluding any room of upper class with its own kitchen, dining or sitting room(s) in a hospital. If the Insured is confined in a hospital which offers multiple classes of private rooms, the Standard Private Room shall refer to the lowest priced private room offered by the hospital. 5. shall means the part of eligible expenses which shall be borne by the policy owner or the insured and which has to be deducted from the reimbursable sum. 6. Source: Information from Hong Kong Cancer Registry, Hospital Authority as of November When the benefit is payable under Organ and Bone Marrow Transplantation, Chemotherapy and Radiotherapy and Kidney Dialysis, FWD shall increase the Annual Limit for that policy year. This benefit is only available once per policy year. The amount of Lifetime Limit shall remain unchanged. Please refer to Policy Provisions for details. 8. Lifetime guaranteed renewal is subject to the continual availability of the Plan offered by FWD, terms and conditions applicable, benefits, and premium rates at the time of renewal. Renewal premiums are not guaranteed and the premiums for each renewal are determined based on the age (at next birthday) and the premium table applicable at that time when the policy is renewed. Premium table is subject to change based on factors including but not limited to the inflation of related medical expense, FWD s medical claim experience and persistency of policies from time to time. FWD reserves the right to revise the benefit payable, terms and conditions and premiums at any time. 9. The application should be made within 31 days immediately before or after the relevant policy anniversary. This right can only be exercised once per lifetime of the insured and is irrevocable. 10. The service is provided by International SOS. FWD shall not be responsible for any act or failure to act on the part of International SOS. FWD may revise the details of the services from time to time without prior notice. International SOS benefits are available to FWD s insureds when travelling outside the home country or country of residence for periods not exceeding 90 consecutive days per trip. 11. Asia includes Afghanistan, Bangladesh, Bhutan, Brunei, Cambodia, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Mainland China, Malaysia, Maldives, Mongolia, Myanmar, Nepal, North Korea, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam. 12. Worldwide exclude USA includes worldwide exclude the USA. 13. FWD shall reduce the amount of benefit payable (except Life Protection) under this Plan to 50% of the relevant benefit payable if: (a) the Insured has taken up residence in the USA for at least 183 days in the past 12 months (including the days of arrival and departure) at the time of confinement, medical treatment and/or service in the USA; and/or (b) the Insured is under confinement or undergoes clinical surgeries in the USA without obtaining FWD s pre-authorisation unless it is directly due to an accident or emergency. FWD reserves the right to change the Plan from to at any time if the Insured has taken up residence in the USA for at least 183 days in the past 12 months (including the days of arrival and departure). 14. Only applicable after the insured s surgery or discharged from Intensive Care Unit. 15. Please refer to the Policy Provisions for the details of the items which the benefits are payable. 16. Daily Hospital Cash will not be paid in conjunction with Daily Hospital Cash for Voluntary Room and Board Stay below Private Room. 17. Specified Items include(i) Pace maker (ii) Stents for Percutaneous Transluminal Coronary Angioplasty (iii) Intraocular lens (iv) Artificial cardiac valve (v) Metallic or artificial joints for joint replacement (vi) Prosthetic ligaments for replacement or implantation between bones and (vii) Prosthetic intervertebral disc. 18. Only applicable to the outpatient consultations result in hospitalization of the insured. 19. The waiting period of this benefit is 5 years. 20. The waiting period of this benefit is 1 year. 21. Only applicable to the insured who is aged 18 (Age Next Birthday) or above and the waiting period of this benefit item is 2 years. Important Notes and Declarations: Plan, and all benefits payable under the Plan are subject to the credit risk of FWD. Brochure. FWD recommends you to carefully consider whether the Plan is suitable for you in view of your financial needs and fully understand the risk involved in the Plan before application. You should not apply or purchase the Plan unless you fully understand it and you agree it is suitable for you. Application of the Plan is your independent and final decision and you need to bear the responsibility of your decision. In case you want to read the terms and conditions of the policy provisions, you can obtain a copy from FWD through Bank of Communications. deposit or time deposit. The Plan is not protected under the Deposit Protection Scheme in the Hong Kong Special Administrative Region. issue of a Notice informing you or your representative that the policy is available for collection and expiry date of the Cooling-off Period, whichever is earlier) by giving a written notice and obtain a refund of any premium paid, provided that you have not made any claims under the policy. notice must be received by FWD on or before the expiry date of the Cooling-off Period. The office address of FWD is 1/F., FWD Financial Centre, 308 Des Voeux Road Central, Hong Kong. buy or provision of any insurance products of FWD outside the Hong Kong Special Administrative Region. All selling and application procedures of the Plan must be conducted and completed in the Hong Kong Special Administrative Region. to accept or decline any application. FWD Life Insurance Company (Bermuda) Limited Address: 28/F., FWD Financial Centre, 308 Des Voeux Road Central, Hong Kong Phone: customerservices@fwd.com Fax: Website: For enquiries, please contact Bank of Communications Co., Ltd. Hong Kong Branch and their sub-branches.

8 衛一醫療總匯 ( 元 ) 年供保費表 ( 中國內地人士除外 ) TheOne Medical Solution (HKD) Annual Premium Table (excluding Mainland Chinese) 0 40,000 80, ,508 10,403 18,293 3,955 4,750 9,147 3,195 3,890 7, ,508 10,403 18,293 3,955 4,750 9,147 3,195 3,890 7, ,508 10,403 18,293 3,955 4,750 9,147 3,195 3,890 7, ,508 10,403 18,293 3,955 4,750 9,147 3,195 3,890 7, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,103 9,908 17,422 3,767 4,524 8,711 3,043 3,704 6, ,122 10,030 17,606 3,776 4,585 8,803 3,050 3,771 7, ,141 10,152 17,789 3,785 4,646 8,895 3,057 3,837 7, ,160 10,274 17,973 3,794 4,707 8,987 3,064 3,903 7, ,161 10,632 18,524 3,795 4,890 9,262 3,064 4,052 7, ,162 10,988 19,074 3,805 5,082 9,569 3,074 4,205 7, ,163 11,088 19,426 3,815 5,158 9,778 3,083 4,262 7, ,164 11,185 19,469 3,825 5,233 9,832 3,093 4,319 7, ,165 11,487 19,512 3,834 5,405 9,886 3,102 4,455 7, ,166 11,780 19,555 3,844 5,574 9,940 3,112 4,572 8, ,167 11,894 19,599 3,854 5,652 9,995 3,121 4,616 8, ,613 12,288 19,819 4,075 5,850 10,089 3,301 4,776 8, ,060 12,682 20,040 4,297 6,048 10,182 3,483 4,937 8, ,500 13,075 20,260 4,516 6,247 10,275 3,663 5,097 8, ,940 13,469 20,728 4,737 6,447 10,493 3,843 5,259 8, ,202 13,862 21,337 4,873 6,647 10,781 3,956 5,421 8, ,506 14,154 21,642 5,031 6,799 10,914 4,086 5,543 8, ,655 14,446 21,947 5,114 6,952 11,047 4,155 5,666 8, ,886 14,738 22,557 5,238 7,105 11,333 4,258 5,790 9, ,172 15,030 23,166 5,388 7,259 11,617 4,382 5,913 9, ,343 15,322 23,776 5,484 7,413 11,900 4,462 6,037 9, ,755 15,851 24,386 5,697 7,683 12,206 4,637 6,255 9, ,969 16,049 24,690 5,814 7,793 12,360 4,735 6,343 9, ,111 16,247 24,837 5,897 7,903 12,434 4,804 6,431 10, ,293 16,445 25,119 6,000 8,014 12,577 4,890 6,519 10, ,377 16,499 25,606 6,055 8,054 12,822 4,937 6,550 10, ,766 16,553 26,804 6,260 8,095 13,423 5,107 6,582 10, ,044 16,943 28,002 6,412 8,300 14,024 5,233 6,747 11, ,322 17,560 29,200 6,564 8,618 14,625 5,359 7,003 11, ,872 18,237 30,397 6,851 8,966 15,226 5,596 7,284 12, ,713 19,085 31,595 7,283 9,399 15,955 5,951 7,634 12, ,633 20,254 33,006 7,734 9,958 16,668 6,320 8,089 13, ,563 21,227 34,413 8,190 10,419 17,379 6,693 8,464 14, ,219 22,006 35,812 8,510 10,783 18,085 6,955 8,761 14, ,882 22,785 37,207 8,834 11,146 18,790 7,219 9,057 15, ,694 23,564 38,593 9,230 11,508 19,489 7,543 9,352 15, ,370 24,343 40,527 9,559 11,868 20,466 7,812 9,646 16, ,053 25,348 42,452 9,891 12,338 21,438 8,083 10,028 17, ,031 26,919 44,370 10,368 13,080 22,407 8,473 10,633 17, ,874 28,588 46,278 10,778 13,867 23,370 8,809 11,274 18, ,017 30,359 48,178 11,336 14,701 24,330 9,264 11,954 19, ,314 32,242 51,461 11,944 15,599 25,962 9,756 12,683 20, ,933 34,239 54,756 12,707 16,551 27,597 10,373 13,456 22, ,582 36,362 58,064 13,481 17,562 29,235 10,998 14,277 23, ,081 38,616 61,386 14,177 18,634 30,877 11,560 15,147 24, ,803 41,751 65,044 14,978 20,129 32,685 12,206 16,361 26,164

9 衛一醫療總匯 ( 元 ) 年供保費表 ( 中國內地人士除外 ) TheOne Medical Solution (HKD) Annual Premium Table (excluding Mainland Chinese) 0 40,000 80, ,731 44,593 69,735 15,875 21,480 35,007 12,929 17,458 28, ,009 47,872 74,434 16,936 23,040 37,329 13,785 18,724 29, ,646 52,243 79,142 18,164 25,121 39,650 14,776 20,414 31, ,705 57,927 83,863 19,589 27,830 41,973 15,926 22,613 33, ,058 64,485 89,813 21,148 30,953 44,907 17,183 25,149 35, ,826 69,139 97,099 22,476 33,187 48,550 18,262 26,964 38, ,586 74, ,677 24,281 35,939 51,339 19,729 29,200 41, ,815 77, ,193 25,351 37,344 54,097 20,598 30,342 43, ,304 80, ,295 26,546 38,612 57,148 21,569 31,372 45, ,881 83, ,909 27,783 39,871 59,955 22,574 32,395 47,964 71* 60,948 85, ,810 29,255 41,025 60,905 23,770 33,333 48,724 72* 64,104 92, ,878 30,770 44,383 63,439 25,001 36,061 50,751 73* 67,155 95, ,630 32,234 45,957 65,815 26,190 37,340 52,652 74* 70,260 99, ,080 33,725 47,531 68,540 27,401 38,619 54,832 75* 73, , ,213 35,229 48,370 71,607 28,624 39,301 57,285 76* 76, , ,099 36,948 49,314 73,550 30,021 40,068 58,840 77* 80, , ,365 38,719 52,462 77,183 31,459 42,625 61,746 78* 84, , ,484 40,439 56,029 81,242 32,857 45,524 64,994 79* 87, , ,786 42,200 57,708 85,893 34,287 46,888 68,714 80* 91, , ,922 43,928 59,492 88,961 35,692 48,337 71,169 81* 95, , ,380 45,832 60,436 92,190 37,238 49,105 73,752 82* 99, , ,052 47,852 63,374 96,526 38,880 51,492 77,221 83* 103, , ,844 49,652 64, ,422 40,342 52,429 80,338 84* 107, , ,066 51,586 65, ,533 41,913 53,367 82,026 85* 110, , ,328 53,180 67, ,664 43,208 55,243 83,731 86* 114, , ,205 55,013 67, ,103 44,698 55,243 85,682 87* 117, , ,938 56,377 68, ,969 45,806 55,627 87,175 88* 120, , ,875 57,755 70, ,938 46,926 56,960 88,750 89* 123, , ,848 59,064 70, ,924 47,990 57,649 90,339 90* 125, , ,856 60,238 72, ,928 48,943 58,981 91,942 91* 127, , ,899 61,206 73, ,950 49,730 59,971 93,560 92* 129, , ,798 62,173 75, ,899 50,516 60,994 95,119 93* 131, , ,910 63,141 76, ,955 51,302 62,132 96,764 94* 133, , ,058 64,109 77, ,029 52,088 63,324 98,423 95* 135, , ,240 65,076 79, ,120 52,875 64, ,096 96* 137, , ,458 66,044 81, ,229 53,661 66, ,783 97* 139, , ,523 67,012 83, ,262 54,447 67, ,409 98* 141, , ,810 67,899 85, ,405 55,168 69, ,124 99* 143, , ,131 68,867 86, ,566 55,954 70, ,852 * 續保保費以供參考 Renewal premium for your reference 重要事項 Important Notes: 1. 本保費表的上次更新日期為 2014 年 02 月 28 日 2. 保證終身續保受限於富衛人壽保險 ( 百慕達 ) 有限公司 ( 富衛 ) 是否持續提供衛一醫療總匯 ( 本計劃 ) 每年續保時將根據當時的條款及細則 保單利益和保費率 3. 以上保費並非保證及每次續保之保費將根據續保時的 及保費表釐定 保費表根據各因素, 括但不受限於相關的醫療費用的通脹及富衛不時的索賠數據及保單續保情況釐定 富衛保留隨時作出修改保單利益 條款及細則及保費的權利 4. 本保費表只供參考, 並不能作為富衛與任何人士或團體所訂立之任何合約或該合約的任何部分 有關本計劃之詳情, 請參閱產品冊子及保單條款 5. 實際年繳保費或會因核保結果, 括但不限於國藉及職業核保, 而與本保費表所列的年繳保費有所不同 1. The last update date of this premium table is Guaranteed renewal is subject to the continual availability of TheOne Medical Solution (the "Plan") offered by FWD Life Insurance Company (Bermuda) Limited ("FWD"), terms and conditions applicable, benefits, and premium rates at the time of renewal. 3. The above premiums are not guaranteed and the premiums for each renewal are determined based on the age (at next birthday) and the premium table applicable at that time when the policy is renewed. Premium table is subject to change based on factors including but not limited to the inflation of related medical expense, FWD s medical claim experience and persistency of policies from time to time. FWD reserves the right to revise the benefit payable, terms and conditions and premiums at any time. 4. This premium table is for reference only and not regarded as a contract or any part thereof between FWD and any other parties. Please refer to the product brochure and policy provisions for the details of the Plan. 5. The actual annual premium may be varied from the annual premium stated in this premium table according to the result of underwriting, including but not limited to nationality and occupational underwriting. PMH055BC1402

10 衛一醫療總匯 ( 美元 ) 年供保費表 ( 中國內地人士除外 ) TheOne Medical Solution (USD) Annual Premium Table (excluding Mainland Chinese) 0 5,000 10, ,091 1,334 2, , ,091 1,334 2, , ,091 1,334 2, , ,091 1,334 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,039 1,271 2, , ,042 1,286 2, , ,044 1,302 2, , ,047 1,318 2, , ,047 1,364 2, , ,047 1,409 2, , ,047 1,422 2, , , ,047 1,434 2, , , ,047 1,473 2, , , ,047 1,511 2, , , ,048 1,525 2, , , ,105 1,576 2, , , ,162 1,626 2, , , ,218 1,677 2, , , ,275 1,727 2, , , ,308 1,778 2, , , ,347 1,815 2, , , ,367 1,853 2, , , ,396 1,890 2, , , ,433 1,927 2, , , ,455 1,965 3, , , ,508 2,033 3, , , ,535 2,058 3, ,000 1, , ,553 2,083 3, ,014 1, , ,577 2,109 3, ,028 1, , ,587 2,116 3, ,033 1, , ,637 2,123 3, ,038 1, , ,673 2,173 3, ,065 1, , ,708 2,252 3, ,105 1, , ,779 2,339 3, ,150 1, , ,887 2,447 4, ,205 2, , ,005 2,597 4, ,277 2, ,038 1, ,124 2,722 4,412 1,050 1,336 2, ,086 1, ,208 2,822 4,592 1,092 1,383 2, ,124 1, ,293 2,922 4,771 1,133 1,429 2, ,162 1, ,397 3,022 4,948 1,184 1,476 2, ,199 2, ,484 3,121 5,196 1,226 1,522 2,624 1,002 1,237 2, ,571 3,250 5,443 1,269 1,582 2,749 1,037 1,286 2, ,697 3,452 5,689 1,330 1,677 2,873 1,087 1,364 2, ,805 3,666 5,934 1,382 1,778 2,997 1,130 1,446 2, ,951 3,893 6,177 1,454 1,885 3,120 1,188 1,533 2, ,118 4,134 6,598 1,532 2,000 3,329 1,251 1,627 2, ,325 4,390 7,020 1,630 2,122 3,539 1,330 1,726 2, ,537 4,662 7,445 1,729 2,252 3,749 1,410 1,831 3, ,729 4,951 7,870 1,818 2,389 3,959 1,483 1,942 3, ,950 5,353 8,339 1,921 2,581 4,191 1,565 2,098 3,355

11 衛一醫療總匯 ( 美元 ) 年供保費表 ( 中國內地人士除外 ) TheOne Medical Solution (USD) Annual Premium Table (excluding Mainland Chinese) 0 5,000 10, ,197 5,718 8,941 2,036 2,754 4,489 1,658 2,239 3, ,489 6,138 9,543 2,172 2,954 4,786 1,768 2,401 3, ,827 6,698 10,147 2,329 3,221 5,084 1,895 2,618 4, ,219 7,427 10,752 2,512 3,568 5,382 2,042 2,900 4, ,649 8,268 11,515 2,712 3,969 5,758 2,203 3,225 4, ,004 8,864 12,449 2,882 4,255 6,225 2,342 3,457 4, ,486 9,599 13,164 3,113 4,608 6,582 2,530 3,744 5, ,772 9,975 13,871 3,251 4,788 6,936 2,641 3,890 5, ,091 10,314 14,654 3,404 4,951 7,327 2,766 4,023 5, ,421 10,650 15,373 3,562 5,112 7,687 2,895 4,154 6,150 71* 7,814 10,958 15,617 3,751 5,260 7,809 3,048 4,274 6,247 72* 8,219 11,855 16,267 3,945 5,691 8,134 3,206 4,624 6,507 73* 8,610 12,275 16,876 4,133 5,892 8,438 3,358 4,788 6,751 74* 9,008 12,696 17,575 4,324 6,094 8,788 3,513 4,952 7,030 75* 9,410 12,920 18,361 4,517 6,202 9,181 3,670 5,039 7,345 76* 9,869 13,172 18,859 4,737 6,323 9,430 3,849 5,137 7,544 77* 10,342 14,013 19,791 4,964 6,726 9,896 4,034 5,465 7,917 78* 10,802 14,966 20,832 5,185 7,184 10,416 4,213 5,837 8,333 79* 11,272 15,414 22,024 5,411 7,399 11,012 4,396 6,012 8,810 80* 11,733 15,890 22,811 5,632 7,628 11,406 4,576 6,198 9,125 81* 12,242 16,143 23,639 5,876 7,749 11,820 4,775 6,296 9,456 82* 12,782 16,927 24,751 6,135 8,125 12,376 4,985 6,602 9,901 83* 13,262 17,236 25,750 6,366 8,273 12,875 5,173 6,722 10,300 84* 13,779 17,544 26,291 6,614 8,421 13,146 5,374 6,842 10,517 85* 14,204 18,160 26,837 6,818 8,717 13,419 5,540 7,083 10,735 86* 14,694 18,160 27,463 7,053 8,717 13,732 5,731 7,083 10,985 87* 15,058 18,287 27,941 7,228 8,778 13,971 5,873 7,132 11,177 88* 15,426 18,725 28,446 7,405 8,988 14,223 6,017 7,303 11,379 89* 15,776 18,952 28,955 7,573 9,097 14,478 6,153 7,391 11,582 90* 16,090 19,389 29,469 7,723 9,307 14,735 6,275 7,562 11,788 91* 16,348 19,715 29,988 7,847 9,463 14,994 6,376 7,689 11,995 92* 16,607 20,051 30,487 7,971 9,625 15,244 6,477 7,820 12,195 93* 16,865 20,425 31,015 8,095 9,804 15,508 6,578 7,966 12,406 94* 17,124 20,817 31,546 8,220 9,993 15,773 6,678 8,119 12,619 95* 17,382 21,251 32,083 8,344 10,201 16,042 6,779 8,288 12,833 96* 17,640 21,724 32,623 8,468 10,428 16,312 6,880 8,473 13,050 97* 17,899 22,204 33,144 8,592 10,658 16,573 6,981 8,660 13,258 98* 18,136 22,826 33,694 8,705 10,957 16,847 7,073 8,903 13,478 99* 18,394 23,139 34,248 8,830 11,107 17,124 7,174 9,025 13,699 * 續保保費以供參考 Renewal premium for your reference 重要事項 Important Notes: 1. 本保費表的上次更新日期為 2014 年 02 月 28 日 2. 保證終身續保受限於富衛人壽保險 ( 百慕達 ) 有限公司 ( 富衛 ) 是否持續提供衛一醫療總匯 ( 本計劃 ) 每年續保時將根據當時的條款及細則 保單利益和保費率 3. 以上保費並非保證及每次續保之保費將根據續保時的 及保費表釐定 保費表根據各因素, 括但不受限於相關的醫療費用的通脹及富衛不時的索賠數據及保單續保情況釐定 富衛保留隨時作出修改保單利益 條款及細則及保費的權利 4. 本保費表只供參考, 並不能作為富衛與任何人士或團體所訂立之任何合約或該合約的任何部分 有關本計劃之詳情, 請參閱產品冊子及保單條款 5. 實際年繳保費或會因核保結果, 括但不限於國藉及職業核保, 而與本保費表所列的年繳保費有所不同 1. The last update date of this premium table is Guaranteed renewal is subject to the continual availability of TheOne Medical Solution (the "Plan") offered by FWD Life Insurance Company (Bermuda) Limited ("FWD"), terms and conditions applicable, benefits, and premium rates at the time of renewal. 3. The above premiums are not guaranteed and the premiums for each renewal are determined based on the age (at next birthday) and the premium table applicable at that time when the policy is renewed. Premium table is subject to change based on factors including but not limited to the inflation of related medical expense, FWD s medical claim experience and persistency of policies from time to time. FWD reserves the right to revise the benefit payable, terms and conditions and premiums at any time. 4. This premium table is for reference only and not regarded as a contract or any part thereof between FWD and any other parties. Please refer to the product brochure and policy provisions for the details of the Plan. 5. The actual annual premium may be varied from the annual premium stated in this premium table according to the result of underwriting, including but not limited to nationality and occupational underwriting. PMH055BC1402

12 衛一醫療總匯 ( 元 ) 年供保費表 ( 適用於中國內地人士 ) TheOne Medical Solution (HKD) Annual Premium Table (Applicable to Mainland Chinese) 0 40,000 80, ,359 11,444 20,123 4,351 5,225 10,062 3,515 4,279 8, ,359 11,444 20,123 4,351 5,225 10,062 3,515 4,279 8, ,359 11,444 20,123 4,351 5,225 10,062 3,515 4,279 8, ,359 11,444 20,123 4,351 5,225 10,062 3,515 4,279 8, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,914 10,899 19,165 4,144 4,977 9,583 3,348 4,075 7, ,935 11,033 19,367 4,154 5,044 9,684 3,355 4,149 7, ,956 11,168 19,568 4,164 5,111 9,785 3,363 4,221 7, ,976 11,302 19,771 4,174 5,178 9,886 3,371 4,294 7, ,978 11,696 20,377 4,175 5,379 10,189 3,371 4,458 8, ,979 12,087 20,982 4,186 5,591 10,526 3,382 4,626 8, ,980 12,197 21,369 4,197 5,674 10,756 3,392 4,689 8, ,981 12,304 21,416 4,208 5,757 10,816 3,403 4,751 8, ,982 12,636 21,464 4,218 5,946 10,875 3,413 4,901 8, ,983 12,958 21,511 4,229 6,132 10,934 3,424 5,030 8, ,984 13,084 21,559 4,240 6,218 10,995 3,434 5,078 8, ,475 13,517 21,801 4,483 6,435 11,098 3,632 5,254 8, ,966 13,951 22,044 4,727 6,653 11,201 3,832 5,431 9, ,450 14,383 22,286 4,968 6,872 11,303 4,030 5,607 9, ,934 14,816 22,801 5,211 7,092 11,543 4,228 5,785 9, ,223 15,249 23,471 5,361 7,312 11,860 4,352 5,964 9, ,557 15,570 23,807 5,535 7,479 12,006 4,495 6,098 9, ,721 15,891 24,142 5,626 7,648 12,152 4,571 6,233 9, ,975 16,212 24,813 5,762 7,816 12,467 4,684 6,369 10, ,290 16,533 25,483 5,927 7,985 12,779 4,821 6,505 10, ,478 16,855 26,154 6,033 8,155 13,090 4,909 6,641 10, ,931 17,437 26,825 6,267 8,452 13,427 5,101 6,881 10, ,166 17,654 27,159 6,396 8,573 13,596 5,209 6,978 10, ,323 17,872 27,321 6,487 8,694 13,678 5,285 7,075 11, ,523 18,090 27,631 6,600 8,816 13,835 5,379 7,171 11, ,615 18,149 28,167 6,661 8,860 14,105 5,431 7,205 11, ,043 18,209 29,485 6,886 8,905 14,766 5,618 7,241 11, ,349 18,638 30,803 7,054 9,130 15,427 5,757 7,422 12, ,655 19,316 32,120 7,221 9,480 16,088 5,895 7,704 13, ,260 20,061 33,437 7,537 9,863 16,749 6,156 8,013 13, ,185 20,994 34,755 8,012 10,339 17,551 6,547 8,398 14, ,197 22,280 36,307 8,508 10,954 18,335 6,952 8,898 14, ,220 23,350 37,855 9,009 11,461 19,117 7,363 9,311 15, ,941 24,207 39,394 9,361 11,862 19,894 7,651 9,638 16, ,671 25,064 40,928 9,718 12,261 20,669 7,941 9,963 16, ,564 25,921 42,453 10,153 12,659 21,438 8,298 10,288 17, ,307 26,778 44,580 10,515 13,055 22,513 8,594 10,611 18, ,059 27,883 46,698 10,881 13,572 23,582 8,892 11,031 18, ,135 29,611 48,807 11,405 14,388 24,648 9,321 11,697 19, ,062 31,447 50,906 11,856 15,254 25,707 9,690 12,402 20, ,319 33,395 52,996 12,470 16,172 26,763 10,191 13,150 21, ,746 35,467 56,608 13,139 17,159 28,559 10,732 13,952 22, ,527 37,663 60,232 13,978 18,207 30,357 11,411 14,802 24, ,341 39,999 63,871 14,830 19,319 32,159 12,098 15,705 25, ,990 42,478 67,525 15,595 20,498 33,965 12,716 16,662 27, ,884 45,927 71,549 16,476 22,142 35,954 13,427 17,998 28,781

13 衛一醫療總匯 ( 元 ) 年供保費表 ( 適用於中國內地人士 ) TheOne Medical Solution (HKD) Annual Premium Table (Applicable to Mainland Chinese) 0 40,000 80, ,005 49,053 76,709 17,463 23,628 38,508 14,222 19,204 30, ,510 52,660 81,878 18,630 25,344 41,062 15,164 20,597 32, ,411 57,468 87,057 19,981 27,634 43,615 16,254 22,456 34, ,776 63,720 92,250 21,548 30,613 46,171 17,519 24,875 36, ,464 70,934 98,795 23,263 34,049 49,398 18,902 27,664 39, ,509 76, ,809 24,724 36,506 53,405 20,089 29,661 42, ,645 82, ,945 26,710 39,533 56,473 21,702 32,120 45, ,097 85, ,013 27,887 41,079 59,507 22,658 33,377 47, ,835 88, ,725 29,201 42,474 62,863 23,726 34,510 50, ,670 91, ,900 30,562 43,859 65,951 24,832 35,635 52,761 71* 67,043 94, ,991 32,181 45,128 66,996 26,147 36,667 53,597 72* 70, , ,566 33,847 48,822 69,783 27,502 39,668 55,827 73* 73, , ,793 35,458 50,553 72,397 28,809 41,074 57,918 74* 77, , ,788 37,098 52,285 75,394 30,142 42,481 60,316 75* 80, , ,535 38,752 53,207 78,768 31,487 43,232 63,014 76* 84, , ,809 40,643 54,246 80,905 33,024 44,075 64,724 77* 88, , ,802 42,591 57,709 84,902 34,605 46,888 67,921 78* 92, , ,733 44,483 61,632 89,367 36,143 50,077 71,494 79* 96, , ,965 46,420 63,479 94,483 37,716 51,577 75,586 80* 100, , ,715 48,321 65,442 97,858 39,262 53,171 78,286 81* 105, , ,818 50,416 66, ,409 40,962 54,016 81,128 82* 109, , ,358 52,638 69, ,179 42,768 56,642 84,944 83* 113, , ,929 54,618 70, ,465 44,377 57,672 88,372 84* 118, , ,573 56,745 72, ,787 46,105 58,704 90,229 85* 121, , ,261 58,498 74, ,131 47,529 60,768 92,105 86* 126, , ,626 60,515 74, ,814 49,168 60,768 94,251 87* 129, , ,732 62,015 75, ,866 50,387 61,190 95,893 88* 132, , ,063 63,531 77, ,032 51,619 62,656 97,625 89* 135, , ,433 64,971 78, ,217 52,789 63,414 99,373 90* 138, , ,842 66,262 79, ,421 53,838 64, ,137 91* 140, , ,289 67,327 81, ,645 54,703 65, ,916 92* 142, , ,578 68,391 82, ,789 55,568 67, ,631 93* 144, , ,101 69,456 84, ,051 56,433 68, ,441 94* 146, , ,664 70,520 85, ,332 57,297 69, ,266 95* 149, , ,264 71,584 87, ,632 58,163 71, ,106 96* 151, , ,904 72,649 89, ,952 59,028 72, ,962 97* 153, , ,376 73,714 91, ,189 59,892 74, ,750 98* 155, , ,091 74,689 94, ,546 60,685 76, ,637 99* 157, , ,845 75,754 95, ,923 61,550 77, ,538 * 續保保費以供參考 Renewal premium for your reference 重要事項 Important Notes: 1. 本保費表的上次更新日期為 2014 年 02 月 28 日 2. 保證終身續保受限於富衛人壽保險 ( 百慕達 ) 有限公司 ( 富衛 ) 是否持續提供衛一醫療總匯 ( 本計劃 ) 每年續保時將根據當時的條款及細則 保單利益和保費率 3. 以上保費並非保證及每次續保之保費將根據續保時的 及保費表釐定 保費表根據各因素, 括但不受限於相關的醫療費用的通脹及富衛不時的索賠數據及保單續保情況釐定 富衛保留隨時作出修改保單利益 條款及細則及保費的權利 4. 本保費表只供參考, 並不能作為富衛與任何人士或團體所訂立之任何合約或該合約的任何部分 有關本計劃之詳情, 請參閱產品冊子及保單條款 5. 實際年繳保費或會因核保結果, 括但不限於國藉及職業核保, 而與本保費表所列的年繳保費有所不同 1. The last update date of this premium table is Guaranteed renewal is subject to the continual availability of TheOne Medical Solution (the "Plan") offered by FWD Life Insurance Company (Bermuda) Limited ("FWD"), terms and conditions applicable, benefits, and premium rates at the time of renewal. 3. The above premiums are not guaranteed and the premiums for each renewal are determined based on the age (at next birthday) and the premium table applicable at that time when the policy is renewed. Premium table is subject to change based on factors including but not limited to the inflation of related medical expense, FWD s medical claim experience and persistency of policies from time to time. FWD reserves the right to revise the benefit payable, terms and conditions and premiums at any time. 4. This premium table is for reference only and not regarded as a contract or any part thereof between FWD and any other parties. Please refer to the product brochure and policy provisions for the details of the Plan. 5. The actual annual premium may be varied from the annual premium stated in this premium table according to the result of underwriting, including but not limited to nationality and occupational underwriting. PMH055CC1402

14 衛一醫療總匯 ( 美元 ) 年供保費表 ( 適用於中國內地人士 ) TheOne Medical Solution (USD) Annual Premium Table (Applicable to Mainland Chinese) 0 5,000 10, ,201 1,468 2, , , ,201 1,468 2, , , ,201 1,468 2, , , ,201 1,468 2, , , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,143 1,399 2, , ,147 1,415 2, , ,149 1,433 2, , , ,152 1,450 2, , , ,152 1,501 2, , , ,152 1,550 2, , , ,152 1,565 2, , , ,152 1,578 2, , , ,152 1,621 2, , , ,152 1,663 2, , , ,153 1,678 2, , , ,216 1,734 2, , , ,279 1,789 2, , , ,340 1,845 2, , , ,403 1,900 2, , , ,439 1,956 3, , , ,482 1,997 3, , , ,504 2,039 3, , , ,536 2,079 3, ,003 1, , ,577 2,120 3, ,025 1, , ,601 2,162 3, ,047 1, , ,659 2,237 3, ,084 1, , ,689 2,264 3, ,100 1, , ,709 2,292 3, ,116 1, , ,735 2,320 3, ,131 1, , ,746 2,328 3, ,137 1, , ,801 2,336 3, ,142 1, , ,841 2,391 3, ,172 1, , ,879 2,478 4, ,216 2, , ,957 2,573 4, ,265 2, ,028 1, ,076 2,692 4,457 1,028 1,326 2, ,077 1, ,206 2,857 4,656 1,092 1,405 2, ,142 1, ,337 2,995 4,854 1,155 1,470 2, ,195 1, ,429 3,105 5,052 1,202 1,522 2, ,237 2, ,523 3,215 5,249 1,247 1,572 2,650 1,019 1,279 2, ,637 3,325 5,443 1,303 1,624 2,749 1,065 1,319 2, ,733 3,434 5,716 1,349 1,675 2,887 1,103 1,361 2, ,829 3,575 5,988 1,396 1,741 3,024 1,141 1,415 2, ,967 3,798 6,258 1,463 1,845 3,161 1,196 1,501 2, ,086 4,033 6,528 1,521 1,956 3,297 1,243 1,591 2, ,247 4,283 6,795 1,600 2,074 3,432 1,307 1,687 2, ,430 4,548 7,258 1,686 2,200 3,662 1,377 1,790 2, ,658 4,829 7,722 1,793 2,335 3,893 1,463 1,899 3, ,891 5,129 8,190 1,902 2,478 4,124 1,551 2,015 3, ,102 5,447 8,657 2,000 2,628 4,355 1,632 2,137 3, ,345 5,889 9,173 2,114 2,840 4,611 1,722 2,308 3,691

15 衛一醫療總匯 ( 美元 ) 年供保費表 ( 適用於中國內地人士 ) TheOne Medical Solution (USD) Annual Premium Table (Applicable to Mainland Chinese) 0 5,000 10, ,617 6,290 9,836 2,240 3,030 4,938 1,824 2,463 3, ,938 6,752 10,498 2,390 3,250 5,265 1,945 2,642 4, ,310 7,368 11,162 2,562 3,544 5,593 2,085 2,880 4, ,741 8,170 11,828 2,764 3,925 5,921 2,247 3,190 4, ,214 9,095 12,667 2,984 4,366 6,334 2,424 3,548 5, ,605 9,751 13,694 3,171 4,681 6,848 2,577 3,803 5, ,135 10,559 14,481 3,425 5,069 7,241 2,783 4,119 5, ,450 10,973 15,259 3,577 5,267 7,630 2,906 4,279 6, ,801 11,346 16,120 3,745 5,447 8,060 3,043 4,426 6, ,164 11,715 16,911 3,919 5,624 8,456 3,185 4,570 6,765 71* 8,596 12,054 17,179 4,127 5,786 8,590 3,353 4,702 6,872 72* 9,041 13,041 17,894 4,340 6,261 8,948 3,527 5,087 7,158 73* 9,471 13,503 18,564 4,547 6,482 9,282 3,694 5,267 7,427 74* 9,909 13,966 19,333 4,757 6,704 9,667 3,865 5,448 7,733 75* 10,351 14,212 20,198 4,969 6,823 10,100 4,037 5,543 8,080 76* 10,856 14,490 20,745 5,211 6,956 10,373 4,234 5,651 8,299 77* 11,377 15,415 21,771 5,461 7,399 10,886 4,438 6,012 8,709 78* 11,883 16,463 22,916 5,704 7,903 11,458 4,635 6,421 9,167 79* 12,400 16,956 24,227 5,953 8,139 12,114 4,836 6,614 9,691 80* 12,907 17,479 25,093 6,196 8,391 12,547 5,034 6,818 10,038 81* 13,467 17,758 26,003 6,464 8,524 13,002 5,253 6,926 10,402 82* 14,061 18,620 27,227 6,749 8,938 13,614 5,484 7,263 10,892 83* 14,589 18,960 28,325 7,003 9,101 14,163 5,691 7,395 11,330 84* 15,157 19,299 28,921 7,276 9,264 14,461 5,912 7,527 11,569 85* 15,625 19,976 29,521 7,500 9,589 14,761 6,094 7,792 11,809 86* 16,164 19,976 30,210 7,759 9,589 15,106 6,305 7,792 12,084 87* 16,564 20,116 30,736 7,951 9,656 15,369 6,461 7,846 12,295 88* 16,969 20,598 31,291 8,146 9,887 15,646 6,619 8,034 12,517 89* 17,354 20,848 31,851 8,331 10,007 15,926 6,769 8,131 12,741 90* 17,699 21,328 32,416 8,496 10,238 16,209 6,903 8,319 12,967 91* 17,983 21,687 32,987 8,632 10,410 16,494 7,014 8,458 13,195 92* 18,268 22,057 33,536 8,769 10,588 16,769 7,125 8,602 13,415 93* 18,552 22,468 34,117 8,905 10,785 17,059 7,236 8,763 13,647 94* 18,837 22,899 34,701 9,042 10,993 17,351 7,346 8,931 13,881 95* 19,121 23,377 35,292 9,179 11,222 17,647 7,457 9,117 14,117 96* 19,404 23,897 35,886 9,315 11,471 17,944 7,568 9,321 14,355 97* 19,689 24,425 36,459 9,452 11,724 18,231 7,680 9,526 14,584 98* 19,950 25,109 37,064 9,576 12,053 18,532 7,781 9,794 14,826 99* 20,234 25,453 37,673 9,713 12,218 18,837 7,892 9,928 15,069 * 續保保費以供參考 Renewal premium for your reference 重要事項 Important Notes: 1. 本保費表的上次更新日期為 2014 年 02 月 28 日 2. 保證終身續保受限於富衛人壽保險 ( 百慕達 ) 有限公司 ( 富衛 ) 是否持續提供衛一醫療總匯 ( 本計劃 ) 每年續保時將根據當時的條款及細則 保單利益和保費率 3. 以上保費並非保證及每次續保之保費將根據續保時的 及保費表釐定 保費表根據各因素, 括但不受限於相關的醫療費用的通脹及富衛不時的索賠數據及保單續保情況釐定 富衛保留隨時作出修改保單利益 條款及細則及保費的權利 4. 本保費表只供參考, 並不能作為富衛與任何人士或團體所訂立之任何合約或該合約的任何部分 有關本計劃之詳情, 請參閱產品冊子及保單條款 5. 實際年繳保費或會因核保結果, 括但不限於國藉及職業核保, 而與本保費表所列的年繳保費有所不同 1. The last update date of this premium table is Guaranteed renewal is subject to the continual availability of TheOne Medical Solution (the "Plan") offered by FWD Life Insurance Company (Bermuda) Limited ("FWD"), terms and conditions applicable, benefits, and premium rates at the time of renewal. 3. The above premiums are not guaranteed and the premiums for each renewal are determined based on the age (at next birthday) and the premium table applicable at that time when the policy is renewed. Premium table is subject to change based on factors including but not limited to the inflation of related medical expense, FWD s medical claim experience and persistency of policies from time to time. FWD reserves the right to revise the benefit payable, terms and conditions and premiums at any time. 4. This premium table is for reference only and not regarded as a contract or any part thereof between FWD and any other parties. Please refer to the product brochure and policy provisions for the details of the Plan. 5. The actual annual premium may be varied from the annual premium stated in this premium table according to the result of underwriting, including but not limited to nationality and occupational underwriting. PMH055CC1402