Protecting your employees now comes with greater flexibility.

Transcription

1 Protecting your employees now comes with greater flexibility. The flexible plan that lets you choose how you protect your greatest assets your employees. PRUtreasures flexi Your relationships are precious. Protect them. PRUtreasures flexi 01

2 A good protection plan can increase productivity at work. That s why, apart from providing your employees a stable income and career growth, their protection needs are just as important. PRUtreasures flexi offers a comprehensive plan to ensure your employees are protected from the financial impact of unforeseen illnesses and accidents. PRUtreasures flexi lets you choose your group protection plan according to your organisation s unique needs by selecting the amount of coverage, medical protection and benefits. Help your employees cope with their healthcare Gross Medical Inflation 15 % in 2016 Source: Aon Hewitt 2017 Global Medical Trend Rates Report Sharp rise in numbers diagnosed with cancer 35 PEOPLE are diagnosed with cancer every day in Singapore Source: Singapore Cancer Society (2017 November 8), retrieved from common-types-of-cancer-in-singapore.html 02 PRUtreasures flexi

3 PRUtreasures flexi allows you to select the coverage for your employees We help you protect your employees against uncertainties with a comprehensive coverage protection against death, total and permanent disability, terminal illness and critical illness, hospitalisation, outpatient clinic, specialist, dental and even Traditional Chinese Medicine (TCM) treatments. Small Group Size You can start policy coverage with just 3 employees. Flexibility Choice of plans to suit your needs and budget. Guaranteed Coverage Eligible employees enjoy guaranteed coverage of up to S$200,000 for Group Term Life and up to S$100,000 for Group Crisis Cover Accelerated. Comprehensive Solutions High sum assured of up to S$500,000 upon death, total and permanent disability or terminal illness. Repatriation of Mortal Remains of up to S$50,000 per member. Coverage of up to S$250,000 upon diagnosis of any of the covered critical illnesses. Coverage of up to 1-bedded wards in private hospitals. Coverage for outpatient clinical with TCM option, specialist and dental. Portfolio Pricing Premiums are calculated based on the claims experience of the entire PRUtreasures flexi portfolio. PRUtreasures flexi 03

4 Convenience & Ease of Access Cashless access at Prudential's panel of General Practitioners. Go paperless and submit your claims online. Double Sum Assured Double death benefit due to accident while travelling as a fare-paying passenger in a Public Land Conveyance in Singapore, including Uber and Grab service. Complimentary Health Screening Complimentary health screening is offered to group size with more than 10 insured employees covered in Group Hospital & Surgical at no additional cost*. Extended Coverage Extended coverage to dependants for medical products. Extended coverage to employees residing outside of Singapore 1. Group Size Discount Discount is applied to group size of at least 11 employees. *Subject to availability. 1 Please refer to the Underwriting Guideline for covered countries found on page 14 and 15. Terms and Conditions apply. Please refer to for more details. 04 PRUtreasures flexi

5 Benefits at a Glance You can choose between the Group Term Life and Group Hospital & Surgical plans as your core plans. These plans, along with additional optional supplementary benefits, give you more options to customise an employee's insurance scheme that can keep pace with their evolving needs. Group Term Life (GTL) Receive up to S$500,000 due to death, total and permanent disability or terminal illness. Group Hospital & Surgical (GHS) Reimbursement of hospital expenses due to a sickness or injury. ADD ON RIDERS (OPTIONAL) Group Crisis Cover Accelerated (GCCA) Be covered against 37 critical illnesses. ADD ON RIDERS (OPTIONAL) Group Extended Major Medical (GEMM) Reimbursement of hospital expenses in excess of eligible hospital expenses. ADD ON RIDERS (OPTIONAL) Group Accidental Death & Dismemberment (GADD) Receive up to S$500,000 due to accidental death and injuries. ADD ON RIDERS (OPTIONAL) Group Accidental Death & Dismemberment (GADD) Receive up to S$500,000 due to accidental death and injuries. ADD ON RIDERS (OPTIONAL) Group Outpatient General Practitioner & Specialist (GP & SP) Cashless for GP Panel Clinics and reimbursement for outpatient specialist medical expenses. ADD ON RIDERS (OPTIONAL) Group Outpatient General Practitioner (GP) Cashless for GP Panel Clinics. Or Group Outpatient General Practitioner & Specialist (GP & SP) Cashless for GP Panel Clinics and reimbursement for outpatient specialist medical expenses. ADD ON RIDERS (OPTIONAL) Group Dental (GDEN) Reimbursement for eligible dental expenses. PRUtreasures flexi 05

6 CORE PLAN GROUP TERM LIFE BENEFITS / PLAN TYPE PLAN 1 2 PLAN 2 PLAN 3 PLAN 4 PLAN 5 Group Term Life (Double Death Benefits payable in the event of death due to accident in a public land conveyance) - Death - Total and Permanent Disability (TPD) - Terminal Illness (TI) S$ 500,000 S$ 200,000 S$ 150,000 S$ 80,000 S$ 50,000 Repatriation of Mortal Remains (per member) S$ 50,000 S$ 50,000 S$ 50,000 S$ 50,000 S$ 50,000 2 Health declaration required. ANNUAL PREMIUM RATE GROUP TERM LIFE AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 2, S$ 1, S$ S$ S$ S$ 4, S$ 2, S$ 1, S$ S$ S$ 7, S$ 3, S$ 2, S$ 1, S$ S$ 13, S$ 6, S$ 5, S$ 2, S$ 1, For renewals only. GROUP SIZE DISCOUNT FOR GROUP TERM LIFE GROUP SIZE (INSURED EMPLOYEES) DISCOUNT % 16 and above 10% CORE PLAN GROUP HOSPITAL & SURGICAL BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 1 Daily Room and Board Benefit (Per day, up to 120 days per disability) 1-Bed Ward Private 2-Bed Ward Private 4-Bed Ward Private 4-Bed Ward Government Restructured 1-Bed Ward Government Restructured 2 3 Intensive Care Unit (ICU) (Max. per day, up to 30 days per disability) High Dependency Ward (HDW) (Max. per day, up to 30 days per disability) 3 x 1-Bedded 3 x 2-Bedded 3 x 4-Bedded 2 x 1-Bedded 2 x 2-Bedded 2 x 4-Bedded S$15,000 per disability limit for items 2 to 8 S$20,000 per disability limit for items 2 to 8 06 PRUtreasures flexi

7 BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 4 Other Hospital Services Benefits Including implants (Max. per disability) 5 Surgical Fees (subject to surgical schedule) In-Hospital Doctor's Consultation Benefit (Max. 120 days) Pre (90 days) & Post (90 days) Hospitalisation/Surgery, Specialist Consultation, Diagnostic X-Ray and Lab Test, Traditional Chinese Medicine S$25,000 per disability limit for items 4 to 8 S$20,000 per disability limit for items 4 to 8 S$15,000 per disability limit for items 4 to 8 S$15,000 per disability limit for items 2 to 8 S$20,000 per disability limit for items 2 to 8 8 Emergency Accidental Outpatient Treatment Benefit (Including Accidental Dental Treatment) 9 Miscarriage Benefit Covered under benefits (items 1 to 8), as per the respective benefit limits Outpatient Cancer Treatment (Max. per policy year) Outpatient Kidney Dialysis (Max. per policy year) Overseas Hospitalisation for Accident Benefit Rehabilitation Benefit (Max. per disability, up to 31 days) Hospital Cash Benefit (Max. per day, up to 90 days per disability) Singapore Government Restructured B1 Ward Singapore Government Restructured B2 Ward Singapore Government Restructured C Ward In-Hospital Psychiatric Treatment (Max. per policy year, applicable to Singapore GRH only) Death Benefit (Double Death Benefits payable in the event of death due to accident in a public land conveyance) S$ 10,000 S$ 10,000 S$ 10,000 N.A N.A S$ 10,000 S$ 10,000 S$ 10,000 N.A N.A 150% of GHS benefit (for items 1 to 7) S$ 5,000 S$ 5,000 S$ 5,000 S$ 5,000 S$ 5,000 S$ 50 S$ 40 Nil Nil Nil S$ 100 S$ 80 S$ 40 Nil Nil S$ 150 S$ 120 S$ 80 Nil Nil S$ 1,000 S$ 1,000 S$ 1,000 S$ 1,000 S$ 1,000 S$ 5,000 S$ 5,000 S$ 5,000 S$ 5,000 S$ 5, Pro-ration factor for: Plan 2 & 3 Applicable to items 4 7 Plan 4 & 5 Applicable to items 2 7 Nil 75% applies if Insured Member stays in 1 Bedded ward (Private or Government Restructured) 75% applies if Insured Member stays in 2 Bedded or higher ward (Private or Government Restructured) 75% applies if Insured Member stays in 4 Bedded or higher ward (Private) or 2 Bedded or higher ward (Government Restructured) 75% applies if Insured Member stays in 1 Bedded ward (Private) 18 Complimentary Health Screening (For employee only) Applicable for group size >10 eligible employees 4 i. Waiver of surgical schedule if insured member is admitted to government restructured hospital. ii. Surgical fee more than S$1,500 is subject to surgical schedule if insured member is admitted to a private hospital. PRUtreasures flexi 07

8 ANNUAL PREMIUM RATE GROUP HOSPITAL & SURGICAL For Employee Only (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 1, S$ 1, S$ S$ S$ S$ 2, S$ 1, S$ 1, S$ S$ 1, S$ 3, S$ 2, S$ 2, S$ 1, S$ 1, For Employee and Spouse or Children Coverage Only (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 1, S$ 1, S$ S$ S$ S$ 2, S$ 1, S$ 1, S$ S$ 1, S$ 2, S$ 2, S$ 1, S$ 1, S$ 1, S$ 3, S$ 2, S$ 2, S$ 1, S$ 1, S$ 5, S$ 4, S$ 3, S$ 1, S$ 2, S$ 7, S$ 5, S$ 4, S$ 2, S$ 3, For Employees and Spouse and Children Coverage (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ 1, S$ 1, S$ S$ S$ S$ 1, S$ 1, S$ S$ S$ S$ 1, S$ 1, S$ S$ S$ S$ 1, S$ 1, S$ 1, S$ S$ S$ 1, S$ 1, S$ 1, S$ S$ S$ 1, S$ 1, S$ 1, S$ S$ 1, S$ 2, S$ 1, S$ 1, S$ S$ 1, S$ 3, S$ 2, S$ 1, S$ 1, S$ 1, S$ 4, S$ 3, S$ 2, S$ 1, S$ 2, S$ 5, S$ 4, S$ 3, S$ 2, S$ 3, S$ 8, S$ 6, S$ 5, S$ 2, S$ 4, S$ 12, S$ 9, S$ 7, S$ 3, S$ 5, For renewals only. GROUP SIZE DISCOUNT FOR GROUP HOSPITAL & SURGICAL GROUP SIZE (INSURED EMPLOYEES) DISCOUNT % 16 and above 10% 08 PRUtreasures flexi

9 Enhance Your PRUtreasures flexi Plan According To Your Needs PRUtreasures flexi offers supplementary benefits to complement the core coverage. Depending on the core plans selected, you can choose up to 7 optional supplementary benefits to suit your company s budget and needs. GROUP CRISIS COVER ACCELERATED/ RIDER TO GROUP TERM LIFE BENEFITS / PLAN TYPE PLAN 1 6 PLAN 2 PLAN 3 PLAN 4 PLAN 5 Group Crisis Cover Accelerated S$ 250,000 S$ 100,000 S$ 75,000 S$ 40,000 S$ 25,000 ANNUAL PREMIUM RATE GROUP CRISIS COVER ACCELERATED AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 1, S$ S$ S$ S$ S$ 3, S$ 1, S$ 1, S$ S$ S$ 5, S$ 2, S$ 1, S$ 1, S$ S$ 7, S$ 3, S$ 2, S$ 1, S$ Health declaration required. 7 For renewals only. Note: Coverage for Group Crisis Cover Accelerated benefit ceases at age 70 last birthday. GROUP ACCIDENTAL DEATH & DISMEMBERMENT / RIDER TO GROUP TERM LIFE OR GROUP HOSPITAL & SURGICAL WITH OPTIONAL BENEFIT: GROUP ACCIDENTAL MEDICAL REIMBURSEMENT BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 Group Accidental Death & Dismemberment S$ 500,000 S$ 200,000 S$ 150,000 S$ 80,000 S$ 50,000 Optional Benefit: Accidental Medical Reimbursement S$ 5,000 ANNUAL PREMIUM RATE (inclusive of 7% GST) GROUP ACCIDENTAL DEATH & DISMEMBERMENT OCCUPATIONAL CLASS Class 1 Class 2 Class 3 AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ PRUtreasures flexi 09

10 ANNUAL PREMIUM RATE (inclusive of 7% GST) GROUP ACCIDENTAL MEDICAL REIMBURSEMENT OCCUPATIONAL CLASS Class 1 Class 2 Class 3 AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ For renewals only. GROUP EXTENDED MAJOR MEDICAL / RIDER TO GROUP HOSPITAL & SURGICAL BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 Provides reimbursement of eligible expenses in excess of Basic GHS if: a) Hospitalisation is at least 20 days; or b) Surgical Percentage is at least 75% per incision S$ 80,000 per disability S$ 60,000 per disability S$ 40,000 per disability S$ 20,000 per disability S$ 60,000 per disability Daily Home Nursing Benefit (max. per day, up to 30 days per disability) HIV Due to Blood Transfusion and Occupationally Acquired HIV Parent Accommodation (up to 60 days for accompanying child age 12 and below) Deductible S$ 80 per day for all plans (subject to respective benefit limit) S$ 5,000 per policy year for all plans (subject to respective benefit limit) S$ 100 per day for all plans (subject to respective benefit limit) As per Basic GHS Co-Insurance 20% 10 PRUtreasures flexi

11 ANNUAL PREMIUM RATE GROUP EXTENDED MAJOR MEDICAL For Employee Only (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ For Employee and Spouse or Children Coverage Only (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ For Employee and Spouse and Children Coverage Only (inclusive of 7% GST) AGE LAST BIRTHDAY PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN S$ S$ S$ S$ S$ S$ S$ S$ S$ S$ For renewals only. PRUtreasures flexi 11

12 GROUP OUTPATIENT GENERAL PRACTITIONER / RIDER TO GROUP TERM LIFE 10 OR GROUP HOSPITAL & SURGICAL BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 PLAN 6 a Panel Registered Medical Practitioner Cashless b Non-Panel Registered Medical Practitioner (covers treatment in Singapore only) Reimbursement up to S$30 per visit c Singapore Government Polyclinic Full Reimbursement d Accident & Emergency Department in Singapore Hospitals Reimbursement up to S$100 per visit (capped at 2 visits per policy year) e Paediatrician Direct Access Reimbursement up to S$30 per visit f Overseas Registered Medical Practitioner Reimbursement up to S$100 per visit g Registered Traditional Chinese Medicine Practitioner (TCM) (Consultation and Medicine) Reimbursement of up to S$30 per visit (capped at 6 visits per policy year) Not Applicable h Co-Payment per visit (applicable for all benefits) NIL S$ 5 S$ 10 NIL S$ 5 S$ 10 ANNUAL PREMIUM RATE (inclusive of 7% GST) GROUP OUTPATIENT GENERAL PRACTITIONER PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 PLAN 6 Annual Premium S$ S$ S$ S$ S$ S$ GROUP OUTPATIENT SPECIALIST/ RIDER TO GROUP TERM LIFE 10 OR GROUP HOSPITAL & SURGICAL BENEFITS / PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 a Specialist Consultation at Singapore Govt Restructured Hospital (GRH) (recommended by a Registered Medical Practitioner) S$ 2,000 per policy year S$ 1,500 per policy year S$ 1,000 per policy year b Specialist Consultation at Private Hospital (PTE) (recommended by a Registered Medical Practitioner) S$ 800 per policy year S$ 400 per policy year S$ 200 per policy year Overall policy year limit of S$ 500 c All other Diagnostic X-Ray and Lab Test (GP or SP referral required) S$ 800 per policy year S$ 400 per policy year S$ 200 per policy year ANNUAL PREMIUM RATE (inclusive of 7% GST) GROUP OUTPATIENT SPECIALIST PLAN TYPE PLAN 1 PLAN 2 PLAN 3 PLAN 4 Annual Premium S$ S$ S$ S$ GP and SP are to be taken up together if they are taken up as a rider to GTL. 12 PRUtreasures flexi

13 GROUP DENTAL / RIDER TO GROUP HOSPITAL & SURGICAL BENEFITS / PLAN TYPE PLAN 1 1 Medication Fee 2 X-Ray 3 Prophylaxis Treatment (General Scaling and Polishing) 4 Fillings 5 Simple and Surgical Extraction 6 Root Canal Treatment As charged for items 1 to 9 7 Gum Treatment (including Curettage) 8 Periodontal Surgery 9 Repairs of Dentures, Crowns and Bridges Due to Accident 10 Overall Dental's Limit (per policy year) S$ Co-insurance 20% ANNUAL PREMIUM RATE (inclusive of 7% GST) GROUP DENTAL PLAN TYPE PLAN 1 Annual Premium S$ Occupational Class Class 1 Clerical, administrative or other similar non-hazardous occupations Class 2 Occupations where some degree of risk is involved, e.g. supervision of manual workers, totally administrative job in an industrial environment Class 3 Occupations involving regular light to medium manual work but no substantial hazard which may increase the risk of sickness or accident Class 4 Not covered Call your Prudential Financial Consultant or our PruCustomer Line at today, or visit PRUtreasures flexi 13

14 Underwriting Guidelines for PRUtreasures flexi Period of Insurance: Duration of coverage is for 12 months. Coverage starts from stated effective date upon clearance of required MAS 314 and Compliance checks. Age Eligibility: 1) Employees All benefits, except Group Crisis Cover Accelerated, are available to eligible employees of age 16 to 69 inclusive, and renewable up to age 74. Group Crisis Cover Accelerated is available to eligible employees of age 16 to 64 inclusive, and renewable up to age 69. 2) Dependants A) the Insured Member s spouse who is: below 69 years old at his last birthday, and up to 74 years old at his last birthday; and not an Insured Member under this Policy; or B) the Insured Member s natural or step child from a legal marriage or legally adopted child who is: two (2) weeks old; or up to 25 years old at his last birthday, and is single and unemployed. (Note: National Service Personnel are not covered) Based on age last birthday. Eligibility and Participation Requirements: All full time and work-active employees, directors, partners and proprietors. Eligible dependants can select Group Hospital & Surgical and its supplementary benefits. Dependant's plan must be the same as Employee s plan. The Company can choose Group Term Life and/or Group Hospital & Surgical as their basic core plan(s). If dependant s coverage is taken up, it will apply to all eligible employees in the same classification. PRUtreasures flexi is available to companies with a minimum of 3 employees. Insurance cover must be provided to all specified categories of employees on a compulsory basis. All benefits are applicable for Occupational Class 1 to 3 only. For employees holding a Singapore Ministry of Manpower's S Pass or work permit, the Company can choose any plan under Group Hospital & Surgical with Group Extended Major Medical. Take-over clause is applicable if the Company has prior Group Employee Insurance cover with a headcount of 25 standard life employees and above. Take-over refers to waiver of pre-existing conditions. This feature is only available for GHS and its medical riders. However, the 12 months waiting period will apply to members who have not been continuously insured under the existing group insurance policy for 12 months. Member listing from previous insurer is required to be provided for take-over to be approved. Coverage is only applicable to groups with the majority of employees (at least 50%) working in Singapore, and the rest of the employees based in the following countries: i. Brunei ii. Indonesia (Jakarta only) iii. Japan iv. Malaysia v. Macau vi. Philippines (Manila only) vii. People's Republic of China (except Xinjiang and Tibet) viii. South Korea ix. Taiwan x. Thailand 14 PRUtreasures flexi

15 An individual is considered a resident of Singapore or a resident of the above countries on the basis that the individual does not travel or work outside of Singapore or the above countries for more than 180 cumulative days in any 365 consecutive days. Plan selection for GTL and GCCA must be the same if GCCA is taken up. Crossing of plans between GTL and GADD is allowed i.e. GADD s plan selection/sum Assured can be higher than GTL. Plan selection for GHS and GEMM must be the same if GEMM is taken up. GP and SP are to be taken up together as a rider to GTL and GHS. GP can be taken up on stand-alone basis as a rider to GHS. Pre-Existing Conditions GHS: Shall not pay if the loss or disability arises out of a pre-existing condition, unless the insured member has been insured under this policy continuously for 12 months. All pre-existing conditions are permanently excluded for outpatient kidney dialysis or outpatient cancer treatment benefits. Pre-Existing Conditions GEMM: Shall not pay if the loss or disability arises out of a pre-existing condition for which the insured member received medical treatment, diagnosis, consultation or prescribed drugs during the 24 months preceding the policy effective date of the coverage. All pre-existing conditions are permanently excluded for outpatient kidney dialysis or outpatient cancer treatment benefits. Pre-Existing Conditions GTL: Shall not pay if the loss or disability arises out of a pre-existing condition, unless the insured member has been insured under this policy continuously for 12 months. Pre-Existing Conditions GCCA: Shall not pay if the loss or disability arises out of a pre-existing condition. Premium: Premium rates are in Singapore Dollars. The premium rates are based on age last birthday of individual employees. Payment of premium is to be made annually. Medical Underwriting: Employee (16 to 64 age last birthday) selecting Plan 1 of Group Term Life will require underwriting. Employee (16 to 64 age last birthday) selecting Plan 1 of Group Crisis Cover Accelerated will require underwriting. Employee (from 65 age last birthday onwards) selecting Group Term Life will require underwriting. For Group Term Life, employee of 70 to 74 age last birthday will require underwriting at each renewal. Required Documents: Application Form. A copy of the duly completed, company stamped and signed MAS Notice 314 Declaration on Parties Relevant to the Policyholder Form. Business Profile report from the Account & Corporate Regulatory Authority (ACRA). Health Declaration Form when Medical Underwriting is required. Note: You are recommended to seek advice from a qualified Prudential Financial Consultant for a financial analysis before purchasing a policy suitable to meet your needs. This plan has no cash value. Buying health insurance products that are not suitable for you may impact your ability to finance your future healthcare needs. Premiums are not guaranteed and may be adjusted based on future claims experience. This brochure is for reference only and is not a contract of insurance. Please refer to the exact terms and conditions, specific details and exclusions applicable to these insurance products in the policy documents that can be obtained from your Prudential Financial Consultant. This brochure is for distribution in Singapore only and shall not be construed as an offer to sell or solicitation to buy or provision of any insurance product outside Singapore. Information is correct as at 30 Nov PRUtreasures flexi 15

16 PruCustomer Line: PRUtreasures flexi APPLICATION FORM WARNING: PURSUANT TO SECTION 25(5) OF THE INSURANCE ACT (CAP 142), YOU ARE TO DISCLOSE IN THIS APPLICATION FORM FULLY AND FAITHFULLY ALL THE FACTS WHICH YOU KNOW OR OUGHT TO KNOW, OTHERWISE YOU MAY RECEIVE NOTHING FROM THE POLICY. Declaration Please read carefully before signing this PRUtreasures flexi application form. I understand that the assurance will not commence until the proposal has been officially accepted by Prudential Assurance Company Singapore (Pte) Limited ("Prudential Singapore"), premiums have been paid and an official letter indicating cover has commenced has been issued. I declare that the information given in this form and any information supplied to Prudential Singapore or the Medical Examiner of Prudential Singapore is true, and that no material facts, that is, facts likely to influence the assessment and acceptance of this proposal, have been withheld and to the best of my knowledge and belief the information given herein is true and complete. I agree to pay Prudential Singapore the amount of any medical fee incurred should I fail to take up the coverage after the date of Prudential Singapore's letter notifying me of the acceptance of the proposal's standard rates. We declare and confirm that our employees have given us their consent to Prudential Singapore, its officers and employees, in collecting, using and disclosing any and all information relating to them in this form to any of Prudential Singapore's contractors or third party service providers or distribution partners, any regulatory, supervisory or other authority, court of law, for the purpose(s) of underwriting, claims assessment and customer servicing. Name of ("Company") : Company Address : Nature of Business : Effective date of Policy (DD/MM/YY) : (date must be on or after the date of application) Effective date of new employees : on the date of employment OR months from the date of employment Checklist of Required Documents Application Form A copy of the duly completed, company stamped and signed MAS Notice 314 Declaration on Parties Relevant to the Policyholder Form and MAS 314 Declaration on Beneficial Owner(s) Form (in the event that there are Corporate Shareholders Owning 25% of the company). Health Declaration (Applicable if GTL Plan 1 is selected for employee or medical underwriting is required) If a material fact is not disclosed in this proposal, any policy issued may not be valid. If you are in doubt as to whether a fact is material, you are advised to disclose it. This includes any information that you may have provided to the agent but was not included in the proposal. Please check to ensure you are fully satisfied with the information declared in this proposal. Name of Authorised Signatory : Choice of Options Designation : CORE OPTIONS GTL (Group Term Life) GCCA (Group Crisis Cover Accelerated) GADD (Group Accidental Death & Dismemberment) GADD + GAMR (Group Accidental Death & Dismemberment with Accidental Medical Reimbursement) GP + SP (Group Outpatient General Practitioner with Group Outpatient Specialist) HR Address : HR Contact No : Date of Application : Company Stamp : Signature of Authorised Signatory : GHS (Group Hospital & Surgical Plan) GEMM (Group Extended Major Medical ) GP (Group Outpatient General Practitioner) GP + SP (Group Outpatient General Practitioner with Group Outpatient Specialist) GDEN (Group Dental) GADD (Group Accidental Death & Dismemberment) GADD + GAMR (Group Accidental Death & Dismemberment with Accidental Medical Reimbursement) Name of Financial Consultant : Financial Consultant Code : Location : Contact No : Signature : Tick where appropriate 16 PRUtreasures flexi

17 No. Name (Please underline surname) NRIC / Passport no. Gender (M/F) DOB (DD/MM/ YYYY) Age Last Birthday Marital Status Occupation Dependants (S/C) Nationality Country of Residence 1 Date of Employment (DD/MM/ YYYY) Corporate Address (Please note that e-claims can only be set up for employees with corporate addresses) GTL Core (Employee Only) GCCA 3 (Option to GTL Core) (Employee Only) GADD (Option to GTL Core or GHS Core) (Employee Only) Plan no. Premium Plan no. Premium Plan no. Occ Class Premium With GAMR (Y/N) Premium Plan no. Plan Type 5 (EO/ES/ EC/EF) GHS Core Total Lives Premium Plan no. GEMM 4 (Option to GHS Core) Plan Type 5 (EO/ES/ EC/EF) Total Lives Premium Plan no. GP 2 (Option to GTL Core or GHS Core) No. of Deps Covered for GP Premium Plan no. SP 2 (Option to GTL Core or GHS Core) No. of Deps Covered for SP Premium Plan no. Dental (Option to GHS Core) No. of Deps Covered for Dental Premium Total Amount Payable: (before group size discount if any) $ NOTE: Premium amounts may differ due to the rounding factor and the entitled group discount (if any). Please pay the stated amount based on the Premium Notice. 1 Please refer to the brochure for the list of accepted countries where the employees are residing. Kindly note that the following provinces/areas are not covered. Country Indonesia Philippines People's Republic of China Provinces/areas All except Jakarta All except Manila Xinjiang and Tibet 2 For Option to GTL Core, GP is to be bundled with SP. For Option to GHS Core, the selection can be either GP only or GP + SP. 3 Plan selection for GTL and GCCA must be the same if GCCA is taken up. 4 Plan selection for GHS and GEMM must be the same if GEMM is taken up. 5 Plan Type: EO for employee coverage only. ES for employee and spouse coverage. EC for employee and children coverage. EF for employee and spouse and children coverage. DECLARATION BY COMPANY I / We hereby declare that, to the best of my / our knowledge and belief, the information given here is true and complete, and agree that if a contract of insurance is effected, all information submitted in connection with this application shall form the basis of such contract between the Company and the Insurer. Signature & Name of Authorised Officer NRIC / Passport no. : Designation Company Stamp : : DECLARATION BY INSURANCE REPRESENTATIVE I / We hereby declare and acknowledge that I / we have reviewed this form with the authorised officer of the Company, and that I / we have verified that all information in this form is true and complete. Signature & Name of Insurance Representative NRIC / Passport no. : Agency Code Agency Location : :

18 PruCustomer Line: Page 1 of 4 GROUP HEALTH DECLARATION PTRF Sum Assured Sum Assured (FCL) FOR OFFICE USE ONLY GTL/TPD GCCA WARNING: YOU ARE REQUIRED TO FULLY AND FAITHFULLY DISCLOSE ALL THE FACTS THAT YOU KNOW OR OUGHT TO KNOW. OTHERWISE, YOUR INSURANCE COVERAGE PROVIDED UNDER THIS PLAN MAY BE VOID. Name of Company Group Policy No. Details of Employee Full Name of Employee in Block (as shown in NRIC - underline surname) NRIC/FIN/Passport No. Date of Birth Gender Male / Female Marital Status Occupation Date of Employment Monthly Salary S$ Country of Residence Nationality Height (cm) Weight (kg) Health Declaration (All questions must be answered and any alteration must be signed) Employee 1. Do you engage in military or private flying other than as passenger travelling solely for transport or in hazardous pursuits such as but not limited to scuba diving, mountain and climbing sport, free fall parachuting, sky diving and motor racing? If Yes, please state details on activity, depth dived, locations and frequency in the box provided on the right. Yes No 2. Have you taken narcotics, any habit forming drugs or ever been treated for drug or alcohol addiction? If Yes, please provide details including name of substance, date, treatment, name & address of doctor in the box provided on the right. Continued next page

19 Page 2 of 4 Name of Employee: NRIC/ FIN/ Passport No.: Group Policy No. GROUP HEALTH DECLARATION Health Declaration (All questions must be answered and any alteration must be signed) Employee 3. Do you have any health or life insurance application that has been rejected, postponed or accepted at special rates or terms by any insurance company? If Yes, please provide details on date/type of application and reason for special terms in the box provided on the right. 4. Have you in the last 3 months had any of the following symptoms for more than one week continuously: fatigue, weight loss, diarrhoea, enlarged nodes or unusual skin lesions? If Yes, please provide details including date, diagnosis, treatment, name & address of doctor in the box provided on the right. Yes No 5. Do you smoke any cigarettes? If Yes, please state number of years and the number of sticks per day No. of years: No. of sticks (per day): 6. Do you consume alcohol? If Yes, please state the type, quantity and frequency Type: Quantity: Frequency (per week): 7. Have you or any of your family members, ever been told to have, received any medical advice, counseling or treatment in connection with sexually transmitted disease, AIDS, AIDS Related Complex or any other AIDS related conditions? If Yes, please provide details including date, relationship, diagnosis, treatment, name & address of doctor in the box provided on the right. 8. In the past 5 years, have you attended to any tests such as X ray, ultrasound, CT scan, biopsy, electrocardiogram (ECG), endoscopy, blood or urine test? If Yes, please provide details including date/type/reason/results of test done, treatment, name & address of doctor in the box provided on the right. 9. Have either of your natural parents or siblings died or suffered from cancer, heart disease, stroke, high blood pressure, diabetes, kidney disease, mental disorder, dementia, tuberculosis, Down s syndrome or any hereditary disease? Relationship Condition/ Cause of Death Age of Onset If Deceased, Age of Death If Yes, please provide full details in the box provided on the right.

20 Page 3 of 4 Name of Employee: NRIC/ FIN/ Passport No.: Group Policy No. GROUP HEALTH DECLARATION Health Declaration (All questions must be answered and any alteration must be signed) Employee 10. Have you EVER had or been told you had or been treated for: a) asthma, bronchitis, persistent cough, tuberculosis or respiratory disorder? b) epilepsy, fits, stroke, paralysis, weakness of limb, prolonged headache/giddiness, unconsciousness, nervous breakdown, depression or any other nervous/mental disorders or any disease of the brain? Yes No c) gastritis, stomach or duodenal ulcer, blood in stools, fistula, piles or any other stomach or bowel disorders? d) blood, protein or sugar in urine, kidney stones, infection or any other disorders of the kidney, bladder or genital organs? e) anaemia, diabetes, thyroid disorders or any other endocrine disorder? f) cancer, tumour, cyst or growth of any kind? g) any form of eye, hearing or speech disorder or disease? h) jaundice, Hepatitis B carrier or any form of hepatitis, liver or gallbladder disorders? i) slipped disc, gout, arthritis, pain or deformity or disorders of the muscles, spine, limbs or joints or severe injury? j) raised cholesterol, high blood pressure, heart attack, heart murmur, irregular or fast heart rate, chest discomfort or pain, diseases or any other disorders of the heart, heart valves or blood vessels? k) any other illness, disorder, injury, disability, operation or hospitalisation not mention above? 11. For Female Insured only a) Have you ever had any abnormal pap smear test or been told by a doctor to have a repeat pap smear within the next 6 months? If yes, advise the date and result of the test and enclose a copy of the result, if available. b) Have you had an abnormal mammogram or been advised to have mammogram,ultrasound, biopsy, operation of the breasts, ultrasound of pelvis or attended to any other gynecological investigations? c) Have you ever consulted a doctor for irregular, painful menstruation or other problems(s) involving the female organs? d) Have any of your family members been diagnosed with breast cancer? If Yes, please provide full details in the box provided on the right. Relationship to Insured Age of Diagnosis e) Are you currently pregnant? If Yes, please state no of months Continued next page

21 Page 4 of 4 Name of Employee: NRIC/ FIN/ Passport No.: Group Policy No. GROUP HEALTH DECLARATION If any of the answer to Questions 10 and 11 is Yes, please provide details below for each condition: Qn No. Name of Insured Name of Condition / Treatment Date of Test / Diagnosis Duration of Illness / injury Result / Reason for Test done Name & Address of Doctors / Clinics / Hospitals Consent, Declaration and Authorisation - Please read carefully before signing this Group Health Declaration Form. I/We consent to Prudential Assurance Company Singapore (Pte) Limited ( Prudential ), its officers and employees : a) Collecting and using at their sole discretion any and all information relating to me/us, including my/our personal particulars, in this Group Health Declaration for the purposes of underwriting; and b) Disclosing at their sole discretion any and all information relating to me/us, including my/our personal particulars, in this Group Health Declaration to the servicing intermediary for the above group policy for the purpose of customer service. I/We declare that no material facts, that are facts likely to influence the assessment and acceptance of my/our group application, have been withheld and the Information given above is true and complete and best to my/our knowledge and they shall be the basis of the issuance of my/our group insurance coverage. I/We agree to inform Prudential if there is any change in the state of my/our health/activity between the date of this Health Declaration or medical examination and the date of full insurance coverage provided by Prudential to me/us. I/We understand that the terms of accepting me/ us as a risk for insurance coverage may vary according to such information received. I/We agree and authorise any medical source (i.e. physician and hospital), insurance office or organisation that has my/our records to release to Prudential any relevant information at any time for the purpose of underwriting this group application. A photographic copy of this authorisation shall be as valid as the original. I/We further declare that I/we have read and understood the Your Guide To Health Insurance and Product Summary (applicable to voluntary coverage only). Signature of Employee Date: Signature/Name/Designation of Witness (Employer) Date: EBS HD Oct 2017 (PTRF) Prudential Assurance Company Singapore (Pte) Limited (Reg. No Z) Employee Benefit Solutions Address: Singapore Post Centre Post Office PO Box 399 Singapore sgp.employeebenefitsolutions.billing@prudential.com.sg Fax:

22 PruCustomer Line: Page 1 of 2 MAS NOTICE 314 DECLARATION ON PARTIES RELEVANT TO THE POLICYHOLDER Proposal / Policy Number The information requested in this form must be provided in order to comply with the mandatory requirements of MAS Notice 314 Preventing Money Laundering and Countering the Financing of Terrorism Life Insurance (MAS 314). The personal data collected in this form, in other documents or provided to Prudential Assurance Company Singapore (Pte) Limited ( Prudential ) shall be used for the purposes stated in the proposal form and Prudential s Privacy Notice (which is available at The personal data may be collected, used and/or disclosed by Prudential, its officers, associated organisation(s) employee representative(s), third party distributors and other organisations stated in Prudential's Privacy Notice whether in Singapore or outside Singapore. (A) Name of Policyholder / Insured Company(ies) / Assignee(s) / Applicant(s) / Beneficiary(ies) (delete accordingly) (B) Principal Place of Business ( PPOB ) PPOB refers to the main operating office where the senior management of the policyholder resides. Is the PPOB different from the registered or business address Yes No If yes please provide PPOB in the space provided (C) Information on Chairman / CEO / Managing Partner of the company(ies) stated in (A): Full Name (including any aliases : (1) Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Designation : Chairman / CEO / Managing Partner (delete accordingly) (2) Mr / Mrs / Ms / Mdm (delete accordingly) Chairman / CEO / Managing Partner (delete accordingly) Company Name : NRIC / Passport No. : Date of Birth : Nationality : Full Name (including any aliases : (3) Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Designation : Chairman / CEO / Managing Partner (delete accordingly) (4) Mr / Mrs / Ms / Mdm (delete accordingly) Chairman / CEO / Managing Partner (delete accordingly) Company Name : NRIC / Passport No. : Date of Birth : Nationality : Full Name (including any aliases : (5) Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) (6) Mr / Mrs / Ms / Mdm (delete accordingly) Designation : Chairman / CEO / Managing Partner (delete accordingly) Chairman / CEO / Managing Partner (delete accordingly) Company Name : NRIC / Passport No. : Date of Birth : Nationality : Version Oct 2017 Continued next page

23 Page 2 of 2 MAS NOTICE 314 DECLARATION ON PARTIES RELEVANT TO THE POLICYHOLDER Proposal / Policy Number (D) Person(s) authorised to act on matters relating to the purchase of the Policy / assigned Policy Declaration by Representative of the policyholder/ insured company/ assignee / applicant / beneficiary/ trustee (This Representative could be the CEO, Directors (listed in the ACRA), Managing Director, Partner or Managing Partner of the company/policyholder.) I declare that the information given in this form is complete and accurate. I shall promptly inform Prudential of changes to such natural person s information in this form. I acknowledge and agree that if the information disclosed in this form is incomplete and/or inaccurate, some or all of the benefits under the policy issued to the Policyholder may not be available. I further acknowledge and agree that Prudential has the right to request supporting documents in relation to the information disclosed in this form. Note: This declaration shall be accompanied by a copy of the NRIC/Passport/FIN containing a clear photograph of the representative and all authorised person(s). Full Name (including any aliases as per identification document) : Mr / Mrs / Ms / Mdm (delete accordingly) Signature with company stamp: Designation : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Date: Please tick this box if the representative is also an authorised person. If there are other authorised person(s) appointed to act on matters relating to the policy(s), please provide their details in the fields below: Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) Signature: as per identification document) Designation : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Designation : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Signature: Signature: Designation : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Note: Please complete a separate form, signed by the Representative, if fields provided are insufficient under items (A) - (D). Version Oct 2017

24 PruCustomer Line: Page 1 of 2 MAS 314 DECLARATION ON BENEFICIAL OWNER(S) Proposal / Policy Number The information requested in this form must be provided in order to comply with the mandatory requirements of MAS Notice 314 Preventing Money Laundering and Countering the Financing of Terrorism Life Insurance (MAS 314). The personal data collected in this form, in other documents or provided to Prudential Assurance Company Singapore (Pte) Limited ( Prudential ) shall be used for the purposes stated in the proposal form and Prudential s Privacy Notice (which is available at The personal data may be collected, used and/or disclosed by Prudential, its officers, associated organisation(s), employees, representative(s), third party distributors and other organisations stated in Prudential s Privacy Notice whether in Singapore or outside Singapore. (I) Name of Policyholder / Insured Company(ies) / Assignee(s) / Applicant(s) / Beneficiary(ies) (delete accordingly) (II) Beneficiary owner(s) is either a (a) natural person who ultimately owns or controls the beneficiary /proposer /assignee /applicant (with shareholding of 25% of the company s ordinary shares) or the natural person on whose behalf business relations are established; or (b) natural person who does not meet the shareholder threshold and who exercises significant influence (i.e. board of directors of corporate shareholder owing the policyholder, person financing the policy) over the beneficiary /proposer /assignee /applicant. (III) Information on all shareholder(s) or ultimate shareholder who are non-natural person with shareholding of 25% of the ordinary shares of company stated in (I): Section (A): Corporate Shareholder(s) ( CSH ) directly owning 25% of the policyholder (1) Name of Corporate Shareholder ( CSH ) (2) Percentage of shareholding A1 A2 A3 A4 ( ) % ( ) % ( ) % ( ) % Section (B): CSHs owning 25% of the policyholder through ordinary shares of CSHs listed in (A) (3) Name of CSH(B) owing CSH(A) listed in section (A) (4) * CSH of (5) % owned in CSH [listed in section (A)] B1 B2 B3 B4 A( ) A( ) A( ) A( ) % % % % (4)* Please indicate within the bracket the corresponding number in Part II Section (A). In the event that there are CSHs owning 25% of the company in Section B, please provide their details on a separate form signed by the Representative. (IV) Details of all beneficial owner(s) as defined in (II) of the companies listed in Part (III) A and/or B or any natural person who exercise significant influence over the Policyholder(s) / Insured Companies / Assignee(s) / Applicant(s) / Beneficiary(ies). Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Percentage of Shareholding (ordinary shares): Relationship to the Policyholder : NRIC / Passport No. : Date of Birth : Name of company: Nationality : Country of Residence : Version Oct 2017 Continued next page

25 Page 2 of 2 MAS 314 DECLARATION ON BENEFICIAL OWNER(S) Proposal / Policy Number Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Percentage of Shareholding (ordinary shares): Relationship to the policyholder : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Name of Company: Percentage of Shareholding (ordinary shares): Relationship to the policyholder : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Full Name (including any aliases : Mr / Mrs / Ms / Mdm (delete accordingly) as per identification document) Name of Company: Percentage of Shareholding (ordinary shares): Relationship to the policyholder : NRIC / Passport No. : Date of Birth : Nationality : Country of Residence : Name of Company: Note: Please complete a separate form, signed by the Representative, if fields provided are insufficient. Declaration Declaration by Representative of the policyholder / insured company / assignee / applicant / beneficiary / trustee (This Representative could be the CEO, Directors (listed in the ACRA), Managing Director, Partner or Managing Partner of the company /policyholder.) I declare that the information given in this form is complete and accurate. I shall promptly inform Prudential of changes to such natural person s information in this form. I acknowledge and agree that if the information disclosed in this form is incomplete and /or inaccurate, some or all of the benefits under the policy issued to the Policyholder may not be available. I further acknowledge and agree that Prudential has the right to request supporting documents in relation to the information disclosed in this form. Full Name of Representative (including any aliases as per identification document) : Signature with company stamp: Designation : Company Name : NRIC / Passport No. : Date: Nationality : Country of Residence : Version Oct 2017