Europat Gold EU. Keynotes

Transcription

1 Keynotes Europat Gold EU

2 Who is Expat & Co? Expat & Co is the specialist underwriter of insurances for expats, international students and other globally mobile people; Expat & Co has a license to work in all countries of the EEA; Expat & Co s insurance policies have been developed to travel with you around the globe; Your policy is portable when you relocate and adapts to your new environment and social security (Chameleon principle); Enjoy continuity of coverage, wherever you are; But our clients always need to have a European link (European national, non-european living in Europe, working for European organisations).

3 Expat & Co s Groundbreaking Chameleon Principle Most European countries have a national health system (social security) in place to which you make compulsory contributions. There are 2 types of public health care: Reimbursement System ( Bismarckian or Mutual Insurance Model): Free choice of doctor Pay first and claim later (reimbursement) Care-in-Kind system ( Beveridge model or National Health Service ): Only in public hospitals and with state doctors For free (care-in-kind), no administration The Reimbursement System is an insurance model, Care-in-Kind isn t.

4 Expat & Co s Groundbreaking Chameleon Principle Why pay twice for similar coverage? Why pay for a full, private insurance from the very 1st if you already have a basic insurance in place? To answer this Expat & Co has developed a number of insurance solutions under the Chameleon Principle which offer different settings: Full cover ( 1st or Integral insurance) when you have no social security or a Care-in-Kind system, to offer you free choice doctor/hospital; Top-Up ( Additional insurance) where there is a reimbursement system in place; Sleeper when you have temporarily an employer policy, and you don t want to lose your medical underwriting/acceptation; You can switch from one system to another within the same policy. Europat Gold EU is a Chameleon Principle insurance package.

5 Expat & Co s Groundbreaking Chameleon Principle Never pay for double cover again Expat & Co s insurance can Top-up most reimbursement systems in the world: AT BE(RIZIV/INAMI), BE(DOSZ/OSSOM) CH CZ DE EE FR(CPAM/CMU), FR(CFE) JP LI LU NL (restitutie) UAE (Dubai & Abu Dhabi) Systems of international institutions (EU, UN, FAO) > Why not the Greek system? There aren t enough State Guarantees.

6 Expat & Co s Groundbreaking Chameleon Principle Simply enjoy Switch seamlessly from one system to another within the same policy depending on your needs and enjoy continuity of coverage with the flexibility of a policy that travels with you, wherever you go.

7 Claims Handling N Medical Claims [download our Claims Manual] [download our USA Claims Manual] Hospitalisation: direct payment to all hospitals in the world willing to accept our payment guarantee; Outpatient claims: pay yourself & claim afterwards; In US: direct payment to all providers of the Olympus network ( ), outside the network: pay & claim. A 20% co-pay may be asked of you. N Other claims: find claim forms [here] N Send bills, payment proofs, prescriptions and claim form to Expat&Co: Per post (including the originals); Electronically (may be refused); Conditions for electronic claims : Scans/copies must be complete and well readable Keep the originals for at least 1 year (for questions or audits) Top-Up is only possible if first sent to Mutual health fund (send copies of all documents sent to Mutual fund + their reimbursement overview to Expat &Co)

8 Taxes and Administration Costs N European taxes are applied according to the country of the policyholder s address. Addresses outside Europe do not pay tax on Expat & Co policies. N Parafiscal taxes of 10% are applied in Belgium (RIZIV/INAMI tax): If insured s residence is in Belgium; AND he/she has Belgian social security (Belgian Mutual health fund); A further 9,25% additional to Belgian fiscal taxes is applied to the following covers: LP Hospital Plan All Assistance policies N Expat & Co charges an administration cost of 10 (5 in GSI) for every new policy certificate or change.

9 Expat & Co Products Europat Local Plus: insurance package for expats Europat Gold EU: insurance package for EU Officials Global Student Insurance: insurance package for students, interns and university staff. Also used for au-pairs. Global Family Insurance: insurance package for world travellers, low budget expats and other mobile people with temporary insurance needs. Global Care Insurance: insurance package for NGO s Business Travellers Insurance: travel insurance for business travellers, conference organisers Schengen Zone Insurance: travel insurance for guests from outside Europe

10 Product: Europat Gold EU N Type of insurance: insurance package for EU-Officials N Who can apply? All individuals and families who have RCAM/JSIS as basic cover; Max. ages can differ per cover. N How to apply? Individual underwriting [online] Medical questionnaire or examination (see further down) N What if you leave RCAM/JSIS? You can switch your policy to a normal Europat Local Plus policy (Gold version); In case of retirement, your policy will continue under the same conditions. N Possible premium fractions: annual, semi-annual (+2%), quarterly (+3%), monthly (+5%)

11 Product: Europat Gold EU N Product schedule Module 1 Medical care (additional to RCAM/JSIS) hospital plan, elective home country treatment, outpatient plan, dental/optical plan Module 2 Assistance expat assistance, travel assistance, cancellation Module 3 Personal Protection accident insurance, critical and incurable illness, term life, K&R Module 4 Disability Pension for working persons and their non-working partners Module 5 Personal Belongings content, tenant liability, valuables, baggage Module 6 Private Liability including legal assistance } identical to Europat Local Plus

12 Product: Europat Gold EU MODULE 1: Medical Care Who can apply? All persons, sound and able-bodied, with a max. age of 70. How to apply? Application form [individual] All members of the same group or family have to choose the same covers. Health declaration: I declare I am healthy and I do not intend to have surgery, medical or dental treatment or to be hospitalised in the near future, as far as I know at the time of signing this application form. This question has to be answered correctly. Incorrect answers or concealment of facts can be seen as insurance fraud.

13 Product: Europat Gold EU MODULE 1: Medical Care Area of Cover? We have 4 possible zones: European Economic Area + CH; Worldwide, excl. USA, Canada, Hong Kong; Worldwide, excl. USA (premium x 1,50); Worldwide (premium x 2,25). Everyone is covered for emergencies outside of their regular area of cover for a maximum of 90 days/year.

14 Product: Europat Gold EU MODULE 1: Medical Care Which covers can I choose in Medical Care? Hospital Plan (mandatory); Elective home country treatment; Outpatient Plan (ambulatory costs); Dental/Optical/Hearing Aids Plan. Premiums are fixed at the age at which your policy starts, except for children. Children will change over to the adult tariff upon their 20th birthday. Are there limits, deductibles and/or co-pays? No deductibles or co-pays; Covers can have waiting periods. All treatments before the end of the waiting period will not be reimbursed. Covers can have max. limits per year or per lifetime [see benefits list p. 7] Meaning of: 100%: E&Co will cover up to 100%, after reimbursement of RCAM. If RCAM does not reimburse, we cover 100%. 100%/20%: E&Co will cover up to 100% if partially reimbursed by RCAM. If not, we only cover 20%. 100%/0%: E&Co will cover up to 100% if partially reimbursed by RCAM. If not, we don t cover.

15 Product: Europat Gold EU MODULE 1: Medical Care Hospital Plan (mandatory) All medical cost due to hospitalisation; Definition of hospitalisation: when you occupy a hospital bed; Private room covered (no suites); Claims handling: Direct payment of all hospitals willing to accept our payment guarantee (in US within Olympus network). Call Expat & Co, the Alarm centre (24/7) or Olympus (US). Ambulatory costs in connection with the hospitalization (pre/post hospitalisation); Ambulatory costs in connection with critical illnesses; An annual check-up (general check up, cancer tests); Necessary vaccinations for travel, after a waiting period of 3 months. Necessary vaccinations to live in the new host country are seen as normal preparatory measures prior to the conclusion of the policy, and as such are not insurable.

16 Product: Europat Gold EU MODULE 1: Medical Care Outpatient Plan (optional) Covers ambulatory medical costs (doctor consults, pharmacy, therapies); Pay attention: OTC s (Over The Counter medication = medication available without prescription) are not covered, even with a prescription. Example: painkillers, vitamins ; Claims handling: pay & claim.

17 Product: Europat Gold EU MODULE 1: Medical Care Dental/Optical/Hearing Aids Plan (optional) Covers ambulatory dental costs, glasses and hearing aids. Dental: Urgent dental = pain-stilling dental costs (eg. fillings, root canal treatments); Routine dental = annual check-ups and preventative treatments (eg. dental cleaning); Special dental = periodontics, crowns, dentures, implants, inlays, etc + orthodontics (only for minors); Please note: For special dental, there is a waiting period of 12 months. Treatments that take place before the end of the waiting period will not be reimbursed. Dental surgery = stomatology under local anesthesia (full anesthesia in clinic = hospitalisation). Glasses: 1 per year, 1 frame per 3 years; Hearing aids: 1 per 3 years and per ear; Claims handling: pay & claim.

18 Visit our Website: to download documents for claims information

19 Visit our Website: to get quotes and apply online

20 Visit our Website: to manage your files to contact us

21 Please note: these keynotes do not contain any guarantees. The only legally valid documents are our general conditions and policy schedule.