BLUE ROYALE PREMIER. Here for You

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1 BLUE ROYALE PREMIER A worldwide Dollar plan specifically designed for senior citizens that offers complete freedom of choice for the best medical care Make the most out of life s most precious moments. With Pacific Cross, you can enjoy medical coverage that helps secure your peace of mind, wherever life takes you. Here for You

2 The rising costs of hospitalization and medical treatment are one of the pressures you have to deal with in today s times. When illness strikes, you undoubtedly want to look for the best ways to secure you and your loved ones. Pacific Cross understands your need to ensure that you and your loved ones will be secured, even in your later years. In order to help you better deal with life s physical and financial uncertainties, we offer you Blue Royale Premier. BLUE ROYALE PREMIER A Product of Pacific Cross Insurance, Inc. A Dollar plan especially designed for Senior Citizens Maximum coverage of up to US Your choice of hospital, clinic, pharmacy and doctor WORLDWIDE! Swift reimbursement of medical expenses based on your coverage Comprehensive range of Medical Insurance Benefits 24-Hour Customer Assistance and Emergency Hotline Page 2 of 6

3 ? Frequently Asked Questions (For New Applicants) Q: How do I get a Blue Royale Premier Medical Insurance Plan? A: Contact our Medical Sales office at (632) or us at medical_sales@pacificcross.com.ph. Our Account Executives will be more than happy to answer your questions or give you a free presentation in person. Q: How do I pay my Blue Royale Premier Premium? A: Pacific Cross offers you several convenient ways to pay your premium: You can pay in cash or credit, via bank Bills Payment Facilities, either annually or semi-annually. Q: Do I need to undergo a physical examination before I can get a Pacific Cross Insurance plan? A: No, applicants normally do not need to undergo a physical exam. All you have to do is answer the application form and medical questionnaire as truthfully as possible. Failure to answer the questions in the declaration in full, concealment, or misrepresentation of any significant condition will affect your Policy and the payment of your claims. Q: What is a pre-existing condition? A: A pre-existing condition is a disability or illness which existed before the commencement of cover. The existence of a preexisting condition can be clinically determined given its natural history, irrespective of whether or not the insured is aware of the illness or condition. Providing cover for a pre-existing condition is subject to evaluation by our Medical Director, and if it is excluded from cover we will notify the insured accordingly. Q: How soon can I avail of my Blue Royale Premier Benefits? A: You can avail of your Blue Royale Premier Benefits thirty (30) days after the date shown on your Policy. However, you already have immediate coverage for accidental injury. Q: How can Blue Royale Premier take care of me when I am abroad? A: In the event that you are hospitalized while abroad, our worldwide emergency assistance partner will be there to help you. Pacific Cross includes coverage for a maximum of ninety (90) days abroad per trip. Coverage is extended beyond ninety (90) days provided the reason for going abroad is not to seek medical treatment. The extension of stay overseas must also be due to an emergency illness or condition (leading to confinement) that arose on or before your 90 th day abroad, for which the continued hospitalization will require you to stay abroad beyond ninety (90) days. Q: What does 90 day per trip coverage mean? A: This means that you can travel an unlimited number of trips outside the Philippines with insurance coverage provided that each trip does not exceed ninety (90) days. Premium may change for overseas stay of more than ninety (90) days. Page 3 of 6 Blue Royale Premier

4 CORE BENEFITS (10% CO-PAYMENT: means that Pacific Cross will pay 90% of the approved claim amount.) MAXIMUM COVERAGE PER YEAR (aggregate limit per year) for age 66 up to 75 MAXIMUM COVERAGE PER YEAR (aggregate limit per year) for age 76 and above IN-PATIENT BENEFITS Room and Board including general nursing care for a maximum of 60 days per disability, per year for confinement abroad. Unlimited number of days for confinement in the Philippines. Miscellaneous In-Patient Charges for required diagnostic laboratory tests; prescribed medicines and supplements; blood and components; anesthesia; surgical appliances and devices; and intra-operative standard prosthetics (as approved by Pacific Cross) Professional Fee Intensive Care Unit, Coronary Care Unit, Telemetry Operating Theater & Recovery Room Surgeon s Fee includes pre-surgical assessment and normal post-surgical care while confined in the treatment country for each disability. Anesthetist s Fee Organ Transplant fees for kidney, heart, liver, lungs and bone marrow transplants including follow up treatments and sequelae (as approved by Pacific Cross) to a total limit per year of Mental and Nervous Disorders covering biologically based mental illness and degenerative brain disorder as defined in the Policy. $ 5,000 per year with a lifetime limit of Private Duty Nurse when certified necessary by the attending physician (at home for up to 30 days immediately after hospitalization) Procedure Done on an Out-Patient Basis for selected procedures as approved by Pacific Cross OUT-PATIENT BENEFITS (via reimbursement only) physician and specialist fees for office visits; physiotherapist necessary for the treatment of a covered disability; chiropractor, and acupuncturist, Chinese medicine practitioner and herbalist; required diagnostic laboratory procedures, prescribed medicines and supplements; herbal and Chinese medicines; durable medical equipment & corrective devices as approved by Pacific Cross Other Alternative Treatments Homeopathy; Osteopathic Manipulative Therapy (OMT); Bonesetter; Iridology and any medication prescribed by the mentioned alternative treatments EMERGENCY BENEFITS Emergency Out-Patient for treatment of emergency cases/conditions not leading to confinement provided by the out-patient department of a hospital or a licensed doctor in his clinic for a covered disability Emergency Dental Services due to covered accident Emergency Local Ambulance Service from place of occurrence to the nearest hospital facility or from hospital to hospital using land transportation service. If local land transportation facility is not available, other transportation facilities are allowed subject to the approval of Pacific Cross. Emergency Overseas Coverage overseas cover is for an unlimited number of trips outside the Philippines, provided that each trip does not exceed ninety (90) days except if Treatment Area Limitation (TAL) discount option is selected. Worldwide Emergency Assistance Pacific Cross, through our emergency assistance partner, will provide the assistance and advice (24 hours a day, 7 days a week) for free but the client will be responsible for any third party charges incurred as a result of such advice or assistance unless otherwise specified elsewhere in the Policy. Insured Person must be traveling 100 miles (or 150 kilometers) or more from his primary and legal address or in another country which is not his Country of Residence for less than 91 days unless otherwise endorsed in the Policy. Services* include but are not limited to the following: Emergency Medical Evacuation: Evacuation under appropriate medical supervision to the nearest medical facility $ 250,000 $ 300 $ 15,000 ($ 30,000 option) 40% of Surgeon s Fee $ 5, day post-hospitalization follow-up care only Not Available $ 500,000 $ 600 $ 10,000 Subject to the limit of In-Patient Benefits $ 1,500 Page 4 of 6 Blue Royale Premier

5 EMERGENCY BENEFITS Medical Repatriation: Repatriation under medical supervision to the Insured Person s legal residence or to a medical or rehabilitation facility near the Insured Person s residence Return of Mortal Remains: The return of mortal remains will be arranged and paid for. Compassionate Visit: When an Insured Person is traveling alone and will be hospitalized for more than 7 consecutive days, an economy, round-trip, common carrier transportation will be provided to a family member or a friend to accompany the Insured Person. Care of Minor Child(ren): One-way economy common carrier transportation will be provided to the place of residence of minor child(ren) when they are left unattended as a result of medical emergency or death of an Insured Person. * Availment of services through our designated assistance provider, limit per year of * Availment of services not through our designated assistance provider, limit per year of The actual cost will be paid via reimbursement by the Company subject to the limits specified which will form part of the Maximum Coverage Limit of the plan provided that such assistance is a result of a covered illness, accidental injury or death occurring during the Period of Insurance. VALUE ADDED BENEFITS Pacific Cross Health Care Card treatment at all Pacific Cross accredited medical facilities in the Philippines, up to plan limits with no cash outlay. Emergency treatment and confinement only. Excludes out-patient benefits and medicines. Sports Coverage for recreational sports including skiing and scuba; excluding contact sports (subject to Policy limits) and on top of the Maximum Coverage Limit and part of the Maximum Coverage Limit ANNUAL PREMIUMS as of 1 July 2013 AGE $ 2,437 2,572 2,707 2,842 2,978 3,279 3,588 3,858 4,050 4,244 5,444 7,677 10,733 15,137 21,161 Premiums are inclusive of all applicable taxes. $ 30K Surgeon s Fee* $ ,123 1,570 $ 6,523 6,885 7,248 7,611 7,973 8,612 9,422 10,131 10,638 11,145 14,163 19,670 27,672 38,681 54,070 The Documentary Stamp Tax (DST - $2.00) should be deducted from the Core Benefits Premium before applying any discount and/ or loading (i.e., additional premium). The DST should be added back after all discounts and loadings have been applied. * The $ 30,000 Surgeon s Fee benefit limit is optional for the Major Plan. The Surgeon s Fee benefit is for the Standard Plan. DISCOUNT OPTIONS $ 2,500 Deductible Option $ 5,000 Deductible Option Treatment Area Limit 30% Discount 40% Discount 25% Discount 18% Discount 24% Discount 25% Discount Notes for Discount Options: 1. The above percentage discounts are not applicable to optional benefits and surgeon s fee option. 2. Deductibles are computed on a per annum basis and applied to the following: a. in-patient benefits b. 90 days post-hospitalization follow-up care benefits 3. The 10% Co-payment will apply to the eligible amount in the claims computation for Deductibles. Pacific Cross will pay the amount in excess of the Deductible. 4. Treatment area limitation excludes treatment in Canada, United States of America, its dependent territories and the Caribbean Islands; Japan & China including Hong Kong. Page 5 of 6 Blue Royale Premier

6 Our Companies Pacific Cross Insurance, Inc. and Pacific Cross Health Care, Inc. Pacific Cross is EXCELLENCE. We are committed to bringing nothing but the best to our clients. Our decisions are based on an intricate understanding of our clients needs, demands and expectations. We strive to create and innovate programs that will best serve our customers. Pacific Cross is STABILITY. We are one of the leading and most financially stable companies in the industry today. Our Premiums Earned in recent years put us in the top 10 non-life insurance companies in the Philippines. Pacific Cross is EXPERIENCE. We draw from more than sixty-five years of experience in the insurance industry. Our actions are guided by a deep insight brought about by the knowledge we have gained through the years. Pacific Cross is CUSTOMER SERVICE. We are rooted in a commitment to ever improving customer service. We aim to be continuously progressive and professional. Our commendable track record and competent support staff ensure that you are given immediate and excellent service at all times. Pacific Cross is a PARTNERSHIP OF TRUST. We build and value enduring relationships. We consistently prove that we are worthy of the highest confidence by our strict standards, the integrity of our promises and the results we deliver. In the event of a crisis, we assure you that Pacific Cross will be your friend and ally. Get in touch with us today! Call medical_sales@pacificcross.com.ph HEAD OFFICE Pacific Cross Center, 8000 Makati Avenue, 1200 Makati City, Metro Manila, Philippines Tel. No.: Fax No. : medical_sales@pacificcross.com.ph PACIFIC CROSS 8 ROCKWELL MEDICAL SALES CENTER Unit 8B, 8th Floor, 8 Rockwell Building Hidalgo Drive, Makati City, Metro Manila, Philippines Tel. No.: Fax No. : medical_sales@pacificcross.com.ph CEBU Unit 202, Avagar Building, No. 09, Escario corner Molave Street, Lahug, Cebu City Tel. Nos.: ; ; Fax No.: cebu@pacificcross.com.ph SUBIC Suite 64, West Gate Bldg., Sampson Road, Subic Bay Freeport Zone, Zambales Tel. No.: Telefax: subic@pacificcross.com.ph DAVAO 2 nd Floor, Left Wing, Door No. 6, Matina Town Square, Mac Arthur Highway, Matina, Davao City Tel. No.: Telefax: davao@pacificcross.com.ph V07.16 We also have Agency Offices in: Bacolod Baguio Bicol Bohol Butuan Cagayan de Oro Cavite Dumaguete General Santos Laguna Pampanga Zamboanga

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