2018 vmware foreign employee commercial insurance handbook · 2017 vmware foreign employee...

2018 VMware Foreign Employee

Commercial Insurance Handbook

From January 1, 2017 to December 31, 2017

2017 VMware Foreign Employee Commercial Insurance Handbook

PREFACE

Effective from January 1, 2017, Ping An Annuity Insurance Company, Ltd. (referred as

“Ping An” hereinafter) will provide a group life and group medical insurance service to you

and your dependents. You can also enjoy more thoughtful and professional claim service

and other services. You can seek help from Ping An customer service representatives

throughout China via E-mail or telephone when you need.

Ping An will provide comprehensive benefits to you and your dependents from January 1,

2017 to December 31, 2017 as below:

Company Paid Supplemental Insurance Program:

Group Life Insurance for employees

Critical Illness Insurance Plan for employees

Hospital Allowance Insurance Plan for employees

Medical Insurance for employees

Medical Insurance Plan for spouses or cohabitation partners 65 years old and below.

The cohabitation partner can be of same or different sex and have lived together for

at least one year.

Medical Insurance Plan for children 23 years old and below

The main content of this handbook including: introduction of insurance benefit, basic

procedures and relative documents, claim service and other special services, contact

information of Ping An customer service representatives, “All-in-One Account” (Ping An

self-service system) and so on. For your better and faster understanding of the insurance

benefit and services provided by Ping An, we have respond the usual queries by way of

Q&A. Thanks for reading this handbook, should you have any queries, please contact our

customer representatives in time. For information of Ping An customer service

representatives please refer to “Ping An Customer Service Representatives List”.


Contents

Ping An Customer Service Representatives List: ........................................................................................ 4

PartⅠ Q & A ........................................................................................................................................................ 5

1. Summary of Insurance Benefits (Company Paid) .............................................................................. 5

2. I am a new employee. ............................................................................................................................ 8

3. I am working in different location. ......................................................................................................... 9

4. Medical Care............................................................................................................................................ 9

5. Questions about seeing a doctor ........................................................................................................ 14

6. Claim and service ................................................................................................................................. 16

Part Ⅱ Group Life Insurance .................................................................................................................. 22

1. Sum Insured .......................................................................................................................................... 22

2. Life Insurance Benefit........................................................................................................................... 22

3. Life Insurance Beneficiaries ................................................................................................................ 22

4. Exclusions .............................................................................................................................................. 22

5. Life Insurance Claim ............................................................................................................................. 24

Part Ⅲ Health Insurance (Company Paid) .......................................................................................... 24

1. Members’ Eligibility ............................................................................................................................... 24

2. Designated Hospitals, Medication and Medical Treatment ............................................................ 24

3. Medical Benefits (only cover in mainland China) ............................................................................. 28

4. Medical Claim Procedure..................................................................................................................... 34

5. Delayed or Rejected Claims ................................................................................................................ 34

Part Ⅳ Service Standard Commitment .................................................................................................. 36

1. Onsite Services ..................................................................................................................................... 36

2. Claim Services ...................................................................................................................................... 36

3. Customer Services ............................................................................................................................... 37

4. E-Services .............................................................................................................................................. 37

Appendix A: Claim Procedure of Medical Insurance .............................................................................. 38

Appendix B: Medical Insurance Claim Application Form ...................................................................... 41

Appendix C: Designated Beneficiary for Life Insurance Process ....................................................... 42

Appendix D: Health Questionnaire .............................................................................................................. 46

Appendix E: Definition of Critical Illness ................................................................................................... 50

Appendix F: Ping An “All-in-One Account” Self-Service System ....................................................... 60


Ping An Customer Service Representatives List:

Service

Area

Name Tel Mobile Email Address

Shanghai 陆青华

Lu

Qinghua

021-620

78644

1358563

4732

Luqinghua815@pingan.

com.cn

上海市静安区

常熟路8号静安

广场8楼

Beijing 赵晓明

Zhao

Xiaoming

010-597

31815

1881009

1005

Zhaoxiaoming639@ping

an.com.cn

北京市金融街

23号平安大厦9

层

Notes: Employee can submit claim documents by Ping An’s requirement to local

Claim Collection Box. Employee also can mail claim documents to Shanghai or

Beijing Ping An customer service representative directly. Please feel free to contact

country coordinator if any service improvement suggestion.


PartⅠ Q & A

1. Summary of Insurance Benefits (Company Paid)

Life Insurance

The Insured Coverage Sum Insured

(Defult Plan)

Sum Insured

(Upgrade Plan 1)

Sum Insured

(Upgrade Plan 2)

Employee Upon the death of the

Insured due to the

illness itself

3*Annual OTE 4*Annual OTE 5*Annual OTE

Upon the death of the

Insured due to the

accident itself

3* Annual OTE 4*Annual OTE 5*Annual OTE

Body disability from

and only from the

same accidental injury

3* Annual OTE *

Proportion

4*Annual OTE*

Proportion

5*Annual OTE*

Proportion

Total and permanent

disability (defined as

Class 1 disability in

the Schedule) due to

illness

3* Annual OTE

4*Annual OTE 5*Annual OTE

* OTE: On target earnings.

* Proportion: In accordance with Ping An Schedule of Benefits for Disabilities (see Appendix I)

Critical Illness

The Insured Coverage Sum Insured

(Defult Plan)

Sum Insured

(Upgrade Plan 1)

Sum Insured

(Upgrade Plan 2)

Employee 30 kinds of Critical

Illness

RMB300,000 RMB400,000 RMB500,000


* waiting period for CI: 3 months. (Waiting period is only applicable for newly enrolled person)

Medical coverage in Mainland China

Employee

Coverage Sum Insured

(Defult Plan)

Sum Insured

(Downgrade Plan)

Sum Insured

(Upgrade Plan )

Hospital

Allowance

RMB120 per day.

Cover up to 180 days

for inpatient and up to 7

days for maternity

Same as Defult Plan Same as Defult Plan

Medical Insurance RMB 40,000, 100%,

Daily registration fee:

RMB400; Daily Room&

board limit: RMB500

Cover Public Hospital’s

VIP yard and

Designated Private

hospitals

RMB 40,000, 100%;

Daily registration fee:0;

Daily Room& board

limit: RMB100

Uncover Public

Hospital’s VIP yard

and Private hospitals

RMB 100,000, 100%,


RMB800; Daily Room&

board limit: RMB1000


VIP yard and

Designated Private

hospitals

Maternity*

(Maternity benefit is

only applicable for

female employee and

female spouse not for

cohabitation partner)

RMB8,000, 100%,


RMB400; Daily Room&

board limit: RMB500


VIP yard and

Designated Private

hospitals

RMB8,000, 100%,


RMB0; Daily Room&

board limit: RMB80

Uncover Public



RMB20,000, 100%,


RMB800; Daily Room&



VIP yard and

Designated Private

hospitals

(waiting Period 10

months)

Dental Benefit RMB200 for per year

teeth cleaning Same as Defult Plan Same as Defult Plan


Spouse or Cohabitation partner


(Defult Plan)

Sum Insured

(Downgrade Plan)

Sum Insured

(Upgrade Plan )



RMB400; Daily Room&

board limit: RMB500


VIP yard and

Designated Private

hospitals

RMB 40,000, 100%;


Daily Room& board

limit: RMB100

Uncover Public



RMB 100,000, 100%,


RMB800; Daily Room&



VIP yard and

Designated Private

hospitals

Maternity*

(Maternity benefit is

only applicable for

female employee and

female spouse not for

cohabitation partner)

RMB8,000, 100%,


RMB400; Daily Room&

board limit: RMB500


VIP yard and

Designated Private

hospitals

RMB8,000, 100%,


RMB0; Daily Room&

board limit: RMB80

Uncover Public



RMB20,000, 100%,


RMB800; Daily Room&



VIP yard and

Designated Private

hospitals

(waiting Period 10

months)

Child


(Defult Plan)

Sum Insured

(Downgrade Plan)

Sum Insured

(Upgrade Plan )



RMB400; Daily Room&

board limit: RMB500

RMB 40,000, 100%;


Daily Room& board

limit: RMB100

RMB 100,000, 100%,


RMB800; Daily Room&




VIP yard and

Designated Private

hospitals

Uncover Public




VIP yard and

Designated Private

hospitals

2. I am a new employee.

Q1: When will my insurance program be effective?

A: If you become a member of VMware after Jan 1st, 2018, your insurance program will be

effectiveon your first working day in VMware. Ping An will accept the date submitted by

VMware HR department.

Q2: What does the life insurance cover?

A: If death occurred due to illness or accident, the insured amount shall be paid to the

beneficiary.

If accidental disability occurred, Ping An will pay the indemnity that equals the sum

insured times the compensation proportion.

Q3: Are my dependants eligible to the medical insurance program?

A: Foreign employees’ spouse or cohabitation partner （under the age of 65） and children

（under the age of 23）.

Q4: When can I hand in my claim documents?

A: After 30 days of your employment date for the insurance of Critical Illness.

Q5: Who is the beneficiary of my life insurance?

A: If you do not designate your life insurance beneficiary, your indemnity will be inherited

according to Chinese insurance law and Chinese inheritance law.

The first order is spouse, children and parents.


The second order is brothers and sisters and grandparents.

You also can designate your beneficiary by sending the “Confirmation Letter of Life

Insurance Beneficiary” to Ping An, which you can download from VMware intranet.

(See this handbook Appendix C: Definition of Beneficiary for Life Insurance). The

Confirmation Letter of Life Insurance Beneficiary is a legal documentation; please

ensure to provide complete and accurate information.

3. I am working in different location.

Q6: What should I pay attention to if I’m working in different locations?

A: Firstly, you should be sure that the hospital you choose is a local social public hospital

designated by Ping An.

Secondly, please confirm that the medical treatment is covered by the medical

insurance coverage.

The non-cured treatment such as psychotherapy, rehabilitation, tooth beauty etc., is not

covered in the medical insurance coverage. You should tell the doctor to control your

medical scope under social insurance to avoid the self-funded expense.

Q7: How can I send the reimbursement in my accrediting city?

A: Employee can directly submit all of your claim documents needed by Ping An to claim

collection box.

You can post all claim documents to Ping An customer service representative.

Please staple the medical receipts with relevant diagnostic documents on the back of

the claim form. (See this handbook Appendix A and Appendix B)

For your convenience, please read following 3, 4 and 5 carefully.

4. Medical Care


Q8: Which medical expense can be reimbursed?

A: For Foreign employees and their dependents:

• Outpatient medical expenses only in the mainland of China are 100% covered.

• Inpatient medical expenses only in the mainland of China are 100% covered.

• Maternity medical expenses for female employee and female spouse not

cohabitation partner only in the mainland of China are 100% covered.

Q9: Which are the designated hospitals?

A: Foreign employees and their dependents can go to a local social public hospital which

is designated by Ping An. Children can go to local public children hospitals.

If choose the Default Plan or Upgrade Plan, The medical expenses arising from foreign

guest wards, special care wards, senior cadre wards etc., which are within the scope of

public hospitals will be reimbursed. And Ping An adds additional designated hospitals

as below (whole hospital list refers to VMware internal website):

Shanghai

1. Huashan Worldwide Medical Center ;

复旦大学华山医院环宇保健医疗中心

地址：上海市乌鲁木齐中路 12 号；

Add：12 Wulumuqi Zhong Rd. Shanghai

2. Shanghai United Family Hospital and Clinics;

上海和睦家医院

地址：上海市长宁区仙霞路 1139 号；浦东新区红枫路

Add：1139 Xianxia Road Changning District；Hong Feng Rd, Pudong, Shanghai

3. Shanghai Sino-Foreign Co-Operation Guang Ci Hospital;

上海广慈医院(瑞金医院外宾部)

地址：上海市瑞金二路 197 号 38 号楼

Add：Building #38, 197 Ruijin Er Road. Shanghai

4. Shanghai Children's Medical Center;

上海交通大学医学院附属上海儿童医学中心


Add：3rd Floor, 1678 Dongfang Road. Shanghai

5. Children's Hospital of Fudan University, VIP Clinic;

复旦大学附属儿科医院特需门诊部

地址：上海市枫林路 183 号

Add：183 Fenglin Road. Shanghai

6. Shanghai Ruijin Hospital Pudong Branch;

上海瑞金医院浦东分院

地址：上海锦绣东路 120 号

Add：No 120, Jin Xiu East Road, Shanghai

7. VIP Maternity & GYN Center of International Peace Maternity & Child Health

Hospital;

中国福利会国际和平妇幼保健院外宾部

8. Complex Building, HuaShan Hospital, 12 WuLuMuQi Zhong Road, Shanghai

In-patient Care Center;

上海乌鲁木齐中路 12 号华山医院综合楼

9. Shanghai Orient Hospital VIP Clinic;

上海东方医院特需门诊部

地址：上海市浦东新区即墨路 150 号

Add：No. 150 Ji Mo Road. Shanghai

10. ParkwayHealth Glenagles Medical & Surgical Center;

上海百汇瑞鹰门诊部

地址：上海南京西路 389 号明天广场裙房四楼

Add：4/F, No.389 Tomorrow Square, Nanjing Xi Road, Shanghai

11. ParkwayHealth Hong Qiao Medical Center;

上海百汇瑞祥门诊部

地址：上海虹桥路 2258 号

Add: No.2258 Hong Qiao Road. Shanghai

12. ParkwayHealth Manderine City Medical Center;

上海百汇瑞虹诊所

http://www.parkwayhealth.cn/medical-center-locations/mandarine-city-japanese-clinic.php


地址：上海虹许路 788 号名都城 30 号底层

Add: No.788 Hong Xu Road, Shanghai

13. ParkwayHealth Shanghai Centre Medical & Dental Centers;

上海百汇瑞新医疗中心

地址：上海南京西路 1376 号上海商城西峰 203-204 室

Add: 2/F, Shanghai Centre, 1376 Nanjing Xi Road, Suites 203-204. Shanghai

14. ParkwayHealth Shanghai Specialty and Inpatient Centers (Lu Wan)

上海百汇新瑞医疗中心（卢湾）

地址：上海淡水路 170 号 3 楼

Add: 3/F, No.170 Danshui Road. Shanghai

15. Parkway Health Jin Qiao Medical and Dental Center;

上海百汇瑞浦门诊部

地址：上海浦东金桥碧云路 997 号

Add: 997, Bi Yun Road, Jin Qiao, Pudong, Shanghai

16. Parkway Health Jin Mao Tower Medical Center.

上海百汇汇星金浦门诊部

地址：上海浦东世纪大道 88 号金茂大厦裙房金茂时尚生活中心一层

Add: 1N01(B) Jin Mao Tower (close to Gate 1),No.88 Century Ave, Pudong, Shanghai

Beijing

1. Amcare Women's and Children's Hospital;

美中宜和妇儿医院

地址：北京市朝阳区方园西路 9 号

Add: No.9 Fang Yuan Xi Road, Chaoyang District, Beijing

2. Beijing United Family Hospital;

北京和睦家医院

地址：北京朝阳区将台路 2 号

Add: No.2 Jiangtai Road, Chaoyang District, Beijing

3. Beijing International Medical Centre;

北京国际医疗中心

地址：北京亮马桥路五十号汉莎中心办公 S106/111

http://www.parkwayhealth.cn/ruixin.html

http://www.parkwayhealth.cn/xinrui.html

http://www.parkwayhealth.cn/ruipu.html

http://www.parkwayhealth.cn/huixing.html


Add: S106/111, Hansha Center, No.50 Liangmaqiao Road, Chaoyang District, Beijing

4. Hong Kong International Medical Clinic;

北京香港国际医务诊所

地址：北京市朝阳区潮阳门北大街 2 号，港澳中心 9 层

Add: 9/F, HongKong Macao Centre, No.2 Chaoyangmen bei Road, Chaoyang District, Beijing

5. Bayley and Jackson Medical Centre;

庇利积臣医疗中心

地址：北京朝阳区日坛东路 7 号

Add: No.7 Ritan Dong Road, Chaoyang District, Beijing

6. New Century Children's Hospital;

北京新世纪儿童医院

地址：北京市西城区南礼士路 56 号

Add: No.56 Nanlishi Road, Xicheng District, Beijing

Guangzhou

1. Ji'nan University affiliated No.1 hospital;

暨南大学附属第一医院特诊中心

2. Zhongshan University Affiliated No.1 Hospital;

中山大学附属第一医院特种医疗中心


中山大学附属第二医院博济中心

Chengdu

Global Doctor Chengdu Clinic.

环球医生成都诊所

Q10: How can I enroll medical insurance for my dependents?

A: To enroll your spouse(or cohabitation partner) / children, you need to update the

information of your spouse(or cohabitation partner) / children, and then submit the

enrollment documents (Marriage Certificate for spouse, Birth Certificate for child,

Declaration of Committed Relationship for cohabitation partner) to local HR within 1

month so that your enrollment would be activated.


Q11: Can the medical expenses be reimbursed if my dependents and I live in

different cities

A: Ping An will compensate the medical expenses arising from medical treatment in local

social public hospitals designated by Ping An in mainland China for your dependents, no

matter your dependents lived in your working city or not.

5. Questions about seeing a doctor

Q12: What should I pay attention to when I’m seeing a doctor?

A: You should tell the doctor to control your medical scope under social insurance to

avoid the self-funded expense. And also you should keep the invoice, prescription,

medical record, expense list, inspection report and etc.

Q13: What is the restriction of the medication?

A: Please note:

1. prescription for emergency treatment should not be more than 3 days;

2. Prescription for normal treatment should be 7 days;

3. Medications for post-hospitalization treatment, business travel and holiday/vacation

should not be more than 14 days;

4. Medications for chronic treatment should not be more than 30 days;

Q14: Can I buy medicine from a pharmacy?

A: Please see a doctor in the designated hospital. Any medicine purchasing from a

pharmacy will be rejected.

Q15: When should I submit the claim documents?


A: Generally, you should submit the claim documents within 90 days after your medication.

For maternity reimbursement, you should submit the claim documents within 180 days

after hospitalization.

Q16: Can I get the reimbursement of the dental expense?

A: Dental expenses (rising from cracked tooth fillings, treatment of tooth nerve, tooth

extraction, treatment of periodontal diseases) due to decayed tooth, dental pulp

disease and cracked teeth in accordance with the provisions of social medical

insurance can be reimbursed.

Q17: How can I transfer to another hospital which is not a designated hospital?

A: If the hospital cannot supply necessary facilities, after informing Ping An service

representative and the consultation of doctors, you can transfer to another hospital

with the certificate of transference.

Q18: How to seek medical treatments during holiday/vacation or business travel?

A: Ping An will reimburse the medical expenses of outpatient and emergency

hospitalization in local public hospitals designated by Ping An. And Ping An will not

reimburse the medical expenses arising outside mainland of China.

Expenses arising Hong Kong, Macao, Taiwan will not be reimbursed, either.

Q19: What is emergency treatment? What should I know when I’m getting an

emergency treatment?

A: You or any of your insured dependents can choose to go to any local public hospital

(Emergency observation period is 7 days) and your medical record should clearly

marked as “emergency case” by the hospital.

The following cases will be regarded as Emergency cases:

1. fever heat (adult above 38.5℃);

2. acute abdominal pain, serious vomiting, serious diarrhea;

3. kinds of shocks;


4. coma;

5. epileptic attack;

6. serious breathing spell, difficult breathing;

7. acute chest pain, acute heart failure, serious arrhythmia cordis;

8. hypertension, hypertension brain disease, cerebral accident;

9. different acute haemorrhage;

10. acute urethrorrhagia, metrorrhagia, renal colic pain;

11. different acute poisoning (food or medicine poisoning),different accident

(electroshock, drown);

12. brain trauma, fracture, dislocation, laceration, burn, scald, or other acute trauma;

13. bite by different poison animal or insect, acute hypersensitivity disease;

14. foreign body in facial features, breathe system and esophagus, acute eye-ache, red

and swollen, suddenly eye sight dysfunction and eye trauma;

15. diseases of infants below two months;

16. other serious disease.

6. Claim and service

Q20: What are the specific requirements of the claim documents?

A: Your claim documents should measure up to the following standard:

1. The diagnosis, investigative examination, treatments, prescription must be written

down clearly;

2. The sum of medical expenses on the medical record should be conforming to those

on the receipt.

3. The items and treatment date on the medical record should be conforming to those

on the receipt.

4. Formal receipt (invoice) of the hospital;

5. A stamp of the hospital on the receipt is required;

6. The name on the receipt is correct. If there is a mistake, the hospital shall chop on


the corrected name to confirm.

Q21: What are the specific requirements of the claim documents?

A: The documents requirement varies from the different expenses:

Outpatient:

1. Medical Insurance Claim Application Form (See this handbook Appendix B);

2. Original or copy of the medical record with clear description of symptom, diagnosis

and treatment decisions and medicines applied (including medicine name,

medicine dosage and administration, total count.);

3. Original or copies of examination and laboratory tests reports;

4. Original prescriptions (hardcopy) and original outpatient medicine prescription

(need to be provided if the hospitals use duplicate prescription forms and outpatient

medicine prescription lists);

5. Original invoices, hardcopies of invoices of the part been reimbursed by other

parties and other relevant evidences;

6. Clear list of treatment expenses;

7. Other documents deemed necessary by the insurer under special conditions;

Hospitalization:


2. Details of hospitalization expenses, which including every expense for each day;

3. Hospital discharge brief summary, which should have a record of the diagnoses

before and after hospitalization, key diagnoses and treatments in the hospital and

rehabilitation when being discharged from the hospital. Certificate of Diagnosis

issued by the hospital;

4. Original invoices of medical expenses (should be with the charge stamp of the

hospital;

If it were reimbursed by multi-organization, then copy of the invoices of the part,

which has been reimbursed, should be provided;

5. Details of hospitalization expenses, which including every expense for each day;

6. Other documents deemed necessary by the insurer under special conditions.


Maternity


2. When applying for reimbursement of pregnant treatment expenses, pregnant

inspection brochure needs to be provided;

3. Hospitalization expenses list;

4. The copy of marriage certificate;

5. Child’s birth certificate;

6. Other documents deemed necessary by the insurer under special conditions;

7. Copies of Identification certificate or passport;

8. If it were reimbursed by multi-organization, then copy of the invoices of the part,

which has been reimbursed, should be provide.

Accidental Death

1. Certification of the insured person and insurance policy or other insurance

documents, premium application.

2. Beneficiary’s household registration and identification certificate; If beneficiary is

statutory insurance beneficiary, relationship evidence is required.

3. Death certificate from Hygiene Department or Police Department of State Council of

PRC.

4. If the insured person is pronounced dead, the beneficiary must provide the People’s

Court with death certificate.

5. The beneficiary’s cancellation of household registration certificate and cremation

certificate.

6. Accident certificate from related department (ex: traffic accident responsibility report

from Traffic Administration Department).

Accidental Dismemberment



2. Identification certification of insured person or beneficiary.

3. Hardcopy of prescriptions and outpatient medicine prescription, record of the

diagnoses before and after hospitalization, key diagnoses and treatments in the


hospital and rehabilitation when being discharged from the hospital,

dismemberment authentication letter from national certifying agency.

4. Character, causes and other certificates of the insured accident from beneficiary.

5. Beneficiary’s bank deposit book copy.

Death due to Disease



2. Beneficiary’s household registration and identification certificate; If beneficiary is

statutory insurance beneficiary, relationship evidence is required.

3. Death certificate from Hygiene Department or Police Department of State Council of

PRC.

4. The beneficiary’s cancellation of household registration certificate and cremation

certificate.

5. Character, causes and other certificates of the insured accident from beneficiary.

6. Claim certificate confirmations and authorizations when more beneficiary are more

than one person.

7. Beneficiary’s bank deposit book copy.

Hospitalization Allowance:

1. Medical Insurance Claim Application Form (See this handbook Appendix B)

2. Identification certificate of the insured.

3. Hospital discharge brief summary, which should have a record of the diagnoses




4. Other documents deemed necessary by the insurer under special conditions

5. Copies of Identification certificate when the claims are exceed RMB 10,000.

Critical Illness


2. Copies of ID certificate or passport.

3. Test report certificate with pathological microscopy and blood test report or other


scientific test report.

4. Other document deemed necessary by the insurer under special conditions.

5. Legal inheritance certificates are needed when the insurance benefit is used as

heritage.

6. Copies of bankbook of the insured or beneficiary.

Dental Clean

1. Medical Insurance Claim Application Form(See this handbook Appendix B);

2. Original Invoice of dental clean expenses.

Q22: What are the reasons for delayed or rejected claims?

A: The reasons for delayed claim:

1. Failure to submit certain required documents or materials, or provide incorrect

documents;

2. Different issue dates on the diagnosis form and the receipts;

3. The name on the medical receipt is not same as the name on application form;

4. When long term medicine treatment needed, failed to provide case history;

5. Getting the medical treatment from the un-designated hospital;

6. The medical expenses which is not covered in medical insurance coverage or out

of valid term;

7. The dependent do not join the medical insurance coverage;

8. Behavior deemed as violation of the bona fide principle.

The reasons for rejected claim:

1. The expenses of no-medical treatment, such as healthcare, rehabilitation;

2. The treatment of transfer hospital without permission;

3. Vaccine fees (excluding hepatitis B vaccine), Physical examination fees,

self-funded medicine and self-funded medical item;

4. The medical expenses are not in the term of insurance;

5. Going to un-prescribed hospital;


6. The medical claim before their dependents insured;

7. The medical expenses of against the principle of honest.

Remarks: If there are any conflicts between this handbook and the insurance

contract, the insurance contract shall prevail.


Part Ⅱ Group Life Insurance

1. Sum Insured

For VMware, the sum insured of this life insurance benefit is 3 times of your OTE* when

you claim a life insurance.

Life insurance benefit includes worldwide 24 hours Disease and Accidental Death and

Disablement coverage.

* OTE: on target earnings

If the sum insured exceeds CNY 3,000,000, the individual underwriting materials will be

requested on November each year, such as Health Questionnaire and Physical

Examination Report issued within 6 months.

2. Life Insurance Benefit

1) If death occurred due to illnesses or accident, the insured amount shall be paid to

the beneficiary.

2) If accidental disability or burnt occurred, Ping An will pay the indemnity that equals

the sum insured times the compensation proportion.

3. Life Insurance Beneficiaries

When applying for the life insurance, you will be deemed to have chosen beneficiary in the

order of preference set by law.

If you prefer to designate the beneficiary for death benefit by yourself, you need to

designate the beneficiaries in a written form of “Confirmation Letter of Life Insurance

Beneficiary” and submit to Ping An (please refer to Appendix C).

4. Exclusions

If the employee’s death is caused by one of the following reasons, Ping An will not

reimburse the compensation.

1) The applicant kills or injures the insured intentionally;

2) The insured intentionally commits a crime or resists any criminal coercive measure

taken according to


3) law or commits a suicide, unless the insured has no capacity for civil conduct at

suicide;

4) The insured voluntarily takes or injects drugs;

5) The insured drives under the influence of alcohol or without a valid driving license or

the motor vehicle which does not have a valid driving permit;

6) War, military conflict, riot or armed revolt;

7) Nuclear explosion, nuclear radiation or nuclear pollution.

If the employee’s disability is caused by one of the following reasons, Ping An will

not reimburse the compensation.


2) The insured intentionally injures himself/herself, commits a crime, resists any

criminal coercive measure taken according to law or commits a suicide, unless the

insured has no capacity for civil conduct at suicide;

3) The insured fights, drinks excessively, or takes or injects drugs;




6) Nuclear explosion, nuclear radiation or nuclear pollution;

7) The insured suffers from any injury due to gestation (including ectopic pregnancy),

miscarriage and parturition (including cesarean section);

8) The insured is injured due to medical accident, medicine allergy or mental and

behavioral disorders (as determined according to the Tenth Revision of the

International Statistical Classification of Diseases and Related Health Problems

(ICD-10) released by the World Health Organization);

9) The insured takes any medicines without the permission of his/her doctor, but

excluding the use of OTC medicines according to use instructions;

10) Bacterial or virus infection (excluding wound infection due to an accident);

11) The insured participates in diving, parachuting, rock climbing, bungee jumping,

aerodone or paraglider driving, expedition, wrestling, martial art competition, stunt

performance, horse racing, motor racing, or any other high-risk sport.


5. Life Insurance Claim

If accidental injury occurred, please contact HR or Ping An service representative as soon

as possible. Ping An service representative will follow up all the things.

Part Ⅲ Health Insurance (Company Paid)

1. Members’ Eligibility

Eligible employee: Foreign employees of VMware

Eligible dependents: Foreign employees’ spouses (or cohabitation partners) aged below

65 and children under age23 (including).

2. Designated Hospitals, Medication and Medical Treatment

2.1 Designated Hospitals

a) Foreign employees and their dependents can go to a local social public hospital which

is designated by Ping An. Children can go to local public children hospitals.

b) If choose the Default Plan or Upgrade Plan, The medical expenses arising from foreign

guest wards, special care wards, senior cadre wards etc., which are within the scope of

public hospitals will be reimbursed. And Ping An adds additional designated hospitals as

below (whole hospital list refers to VMware internal website):

Shanghai

1. Huashan Worldwide Medical Center ;

复旦大学华山医院环宇保健医疗中心

地址：上海市乌鲁木齐中路 12 号；

Add：12 Wulumuqi Zhong Rd. Shanghai

2. Shanghai United Family Hospital and Clinics;

上海和睦家医院

地址：上海市长宁区仙霞路 1139 号；浦东新区红枫路

Add：1139 Xianxia Road Changning District；Hong Feng Rd, Pudong, Shanghai

3. Shanghai Sino-Foreign Co-Operation Guang Ci Hospital;


上海广慈医院(瑞金医院外宾部)

地址：上海市瑞金二路 197 号 38 号楼

Add：Building #38, 197 Ruijin Er Road. Shanghai

4. Shanghai Children's Medical Center;

上海交通大学医学院附属上海儿童医学中心

Add：3rd Floor, 1678 Dongfang Road. Shanghai

5. Children's Hospital of Fudan University, VIP Clinic;

复旦大学附属儿科医院特需门诊部

地址：上海市枫林路 183 号

Add：183 Fenglin Road. Shanghai

6. Shanghai Ruijin Hospital Pudong Branch;

上海瑞金医院浦东分院

地址：上海锦绣东路 120 号

Add：No 120, Jin Xiu East Road, Shanghai

7. VIP Maternity & GYN Center of International Peace Maternity & Child Health

Hospital;

中国福利会国际和平妇幼保健院外宾部

8. Complex Building, HuaShan Hospital, 12 WuLuMuQi Zhong Road, Shanghai

In-patient Care Center;

上海乌鲁木齐中路 12 号华山医院综合楼

9. Shanghai Orient Hospital VIP Clinic;

上海东方医院特需门诊部

地址：上海市浦东新区即墨路 150 号

Add：No. 150 Ji Mo Road. Shanghai

10. ParkwayHealth Glenagles Medical & Surgical Center;

上海百汇瑞鹰门诊部

地址：上海南京西路 389 号明天广场裙房四楼

Add：4/F, No.389 Tomorrow Square, Nanjing Xi Road, Shanghai

11. ParkwayHealth Hong Qiao Medical Center;


上海百汇瑞祥门诊部

地址：上海虹桥路 2258 号

Add: No.2258 Hong Qiao Road. Shanghai

12. ParkwayHealth Manderine City Medical Center;

上海百汇瑞虹诊所

地址：上海虹许路 788 号名都城 30 号底层

Add: No.788 Hong Xu Road, Shanghai

13. ParkwayHealth Shanghai Centre Medical & Dental Centers;

上海百汇瑞新医疗中心

地址：上海南京西路 1376 号上海商城西峰 203-204 室

Add: 2/F, Shanghai Centre, 1376 Nanjing Xi Road, Suites 203-204. Shanghai

14. ParkwayHealth Shanghai Specialty and Inpatient Centers (Lu Wan)

上海百汇新瑞医疗中心（卢湾）

地址：上海淡水路 170 号 3 楼

Add: 3/F, No.170 Danshui Road. Shanghai

15. ParkwayHealth Jin Qiao Medical and Dental Center;

上海百汇瑞浦门诊部

地址：上海浦东金桥碧云路 997 号

Add: 997, Bi Yun Road, Jin Qiao, Pudong, Shanghai

16. ParkwayHealth Jin Mao Tower Medical Center.

上海百汇汇星金浦门诊部

地址：上海浦东世纪大道 88 号金茂大厦裙房金茂时尚生活中心一层

Add: 1N01(B) Jin Mao Tower (close to Gate 1),No.88 Century Ave, Pudong, Shanghai

Beijing

1. Amcare Women's and Children's Hospital;

美中宜和妇儿医院

地址：北京市朝阳区方园西路 9 号

Add: No.9 Fang Yuan Xi Road, Chaoyang District, Beijing

2. Beijing United Family Hospital;

北京和睦家医院

http://www.parkwayhealth.cn/medical-center-locations/mandarine-city-japanese-clinic.php

http://www.parkwayhealth.cn/ruixin.html

http://www.parkwayhealth.cn/xinrui.html

http://www.parkwayhealth.cn/ruipu.html

http://www.parkwayhealth.cn/huixing.html


地址：北京朝阳区将台路 2 号

Add: No.2 Jiangtai Road, Chaoyang District, Beijing

3. Beijing International Medical Centre;

北京国际医疗中心

地址：北京亮马桥路五十号汉莎中心办公 S106/111

Add: S106/111, Hansha Center, No.50 Liangmaqiao Road, Chaoyang District, Beijing

4. Hong Kong International Medical Clinic;

北京香港国际医务诊所

地址：北京市朝阳区潮阳门北大街 2 号，港澳中心 9 层

Add: 9/F, HongKong Macao Centre, No.2 Chaoyangmen bei Road, Chaoyang District, Beijing

5. Bayley and Jackson Medical Centre;

庇利积臣医疗中心

地址：北京朝阳区日坛东路 7 号

Add: No.7 Ritan Dong Road, Chaoyang District, Beijing

6. New Century Children's Hospital;

北京新世纪儿童医院

地址：北京市西城区南礼士路 56 号

Add: No.56 Nanlishi Road, Xicheng District, Beijing

Guangzhou

1. Ji'nan University affiliated No.1 hospital;

暨南大学附属第一医院特诊中心


中山大学附属第一医院特种医疗中心


中山大学附属第二医院博济中心

Chengdu

Global Doctor Chengdu Clinic.

环球医生成都诊所

c) The medical expenses arising from foreign guest wards, special care wards, senior

cadre wards etc., which are within the scope of public hospitals will be reimbursed by Ping

An.


d) All medical expenses arising from non-public open hospitals, private medical centers

or clinics will not be reimbursed by Ping An.

(Please visit VMware internal website for Hospital List.)

2.2 Medication and Medical Treatment

a) All Foreign employees and their spouses (or cohabitation partner) can obtain

medical treatment and claim reimbursement for the covered expenses as listed in

the scope of local “social medical insurance medical treatment and medication”.

b) Children can obtain medical treatment and claim reimbursement for the covered

expenses as listed in the scope of local “social medical insurance medical

treatment and medication”.

c) For self-payment part of medical expenses, Ping An will reimburse the medical

expenses which extracts self-payment part.

d) Ping An will reimburse the expenses of MRI examination (Magnetic Resonance

Imaging).

2.3 Dosage

a) Prescription for emergency treatment should not be more than 3 days;

b) Prescription for normal treatment should not be more than 7days;

c) Medications for post-hospitalization treatment, business travel and holiday/vacation

should not be more than 14 days;

d) Medications for chronic treatment should not be more than 30 days;

Please Note: Details of the designated hospitals list, medicine categories can be found on

VMware internal website.

3. Medical Benefits (only cover in mainland China)

Sum Insured:

• Foreign employee: For Default Plan and Downgrade Plan, RMB40, 000 per person

per year; For Upgrade Plan, RMB100, 000 per person per year.

• Foreign employee’s Dependents: For Default Plan and Downgrade Plan, RMB40,


000 per person per year; For Upgrade Plan, RMB100, 000 per person per year.

3.1 Outpatient

a) Foreign employee can go to local public hospitals designated by Ping An (please

refer to “Part III: 2.1 Designated Hospitals” for more information). Ping An will

reimburse 100% of medical expenses and the register fee is RMB400 per day per

person. The medical treatment should be listed in the scope of local “social medical

insurance medical treatment and medication”;

b) On business travel or holiday/vacation Foreign employee can go to local public

hospitals designated by Ping An, Ping An will reimburse 100% of medical

expenses;

c) Foreign employee’s dependents can go to local public hospitals designated by Ping

An. Ping An will reimburse 100% of medical expenses. The medical treatment

should be listed in the scope of local “social medical insurance medical treatment

and medication”.

3.2 Emergency Treatment

For emergency cases, foreign employee or their dependents can go to any local public

hospital and the medical record should clearly be marked as “Emergency Case” by the

hospital.

Please refer to “Part I: Q19” for definition of “Emergency Treatment”.

3.3 Hospitalization

a) Foreign employee can go to local public hospitals designated by Ping An (please

refer to “Part III: 2.1 Designated Hospitals” for more information). Ping An will

reimburse 100% of medical expenses for hospitalization and the limit for ward fee

according to the insurance plan. The medical treatment should be listed in the

scope of local “social medical insurance medical treatment and medication”;

b) Foreign employee’s spouse (or cohabitation partner) and their children can go to


local public hospitals designated by Ping An, and children can also go to local

public children hospital (please refer to “Part III: 2.1 Designated Hospitals” for

more information). Ping An will reimburse 100% of medical expenses for

hospitalization and the limit for ward fee according to the insurance plan. The

medical treatment should be listed in the scope of local “social medical insurance

medical treatment and medication”.

3.4 Maternity

The Foreign female employee or employee’s female spouse (exclude cohabitation partner)

can enjoy the maternity insurance coverage, the Standard is listed below:

a) Scope:

fees for examinations during pregnancy;

Fees for confinement and delivery (excluding fees for the infant. However, you can

apply the claim after your baby joins the insurance coverage, please ensure to

complete dependent’s enrollment process which refer to VMware Internal website

ASAP).

Fees arising from abortion or miscarriage or operation for terminating the

pregnancy of an employee or spouse.

b) Compensation:

Ping An will reimburse 100% of medical expenses arising from maternity for female

employee. The sum insured of maternity is RMB 8,000 per year for Default Plan

and Downgrade Plan, or RMB 20,000 per year for Upgrade Plan.

Ping An will reimburse 100% of medical expenses arising from maternity for

employee’s female spouses. The sum insured maternity is RMB 8,000 per year for

Default Plan and Downgrade Plan, or RMB 20,000 per year for Upgrade Plan.

If the insured choose Upgrade Plan, the maternity benefit would have 10 months

waiting period. If the insured is pregnant during waiting period, Ping An would

reimburse according to Default Plan.

The limit for ward fee and the register fee is according to the insurance plan.

If the period of pregnancy or the confinement is not the same annual term of


insurance, the maternity expenses will be uniformly reimbursed by Ping An at the

compensation rate of the year in which the birth occurred;

Fees for the examination of the married insured during pregnancy and fees for

delivery can be claimed from Ping An after the delivery;

Compensation in respect of medical treatment fees incurred due to abortion or

miscarriage by the employee may be claimed from Ping An every time.

Notes: Generally, you should submit the claim documents within 90 days after your

medication. For maternity reimbursement, you should submit the claim documents

within 180 days after hospitalization.

3.5 Accidental Injury

Ping An will reimburse the medical expenses caused by accidental injury according to the

scope of local “social medical insurance medication and medical treatment”. But Ping An

will not reimburse the medical expenses of employee and his dependents which should

legally afford by third party.

3.6 Public coverage

a) Only when the expenses exceed the maximum cap and suffering from critical illness,

employee or dependent can claim from the company public pool and should be

approved by HR. (Critical illness list refer to Ping An’s policy)

b) The employee or the dependent should follow the rule of individual medical

insurance.

c) This is for the medical expenses caused by accident or disease only, not applicable

for maternity expenses.

d) Maximum 100,000 RMB per policy year for employee and maximum 50,000 RMB

per policy year for dependent.

e) HR reserves the right of final interpretation of the policy at any time.

3.7 Medical Treatment in Different Locations


Location of medical treatment is different from your working location: Please go to

local public hospitals designated by Ping An. The medical treatment should be listed in the

scope of local “social medical insurance medical treatment and medication”.

3.8 Exclusions of Medical Insurance

The following conditions are not covered.

a) The deliberate action by the Policyholder that leads to the death or injuries of the

Insured;

b) The Insured deliberately resists arrest, commits crime, suicide or self-mutilation;

c) The insured takes, sucks or injects illegal drugs;

d) Insured drunk-drives, drives without license or drive vehicles without proper

registration;

e) The insured is Involved in war, military action, terrorist activity, riots or rebellion;

f) Nuclear explosion, nuclear radiation or nuclear contamination;

g) The insured’s injuries caused by medical accident, drug allergy, spiritual or

behavioral disturbance (confirmed by ICD-10);

h) The Insured takes, applies or injects medicine against the doctor's instruction;

i) The insured gets AIDS or AIDS virus infection;

j) Transmissibility disease, congenital abnormality or distortion, chromosome

imbalances, congenital disease, psychopathic disease, Schizophrenia;

k) The insured undertakes treatment at rehabilitation hospital, united clinic, private

hospital, private clinic, family ward, massage hospital, etc. or fakes hospitalization;

l) The insured undertakes treatment such as teeth scaling, non-therapeutic teeth

polishing, false teeth maintenance, fitting false teeth, roast porcelain teeth, teeth

implant, teeth autotransplantation, teeth replantation, restoration of clipped

teeth/false teeth, prosthodontic treatment, orthodontic treatment, teeth stain

removal, etc.(unless agreed by the relevant agreement);

m) The insured undertakes treatment such as skin pigmentation treatment, facial acne

treatment, facial mask, scar removal, cosmetic laser surgery, mole removal, tattoo

removal, wrinkles removal, freckles removal, eyelid surgery, treatment of white hair


and hair loss, hair transplant, hair removal, rhinoplasty, breast augmentation,

piercing ear hole, etc.;

n) The insurance undertakes orthopedic treatment on axillary osmidrosis, stuttering,

snore (except for respiratory distress syndrome), flat foot deformity, etc. therapy for

weight losing, weight gaining, height increase; various health check-up items;

preventive treatment, health care, recreation, rest cure and special nursing

services; vaccination, foot massage and heath care massage, etc. (unless agreed

by the relevant agreement);

o) optometry & glasses fitting, false eye fitting, artificial limb fitting, hearing aid fitting;

p) ametropic amblyopia caused by myopia and strabismus, as well as congenital

defects.

q) treatment on infertility, sexual dysfunction;

r) cosmetic surgery or expenses caused by medical accident;

s) Medical appraisal: working capability appraisal (industrial injury, occupational

disease), judicial psychiatric appraisal, medical accident appraisal, injury diagnosis

fee, etc.;

t) medical expenses incurred beyond the insurance period or in Taiwan, Hong Kong,

Macao or area outside mainland China;

u) check-up items, therapy, medicine are incompatible with diagnosis;

v) prescription sharing and prescription transfer(Unless with the prescription chop);

w) medicine prescribed without medical records indicating patient statement and

doctor diagnosis;

x) therapy and rehabilitation on pre-existing disability;

y) The pre-existing medical expenses is covered, whereas the expenses caused by

the diseases: malignant tumor, heart disease(heart failure phase II or above),

myocardial infarction, leukemia, hypertension (phase II or above), cirrhosis,

chronic obstructive pulmonary disease, cardio cerebral vascular disease, chronic

kidney disease, diabetes, aplastic anemia, congenital disease, inherited disease,

mental disease or schizophrenia, seizures, legal infectious disease, AIDS, venereal

disease;


3.9 Exclusions of Critical Illness Insurance

The following conditions are not covered.


2) The insured intentionally injures himself/herself, commits a crime or resists any

criminal coercive measure taken according to law;

3) The insured takes or injects drugs;



5) The insured is infected with AIDS virus or suffers fromAIDS;


7) Nuclear explosion, nuclear radiation or nuclear pollution;

8) Hereditary disease, congenital malformation, deformation or chromosome

abnormality.

4. Medical Claim Procedure

Please refer to “Appendix A: Claim Procedure of Medical Insurance”.

5. Delayed or Rejected Claims

The reasons for delayed claim:

1) Failure to submit certain required documents or materials, or provide incorrect

documents;

2) Different issue dates on the diagnosis form and the receipts;

3) The name on the medical receipt is not same as the name on application form;

4) When long term medicine treatment needed, failed to provide case history;

5) Getting the medical treatment from the un-designated hospital;

6) The medical expenses which is not covered in medical insurance coverage or out of

valid term;

7) The dependent do not join the medical insurance coverage;

8) Behavior deemed as violation of the bona fide principle.


The reasons for rejected claim:

1) The expenses of no-medical treatment, such as healthcare, rehabilitation;

2) The treatment of transfer hospital without permission;

3) Vaccine fees (excluding hepatitis B vaccine), Physical examination fees, self-funded

medicine and self-funded medical item;

4) The medical expenses are not in the term of insurance;

5) Going to un-prescribed hospital;

6) The medical claim before their dependents insured;

7) The medical expenses of against the principle of honest.


Part Ⅳ Service Standard Commitment

1. Onsite Services

Employee can submit all of your claim documents needed by Ping An to local clinic room.

Ping An will arrange person to collect documents.

Employee also can mail claim documents to Ping An customer service representative

directly.

Please Note: Please consult the HR Office for the latest time arrangement.

2. Claim Services

2.1 Reimbursement Time

Reimbursement Time of Medical Insurance —from the date when all complete claim

documents are collected, reimbursement bill will be sent to the claimant within 15

working days.

Reimbursement Time of Life Insurance —from the date when all complete claim

documents are collected, reimbursement bill will be sent to the claimant within 30

working days.

Reimbursement Time of Critical Illness Insurance —from the date when all complete

claim documents are collected, reimbursement bill will be sent to the claimant within 30

working days.

2.2 Notice of Medical Claims

After submit your claim documents, you can inquire claim progress by using Ping An

“All-in-One Account” self-service system. (See Appendix H).

After every claim, Ping An will deliver the “Claim Report of Group Medical Insurance”

via email (if your email address changed, please notice your company’s HR) notifying

the information of reimbursement or rejection.

For any reject claim, Ping An will return you all documents.

If original medical expenses receipts need to be returned, please attach copies of all

documents and the envelope which clearly indicate the post code and addressee when

request the claim.


2.3 Claim Account

Set up your salary bank card as your reimbursement account.

In case of your reimbursement account changed, please email the changed account

number, open account, city, employee name and employee ID to Ping An customer service

representative.

3. Customer Services

Ping An customer service representative in Beijing and Shanghai will provide excellent

services for you.

The information of customer service representative of Ping An is listed at preface.

4. E-Services

E-service will provide you convenient, considerate and timely service. By using Ping An

“All-in-One Account” self-service system, you can easily query your personal insurance

information and detailed claims records. (Please see Appendix H for detailed information.)


Appendix A: Claim Procedure of Medical Insurance

1. Medical Claim Procedures

Step 1: After the medical treatments (outpatient, emergency treatment, hospitalization),

please keep the medical receipts, certificate of diagnosis and expenses list and other

related documents.

Step 2: Download “Medical Insurance Claim Application Form” (Appendix B)

Step 3: Employee can submit all your claim documents needed by Ping An to clinic room or

local Ping An service representative, Ping An will arrange person to collect documents.

Employee also can post all claim documents to Ping An service representative directly.

Step 4: When the claim is finished, Ping An will inform you by e-mail, and the

reimbursement will transfer to your account.

If you have any questions about the claim result, please contact local Ping An

service representative via email or phone.

2. Your reimbursement documents refer to the following written materials:

Outpatient:

a. Medical Insurance Claim Application Form (Appendix B);

b. Original invoices, hardcopies of invoices of the part been reimbursed by other

parties and other relevant evidences;

c. Original or copy of the medical record with clear description of symptom, diagnosis

and treatment decisions and medicines applied (including medicine name, medicine

dosage and administration, total count.);

d. Original or copies of examination and laboratory tests reports;

e. Original prescriptions (hardcopy) and original outpatient medicine prescription

(need to be provided if the hospitals use duplicate prescription forms and outpatient

medicine prescription lists);

f. Clear list of treatment expenses;

g. Other documents deemed necessary by the insurer under special conditions;

Hospitalization:



b. Original invoices of medical expenses (should be with the charge stamp of the

hospital).If it were reimbursed by multi-organization, then copy of the invoices of the

part, which has been reimbursed, should be provided;

c. Details of hospitalization expenses, which including every expense for each day;

d. Hospital discharge brief summary, which should have a record of the diagnoses




e. Details of hospitalization expenses, which including every expense for each day;

f. Other documents deemed necessary by the insurer under special conditions;

Maternity


b. When applying for reimbursement of pregnant treatment expenses, pregnant

inspection brochure needs to be provided;

c. B-ultrasonic Examination reports during pregnancy ;

d. Hospitalization expenses list;

e. The copy of marriage certificate;

f. Child’s birth certificate;

g. Other documents deemed necessary by the insurer under special conditions.

3. How to fill in claim form for medical insurance

You need to fill in the related contents on the “Medical Insurance Claim Application

Form” which are as follows:

a. Corporation name: Please fill in the name of corporation.

b. Dependent name: please fill in if claim for dependent.

c. City: Please fill in the city of your office. If you need to work in other places in the

country for a long time, please fill in original city of working.

d. Consultation Date: fill in the date of diagnose (should rest content with original


invoice).

e. Please fill in respectively on every type of medical expenses. If fill in one claim form

for several application, please fill in respectively on every diagnosis, and the

number of total medical receipt, medical receipt amount of total receipts applied.

Notes: If original medical expenses receipts need to be returned, please attach copies of

all documents and the envelope which clearly indicate the post code and addressee when

request the claim.


Appendix B: Medical Insurance Claim Application Form

单证代码:

报案号:

索赔申请指引：

1、请清楚、完整、正确地填写员工或家属资料（家属如为未成年人无身份证号码请填写出生日期）。

2、员工、家属姓名请填写中文姓名；如为身份证号以外的证件，请同时填写性别、出生日期。

3、费用类别填写：1-疾病门急诊费用、2-住院费用、3-生育费用、4-意外门诊费用、5-意外住院费用、6-其他。

4、相应理赔申请资料请按诊治日期、诊治顺序依次装订在本申请书后，勿粘贴。

5、请务必填写索赔收据数量、索赔金额的合计数。

6、退件后再次申请理赔时请重新提交全部资料。

保单号码：GP保险索赔员工或家属资料(必须如实填写):

所在单位

员工姓名必填性别: □男 □女出生日期必填证件号码

证件类型

员工编号固定电话手机号码

联系地址省/直辖市市区/县室邮政编码

家属姓名如果为子女报销必填

家属性别: □男 □女出生日期必填证件号码

理赔金转账账号信息:

开户行名称户名账号

其他个人信息(可选填):

婚姻状况: □已婚 □未婚教育水平: 学历电子邮件: @ .com

医疗帐单资料:

诊治日期费用类别收据数量分割单数量索赔金额核赔金额备注

必填必填必填必填

合计

其他医疗资料：医疗费用清单/处方（）病史资料（）份病理/血液/影像报告（）份

被保险人及连带被保险人（家属）声明：

员工签名必填申请日期必填年月日

必填

威睿公司 VMWare

区号号码分机号

连带被保人报销比例 □ 50% □ 100% □ 双职工子女是否需要开分割单 □ 是 □ 否

□身份证 □护照 □军官证、士兵证 □港澳台回乡证或台胞证 □出生证 □户口本 □驾驶证

团体医疗保险理赔申请书

本人声明上述填写内容，及本人提供的一切资料均完全属实,如有虚假不实或隐瞒情况,中国平安人寿保险公司有权拒付保险

赔偿金。本人全部个人资料,仅限平安集团[指中国平安保险（集团）股份有限公司及其直接或间接控股的公司]及其认为业务必要

而委托的第三方为本人提供高质量的客户服务及推荐产品之用。平安集团及必要第三方对本人的个人信息负有保密义务。同时本

人授权任何医院或其他知情机构或知情人士向中国平安人寿保险公司提供与本次理赔申请有关的一切资料（包括病历、司法证明

材料等）。

必填

被保险人填写(理赔申请人) 保险公司填写

病因

必填

PING AN ANNUITY INSURANCE COMPANY OF CHINA,LTD


Appendix C: Designated Beneficiary for Life Insurance Process

For the issue procedure, the Ping An Insurance will be in accordance with the statutory

death benefit order to determine your insurance beneficiary, you do not need to go through

any formalities. If you want to specify by yourself, please see the application process as the

following:

designated beneficiary process:

The benefit of statutory and designated beneficiary and the benefit of statutory means

of

1. Statutory benefits:

The first order: Spouse, children, parents

The second order: Brothers, sisters, grandparents

With the statutory benefit approach, each beneficiary within the order, by a natural person

sharing insurance. When there is no beneficiary of the first order, the transfer order by the

second beneficiary to receive insurance money.

Download “Confirmation letter of beneficiary of life insurance” from VMware internal website

Fill out

“Confirmation letter of beneficiary of life

insurance”

You fax the “Confirmation letter of beneficiary of life insurance” to Ping An, at the same time scan and

email it to Ping An. Please specify: To Ms Gu Hongxia. Name the email title as: Confirmation letter

Tel: 010-59731803 Email: [email protected]


2. designated beneficiary

If the beneficiary were designed, the share of each beneficiary of the benefit must be

determined; otherwise the default is in accordance with the natural person equally. Many

beneficiaries, the sum of share of defined benefit must be 100%. If the beneficiary died

before the insured, the insured can be re-designated beneficiary, by shares of the benefit.

if there is not the first order beneficiary

The first order:

Spouse, children, parents

each beneficiary within the order, by a

natural person sharing insurance.

The second order:

Brothers, sisters, grandparents

each beneficiary within the order, by a

natural person sharing insurance.


Confirmation Letter of Life Insurance Beneficiary

(Please fill in with black or blue pen)

To: Ping An Annuity Insurance Company Beijing Branch

I, hereby, as insured, fully agree that [ ] VMWare

the policy-holder, insure on VMWare Group Insurance at Ping An Annuity Insurance Co.,

Ltd, and agree with all the items under the Group Insurance signed with Ping An Annuity

Insurance Co., Ltd. Simultaneously, I confirm my beneficiary of life insurance will be listed

below (choice one of them):

□ 1. legal beneficiaries as your beneficiary：

According to “the Law of China Canons of Descent”，legal beneficiaries will be：

First order: spouse, children, parents

Second order: brothers or sisters, grandparents

□ 2. designated beneficiaries as your beneficiary：

If there is not only one beneficiary, please inform the order of beneficiaries and

amount of the benefits.

1、name, ，ID number

Relationship with the insured , benefit ratio %







This confirmation letter is under my personal wish. If you provide “Change Life insurance

beneficiary request” many times; Ping An will keep the latest copy as final version. If you


are not submit modify application, this confirmation will continue valid for next insurance

period.

The insured person (employee) signature:

The insured person (employee) ID number:

Date:


Appendix D: Health Questionnaire

公司名称：Company Name: □VMWare

员工姓名：Name of Employee: 员工编号：Employee No. 联系电话：

Phone number: 配偶姓名：Name of Spouse:

子女姓名：Name of Child

Information Employ

ee

Spou

se

Child

1. Height & weight:

Status of insured person mm，Weight kg；

Status of dependent mm，Weight kg；

Yes No Yes

No

Yes

No

2．Imperfect of body:

any hearing, eyesight, speaking, chewing or intellectual obstacles

any imperfection or obstacles on backbone, check abnormality,

limbs, hand, foot

□ □

□ □

□ □

□ □

□ □

□ □

3．Symptoms: if there has been any symptoms like chronic

cough, coughing blood, choke, heart palpitation, short of breath,

edema, hoarseness, difficulty in swallow, vomit of blood, dark

urine, stomach, ulcer, anaemia, bruise, hematuria, albuminuria,

fleck, unreasonable skin bleeding, weight loss, continuous

headache, dizziness, tic, coma, prolonged fever, highly near

eye-sighted

□ □ □ □ □ □

4．Inquiry of case history: if there is any disease as the

following

A high blood pressure, inherited heart disease, rheumatism

heart disease, endocarditis, coronary heart disease, myocardial

infarction, arrhythmia, inherited, or incidents of heart or brain

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □


vessel

B Parkinson, falling sickness, chest disease, spinal cord and

psychopathy；

C Asthma, phthisic, emphysema, bronchus disease, lung

disease and lung-deduced heart disease

D Digestible abscess, shrinking stomach disease, pancreas,

hepatocirrhosis, liver disease and carrier, gallbladder infection or

calculi；

E Renal calculi or abnormality, chronic kidney disease, or

unfunctional kidney, multi-purse kidney, hydronephrosis, prostate

disease；

F Tumor（including malignancy and temporarily-diagnosed

benign or malignant tumors, cyst and neoplasm）

G Diabetes, gout, hyperpituitarism, Graves’ disease,

hyperadrenalism；

H erythema, lupus, rheumatism, collagen disease, connective

tissue disease, lumbar disease, colic；

I Anaemia, blood platelet decrease, irritable falling sickness,

haemophilia and leucocythemia；

J cataract, retina disease, cornea disease and glaucoma；

K inherited disease, local disease, career disease, disease with

the long term hormone treatment

L organ transplantation

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

□ □

5．Treatment & inspection experience:

A if there is any diagnosis or treatment in the past 3 months

B if there is any disease or surgeries in the past 5 years

□ □

□ □

□ □

□ □

□ □

□ □


6 ． If there is any inherited disease, tuberculosis, cancer,

diabetes, multi-purse kidney, colon disease, palsy, high blood

pressure, lunacy or death due to disease before 60 among your

brothers or sisters

□ □ □ □ □ □

7. only for female：

are you pregnant？if so，pregnant for _______weeks；

if there any disease like matrix tumor, cervices cancer, ovary cyst,

ovary cancer, evil grape fetus, galactophore (bump), galactophore

cancer or irregular bleeding from vagina etc.

□ □

□ □

□ □

□ □

□ □

□ □

8．Record of insurance：

If there is any release from the contract with other insurance

company or prolonged or refused reimbursement, or extra

condition for insurance-acceptance,

If there any claim from other insurance company on the hospital

treatment or incidental reimbursement in the past 3 years?

□ □

□ □

□ □

□ □

□ □

□ □

9．Explanation：（is you choose Yes for the above contents from

2 to 7, please clarify the No. of question and details of

explanation, including treating date, results and name of hospitals

etc. the Co. is responsible for keeping it secretly.）

□ □ □ □ □ □

Declaration and authorization of insured person:

I, hereby, formally declare that I have fully acquired of the signing requirement, insurance

return, hesitating period and all the items of the insurance. All the above-filled contents rest

content with the truth, and all of the declaration will act as credence of insurance bills and

part of insurance contract. Any false can result in the release of the contract. Any incidents

before the insurance will be responded by the insurance Company.


I, hereby, authorize any doctors, hospitals, insurance companies and other organizations,

personnel that have the access of knowing my or related insured personnel’s health

condition or other information, to hand in related datum to Ping An Annuity Insurance

Company, and the copies of the authorization letter will also be valid.

Signature of employee: Date signed:

(mm/dd/yy)


Appendix E: Definition of Critical Illness

The following list, which was composed by the Insurance Association of China and the

Chinese Medical Doctor Association, contained all standard Critical Illness:

1. Malignant tumor

It refers to uncontrolled, progressive proliferation and spread of malignant cells which

infiltrate and destroy surrounding normal tissues, and can metastasize through blood

vessels, lymph vessels, and body cavities to other parts of body. The classification of

malignant tumors will rely on pathological examination results for definite diagnosis

and clinical diagnosis will be based on the standard from the “International Statistical

Classification of Diseases and Health-related Problems (ICD-10) by the World Health

Organization. Following diseases are not covered by insurance:

Carcinoma in situ

2. Chronic Lymphocytic Leukemia with severity equivalent to stage A by the Binet

staging system

3. Hodgkin’s lymphoma with severity equivalent to stage I by the Ann Arbor staging

system

4. Skin cancer (not including malignant melanoma and case of skin cancer with

metastasis)

5. T1N0M0 or earlier stage prostate cancer (TNM staging)

6. Malignant tumor due to HIV infection or AIDS

2. Acute myocardial infarction

It refers to a condition of inadequate blood supply in corresponding to a coronary arterial

embolism, resulting in

necrosis in some myocardia. To be diagnosed with this condition, a patient must satisfy at

least the following three criteria:

1. Typical clinical manifestation such as acute chest pain;

2. Changes in recent electrocardiogram that suggest acute myocardial infarction ;

3. Elevated level of cardiac enzymes or Troponin with a diagnostic significance, OR the


condition matches thedynamic changes for acute myocardial infarction ;

4. After 90 days following the onset, the condition is further verified by examination as

reduction in left ventricular function such as when left ventricular ejection index is less than

50% .

3. Sequela of apoplexy (stroke)

It refers to a sudden onset of cerebrovascular lesion, where condition of hemorrhage,

embolism or infarction can be induced in blood vessels of a brain, which leads to

permanent dysfunction in the nervous system. Permanent neural dysfunction refers to the

condition of having one or more of the following dysfunctions after 180 days

followingdiagnosis:

1. Complete loss of body motor functions in one or more limbs

2. Complete loss of speech or function of mastication and deglutition

3. Completely incapacitated for autonomous management and cannot complete

independently three or more of the six basic daily activities.

4. Major organ transplantation or hematopoietic stem cell transplantation

Major organ transplantation refers to allogeneic transplantation of kidneys, liver, heart, or

lungs in correspondence to organ failure.

Hematopoietic stem cell transplantation refers to the allogeneic transplantation with

hematopoietic stem cells (including bone marrow hematopoietic stem cells, peripheral

hematopoietic stem cells and umbilical hematopoietic stem cells) after being diagnosed

with the impairment of hematopoietic function or malignant tumor in hematopoietic system.

5. Coronary artery bypass graft surgery(or coronary artery bypass transplantation

operation)

It refers to the actual operation of open chest surgery of coronary artery bypass

transplantation for the treatment of severe coronary disease.

Coronary stenting, percutaneous balloon angioplasty, laser ablation, other

non-surgical interventions, and


thorascopic operations are not covered by insurance.

6. Terminal renal disease (or known as the uremic period of chronic renal failure)

It refers to the situation that the patient has undergone at least 90 days of regular dialysis

for treatment or has received renal transplantation after being diagnosed with stage of

uremia of chronic irreversible failure of bothkidneys to function.

7. Loss of multiple limbs

It refers to complete dissociation of two or more limbs from the proximal end of wrist or

ankle (the end close to the body) due to disease or accidental trauma.

8. Acute or sub-acute severe hepatitis

It refers to diffused necrotic state in hepatic tissues due to viral infection of hepatitis

resulting in acute liver failure verified by hematological or virological tests. It must also meet

all the following criteria:

1. Severe jaundice or quick aggravation of the condition of jaundice

2. Hepatic encephalopathy

3. Type-B ultrasonic or other radiological examinations reveal quick atrophy in volume of

the liver

4. Progressive aggravation in the liver function indices

9. Benign brain tumor

It refers to benign tumor in brain, which has already caused an increase in the intracranial

pressure, where it manifests as papilloedema, psychological symptoms, epilepsy, and

motor or sensory dysfunction. And, it is life threatening. The diagnosis must be confirmed

by cranial computer tomography (CT), magnetic resonance imaging (MRI) or positron

emission tomography (PET), as well as satisfying at least one of the following criteria:

1. Actual operation of open-skull surgery to completely or partially remove brain tumor

2. Actual operation of radiotherapy for brain tumor

Pituitary adenoma, perencephaly, and cerebrovascular diseases are not covered by


insurance.

10. The decompensated period of chronic liver failure

It refers to the condition of liver failure due to chronic hepatic diseases. The diagnosis must

satisfy all of the following criteria:

1. Persistent jaundice

2. Ascites

3. Hepatic encephalopathy

4. Congestive splenomegaly with hypersplenism or esophageal gastric varicose

Liver failure due to excessive alcoholic indulgence or drug abuse will not be covered

by insurance.

11. Sequela of encephalitis or meningitis

It refers to permanent dysfunction in the nervous system due to encephalitis or meningitis.

Permanent neural dysfunction refers to the condition of having one or more of the following

dysfunctions after 180 days following diagnosis:




independently three or more of the six basic daily activities

12. Deep coma

It refers to the loss of consciousness due to disease or accidental trauma, where patient

remains unresponsive to outside stimuli and internal body demands and his severity of

coma scores 5 or lower on the Glasgow Coma Scale and respirator or other life support

systems have been continuously used for more than 96 hours.

Deep coma due to excessive alcoholic indulgence or drug abuse will not be covered

by insurance.

13. Deafness in both ears


It refers to permanently irreversible loss of hearing in both ears due to disease or accidental

trauma in which

situation under voice frequencies of 500Hz, 1,000Hz and 2,000Hz, the average hearing

threshold is larger than 90

decibels, which is confirmed by pure tone audiometry, acoustic immittance measurement or

auditory evoked potential test.

During period between the policy date and the 3rd policy anniversary date, the

insured, if suffering from deafness in both ears, is not covered by insurance.

14. Blindness in both eyes

It refers to permanently irreversible loss of eyesight in both eyes due to disease or

accidental trauma. The better one of the both must satisfy at least one of the following

criteria:

1. Loss or removal of eyeball

2. Corrected vision is less than 0.02 (by the international standard chart for visual acuity,

and if using other chart, conversion is required).

3. Radius of vision field is smaller than 5 degree angle.

15. Paralysis

It refers to complete, permanent loss of motor function of two or more limbs due to disease

or accidental trauma. The complete, permanent loss of motor function refers to complete

stiffness or inability to move at the patient’s own will of two major joints out of three in each

limb after 180 days following confirmed diagnosis or after

180 days following the accident.

16. Cardiac valve operation

It refers to the actual operation of open chest surgery for replacement or repair of heart

valve for treating cardiacvalve disease.

17. Severe Alzheimer’s Disease


It refers to severe degeneration or loss in intelligence due to progressive and irreversible

changes in brain.

Clinically, the condition manifests as apparent dysfunction in cognitive ability, abnormal

behavior, and recession in social capability. Patient’s daily activities will require continuous

monitoring by others. The diagnosis must be confirmed by cranial computer tomography

(CT), magnetic resonance imaging (MRI) or positron emission tomography (PET). And,

patient is completely incapacitated for autonomous management and cannot complete

independently three or more of the six basic daily activities.

Neurosis and mental disorders are not covered by insurance.

18. Severe brain trauma

It refers to permanent dysfunction in the nervous system due to mechanical external force

applied to the head, which injures vital parts of the brain. The diagnosis must be confirmed

by radiological examinations such as head computer tomography (CT), magnetic

resonance imaging (MRI) or positron emission tomography (PET).Permanent neural

dysfunction refers to the situation that one or more of the following dysfunctions remain

after 180 days following brain trauma:





19. Severe Parkinson’s Disease

It is a degenerative disease for the central nervous system, where clinical manifestations

show as paralysis agitans and dystaxia.The diagnosis must satisfy all of the following

criteria:

1. Therapy by medication cannot control the progression of disease.



Secondary Parkinson’s syndrome is not covered by insurance.


20. Severe third-degree burn

It refers to the severity of burn as third-degree and the surface area of a third-degree burn

can reach 20% or more of the entire body surface. The calculation of body surface area is

based on the “Chinese New Division by Nine Quadrants.

21. Severe primary pulmonary arterial hypertension

It refers to persistent elevation in pulmonary arterial pressure due to unknown cause which

may progress into achronic state. It will further cause permanently irreversible restriction to

physical ability and the condition can be classified as grade IV of cardiac function by New

York Heart Association. Also, at rest, the average of pulmonary arterial pressure surpasses

30mmHg.

22. Severe motor neuron disease

It refers to a set of progressive and degenerative diseases involving motor neurons in the

central nervous system, including progressive muscular atrophy, progressive bulbar

paralysis, primary lateral sclerosis, and amyotrophiclateral sclerosis. The patient is

completely incapacitated for autonomous management and cannot complete independently

three or more of the six basic daily activities.

23. Loss of speech

It refers to the complete loss of speech due to disease or accidental trauma. After active

treatment for at least 12 months (time restriction does not apply to the case with complete

removal of vocal cord), patient still cannot fully recover from the condition by current

medical treatments.

The loss of speech due to psychological factors is not covered by insurance.

On the policy date and the 1st to 3rd policy anniversary dates, the insured, if

suffering from loss of speech, is not covered by insurance.

24. Severe aplastic anemia


It refers to the conditions of anemia, reduction in number of neutrophils and reduction in

number of platelets due to chronic and persistent failure of hematopoietic function in bone

marrow.The diagnosis must satisfy all of the following criteria:

1. Bone marrow aspiration or bone marrow biopsy supports the diagnosis.

2. Peripheral hemogram must satisfy the following three criteria:

(1) Absolute value of neutrophils 0.5 x 109/L

(2) Reticulocytes < 1%

(3) Absolute value of platelets 20 x 109/L

25. Aortic operation

It refers to the actual operation of open chest or open abdominal surgery to remove,

replace, or repair diseased or injured aorta, for treating aortic disease. Aorta refers to the

thoracic aorta and abdominal aorta, but does not include branches of thoracic and

abdominal aorta.

Intra-arterial angioplasty is not covered by insurance.

The following list, which was composed by the Insurance Association of China and the

Chinese Medical Doctor Association, contains additional diseases to be included as

standard major diseases.

26. Severe multiple sclerosis

It refers to irreversible body dysfunction due to demyelination of the central nervous system

and the condition must be clearly confirmed by specialist from the Department of Neurology

as well as diagnostic reports of CT or MRI findings. Irreversible dysfunction in body part can

persist for more than 180 days after diagnosis of the condition.

Along with clear diagnosis by specialist of the Department of Neurology, it must also

contain the followings:

1. Clear clinical manifestations in correspondence to injuries in optic nerve, brain stem,

and spinal cord

2. Scattered lesions in multiple sites of the nervous system

3. Apparent symptoms and signs described above and history of repetitive aggravation


or alleviation in symptoms to nerve injury

27. Severe type 1 diabetes mellitus

Severe type 1 diabetes refers to the circumstance that the patient has chronic elevation of

blood glucose due to absolute inadequate secretion of insulin and has relied on extrinsic

insulin for more than 180 consecutive days. By measuring insulin and peptide C in blood or

in urine, abnormal results are returned and can then be confirmed for diagnosis by

specialist in the Department of Endocrinology. The patient is insured when the condition is

presented during the validity period of this contract and at least one of the following criteria

must be satisfied:

1. Condition of proliferative reticular lesion has developed.

2. Requirement of implantation of pacemaker for treating heart disease

3. At least one toe must be removed due to gangrene.

28. Invasive hydatidiform mole (or known as malignant hydatidiform mole)

This category of disease refers to hydatidiform mole with abnormally proliferative cilia

infiltrating mesometrium or metastasizing to other organs or tissues. And, patient has

already undergone chemotherapy or surgical treatment.

29. Systemic lupus erythematosus with severe renal insufficiency

The insurance for this category of disease only applies to female.

This category of disease refers to a type of autoimmune disease for connective tissues,

where there are large quantities of pathogenic autoimmune antibodies and immune

complexes, which cause tissue damage. The diagnosis of systemic lupus erythematosus

must be confirmed by a specialist and also satisfies the following conditions:

1. At least present four of the following conditions in clinical manifestations:

(1) Erythema in the shape of butterfly or disc

(2) Hypersensitive to light

(3) Ulceration in mucous membranes of oral and nasal cavities

(4) Arthritis without deformity or pain at multiple joints


(5) Pleurisy or pericarditis

(6) Injury to the nervous system (epilepsy or other psychological symptoms)

(7) Abnormal hemogram (white blood cell count is smaller than 4,000/ l or platelet

count is smaller than

100,000/ l or there is sign of hemolytic anemia)

2. At least present two of the following conditions in test results:

(1) Positive anti-dsDNA antibodies

(2) Positive anti-Sm antibodies

(3) Positive anti-nuclear antibodies

(4) Positive result for Lupus band test (at non-lesion site) or renal biopsy

(5) C3 value is below normal.

3. Lupus nephritis weakens renal functions, and the clearance rate for endogenous

creatinine is lower than 30ml per minute.

30. Severe primary myocardial disease

It refers to a type of myocardial lesion without known cause, including primary dilated

cardiomyopathy, primaryhypertrophic cardiomyopathy, and primary restrictive

cardiomyopathy. Lesion must already cause apparent heart failure due to ventricular

dysfunction (has reached grade IV by the classification of cardiac function by New York

Heart Association). And, hospitalization records also show grade IV of heart failure for

duration of at least 180 days.

This disease must be clearly diagnosed by specialist. Any cardiomyopathy, which is

secondary to systemic disease or disease of other organ system, will not be covered

by insurance.

Grade IV of cardiac function as classified by the New York Heart Association refers to:

indication of prohibiting any physical exercise by medical records and any manifestation of

heart failure such as chest palpitation or dyspnea even at rest.


Appendix F: Ping An “All-in-One Account” Self-Service System

1. Enter www.pingan.com and log onto All-in-One Account index page by click ‘All-in-One

Account’ button in the right column.

2. Input your user name, password, security code and click ‘Login’ on the index page of

‘All-in-One Account’; User name shall be customized name, Ping An company code or

ID Card number. Password is the code you set during registration.

3. Afterwards, you may see the following information: personal basic info, claim inquiry

record, etc.

http://www.pingan.com/


4. Click ‘Claim record inquiry’ and you may see personal claim information. Then click

‘Details review’ and you may see detailed descriptions.

2018 vmware foreign employee commercial insurance handbook · 2017 vmware foreign employee...

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