aviva mycare (eldershield supplement) faq

Strictly for Financial Advisers Only

This document is published for information only and does not have regard to the specific investment objectives, financial situation and needs of any particular person. This information shall not be reproduced or distributed to unintended parties including policyholders, prospects and/or 3rd parties. Aviva Ltd, accepts no liability whatsoever with respect to the use of the document or its contents. The information contained in this document is accurate as at 1 April 2011.

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Frequently Asked Questions Basic ElderShield General 1. What is ElderShield?

ElderShield is an affordable severe disability insurance scheme which provides basic financial protection to those who need long-term care, especially during old age.

ElderShield provides a monthly cash payout of $300 for a maximum of 60 months (i.e. ElderShield300) or $400 for a maximum of 72 months (i.e. ElderShield400) to help pay the out-of-pocket expenses for the care of the severely disabled person.

2. Who is eligible for ElderShield?

All CPF Members (Singapore Citizens and Permanent Residents) who reach the age of 40 will be covered automatically. As it is an auto-cover scheme, you do not have to sign up to join ElderShield.

3. What does severe disability mean?

Severe disability means an inability to perform at least 3 of the 6 activities of daily living (ADL) - Washing, Dressing, Feeding, Toileting, Mobility, and Transferring, even with the aid of special equipment, and always to require the physical assistance of another person throughout the entire activity.

4. How long is the coverage provided by ElderShield?

ElderShield policyholders pay a regular premium until age 65#, but they will be covered for the rest of their lives, once they have paid up their premiums in full. In the event of a claim, the benefit will be payable for 5 years (ElderShield300) or 6 years (ElderShield400). # Last premium payment is at age 65 (last birthday) or age 66 (next birthday)

5. How can I find out whether my client is currently covered under the ElderShield scheme and which plan he is covered under? If your client turned age 40 after September 2007, he should be in the ElderShield400 scheme ($400 per month benefit payable for up to 6 years), unless he has opted out.

If your client turned age 40 before September 2007, he should be in the ElderShield300 scheme ($300 per month benefit payable for up to 5 years), unless he has opted out or upgraded to ElderShield400 scheme with his existing insurer.



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For further clarifications, please call our customer service hotline at 6827 9923 (for advisers) and 6827 7788 (customers) to find out which ElderShield scheme your client is covered under. If your client is insured with another insurer, he/she may check with the respective insurer or contact CPF Board directly for the information.

6. Where else can I get more information on the ElderShield scheme?

You can obtain more information from Aviva’s website at www.aviva.com.sg or alternatively you can visit the Ministry of Health’s website at www.moh.gov.sg. Note: You may refer to the Aviva’s website for more Frequently Asked Questions on the ElderShield scheme.

Benefits 7. What are the benefits of ElderShield?

If your policy commenced before 29 September 2007 and you did not choose to upgrade, you will receive a monthly cash payout of $300, for up to a maximum of 60 months should you become "severely disabled". If your policy commenced after 29 September 2007 or if you have successfully upgraded your policy, the monthly cash payout will be $400, for up to a maximum of 72 months. You can use the money to help you pay for any type of care that is suitable for your needs (e.g. home nursing services, day rehabilitation, nursing homes, etc).

Premiums 8. How can I pay for the premiums of my ElderShield?

You can use your Medisave to pay for your ElderShield premiums and the premiums are subject to current GST rate. If you do not have enough Medisave savings, you may also use the Medisave Accounts of your spouse, parents, children or grandchildren. You may also pay the premiums by cash.

9. Is there a Medisave limit to pay for the premiums of the basic ElderShield plan?

There is no Medisave limit to pay for the premium of basic ElderShield plan. However there is a Medisave limit of $600 per policy year per person for ElderShield Supplement plans.



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Claims 10. How can I make a claim?

You have to fill up the claim form and have your condition assessed by an appointed assessor. The assessor will complete the assessment form and return it to your insurer for processing. You will receive your insurance payouts either by cheque or credited into your bank account 90 days after you have been certified to be severely disabled.

You may obtain a copy of the claim form and list of appointed assessors from the Aviva's website. You can also contact our Customer Service Centre at 6827 9923 (for advisers) and 6827 7788 (customers) for details and advice.

MyCare and MyCare Plus General 11. What are MyCare and MyCare Plus?

MyCare and MyCare Plus are ElderShield Supplement Schemes that expand the coverage of your basic ElderShield plan with additional coverage and benefits for an additional premium. They allow your customers to customise a policy that best meets their own personal coverage needs. MyCare gives your customers a choice of: i. Monthly Severe Disability Benefit Amount - choose your preferred monthly payout

(inclusive of ElderShield benefit) from a minimum of $600 to up to a maximum of $3,500 (in increments of $100).

ii. Benefit Payout Duration - choose between up to 12-year (144 months) duration or an unlimited lifetime payout duration.

iii. Premium Term - choose between paying (i) lifetime or (ii) till 66# age next birthday or for 20 years from age of entry, whichever is later;

# Last premium payment is at age 66 next birthday. MyCare Plus gives your customers a choice of: i. Monthly Severe Disability Benefit Amount - choose your preferred monthly payout

(inclusive of ElderShield benefit) from a minimum of $600 to a maximum of $3,500 (in increments of $100).

ii. Benefit Payout Duration - choose between up to 12-year (144 months) duration or an unlimited lifetime payout duration.



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12. Why should my client, who is young and healthy at age 40, purchase MyCare and/or

MyCare Plus now?

The premiums for MyCare and MyCare Plus are level and are based on entry age, i.e. they do not increase with age. Therefore, the younger he is, the lower the premiums.

13. Can my client purchase both MyCare and MyCare Plus at the same time?

Yes, your client can purchase both MyCare and MyCare Plus at the same time as both plans are separate plans offering different benefits, subject to a maximum monthly payout benefit of $3,500 per Life Assured, aggregated on all supplement plans purchased from Aviva.

14. What does severe disability mean?

Severe disability means an inability to perform at least i. 3 of the 6 ADL* - MyCare ii. 2 of the 6 ADL* - MyCare Plus

even with the aid of special equipment, and always to require the physical assistance of another person throughout the entire activity.

* ADL (Activities of Daily Living) - Washing, Dressing, Feeding, Toileting, Mobility, and Transferring

Refer to the product summary or policy contract for definitions of the 6 ADL.

15. What does Deferment Period mean?

Deferment Period means a period of 90 days from the Claim Date (inclusive) where no benefit will be payable. Benefit shall be payable after the Deferment Period. This Deferment Period shall be waived if the Life Assured suffers from a Severe Disability again arising from the same cause within 180 days from ceasing to suffer from the Severe Disability.

16. What does Waiting Period mean?

Waiting Period means a period of 90 days from the Policy Issue Date, Policy Commencement Date or reinstatement date of the Policy, whichever is latest, where no benefit shall be payable if the Life Assured suffers from a Severe Disability unless the Severe Disability is caused by an Accident or the Severe Disability is such that the Life Assured is unable to perform more than 2 ADL even with the aid of special equipment, and always to require the physical assistance of another person throughout the entire activity. The waiting period is applicable to MyCare Plus only.



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“Accident” means an event caused solely and independently of all other causes and directly by violent, unexpected, external and visible means.

17. How long is the free-look period for MyCare and/or MyCare Plus? The free-look period is 60 days of receipt of the Policy. The premiums will be refunded (without interest). If the Policy is mailed to you, you are deemed to have received the Policy 7 days from posting.

Benefits 18. What are the benefits of MyCare and MyCare Plus?

MyCare provides a monthly severe disability payout in the event the life assured is unable to perform at least 3 of the 6 ADL while MyCare Plus provides a monthly severe disability payout in the event the life assured is unable to perform at least 2 of the 6 ADL. Other benefits include: i. Lump sum benefit ii. Rehabilitation benefit (for MyCare only) iii. Dependent care benefit iv. Death benefit v. Waiver of Premium benefit

The monthly Severe Disability Benefit payouts under MyCare and MyCare Plus are illustrated below: (i) If the Basic ElderShield Policy is to provide for a monthly payout of $300 for up to 5

years (ElderShield300),

Benefit Payout Period Monthly Benefit Payable 1st 5 years Severe Disability Benefit selected less $300 Subsequent years (up to 12 years or a lifetime, depending on benefit payout duration chosen)

Severe Disability Benefit selected

(ii) If the Basic ElderShield Policy is to provide for a monthly payout of $400 for up to 6

years (ElderShield400),

Benefit Payout Period Monthly Benefit Payable 1st 6 years Severe Disability Benefit selected less $400 Subsequent years (up to 12 years or a lifetime, depending on benefit payout duration chosen)

Severe Disability Benefit selected

Note: The monthly benefit payout under MyCare Plus will be computed and payable as shown above, whether or not there is any actual payout payable to you from the Basic ElderShield300/400 Policy. For example, if Life Assured is unable to perform 2 out of 6 ADL, the



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Life Assured will be receiving the difference between the MyCare Plus Severe Disability Benefit and the Basic ElderShield monthly benefit amount though there is no payout from Basic ElderShield Policy.

19. When is the Severe Disability Benefit payable?

The monthly benefit is payable when the Life Assured is certified as severely disabled, after a 90-day deferment period and is still unable to perform at least i. 3 of the 6 ADL for MyCare ii. 2 of the 6 ADL for MyCare Plus* * Note: If the Life Assured suffers from a Severe Disability within 90 days (also known Waiting

Period) from the Policy Issue Date, Policy Commencement Date or reinstatement date of the Policy, whichever is latest, the benefit will not be payable. This waiting period does not apply if the Severe Disability is caused by an Accident or the Severe Disability is such that the Life Assured is unable to perform more than 2 ADL, even with the aid of special equipment, and always to require the physical assistance of another person throughout the entire activity.

20. How long is the Severe Disability Benefit payable?

Your customer has a choice of either setting the length of his severe disability benefit payout term to be either: i. Lifetime or ii. Up to 12 years (144 months) The benefit continues to be payable as long as your customer’s disability lasts, up to the end of the chosen benefit payout duration, or recovery or death, whichever is earliest.

21. When is the Lump Sum Benefit payable? The additional lump sum is payable when the Life Assured is certified as severely disabled and unable to perform at least: i. 3 of the 6 ADL (MyCare) or ii. 2 of the 6 ADL (MyCare Plus) This additional benefit is equal to 3 times the first monthly payout amount payable under MyCare or MyCare Plus and is paid only once in the policy lifetime. Once the 90-day deferment period is complete, both the lump sum and regular benefit payout begins.

22. When is the Rehabilitation Benefit payable?

The monthly rehabilitation benefit is payable when the Life Assured recovers from a severe disability but is still unable to perform 2 of the 6 ADL. The benefit payable is 50% of the monthly Severe Disability Benefit payable under MyCare for the same benefit payout duration as the Severe Disability Benefit.

The Rehabilitation Benefit is applicable to MyCare only as MyCare Plus already covers 2 of 6 ADL.



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The Rehabilitation Benefit is payable until the earliest of (i) Life Assured no longer meets the requirement for Rehabilitation Benefit, (ii) death of the Life Assured or (iii) end of the benefit payout duration.

23. When is the Dependant Care Benefit payable? The additional monthly Dependant Care benefit is payable when the Life Assured is receiving a severe disability or rehabilitation benefit and has at least one child who is aged 21 and below at the time of claim. This benefit is payable once the 90-day deferment period is completed. This additional benefit of $200 per month is payable until the earliest of (i) cessation of the Severe Disability or Rehabilitation Benefit, (ii) end of 36 months or (iii) death of the Life Assured.

24. Does it make any difference how many children my client has who are age 21 and below to enjoy the Dependant Care Benefit? No. The Dependant Care Benefit is payable on a per policy basis. If both parents have a MyCare and/or MyCare Plus policy each and there is only one child, one payout will be made from each policy.

25. When is the Death Benefit payable?

For the existing MyCare policies, a valid claim for the death benefit is payable if the Life Assured dies during the period that Aviva is paying the Severe Disability Benefit or the Rehabilitation Benefit. For MyCare and MyCarePlus policies signed up on or after 4 April 2011, a valid claim for the death benefit will be payable in the event the Life Assured dies as a result of an accident or sickness while Aviva is paying (i) the Severe Disability Benefit (MyCare Plus) or (ii) either the Severe Disability Benefit or the Rehabilitation Benefit (applicable for MyCare only). The revision in wording of the death benefit is to ensure that MyCare and MyCare Plus policies signed up on or after 4 April 2011 are health policies as defined in the relevant regulation. As the instances where the Life Assured dies of a cause other than an accident or sickness is likely to be fairly infrequent, the extent of the death benefit under the new wording is not significantly different from the existing MyCare death benefit. The Death Benefit is 3 times the last paid monthly benefit amount payable under MyCare or MyCare Plus for the Severe Disability Benefit or the Rehabilitation Benefit, whichever is applicable). The Policy will terminate upon the death of the Life Assured.



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Premiums 26. How can my client pay for the premiums of MyCare and/or MyCare Plus?

Your client can use his Medisave to pay for his MyCare and/or MyCare Plus premiums, subject to a maximum of $600 per calendar year per life assured. This is aggregated on all ElderShield supplement plans, if the Life Assured has more than 1 supplement plan. The MyCare Plus premiums are subject to current GST rate. For the position on GST for MyCare policies, please see Q27 and Q28. If he does not have enough Medisave savings, he may also use the medisave accounts of his spouse, parents, children or grandchildren. He may also pay the premiums by cash (as a top-up or pay the total premiums in cash).

27. Why is GST implemented for MyCare policy?

To align with recently expressed views of the relevant authorities, MyCare with the death benefit revised as mentioned in Q25 above, will be re-classified as Health Insurance from 4 April 2011 with current GST rate applicable for ALL new applications signed and dated from 4 April 2011 onwards.

28. What if my client has previously bought a MyCare policy without GST? Does my client have to pay GST for the current policy? Our view is that our existing MyCare policy - purchased or applied for prior to the re-classification - remains a Life policy and all premiums paid in the past and payable in the future in respect of such existing policies are therefore not subject to GST. We are working with the relevant authorities to confirm this position and will inform you once we have their response.

29. Are the premiums for MyCare and MyCare Plus guaranteed?

The premiums for MyCare and MyCare Plus are not guaranteed and may be subject to future review.

30. How can my client pay for MyCare and/or MyCare Plus premiums if he does not have enough Medisave to pay for the premiums? He can use the Medisave of his spouse, parents, children or grandchildren. He may also pay the premiums by cash (as a top-up or pay the total premiums in cash).

31. Is there a limit to the number of MyCare and/or MyCare Plus policies that my client

may purchase?



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No, there no limit to the number of MyCare and/or MyCare Plus policies that your client can purchase. However it is subject to a maximum monthly benefit of $3,500 per Life Assured on all aggregated MyCare and/or MyCare Plus policies (inclusive of basic ElderShield monthly benefits)

New Business and Underwriting 32. Does my client need to be insured under an Aviva basic ElderShield policy to

purchase a MyCare and/or MyCare Plus policy? No. Your client can have a basic ElderShield policy with any of the other two insurers and still purchase Aviva’s MyCare and/or MyCare Plus policy.

33. My client has a basic ElderShield policy with one of the other 2 insurers and would

like to switch to Aviva for easy administrative purposes since he is insured under MyCare and/or MyCare Plus. How can he go about this? If he has just turned 40 recently and his basic ElderShield policy has been allocated to one of the other 2 insurers, he may switch to Aviva within the 90-day opt-out period without undergoing underwriting or any penalty.

However, if he has already been covered under a basic ElderShield policy for a number of years with another insurer, it is not recommended that he replaces the policy with Aviva for the following reasons: i. Basic ElderShield policy premiums are level and are based on entry age. Thus, if he

transfers his policy after it has been in force for a few years, he will have to pay premiums based on his current attained age, which is higher than what he is currently paying his existing insurer.

ii. He will lose the paid-up values or the reserves that have been built up in the last few years with his existing insurer.

iii. He will have to go through full underwriting. 34. If my client had previously opted out of the ElderShield scheme but is now keen to

take up MyCare and/or MyCare Plus, can he purchase MyCare and/or MyCare Plus? Your client will need to have a basic ElderShield policy in place before he can apply for MyCare and /or MyCare Plus. There are a few simple steps for your client to sign up for a basic ElderShield policy: i. Complete the Application Form for ElderShield/MyCare/MyCare Plus. ii. Submit the Application Form to Aviva. iii. All applications will be subjected to underwriting, including the basic ElderShield policy.

35. If my client is covered under the ElderShield300 scheme, and now wants to sign up for MyCare and/or MyCare Plus, does he have to upgrade to the ElderShield400 scheme first?



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No. Your client can purchase MyCare and/or MyCare Plus so long as he has an in-force basic ElderShield policy, whether it is under the ElderShield300 or ElderShield400 scheme.

36. What are the possible outcomes of the underwriting?

The possible outcomes are: i. Accept; or ii. Accept with premium loading; or iii. Decline.

Policy Servicing 37. If my client previously bought a MyCare policy with monthly benefit of $3,500, can he

now reduced the benefit under MyCare and purchase a MyCare Plus?

Yes he can. Please refer to the policy contract for the terms and conditions. 38. What happens if my client is unable to continue with the premium payment after a few

years? Your client may convert his policy into a paid-up policy with a reduced monthly benefit after a certain minimum number of years to prevent his policy from lapsing due to non-payment of premiums, provided that there are sufficient reserves accumulated. The monthly benefit amount is dependent upon his age and how long his policy has been in force. In the event there are insufficient reserves accumulated, the policy will lapse and the cover will cease.

This is applicable to both limited premium payment term (MyCare policies only) and lifetime premium term (both MyCare and MyCare Plus). Please contact our Customer Service Centre at 6827 9923 (for advisers) and 6827 7788 (customers) for details on the minimum premium payment applicable for your customer,

39. Can a policy loan be taken against MyCare and/or MyCare Plus?

No, as there is no cash value in the policy.

40. Is there a paid-up value for MyCare and/or MyCare Plus?

Yes, paid-up value is available. The benefits payable under MyCare and/or MyCare Plus will be reduced depending on the paid-up values accumulated under the policy based on the number of years of premiums paid.

41. Must my client's ElderShield be in force at every MyCare and/or MyCare Plus renewal?



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Yes, ElderShield must be in force at every MyCare and/or MyCare Plus renewal.

Claims 42. How can I make a claim for MyCare and/or MyCare Plus?

You have to fill up the claim form and have your condition assessed by an appointed assessor. The assessor will complete the assessment form and return it to Aviva for processing. You will receive your insurance payouts either by cheque or credited into your bank account 90 days after you have been certified to be severely disabled.

You may obtain a copy of the claim form and list of appointed assessors from the insurer's website. You can also contact Aviva’s Customer Service Centre at 6827 9923 for details and advice.

43. If my client had a relapse of the Severe Disability from the same cause, will he be able

to enjoy the benefits immediately or is it subject to the deferment period?

If the relapse occurs within 180 days and is due to the same cause, the 90-day deferment period will be waived. If the relapse occurs after the 180-day period or is a result of a different cause, the 90-day deferment period shall apply again.

44. Will Aviva perform periodic reviews on my client while he is claiming for severe disability to ensure that he is still eligible for the benefits? How often will Aviva conduct such reviews?

Aviva will make periodic reviews depending on the severity of his disability. As every claim is unique, there is no fix frequency for these reviews.

Healthcare Privileges 45. What are the healthcare privileges available for MyCare and/or MyCare Plus

policyholders?

We have tie-ups with several healthcare services providers to provide our policyholders special rates for healthcare services. Please refer to our website at www.aviva.com.sg/eldershield for more details.



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New Changes at a Glance

Benefits Plans Existing MyCare MyCare

(w.e.f. 4 April 2011) MyCare Plus (NEW)

Severe Disability Benefit At least 3 of 6 ADL At least 3 of 6 ADL At least 2 of 6 ADL

GST Imposed Subject to confirmation from the relevant authorities, no GST imposed on initial and renewal premiums already paid or to be paid in future on MyCare policies purchased prior to 4 April or applied for prior to 4 April 2011* with application received by Aviva by 18 April 2011. *application must be dated and signed before 4 April 2011 � .

Yes � To align with the

views of the relevant authorities, MyCare with the death benefit revised as mentioned in Q25 above, will be re-classified as Health Insurance from 4 April 2011.Current GST rate will be applicable for all new applications signed and dated from 4 April 2011 onwards

Yes

Death Benefits 3 times the last monthly benefit payout* will be payable if death occurs while in claim

3 times the last monthly benefit payout*will be payable in the event the Life Assured dies due to any accident or sickness while in claim

3 times the last monthly benefit payout* will be payable in the event the Life Assured dies due to any accident or sickness while in claim

* Refers to the last paid monthly benefit amount payable under MyCare or MyCare Plus for the Severe Disability Benefit or the Rehabilitation Benefit, whichever is applicable.

aviva mycare (eldershield supplement) faq

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