build your team with health and well-being€¦ · axa smartcare sme well-rounded health protection...

AXA SMARTCARE SME Well-rounded health protection for your company’s most prized assets.

Build yourteam with health

and well-being

Employee Health & Benefits

As an SME owner, your business is fueled by a strong, motivated team. SMARTCARE SME gives you a tailored package to protect the health and well-being of your employees. With a comprehensive and hassle-free solution that is customised to your company size and budget, it has never been easier to take care of the team who keep your business strong.

Start your package with just one employee Allows you to start your policy with just 1 employee* in the first year.

Customisable plans Build a simple plan to fit your company’s needs and budget, with a range of Group Hospital and Surgical options.

Range of riders Enhance the health protection with 6 riders to choose from: • Group Extended Major Medical • Group Outpatient General Practitioner • Group Outpatient Specialist Care • Group Dental • Group Personal Accident

Pre-existing conditions for inpatient plans Give your employees the peace of mind that their pre-existing medical conditions** are covered after a waiting period of just 12 months.

Customisable health protection for your employees

* For Group size of 1 employee, there will be a loading of 60% across all medical covers for all insured members. Brochure rates apply to all subsequent new members. Upon policy anniversary, we will require at least 2 employees to renew the policy. ** Pre-existing cancer and renal failure are permanently excluded.

Grow your business confidently and build a strong, motivated team with AXA SMARTCARE SME, giving you protection against expensive healthcare costs or unforeseen events and injuries to your employees.

2

* Pre-existing cancer and renal failure are permanently excluded. ** Terms and conditions apply. Please refer to the policy wordings for full details.# Subject to Co-payment and up to the policy limit.

Benefits at a glance

Basic Plan

Group Hospital and Surgical

• Covers hospitalisation and surgical expenses• Covers Outpatient Cancer and Kidney Dialysis treatment• 12 months waiting period for pre-existing medical conditions*• 60% Pro-ration applies if the insured member is admitted to a ward or hospital type higher than he is entitled to under the policy; or if it is an overseas hospital admission

Group Size Premium Discount

Applicable Plan and Riders

• Group Hospital and Surgical • Group Extended Major Medical • Group Outpatient – General Practitioner• Group Outpatient – Specialist Care• Group Dental

Group Size (5 – 9 employees) 5% discount

Group Size (10 or more employees) 10% discount

Riders

Group Extended Major Medical

• Provides reimbursement of eligible expenses in excess of benefits payable under the basic Group Hospital and Surgical plan where: – Hospitalisation is more than 20 days; or – Surgical procedures of at least 75% of the benefit is payable under the Schedule of Surgical Benefits• 60% Pro-ration applies if the insured member is admitted to a ward or hospital type higher than he is entitled to under the policy; or if it is an overseas hospital admission• 12 months waiting period for all pre-existing medical conditions*

Group Outpatient – General Practitioner

• Covers eligible expenses incurred at a general practitioner, polyclinic or A&E department of any hospital in Singapore• Provides access to cashless visits at an islandwide panel network of General Practitioner clinics

Group Outpatient – Specialist Care

• Provides reimbursement of eligible expenses incurred at specialist clinics and diagnostic scans, including X-ray and laboratory tests, referred by General Practitioner• Covers Physiotherapy (referred by physician), Chiropractic Treatment and Traditional Chinese Medicine

Group Dental • Provides reimbursement of eligible Reasonable and Customary Charges at a dental clinic of your choice#

Group Personal Accident • Covers loss of life, permanent disablement or dismemberment due to an accident

3

Choose from Option 1, Option 2, and Option 3 for the hospital type and co-payment cover.

Option 1 Option 2 Option 3

Hospital Type Private Hospital Private HospitalGovernment Restructured

Hospital

Co-payment No Co-payment 20% Co-payment No Co-payment

– For Option 1 and Option 2, admission to Government Restructured Hospital (with no co-payment) will still be applicable. – For Option 3, 60% pro-ration applies* if Insured member goes to a private hospital.– For all Options, a 60% pro-ration will be applicable for Hospital type or ward upgrade*.

Choose between 1 Bed or 4 Bed for Daily Room & Board cover.

Choose from Plan A, Plan B and Plan C for benefit limits. You may choose different Plans for different categories of employees in your company.

STEP1

STEP2STEP3

Step-by-step guide to build your best-fit Group Hospital and Surgical cover

* Please refer to the “Limitation of Cover” clause in the policy documents for full details.

4

Basic Plans

Group Hospital & Surgical (GHS)Choice of Hospital Cover: Option 1: Private Hospital with no Co-payment Option 2: Private Hospital with 20% Co-payment Option 3: Government Restructured Hospital with no Co-payment

Benefit Schedule Plan A Plan B Plan C

Policy Limit (applicable to all benefits except items marked *)

250,000 per policy year Maximum per Disability

Daily Room & Board (Standard) (Up to 120 days) Choice of 1 Bed or 4 Bed

Intensive Care Unit (ICU) As Charged 15,000 15,000

Hospital Miscellaneous Expenses As Charged

25,000 15,000

Ambulance Charges As Charged

Surgeon’s Fees (Subject to Schedule of Surgical Benefits for Private Hospital) #

As Charged (not subject to Surgical Table)

In-Hospital Physician’s Visit (Up to 120 days) As Charged

Pre-Hospitalisation / Surgery Specialist’s Consultation (Up to 90 days before hospitalisation / surgery)

As Charged 2,000 1,000Pre-Hospitalisation/ Surgery Diagnostic Services (Up to 90 days before surgery) Post-Hospitalisation/ Surgery Treatment (Up to 90 days)Medical Report Fees 100 100 100

Emergency Outpatient Treatment (due to accident only) As Charged 2,000 1,000

Emergency Outpatient Dental Treatment (due to accident only) 5,000 4,000 2,000

Miscarriage 3,000 2,000 1,000

Surgical Implants 5,000 2,000 1,000

Outpatient Kidney Dialysis (Max. per policy year) 75,000 50,000 20,000

Outpatient Cancer Treatment (Max. per policy year) 75,000 50,000 20,000

Special Grant 5,000 5,000 5,000

Hospital Cash Benefit (Up to 90 days of confinement in Government Restructured Hospital) – B1 Ward (N.A if 4 Bed option is chosen) – B2/B2+ Ward – C Ward

150 250 300

150 250 300

150 250 300

Daily Recovery Benefit (after 3 days of hospitalisation, up to 30 days) 150

N.A N.A

Dread Disease Recuperation Benefit (Multiple Sclerosis, Heart Attack, Cancer & Stroke) ** 10,000

Parent Accomodation as companion for Child(Up to 60 days per year for child below age 12) As Charged

Home Nursing (Up to 26 weeks) As Charged

Emergency Medical Evacuation/ Repatriation * Unlimited

Repatriation of Mortal Remains or Local Burial * Unlimited* The above benefits are not subject to annual policy limits.** Dread Disease Recuperation benefit is subject to a waiting period of 90 days. The Life Insurance Association Singapore (LIA) has standard Definitions for 37 severe-stage Critical Illness (Version 2014). These Critical Illness fall under Version 2014. You may refer to www.lia.org.sg for the standard defintions (Version 2014).# Plan A and surgeon’s fees incurred at a Singapore Government Restructured Hospital are not subjected to Schedule of Surgical Benefits.

5

Annual Premium Per Insured Member (S$) [Inclusive of GST]

Option 1: Private Hospital with no Co-payment

Age next birthday

1 Bed 4 Bed

Plan A Plan B Plan C Plan A Plan B Plan C

0 – 30 1,029.00 596.00 528.00 566.00 327.00 290.00

31 – 40 1,332.00 703.00 623.00 733.00 386.00 343.00

41 – 45 1,493.00 786.00 696.00 821.00 432.00 384.00

46 – 50 1,864.00 952.00 872.00 1,027.00 524.00 480.00

51 – 55 2,264.00 1,190.00 1,057.00 1,245.00 655.00 581.00

56 – 60 2,930.00 1,597.00 1,366.00 1,611.00 880.00 751.00

61 – 65 3,994.00 2,110.00 1,865.00 2,197.00 1,160.00 1,027.00

66 – 70 5,990.00 3,153.00 2,796.00 3,295.00 1,734.00 1,538.00

71 - 75* 7,321.00 3,854.00 3,417.00 4,026.00 2,119.00 1,880.00

76 - 80* 9,585.00 5,046.00 4,474.00 5,272.00 2,775.00 2,461.00

Option 2: Private Hospital with 20% Co-payment

Age next birthday

1 Bed 4 Bed


0 – 30 823.00 476.00 422.00 453.00 262.00 233.00

31 – 40 1,065.00 562.00 500.00 587.00 308.00 275.00

41 – 45 1,194.00 628.00 557.00 658.00 346.00 306.00

46 – 50 1,492.00 762.00 698.00 821.00 419.00 384.00

51 – 55 1,811.00 952.00 845.00 996.00 524.00 465.00

56 – 60 2,344.00 1,278.00 1,094.00 1,289.00 703.00 603.00

61 – 65 3,195.00 1,688.00 1,493.00 1,757.00 928.00 821.00

66 – 70 4,792.00 2,523.00 2,237.00 2,636.00 1,387.00 1,231.00

71 - 75** 5,857.00 3,083.00 2,736.00 3,221.00 1,695.00 1,504.00

76 - 80** 7,669.00 4,037.00 3,579.00 4,217.00 2,221.00 1,969.00

Option 3: Government Restructured Hospital with no Co-payment

Age next birthday

1 Bed 4 Bed


0 – 30 670.00 386.00 343.00 369.00 213.00 189.00

31 – 40 866.00 457.00 405.00 476.00 251.00 223.00

41 – 45 972.00 511.00 452.00 535.00 281.00 248.00

46 – 50 1,212.00 619.00 567.00 667.00 340.00 312.00

51 – 55 1,472.00 774.00 687.00 810.00 426.00 378.00

56 – 60 1,904.00 1,040.00 889.00 1,048.00 572.00 489.00

61 – 65 2,596.00 1,372.00 1,212.00 1,428.00 754.00 667.00

66 – 70 3,894.00 2,049.00 1,817.00 2,141.00 1,127.00 1,000.00

71 - 75** 4,759.00 2,505.00 2,221.00 2,617.00 1,378.00 1,221.00

76 - 80** 6,231.00 3,280.00 2,908.00 3,427.00 1,806.00 1,600.00

* For renewal only. The last entry age on all plans is 70.

6

Riders

Group Extended Major Medical Rider (GEMM)*

* Choice of GEMM rider plan type must follow selected GHS plan type. For example, if you are on GHS Plan A-Option 1, you must choose GEMM Plan A-Option 1.** For renewal only. The last entry age on all plans is 70.

Benefits Schedule Plan A Plan B Plan C

Policy Limit (applicable to all benefits) Maximum Per Disability

Provides reimbursement of eligible medical expenses in excess of Basic Group Hospital & Surgical if: a) Hospitalisation is more than 20 days; or b) Surgical procedure of at least 75% of the benefit payable under the Schedule of Surgical Benefits

100,000 80,000 50,000

Type of Hospital As per Group Hospital & Surgical selection

Room & Board (standard) from 121st day onwards As per Group Hospital & Surgical selection

Surgical Implants 10,000 8,000 5,000

Co-payment Applicable only if Group Hospital & Surgical Option 2 is chosen


Option 1: Private Hospital with no Co-payment

Age next birthday

1 Bed 4 Bed


0 – 30 46.00 44.00 42.00 26.00 25.00 24.00

31 – 40 54.00 50.00 48.00 29.00 27.00 26.00

41 – 45 59.00 56.00 53.00 33.00 30.00 29.00

46 – 50 81.00 77.00 72.00 44.00 42.00 40.00

51 – 55 101.00 96.00 90.00 56.00 53.00 50.00

56 – 60 124.00 118.00 111.00 68.00 65.00 61.00

61 – 65 161.00 152.00 145.00 88.00 84.00 80.00

66 – 70 214.00 204.00 193.00 118.00 112.00 106.00

71 – 75** 295.00 280.00 266.00 163.00 155.00 146.00

76 – 80** 387.00 369.00 349.00 213.00 203.00 192.00

Riders

Group Extended Major Medical Rider (GEMM)*

7


Option 2: Private Hospital with 20% Co-payment

Age next birthday

1 Bed 4 Bed


0 – 30 37.00 35.00 34.00 21.00 20.00 19.00

31 – 40 43.00 40.00 39.00 24.00 22.00 21.00

41 – 45 48.00 44.00 42.00 26.00 25.00 24.00

46 – 50 65.00 61.00 58.00 37.00 34.00 32.00

51 – 55 81.00 77.00 72.00 44.00 42.00 40.00

56 – 60 99.00 96.00 89.00 55.00 51.00 50.00

61 – 65 128.00 122.00 116.00 70.00 67.00 64.00

66 – 70 171.00 163.00 155.00 96.00 89.00 85.00

71 – 75** 236.00 225.00 213.00 131.00 123.00 117.00

76 – 80** 310.00 295.00 279.00 170.00 163.00 153.00

Option 3: Government Restructured Hospital with no Co-payment

Age next birthday

1 Bed 4 Bed


0 – 30 30.00 28.00 27.00 17.00 16.00 15.00

31 – 40 35.00 33.00 32.00 19.00 18.00 17.00

41 – 45 39.00 37.00 35.00 21.00 20.00 19.00

46 – 50 53.00 50.00 48.00 29.00 27.00 26.00

51 – 55 65.00 62.00 59.00 37.00 35.00 33.00

56 – 60 81.00 77.00 72.00 44.00 42.00 40.00

61 – 65 104.00 99.00 96.00 58.00 55.00 51.00

66 – 70 140.00 132.00 126.00 77.00 72.00 69.00

71 – 75** 192.00 183.00 172.00 105.00 101.00 96.00

76 – 80** 252.00 239.00 227.00 139.00 131.00 126.00

* Choice of GEMM rider plan type must follow selected GHS plan type. For example, if you are on GHS Plan A-Option 1, you must choose GEMM Plan A-Option 1.** For renewal only. The last entry age on all plans is 70.

8

Group Outpatient General Practitioner Rider

Benefits Schedule Plan A Plan B

Panel Clinics As Charged As Charged

Visit to Polyclinics As Charged As Charged

X-Ray and Laboratory tests (referred by panel clinic or polyclinic) As Charged As Charged

Non-panel Clinics 35 per visit 35 per visit

A&E Departments 100 per visit 100 per visit

Overseas Outpatient Treatment 50 per visit 50 per visit

Number of visits per year Unlimited Unlimited

Co-payment (applicable to all benefits) N.A 10 per visit

Annual Premium Inclusive of GST (S$)

Plan A Plan B

Per insured member 402.00 289.00

9

Group Outpatient Specialist Care Rider*

Benefits Schedule Plan A Plan B Plan C

Outpatient Specialist Consultation** 3,000 per policy year

2,000 per policy year


Outpatient Diagnostic Scan, X-Ray & Laboratory Tests# 3,000 per policy year



Physiotherapy# / Chiropractic Treatment 1,000 per policy year

500 per policy year

500 per policy year

Traditional Chinese Medicine (TCM)50

per visit (max. 6 visits per year)

50 per visit

(max. 6 visits per year)

50 per visit

(max. 6 visits per year)

Optional: Co-payment## 20% 20% 20%


Plan A Plan B Plan C

No Co-payment option (Per Insured Member) 385.00 325.00 193.00

20% Co-payment option ( Per Insured Member) 320.00 270.00 160.00

* available for selection only if the Group Outpatient General Practitioner Rider Plan is selected.** with GP referral.# with Physician referral.## 20% Co-payment is only applicable if the Co-payment option is taken up.

10

Group Dental Rider

Benefits Schedule Plan A Plan B

Consultation

As Charged up to 1,200 per policy year

As Charged up to 800 per policy year

Medication (including administration of Local Anaesthesia)

X-Rays i) Periapical Film ii) Bite-Wing iii) Occlusal Film iv) OrthopantomographProphylaxis i) Scaling / Polishing ii) Fluoride application

Amalgam Restorations – Fillings Per Surface

Tooth-Coloured Restorations – Fillings Per Surface

Extractions (inclusive of LA) i) Anterior Tooth ii) Posterior ToothOral Surgery (inclusive of LA) i) Surgical Root Removal (Per Tooth) ii) Surgical Removal of Wisdom ToothPulp / Root Canal Treatment i) Pulp Capping ii) Root Canal Treatment (inclusive of temporary fillings) • One Canal • Two Canals

Periodontal Treatment Root Planing (Per Tooth)

Miscellaneous Treatment i) Sedative Dressings ii) Retention pins – restoration of tooth

Crowning – due to accident only

Bridges – due to accident only

Co-payment (applicable to all benefits) 20% 20%


Plan A Plan B

Per insured member 234.00 194.00

11

Group Personal Accident Rider

Plan A Plan B Plan C Plan D Plan E Plan F

Sum Insured (S$) 500,000 300,000 200,000 150,000 100,000 50,000

Annual Premium Per Insured Member Inclusive of GST (S$)

Occupational Class Plan A Plan B Plan C Plan D Plan E Plan F

Occupational Class 1 200.00 120.00 80.00 60.00 40.00 20.00

Occupational Class 2 250.00 150.00 100.00 75.00 50.00 25.00

Occupational Class 3 N/A 256.80 171.20 128.40 85.60 42.80

Occupational ClassClass 1 Professional, administrative, managerial, clerical and non-manual work solely in office or similar non-hazardous places. E.g. Accountant, Bank teller, Programmers, Doctor / Dentist (non-veterinary), Lawyer, Receptionist.

Class 2 Office or supervisory work which involves outdoor, travelling or light manual work, and does not involve the use of tools or machinery or exposure to any special hazard. E.g. Beautician, Homemaker, Insurance Intermediary, Retail Assistant, Tour Guide.

Class 3 Occupation which involves manual work which is not of hazardous nature but involves the use of tools or machinery. E.g. Baker, Chauffeur, Hawker (Food), Mechanic, Painter (not involving work at heights), Plumber.

12

EligibilityCover under this policy shall be subjected to the fulfillment of all of the following eligibility requirements by the Insured Persons:(i) Your employee and your employee’s legal spouse are from Age 16 years to 70 years old and who is a Resident of Singapore;(ii) Your employee’s natural child, step-child or legally adopted child, who is a Resident of Singapore, unmarried and not employed, between 15 days old and Age 25, and in the case between Age 19 and Age 25, the child must be studying full-time in a recognised institution of higher learning (and not in full-time national service).Resident of Singapore shall mean Singapore Citizens and Permanent Residents (holders of re-entry permits) as well as holders of employment passes, work permits, students’ passes or dependents’ passes.An Insured Person’s cover will cease automatically if he remains outside of his Country of Residence for a period in excess of one hundred eighty-five (185) consecutive days.Where Insured Member commenced Cover between Age 16 and Age 70, Insured Member will be eligible for renewal of Cover up to Age 80.

Occupation Risk GuidelineAll benefits under the Group Packaged plan are available to Occupational Risk Class 1 to 3 only.The Group Packaged plan will not be available to employees of firms in the following industries: - Professional sports associations or organizations- Airline companies (pilots, cabin crew)- Companies involved in sea faring- Companies involved in shipbuilding- Companies involved in mining (including underground construction or exploration of minerals)- Companies working in offshore sites, submarine or boat and/or involved directly in the construction on or under water- Companies working in industrial sites- Companies involved in direct contact with explosives or explosive devices- Companies involved directly in oil and gas exploration, production or refining- Companies involved in tobacco production or distribution- Companies involved in the production or refining of hazardous materials and/or chemicals- Companies involved in animal testing- Companies involved in gambling activities or casinos- Field military police and armed security forces- Nuclear facility workers

Participation and Plan Selectiona) Dependants are not eligible for Group Personal Accident. b) Participation of employees and dependents (if applicable) must be on compulsory basis. c) Coverage shall be the same for all employees within the same category in the company. d) Dependent participation (where applicable) must follow the same plan(s) selected for the employees. e) For group size of 1 or 2 employees only, maximum entry age is 50 (age next birthday). For Group size of 1 employee, there will be a loading of 60% across all medical covers for all insured members. Brochure rates apply for all subsequent new members.f) For Extended Major Medical Rider, plan selected for the employees must be the same as the Basic plan selected.g) For General Practitioner Rider, the same plan type must be applied across all categories who opt for the general practitioner coverage.h) For Specialist Care Rider, General Practitioner Benefit must be selected before Specialist benefit is purchased.

Underwriting Guidelines

Limitation of Cover

a) Admission to higher ward or Hospital type that differs from plan entitlement:- If the Insured Member received treatment or is admitted to a ward or Hospital type higher than what he is entitled to under the policy, either as an Inpatient or for Day Surgery, We will pay up to 60% of the eligible Reasonable and Customary Charges (excluding Daily Room and Board) subject to the maximum limit stated in the Policy Schedule. For upgrade in bed type or hospital type, the Daily Room & Board amount will be capped at the highest amount charged by a Hospital in Singapore for the entitled bed type and Hospital type.

b) Outside Country of Residence:-This Policy covers an Insured Member while he is outside his Country of Residence and our liability is limited to 60% of the eligible Reasonable and Customary Charges (excluding Daily Room and Board), subject to the maximum limits set out in the Policy Schedule. The Daily Room & Board amount will be capped at the highest amount charged by a Hospital in Singapore for the entitled bed type and Hospital type.

13

There are certain conditions under which no benefits will be payable. These are stated as exclusions in the contract. The following is a list of some of the exclusions for the respective plans. The exclusions include, but are not limited to, the following conditions. You are advised to read the policy contract for the full list of exclusions.

For Group Hospital and Surgical and Group Extended Major Medical: Pre-existing medical conditions are excluded for the first 12 months of continuous coverage except for pre-existing cancer or renal failure for which these conditions will be permanently excluded.

For Group Outpatient General Practitioner and Specialist Care, charges in respect of the following: a) Routine or preventative physical examinations, investigation, medical check-up, vaccinations, treatments or follow-up consultations.b) Congenital Conditions or genetic defects including hereditary conditions existing from the time of birth regardless of the time of discovery of such anomalies or defects. For Group Dental:a) Orthodontic treatment and temporary dentures. b) Treatment consisting of cosmetic or plastic surgery or for beautification not necessitated by injury illness. For Group Personal Accident:a) Suicide, attempted suicide or self-inflicted injuries, regardless of the Insured member’s mental condition. b) War (declared or undeclared), invasion, act of foreign enemies, hostilities, civil war, rebellion, revolution, insurrection, military or usurped power. c) Participation in racing on wheels. d) Participation in a riot or civil commotion, violation or attempted violation of law, or resistance to lawful arrest or imprisonment. e) Air travel, other than as a fare paying passenger on a licensed commercial aircraft.

Premiuma) Premium rates quoted are for standard lives based in Singapore only. b) Premium rates are quoted in Singapore Dollar and not guaranteed, subject to change without prior notice. c) Prevailing GST applies to all plans. d) All ages, if applicable, refer to the age next birthday.

Application Documentsa) Enrolment form b) Business Profile report from the Accounting & Corporate Regulatory Authority (ACRA) OR copy of Certificate of Incorporation / Registration AND list of persons with executive authority within the company c) List of names, identification numbers and specimen signatures of authorised persons to sign on the enrolment form

Exclusions

14

Important informationAXA SmartCare SME is a plan underwritten by AXA Insurance Pte Ltd. This brochure is not a contract of insurance and is published for general information only. For the full terms and conditions, please refer to AXA SmartCare SME Policy which is the operative document. We reserve the right to amend any of the information shown without prior notice.

You may wish to seek advice from a Financial Adviser before making a commitment to purchase the product.

A product summary is available and may be obtained from AXA Insurance Pte Ltd. You should read the product summary before deciding whether to purchase the policy.

In the event that you choose not to seek advice from a Financial Adviser, you should consider whether the products in question are suitable for you.

This policy is protected under the Policy Owners’ Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact your insurer or visit the GIA/LIA or SDIC websites (www.gia.org.sg or www.lia.org.sg or www.sdic.org.sg).

This advertisement has not been reviewed by the Monetary Authority of Singapore.

Not for use outside Singapore.

All information stated in the brochure is correct as of 1 February 2020.

Contact Us1800 880 4888 (Singapore) 65 6880 4888 (International) [email protected]

Like our Facebook Pagefacebook.com/AXASingapore

AXA Insurance Pte Ltd (Company Reg No. 199903512M)8 Shenton Way #24-01 AXA Tower Singapore 068811

Or scan hereDownload MyAXA