caritas healthshield new gold proposal - plan e (manual)

Expanded GOLD Membership Proposal for:Name Age 45

I. PLAN DESCRIPTION II. CONTRACT PRICE & INSTALLMENTSPlan Name E Contract Price (CP) P163,000

Membership (Preferred or Privileged) Preferred Spot Cash P146,900Expanded Program (6 or 10) 10 5 Years to PayNumber of Units 7 Annual P32,600Total Allocated Healthcare Benefits P455,000 Semi-Annual P17,605Initial Expanded Benefit Limit (IEBL) P70,000 Quarterly P9,130IEBL/EBL Cash Value 50% *Except for Spot Cash, add P200 Policy Fee on first payment.

III. BENEFITS DIAGRAM

Program Year

EXPANDED BENEFIT INSURANCE BENEFITS

Cash Value

1 45 P28,000 P560 - - Fully Paid Fully Paid P163,000 P163,0002 46 P31,500 P700 - - Fully Paid Fully Paid P163,000 P163,0003 47 P35,000 P840 - - Fully Paid Fully Paid P163,000 P163,0004 48 P38,500 P980 - - Fully Paid Fully Paid P163,000 P163,0005 49 P42,000 P1,120 - - Fully Paid Fully Paid P163,000 P163,0006 50 P49,000 P1,400 - -

P163,000 P163,0007 51 P52,500 P1,540 - - P163,000 P163,0008 52 P56,000 P1,680 - - P163,000 P163,0009 53 P59,500 P1,820 - - P163,000 P163,00010 54 P63,000 P1,960 - - P163,000 P163,000

11 55 P70,000 P35,000

**IEBL increases yearly by 5%, 8% if no utilization during the paying period. Cost of availed healthcare services during the expanded period shall be

charged to the Expanded Benefit Limit. Availment of the Cash Value means full and final settlement of the plan.

IV. *HEALTHCARE BENEFITSA. MEDICAL EXPENSE BENEFITS B.

HOSPITALIZATION BENEFITS OUT-PATIENT SERVICES(in CARITAS-accredited hospitals) 12 Consultations per year, 10 pre/post-natal consultations per pregnancy

Room & board Treatment of minor injury or illness, Minor surgery, EENT TreatmentServices of an accredited physician or specialistLab tests, x-ray & other diagnostic procedures ANNUAL PHYSICAL EXAMINATIONUse of operating & recovery room Taking of medical history / Medical examinationUse of ICU, dialysis & chemotherapy equipment Fasting blood sugar, Complete blood sugarAdministration of anesthesia and/or oxygen Chest X-ray (PA), Urine & stool examinationTransfusion of hospital-provided whole blood or plasma ECG & Pap Smear (For 35 years old & above)Medical suppliesPrescribed drugs/medication while under confinement PREVENTIVE HEALTHCARE

EMERGENCY CARE DENTAL CARE4 Consultations per year, Annual oral prophylaxis

SPECIAL DIAGNOSTIC & LAB PROCEDURES Tooth extraction, Temporary fillingX-ray, Ultrasound, 2D Echocardiography with Doppler Treatment of oral pain, lesions, wound, and burns MRI, CT Scan, EMG, Nuclear TestBasic mammography, Treadmill stress test OTHER SERVICES

4 consultations per year for 1 pre-designated dependent24-hour telephone (HOTLINE) assistance: 711-2411

V.Plan Name A+ A B C D E

Units 50 30 20 15 10 7 Health Counselor

IEBL 500,000 300,000 200,000 150,000 100,000 70,000 Date: 11/10/14

Member's Age

HEALTHCARE BENEFITS*

Maximum Coverage per Illness/Year

Daily Room Rate

Medical Fund (IEBL)**

Credit Life (Death)

WIPTD (Disability)

Term Life Insurance

Accidental Death Benefit

PAYING PERIOD

PAID-UP / WAITING PERIOD

Start of EXPANDED

PERIOD

MEMBERSHIP PRIVILEGES

OTHER CARITAS EXPANDED GOLD HEALTHCARE PROGRAMS



Membership (Preferred or Privileged) Preferred Spot Cash P174,800Expanded Program (6 or 10) 10 5 Years to PayNumber of Units 7 Annual P38,800Total Allocated Healthcare Benefits P455,000 Semi-Annual P20,955Initial Expanded Benefit Limit (IEBL) P70,000 Quarterly P10,865IEBL/EBL Cash Value 50% *Except for Spot Cash, add P200 Policy Fee on first payment.


Program Year

EXPANDED BENEFIT INSURANCE BENEFITS

Cash Value

1 55 P28,000 P560 - - Fully Paid Fully Paid P194,000 P194,0002 56 P31,500 P700 - - Fully Paid Fully Paid P194,000 P194,0003 57 P35,000 P840 - - Fully Paid Fully Paid P194,000 P194,0004 58 P38,500 P980 - - Fully Paid Fully Paid P194,000 P194,0005 59 P42,000 P1,120 - - Fully Paid Fully Paid P194,000 P194,0006 60 P49,000 P1,400 - -

P194,000 P194,0007 61 P52,500 P1,540 - - P194,000 P194,0008 62 P56,000 P1,680 - - P194,000 P194,0009 63 P59,500 P1,820 - - P194,000 P194,00010 64 P63,000 P1,960 - - P194,000 P194,000

11 65 P70,000 P35,000











IEBL 500,000 300,000 200,000 150,000 100,000 70,000 Date: 11/10/14

Member's Age



Daily Room Rate


Credit Life (Death)

WIPTD (Disability)

Term Life Insurance


PAYING PERIOD


Start of EXPANDED

PERIOD





Membership (Preferred or Privileged) Privileged Spot Cash P124,373Expanded Program (6 or 10) 10 5 Years to PayNumber of Units 7 Annual P27,594Total Allocated Healthcare Benefits P455,000 Semi-Annual P14,901Initial Expanded Benefit Limit (IEBL) P70,000 Quarterly P7,727IEBL/EBL Cash Value 50% *Except for Spot Cash, add P200 Policy Fee on first payment.


Program Year

EXPANDED BENEFIT NO INSURANCE BENEFIT

Cash Value

1 12 P28,000 P560 - - - - - -2 13 P31,500 P700 - - - - - -3 14 P35,000 P840 - - - - - -4 15 P38,500 P980 - - - - - -5 16 P42,000 P1,120 - - - - - -6 17 P49,000 P1,400 - -

- -7 18 P52,500 P1,540 - - - -8 19 P56,000 P1,680 - - - -9 20 P59,500 P1,820 - - - -10 21 P63,000 P1,960 - - - -

11 22 P70,000 P35,000











IEBL 500,000 300,000 200,000 150,000 100,000 70,000 Date: 11/10/14

Member's Age



Daily Room Rate


Credit Life (Death)

WIPTD (Disability)

Term Life Insurance


PAYING PERIOD


Start of EXPANDED

PERIOD





Membership (Preferred or Privileged) Privileged Spot Cash P140,609Expanded Program (6 or 10) 10 5 Years to PayNumber of Units 7 Annual P31,202Total Allocated Healthcare Benefits P455,000 Semi-Annual P16,850Initial Expanded Benefit Limit (IEBL) P70,000 Quarterly P8,737IEBL/EBL Cash Value 50% *Except for Spot Cash, add P200 Policy Fee on first payment.


Program Year

EXPANDED BENEFIT NO INSURANCE BENEFIT

Cash Value

1 7 P28,000 P560 - - - - - -2 8 P31,500 P700 - - - - - -3 9 P35,000 P840 - - - - - -4 10 P38,500 P980 - - - - - -5 11 P42,000 P1,120 - - - - - -6 12 P49,000 P1,400 - -

- -7 13 P52,500 P1,540 - - - -8 14 P56,000 P1,680 - - - -9 15 P59,500 P1,820 - - - -10 16 P63,000 P1,960 - - - -

11 17 P70,000 P35,000











IEBL 500,000 300,000 200,000 150,000 100,000 70,000 Date: 11/10/14

Member's Age



Daily Room Rate


Credit Life (Death)

WIPTD (Disability)

Term Life Insurance


PAYING PERIOD


Start of EXPANDED

PERIOD



caritas healthshield new gold proposal - plan e (manual)

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