5. 1 Purple Cow 2012 Benefits ACCIDENT 2. ACCIDENT INSURANCE a. Accidental Death * Murder b. Accidental Disablement * Assault HEALTH 3. MEDICAL HMO * 19,401 MD, 382 hospitals, 426 clinics 4. Opt. DENTAL HMO * Basic 10: 790 dentists, 659 clinics 5. Opt. Annual Physical Exam * Basic 5: mobile or clinic 6. Health & Wellness Program * up to 2x/yr; tailored to utilization report LIFE 1. LIFE INSURANCE * Terminal Illness Rider * Total & Perm Disability Income LIFE – ACCIDENT – HEALTH Benefits Overview
6. 2 Purple Cow 2012 Benefits 18. Pooled Employee utilization 6. Accidental Disablement = __% of 5x MBL 13. Access to Big 5 Hospitals & Healthway 1. Life = 5x MBL 23. Same benefits for Dependents 11. HMO patient for no-cash-out 24. Access through Social Media 12. Private patient for reimbursement (HMO rate) 14. 100% Pre-Existing Conditions coverage 2. Terminal Illness = up to 50% of 5x MBL 20. Opt. Dental = HMO buffet of benefits 8. Medical = HMO buffet of benefits 22. Health & Wellness Program (up to 2x/yr) 21. Opt. APE = choice of mobile or clinic 19. Separate Dependent utilization 17. Benefits on top of Philhealth 16. 100% Special Procedures coverage 15. 100% Congenital Conditions coverage 10. Max. Benefit Limits per disability per year 9. Combined inpatient & outpatient limits 7. Assault = __% of 5x MBL 5. Murder = 5x MBL 4. Accidental Death = 5x MBL 3. Total & Perm. Disability Income = 5x MBL LIFE – ACCIDENT – HEALTH Benefits Summary
7. 4 Purple Cow 2012 Benefits _% 5x MBL _% 5x MBL 4. Assault 5x MBL 2. Murder +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo 1. Accidental Death = 5x MBL, for death from any type of accident; 2. Murder = 5x MBL, in lieu of the Accidental Death benefit, for death not due to accident but murder (provoked or not). Example : If MBL = 20T, Accidental Death or Murder = 100,000; If MBL = 40T, Accidental Death or Murder = 200,000; If MBL = 60T, Accidental Death or Murder = 300,000; If MBL = 80T, Accidental Death or Murder = 400,000; If MBL = 100T, Accidental Death or Murder = 500,000. +Principals 18yo-65yo; Dependents 30dy-22yo / 18yo-65yo 3. Disablement = __% of 5x MBL, according to a long schedule of indemnities; 4. Assault = __% of 5x MBL, in lieu of the Disablement benefit, for disability not due to accident but assault (provoked or not). Example : If MBL = 20T, Disability or Assault = __% of 100,000; If MBL = 40T, Disability or Assault = __% of 200,000; If MBL = 60T, Disability or Assault = __% of 300,000; If MBL = 80T, Disability or Assault = __% of 400,000; If MBL = 100T, Disability or Assault = __% of 500,000. Accident benefits are payable on top of Life & Medical HMO benefits 5x MBL 3. Disablement 1. Accidental Death ASIANLIFE 2a. Accident Insurance (worldwide)
8. 5 Purple Cow 2012 Benefits Losses refer to total and permanent loss of use or complete severance 50% 8. Arm between elbow and wrist 100% 6. Any other injury causing Total Perm. Disab. +Multiple losses from 1 accident will be limited to the highest loss, not to exceed 100%. If a member suffered the loss of 1 hand/foot/eye prior to coverage, the benefit for a subsequent loss of the same will be ½. 19. Leg below knee 10% 13. Index finger 15% 12. Thumb 35% 11. Four fingers 50% 10. Four fingers and thumb of one hand 70% 4% 16. Little finger 100% 3. One hand and one foot 50% 5% 25% 50% 60% 3% - 2% 5% 6% 50% 25. Hearing - both ears 50% 24. Sight of one eye 7. Arm at or above elbow 22. Big toe 20. One foot 17. Metacarpals 1 st /2 nd - 3 rd/ 4 th /5 th 23. Any toe other than big toe (each) 21. All toes on one foot 18. Leg at or above knee 15. Ring finger 14. Middle finger 25% 26. Hearing - one ear 50% 100% 100% 100% 100% 5. Injuries resulting in being perm. bedridden 2. Both hands or feet or sight of both eyes 1% 9. One hand 4. Either hand or foot and sight of one eye 1. Life (same as Accidental Death) LONG SCHEDULE OF INDEMNITIES 2b. Accident Insurance…
9. 6 Purple Cow 2012 Benefits 13. Serving in the armed forces of any country, or international authority, whether in war or peace 4. Insect bites 5. Earthquake, volcanic eruption or tidal wave 11. Provoked murder / assault or attempted threat [waived] 10. Participation in any brawl, or committing any crime or felony 3. Poison, gas or fumes voluntarily or involuntarily taken 8. Accident occurring while or because the Insured is under the influence of alcohol or any drug 6. Atomic explosion, nuclear fission, or radioactive gas 12. War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war 2. Disease, sickness, parasite, or disorder of the body/ mind 15. Hunting, motorcycling or pillion riding, mountaineering which necessitates the use of ropes or pitons, racing of any kind, other than on foot, ice or winter sports, water-ski jumping and tricks, yachting beyond 5 km. off a coastline, underwater activities involving the use of underwater apparatus, or using woodworking machinery driven by mechanical power other than portable tools, applied by hand and used solely for private purposes without reward 14. Entering, operating, servicing, ascending or descending from any aerial or submarine device or conveyance, except as provided under a passenger aviation provision 9. Suicide or any attempted threat while sane or insane, or any intentionally self-inflicted injury 7. Pregnancy, childbirth, miscarriage or any complications 1. Bodily or mental infirmity, hernia, ptomaine, bacterial or viral infection (except pyogenic infection occurring with and through an accidental cut or wound) EXCLUSIONS 2c. Accident Insurance…
10. 3 Major Employee Benefits in 1 Plan: You get Group Life, Accident & Health (medical HMO, optional dental HMO, optional APE, and Wellness) – all in 1 plan. (Unlike most HMO plans) You get all the Employee Benefits you will ever need 3 Why Purple Cow? Purple Cow 2012 Competitive Advantages
11. Accidental Death Insurance : Your Accidental Death benefit is a double indemnity to your Life benefit, and covers death by accident only. (Unlike all HMO plans) Accidental Death = 10x MBL 15 Why Purple Cow? Purple Cow 2012 Competitive Advantages
12. Murder : Your Murder benefit is in lieu of your Accidental Death benefit, and payable if you don’t die by accident, but by murder. (Unlike all HMO plans) Murder = 10x MBL, in lieu of Accidental Death 16 Why Purple Cow? Purple Cow 2012 Competitive Advantages
13. Accidental Disablement Insurance : Your Disablement benefit is based on a long schedule of indemnities. For example: loss of hand = 50 % of Disablement benefit. (Unlike all HMO plans) Accidental Disablement = % of 5x MBL 17 Why Purple Cow? Purple Cow 2012 Competitive Advantages
14. Assault : Your Assault benefit is in lieu of your Disablement benefit, if you don’t get disabled by accident, but by Assault. (Unlike all HMO plans) Assault = % of 5x MBL, in lieu of Accidental Disablement 18 Why Purple Cow? Purple Cow 2012 Competitive Advantages
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