Health care is important and we all are aware of the concept of health insurance. However, many consumers neither know nor understand the substantial benefits that health insurance policy has to offer them, especially when the corporate health insurance plan is purchased by the employer, for the working employees of the organization. Therefore, group health insurance training is conducted by our company BLACAZ. to let all the eligible employees truly comprehend what are the benefits available? How they can access the medical coverage they are entitled to? What are the limitations of the insurance plan? And so on.
The Group Health Insurance Training is a kind of comprehensive training given to all the employees so that they could become highly equipped in the event they need to claim for any kind of medical treatment during their health dire need.
Here is the sneak peek of some essential points that are covered in the Group Health Insurance training program that will help you keep abreast of exactly what you are covered for and how to access health insurance in Singapore during a health emergency.
Type Of Medical Insurance Plan And Associated Claims Limits
The group health policy curated by our team for the SME companies fits all size pockets. We are offering the health insurance plan with a different sum of Annual Overall Limit (Max. amount per person per policy year). Under this point, you will come to know about the types of hospitals (Private or government) you can approach to get the full coverage of the medical expenses, whether you are eligible for the private room or shared room. Yes, there are limitations to the health care services that you can claim under this policy. All these points are discussed in this section of the training program so that employees can map their vision accordingly.
Summary of benefits
It is important to emphasize the benefits associated with the group health insurance policy which helps the buyers to comprehend the details of the medical expenses that they are entitled to and the premium they have to pay per policy year to claim the coverage. Some common benefits that will be discussed by the expert during the training program include briefing the employees and employers about the Pre-hospitalization consultation & treatment, Post-hospitalizations consultation, Type of inpatient treatment, Pre-Hospitalization Diagnosis Services, Outpatient Cancer Treatment, Outpatient Kidney Treatment, Treatment covered for surgical implant process, Emergency Medical Evacuation, etc.
Hospital Cash Benefits
The major benefit of hospital cash policy is to offer the holder of the insurance policy a lump sum for each day so that the insured person receives treatment as an in-patient in a private hospital or government hospital.
No matter, if you are entitled to a private room in a private hospital, some of the health insurance plans only cover the hospital cash benefits if the confinement is in a government hospital with shared beds such as B ward, B2/B2+ Ward or C ward.
Apart from the medical emergency, in most of the medical treatment, the hospital need authorization from the insurer, otherwise, the patient has to pay 20% of the medical fees before the treatment. In this portion of the training, it is important to discuss the point that is Letter of Guarantee (LOG) which is a document type that is issued by the insurer, which shows the applicant’s commitment to purchasing the insurance policy.
Policy riders and their benefits
The insurance rider is an amendment, attachment, or endorsement made in the existing policy that gives the policyholder a supplementary coverage. The rider reinforced a health insurance policy by offering policyholder multiple add-on benefits apart from the core. The training will mention the types of policy riders that are entitled. The types of policy riders are illustrated below scroll down:
- Outpatient General Practitioner Rider
- Outpatient Specialist Care Rider
- Personal Accident Rider
- Dental Rider
Discussion on Deductibles and co-insurance
A deductible is a primary amount that you pay before your medical insurance start to cover a substantial portion of your medical expenses. It can be in percentage or deductible amount that could range from $2000 to $10,000.
Co-insurance is a part of the cost of a health care service; this is a percentage of the medical charge you pay when your deductible has been met. In other words, co-insurance is how much you have to co-pay or split the cost with the insurer. For example, if you have a co-insurance of 20%, being a policyholder you will pay 20% of the medical bill.
It is a major point that should be covered in the training program to circumvent hustle-bustle when the insured person applies for the coverage the individual is entitled to. The waiting period is a time before the particular list of health ailments starts to get covered under your intended health insurance policy. Usually, the health insurance policies impose a waiting period of between 90 days and 366 days from approval of the cover. The circumstances under which the waiting period is implied are Maternity cover, pre-existing condition, Survival period, life-threatening Disease Recuperation Benefit such as heart attack and stroke, and major dental treatment.
Point to be noted – no benefits will be given to the policyholder for the health disorder treatment that is being carried out during the waiting period.
The exclusion means something that is not included, the term Policy exclusions in the insurance industry means that the circumstances where the benefits of the policy are not provided or can be eliminated. For example – any illness or pre-existing conditions or disabilities that the policyholder had before splurging into a health insurance policy plan will not be covered under the policy coverage.
Limitation of Cover
Every policy has certain limitations to it; if your existing plan does not cover you under the luxury treatment then your medical expenses will not be fully covered. To elucidate it further, let us take an example – suppose the insured person is admitted to the hospital that offers best medical treatment along with the luxury amenities as the result the medical expenses go beyond the coverage that insured person is entitled to, in this situation the insurance company will not be responsible to clear off the additional or hefty medical bills.
Outside Country of Residence
For the employees working in a certain firm, the country of residence is the country in which they are currently living in, at the time they process their application for the health insurance policy. If you have to go out of your country for business or personals, and unfortunately the situation arises that you need medical treatment in a different country then Outside Country of Residence is applicable. The coverage given under the outside country of residence varies policy to policy. Some policy offer across the globe cover limited to a maximum of 60 to 180 consecutive days outside the country of residence. And some policy offers a certain percentage of coverage by paying only 60% of your medical bills.
It is heart-breaking if your claim gets rejected by the insurer so it is important to divulge yourself with the procedure to apply for the claim. This includes the knowledge about which medical treatment requires a referral letter, provide the details correctly, submission of claim forms, and meet the form submission deadline to avoid the rejection.
Letter of Guarantee (LOG)
Letter of Guarantee is provided by the insurer to the insured person. LOG issued by the insurer equally helps both hospital billing desk and insured person, how? The hospital will get to know that you are covered under the health insurance policy and being insured you don’t have to pay the big amount to the hospital to get admitted and treated. But, remember LOG does not mean that you have a power of attorney that approves every claim. Please note that the insurer will review and has full right to disapprove an inappropriate claim, anytime.
BLACAZ. is counted among the top insurance company Singapore that strives to help you find the right match for your health insurance needs. Our bespoke Group health Policy for SME will serve you best when it comes to providing the best coverage. To get more information on our offerings, contact our experts and avail of the services that are particularly helpful for your employee benefits.