為您及摯愛提供隨身的健康保障 Portable health protection for you and your loved ones 滙安心是一項隨身的醫療保障計劃, 即使您將來轉工或退休, 您和家人仍可繼續享有醫療保障您亦可為自己及摯親增加額外的醫療保障已參加本公司的團體醫療保障計劃至

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1 滙安心時刻在您身旁 PortaProtection stands beside you

2 為您及摯愛提供隨身的健康保障 Portable health protection for you and your loved ones 滙安心是一項隨身的醫療保障計劃, 即使您將來轉工或退休, 您和家人仍可繼續享有醫療保障您亦可為自己及摯親增加額外的醫療保障已參加本公司的團體醫療保障計劃至少連續 12 個月的現有成員, 滙安心提供的保障將包括受保前已存在的有關疾病不論您以後日子怎麼樣, 身在何處, 又或境況有何改變, 甚至不幸長期患病, 滙安心都會時刻在您身旁, 給您支援和保障 PortaProtection is a portable medical scheme, which makes it easy for you and your dependants to continue enjoying medical benefits even when you change jobs or retire. With this plan, you can add extra coverage for yourself or your dependants. PortaProtection will cover relevant pre-existing conditions for any existing members who have been continuously insured under our group medical scheme for at least 12 consecutive months. No matter where life takes you or how your circumstances may change, PortaProtection will be there to support and protect you, even in the face of chronic long-term illness. Important Note: Applicants wishing to apply through HSBC must be an HSBC credit card/account holder. 注意 : 申請人若透過滙豐投保必須為滙豐信用卡 / 戶口持有人主要特色 * Unique Features* 終身保障保證續保 Lifelong cover and guaranteed renewal 您一旦參加了滙安心, 不論您健康狀況如何, 都享有每年續保的終身保證 Once you have joined PortaProtection, you can enjoy a lifetime guarantee of annual renewal irrespective of your health condition. 可由本公司的團體醫療保障計劃轉到滙安心 Portability of membership from our group medical scheme to PortaProtection 即使您轉換新工作, 您不但可繼續享有這項隨身的醫療保障計劃, 更可為您在新公司的團體醫療計劃之上, 加添額外保障 When you move on to a new career, it allows you to continuously enjoy the medical coverage under this portable plan and add extra coverage for yourself on top of your employer s group medical schemes. 承保受保前已存在的疾病 Cover pre-existing conditions 凡連續參加本公司的團體醫療保障計劃至少連續 12 個月的現有成員, 其受保前已存在的疾病 ( 任何列明於本公司的團體醫療保障計劃下有關現有成員的不受保項目除外 ) 將可獲承保 Pre-existing conditions (except any exclusions relevant to existing members stated under the our Company s group medical scheme) will be covered for any existing members who have been continuously insured under an our Company s group medical scheme for at least 12 consecutive months. 無分地域覆蓋全球 Worldwide coverage without geographical limitation 無論您身在何處, 滙安心都伴隨您左右, 全面照顧您 Wherever you are, PortaProtection will be there to take care of you. 其他主要保障包括 Additional Key Benefits include 提供總額住院及手術保障選項 Choice of lump sum hospital and surgical benefits coverage 門診保障涵蓋由註冊西醫提供的精神病治療 Out-patient benefits that cover mental illness treated by western registered medical practitioners 免費額外總額保障涵蓋化療放射治療或腎透析治療的住院或門診服務 Free additional lump sum coverage for either in-patient or out-patient treatment involving chemotherapy, radiotherapy or renal dialysis * 詳情請參閱下頁之參加資格 Please refer to the Enrolment Guidelines on the next page for more information. 續保保費將因應續保時的年齡而決定安盛保險有限公司保留權利隨時調整收費表 Renewal premium will be determined based on your age at the time of renewal. AXA General Insurance Hong Kong Limited reserves the right to adjust the premium table applicable from time to time.

3 參加資格 Enrolment Guidelines Important Note: Applicants wishing to apply through HSBC must be an HSBC credit card/account holder. 注意 : 申請人若透過滙豐投保必須為滙豐信用卡 / 戶口持有人任何 65 歲以下及已參加本公司的團體醫療保障計劃的現有成員均可在以下情況參加滙安心 : 參加本公司的團體醫療保障計劃時 ; 或該團體醫療保障計劃其後的保單周年日 ; 或當他們離職, 而其於本公司的團體醫療保障計劃的會籍被終止時若申請人曾終止滙安心保單, 申請將不會被接納 Any existing members who are under the age of 65 and are currently covered by our group medical scheme can apply for PortaProtection: when they join our group medical scheme; or at any subsequent policy anniversary date of our group medical scheme; or when they cease employment and their membership in our group medical scheme is being terminated. Application will not be accepted if any applicant has cancelled PortaProtection policy previously. 滙安心保單生效日期必須為每月的第一日如成員不是於某月的第一日參加本公司的團體醫療保障計劃, 滙安心保單生效日期將為隨後一個月的第一日同樣地, 如成員於本公司的團體醫療保障計劃的最後受保日並非某月的最後一日, 滙安心保單生效日期將為成員於本公司的團體醫療保障計劃的會籍被終止的該月的第一日, 以確保保障得以持續 The effective date for PortaProtection must be the first day of a month. In the event that the member is not joining our group medical scheme on the first day of a month, the effective date for PortaProtection will be the first day of the following month. Likewise, if the member s last day of coverage in our group medical scheme is not the last day of a month, the effective date for PortaProtection will be the first day of the month in which the membership is terminated in our group medical scheme in order to ensure continuous coverage. 如您在滙安心保障生效當日正在住院, 滙安心的保障將會在您出院後首日開始生效 If you happen to be hospitalised on the day your benefit would otherwise become effective, your PortaProtection benefits will commence on the first day after you are discharged from the hospital. 現有成員不需經由核保部審批凡參加本公司的團體醫療保障計劃至少連續 12 個月的現有成員, 其受保前已存在的疾病 ( 任何列明於本公司的團體醫療保障計劃下有關現有成員的不受保項目除外 ) 將可獲承保 No underwriting is required for existing members. Pre-existing conditions (except any exclusions relevant to existing members stated under our group medical scheme) will be taken over for any existing members who have been continuously insured under our group medical scheme for at least 12 consecutive months. 本公司的團體醫療保障計劃內現有成員的近親家屬可參加此項醫療保障計劃近親家屬包括現有成員的配偶和子女父親母親, 兄弟和姊妹近親家屬必須滿 15 日, 但年齡在 65 歲以下, 而其申請必須在現有成員於本公司的團體醫療保障計劃內的會籍仍生效時作出 Immediate families of the existing members of our group medical scheme may also apply for this medical scheme. Immediate families include the existing members spouse and child(ren), father, mother, brother and sister. Immediate families must reach 15 days old and under the age of 65, and their applications must be made when the existing members are still in active membership under our group medical scheme. 近親家屬必須填寫健康申報表, 並經由核保部審批, 並可能附加不受保項目 Health declaration is required for immediate families and subject to underwriting approval. Exclusions may be applied. 所有申請必須於滙安心保障預計生效日期之前的 30 日內提交 All applications should be submitted within 30 days prior to the intended effective date of coverage for PortaProtection. 為確保您和摯親都享有周全的醫療保障, 請即登記參加滙安心! Ensure you and your loved ones always enjoy the comprehensive medical protection. Enrol in PortaProtection today! 詳情請致電客戶服務中心查詢, 或瀏覽我們的網頁 For more details, please call our Client Servicing Centre on or visit our commercial banking website

4 傳統住院及手術保障 ( 必選項目 ) Traditional Hospital and Surgical Benefits (Mandatory) 保障範圍 (1) 病房及普通護理費每日最高賠償限額每症最高可達日數 (2) 膳食費每日最高賠償限額每症最高可達日數 (3) 深切治療費每症最高賠償限額 (4) 住院醫生診療費 ( 非手術性的治療 ) 每日最高賠償限額每症最高可達日數 (5) 醫療服務費 ( 不包括先進診斷掃描 ) 每年最高賠償限額 (6) 住院專科醫生費每症最高賠償限額 (7) 手術費 ( 包括醫生巡房費 ) 每症最高賠償限額繁複手術 ( 包括診所進行手術 ) 大型手術 ( 包括診所進行手術 ) 中型手術 ( 包括診所進行手術 ) 小型手術 (8) 麻醉科醫生費每症最高賠償限額繁複手術大型手術中型手術小型手術 (9) 手術室費每症最高賠償限額繁複手術大型手術中型手術小型手術 () 手術後診症 ( 包括出院後診斷性病理學上的檢驗 ) 每症最高賠償限額 (11) 額外診所進行的小型手術每症最高賠償限額 (12) 先進診斷掃描 ( 包括在門診進行 ) 磁力共振造影電腦斷層掃描正電子釋放斷層掃描每症最高賠償限額 Summary of Benefits Room and General Nursing Care Daily limit Maximum days per disability Meal Allowance Daily limit Maximum days per disability 每名受保人的最高賠償限額 ( 港元 ) Maximum Limit per Insured Person (HK$) , , Intensive Care 14,000 28,000 42,000 In-patient Physician s Fees (non-surgical) Daily limit Maximum days per disability 700 1,750 3,500 Hospital Services Charge (excluding advanced diagnostic imaging test) Maximum limit per year 15,000 30,000 45,000 In-patient Specialist s Fees 7,000 17,500 35,000 Surgical Fees (including ward attendance fees) Complex (including clinical operation) Major (including clinical operation) Intermediate (including clinical operation) Minor Anaesthetist s Fees Complex Major Intermediate Minor Operating Theatre Charge Complex Major Intermediate Minor 50,000 25,000 12,500 6,250 15,000 7,500 3,750 1,875 15,000 7,500 3,750 1,875 75,000 37,500 18,750 9,375 22,500 11,250 5,625 2,813 22,500 11,250 5,625 2,813,000 50,000 25,000 12,500 30,000 15,000 7,500 3,750 30,000 15,000 7,500 3,750 Post-operative Consultation (after discharge from hospital including diagnostic/pathology exam) 2,500 3,750 5,000 Additional Minor Clinical Operation at Doctor s Clinic 6,250 9,375 12,500 Advanced Diagnostic Imaging Test (including test performed in out-patient settings) Magnetic Resonance Imaging Computerised Tomography Scan Positron Emission Tomography Scan 5,000 7,500,000 膳食費以每日計算, 不能作累積計算 Meal allowance is counted on a daily basis and cannot be accumulated. 診所進行的手術包括進行手術當日及手術後治療的所有有關門診及藥物治療的費用 Clinical operation includes all related consultation and medication incurred on the date of operation and post-operative therapy.

5 總額住院及手術保障 ( 必選項目 ) Lump Sum Hospital and Surgical Benefits (Mandatory) 保障範圍病房類別由 (1) 至 (12) 項目的每年最高賠償限額 ( 不設每項限額 ) 賠償百分率 Summary of Benefits Room Type Entitlement Maximum limit per year for items (1) to (12) (no item limit is applied) 每名受保人的最高賠償限額 ( 港元 ) Maximum Limit per Insured Person (HK$) 普通房 Ward 150,000 計劃 5 Plan 5 雙人房 Semi-private 計劃 6 Plan 6 私家房 Private 600,000 計劃 7 Plan 7 計劃 8 Plan 8 計劃 9 Plan 9 病房類別由 (1) 至 (12) 項目的每年最高賠償限額 ( 不設每項限額 ) 賠償百分率 Room Type Entitlement Maximum limit per year for items (1) to (12) (no item limit is applied) 普通房 Ward 150,000 雙人房 Semi-private 私家房 Private 600,000 如住院病房等級超出受保人所屬病房類別, 將根據以下百分率作出賠償 : The amount payable will be paid in the following percentages if the incurred room type is higher than insured person s entitlement: 計劃所屬病房類別 Room type entitlement 接受治療所屬病房類別 Received treatment in 賠償百分率普通房 Ward 雙人房 Semi-private 50% 普通房 Ward 私家房 Private 25% 雙人房 Semi-private 私家房 Private 50% 免費附加的癌症透析治療 Free Top Up Cancer/Dialysis Treatment 化療放射治療腎透析治療 Chemotherapy/Radiotherapy/Renal Dialysis Treatment 適用於住院和門診 Apply to in-patient and out-patient settings 每症最高賠償限額賠償百分率,000 每名受保人的最高賠償限額 ( 港元 ) Maximum Limit per Insured Person (HK$) 0,000,000 計劃 5 Plan 5 0,000 計劃 6 Plan 6 計劃 7 Plan 7 計劃 8 Plan 8 計劃 9 Plan 9 每症最高賠償限額賠償百分率,000 0,000 須於必選項目的住院及手術保障限額耗盡後才適用 Applicable after the limit of Hospital and Surgical Benefits under the mandatory plan is exhausted.

6 門診保障 ( 自選項目 ) Out-patient Benefits (Optional) 保障範圍 Summary of Benefits 每名受保人的最高賠償限額 ( 港元 ) Maximum Limit per Insured Person (HK$) (1) 普通科醫生門診 General Medical Practitioner ( 包括西藥費 ) (including western medication) 每次最高賠償限額 Maximum limit per visit 1 至次內每次賠償百分率 per visit between 1 and visits 第次以後每次賠償百分率 per visit after the tenth visit (2) 專科醫生門診 ** ( 包括西藥費 ) 每次最高賠償限額每年最高次數 1 至 5 次內每次賠償百分率第 5 次以後每次賠償百分率 Specialist** (including western medication) Maximum limit per visit Maximum visits per year per visit between 1 and 5 visits per visit after the fifth visit (3) 物理治療 ** 脊骨療法 ** 每次最高賠償限額每年最高次數 1 至 8 次內每次賠償百分率第 8 次以後每次賠償百分率 Physiotherapy**/Chiropractic Treatment** Maximum limit per visit Maximum visits per year per visit between 1 and 8 visits per visit after the eighth visit (4) 註冊中醫門診 ( 包括中藥費 ) 每次最高賠償限額每年最高次數每次賠償百分率 Registered Chinese Medicine Practitioner (including Chinese medicine) Maximum limit per visit Maximum visits per year per visit (5) 精神病情緒失調門診 ( 包括西藥費 ) 每年最高賠償限額每次賠償百分率 Consultation for Mental Illness and Emotional Disorder (including western medication) Maximum limit per year per visit 2,500 4,000 5,000 (6) X 光診斷及化驗 ** 每年最高賠償限額每次賠償百分率 Diagnostic X-Ray and Laboratory Test** Maximum limit per year per visit 4,000 4,000 (7) 長期處方西藥 ** 於註冊藥房購買 ( 醫生及醫院診所以外 ) 每年最高賠償限額每次賠償百分率 Long Term Western Medication** From licensed medical dispensary (other than doctor s and hospital s clinic) Maximum limit per year per visit 4,000 5,000 (1) + (2) + (3) + (4) = 每保單年度最多 50 次 Maximum 50 visits per policy year ** 需有普通科西醫轉介信 Referral letter from a general medical practitioner is required. 門診服務必須為註冊西醫所提供 Consultation must be rendered by a western registered medical practitioner.

7 保費表 Premium Table 每名受保人每年保費 ( 港元 ) Annual Premium per Insured Person (HK$) 住院及手術保障 Hospital and Surgical Benefits 年齡組別 Age Group 門診保障 ( 自選項目 ) Clinical/Out-patient Benefits (Optional) 年齡組別 Age Group ,501 1,685 2,171 2,257 3,1 4,568 5,778 11,804 3,272 3,121 3,121 3,121 3,121 3,542 3,823 4,784 2,408 2,722 3,542 3,683 5,130 7,603 9,655 19,861 3,9 3,726 3,726 3,726 3,726 4,234 4,558 5,724 每名受保人每月保費 ( 港元 ) Monthly Premium per Insured Person (HK$) 住院及手術保障 Hospital and Surgical Benefits 年齡組別 Age Group 門診保障 ( 自選項目 ) Clinical/Out-patient Benefits (Optional) 年齡組別 Age Group , , ,456 3,9 5,119 5,324 7,452 11,092 14,116 29,128 5,551 5,292 5,292 5,292 5,292 6,005 6,469 8, ,027 1,307 2, ,058 1,177 1,501 1,555 2,128 3,089 3,899 7,895 6,221 5,929 5,929 5,929 5,929 6,718 7,247 9, 計劃 5 Plan 5 1,933 2,171 2,808 2,927 4,061 5,994 7,592 15,584 計劃 5 Plan ,443 計劃 6 Plan 6 3,661 4,147 5,432 5,648 7,927 11,794 15,001 30,985 計劃 6 Plan ,092 1,389 2,869 計劃 7 Plan 7 1,112 1,231 1,577 1,631 2,236 3,251 4,4 8,316 計劃 7 Plan 計劃 8 Plan 8 2,0 2,279 2,959 3,078 4,277 6,318 8,014 16,448 計劃 8 Plan ,523 計劃 9 Plan 9 3,856 4,374 5,724 5,962 8,348 12,431 15,822 32,692 計劃 9 Plan ,151 1,465 3,027 安盛保險有限公司保留權利隨時調整收費表 AXA General Insurance Hong Kong Limited reserves the right to adjust the premium table applicable from time to time. 包括附加的癌症透析治療 Including top up cancer/dialysis treatment. 只適用於保單續保 Applicable to policy renewal only. 注意 : 如保單於保單周年日自然屆滿前終止或取消, 保費 ( 全部或部分 ) 將不會被退回 Note: No premium (in full or in proportional) will be refunded for termination or cancellation of policy before the natural expiry of the policy anniversary date.

8 以上保單由安盛保險有限公司 ( 安盛 ) 承保, 安盛已獲香港保險業監理專員授權並受其監管安盛將負責按保單條款為您提供保險保障以及處理索償申請香港上海滙豐銀行有限公司乃根據保險公司條例 ( 香港法例第 41 章 ) 註冊為安盛於香港特別行政區分銷一般保險產品之授權保險代理商 The above policy is underwritten by AXA General Insurance Hong Kong Limited ( AXA ), which is authorised and regulated by the Commissioner of Insurance of the Hong Kong SAR. AXA will be responsible for providing your insurance coverage and handling claims under your policy. The Hongkong and Shanghai Banking Corporation Limited is registered in accordance with the Insurance Companies Ordinance (Cap. 41 of the Laws of Hong Kong) as an insurance agent of AXA for distribution of general insurance products in the Hong Kong SAR. 由安盛保險有限公司刊發 Issued by AXA General Insurance Hong Kong Limited PP v07/sep14a

保費表 Premium Table CIGNA HEALTHFIRST ELITE MEDICAL PLAN 信諾尊尚醫療保 Premium Table 保費表 Effective from 1 April 年 4 月 1 日起生效

保費表 Premium Table CIGNA HEALTHFIRST ELITE MEDICAL PLAN 信諾尊尚醫療保 Premium Table 保費表 Effective from 1 April 2019 2019 年 4 月 1 日起生效 Premium For Non Smoker Asia 非吸煙人士保費亞洲 Accommodation Room Type: Semi-private