For enquiry, please contact Ageas Insurance Brokers (HK) Limited Suite 612 6/F Tower 2 The Gateway Harbour City Kowloon Hong Kong Tel 電話 2176 2977 Fax 傳真 2591 8660 如欲查詢 請聯絡 富保顧問(香港)有限公司 香港九龍海港城港威大厦 第二座六樓612室 CORPORATE HEALTHNET PLUS 公司僱員健康網 HEALTHY PEOPLE FOR A HEALTHY BUSINESS 穩健企業 有賴健康團隊 www.bupa.com.hk
INTRODUCTION TO CORPORATE HEALTHNET PLUS 公司僱員健康網團體醫療保障計劃簡介 Healthy employees are the key to a healthy business. Designed to meet the needs of businesses with five to 50 employees, Corporate HealthNet Plus is your ideal choice to help you protect the health of your workforce. Corporate HealthNet Plus provides your employees with comprehensive health cover while giving you the flexibility to choose a plan that suits your budget. Members can use our medical card for cashless out-patient treatment, with a wide choice of around 1,500 doctors and medical service providers in Hong Kong and Macau. 企業要穩健發展, 必須擁有一支健康的團隊 此醫療計劃專為 5 至 50 名僱員的公司而設, 助僱主保障僱員的健康 公司僱員健康網 為僱員提供面的醫療保障, 同時讓您靈活選擇符合預算的計劃 會員只要出示我們的醫療卡, 使用門診服務時便無須付款 我們的港澳醫療網絡龐大, 共有約 1,500 名醫生和醫療服務供應商可供選擇 1
Corporate HealthNet Plus provides your employees with comprehensive cover and a range of superior benefits, making sure they get quality health protection at great value. 公司僱員健康網 為您的僱員提供周保護和多種優越保障, 以相宜保費享有優質的醫療服務 SCHEME OVERVIEW 計劃概要 Cover at a glance 保障一覽表 Basic benefit 基本保障 Optional benefit 自選保障 Free benefits 免費保障 Hospital and Surgical Benefit 住院及手術保障 Clinical Benefit (comes with Free Dental Benefit) Free Hospital Cash Benefit 免費住院現金保障 Free Supplementary Major Medical Benefit Free Bupa Worldwide Assistance Programme 免費保柏國際援助計劃 Medical card 醫療卡 Choice of benefit levels 保障等級選擇 Yes (for Clinical Benefit) 有 ( 適用於門診保障 ) Private (Plan 1, 4, 7) 私家房 ( 計劃 1, 4, 7) Semi-private (Plan 2, 5, 8) 半私家房 ( 計劃 2, 5, 8) Ward (Plan 3, 6, 9) 大房 ( 計劃 3, 6, 9) Eligibility 投保資格 Company size 公司規模 Employees 僱員 Employees dependants 僱員之家屬 5 50 employees 5 至 50 名僱員 All full-time employees aged under 65 Spouse aged under 65 65 歲以下的配偶 Unmarried children aged between 15 days and 17 years, or under 23 years for full-time students (with valid proof) Enrolment 投保 Submit application form with member details and relevant subscription payment at least 10 working days before the end of the month 請於月底前最少 10 個工作天交回申請表, 填妥會員資料並連同正確保費 Contract will come into effect on the first day of the following month 合約將於下月 1 號生效 Please refer to the Schedule of Benefits for more information. 詳情請參閱保障金額表 2
10 REASONS TO CHOOSE CORPORATE HEALTHNET PLUS 選擇公司僱員健康網的 10 大理由 1. Comprehensive cover for hospital expenses We offer comprehensive worldwide cover for hospital expenses such as surgeries, ICU and miscellaneous services. Our benefits are restored every year, which provides higher cover especially for those who require lengthy treatment for serious illnesses. 2. Day-case surgery and clinical operations included To increase the value of our members cover, we have included day-case surgery and clinical operations in our Hospital and Surgical Benefit. This covers many common procedures such as wound sutures, endoscopies and colonoscopies that do not require a hospital stay. 3. Generous out-patient cover Our optional Clinical Benefit provides generous full cover for eligible medical expenses, including visits to Western physicians, Chinese herbalists and bonesetters, and physiotherapists, as well as diagnostic imaging and lab tests within our network. Alternatively, members can choose to receive treatment outside our network and receive reimbursement up to the maximum benefit limits. 1. 我們提供面的環球住院費用保障, 包括手術 深切治療及雜項服務的費用 保障額每年重新計算, 對於須要長期治療嚴重疾病的僱員可提供更高保障 2. 保障涵蓋日症手術及診所手術 為提升會員的醫療保障, 我們的 住院及手術保障 特別涵蓋日症手術和診所手術, 當中包括許多常見的醫療程序, 例如不須要住院的傷口縫針 內窺鏡或結腸鏡等 3. 充裕的門診保障 我們的自選 門診保障 為您提供充裕的保障 所有合資格費用, 包括我們的網絡西醫 中醫師 跌打醫師及物理治療師的診症費用, 以及診斷影像和化驗費用, 都可數賠償 此外, 會員還可選用非網絡醫生或醫師, 這費用可賠償至最高保障限額 4. 龐大醫療網絡免繳費治療 會員只要出示我們的醫療卡, 在接受 門診保障 治療時便無須支付任何賬單或申請索償 保柏醫療卡適用於龐大的醫療網絡, 於港澳地區共有約 1,500 名醫生及醫療服務供應商可供選擇 4. Cashless treatment at extensive medical network Members can use the Bupa medical card to enjoy cashless treatment under our Clinical Benefit without having to pay any bills or submit claims. Our medical card is accepted by an extensive network of around 1,500 doctors and medical service providers in Hong Kong and Macau. 3
Service pledge No claims procedure is required when members use the Bupa medical card. All hospitalisation and other out-patient claims will be settled within 5-7 working days after full documentation is received. 賠償服務承諾如您使用保柏醫療卡, 無需索償手續 所有住院及其他門診索償, 於收妥所需文件後 5-7 個工作天內支付 5. Range of free benefits Members will get extra protection against costly medical expenses with our free Supplementary Major Medical Benefit and Hospital Cash Benefit. Our Free Bupa Worldwide Assistance Programme also provides assistance for members who are hospitalised overseas due to emergencies. Furthermore, members who are covered by our Clinical Benefit will enjoy our Free Dental Benefit. 6. Stable subscriptions To give you better value, all members under the same plan will enjoy a flat subscription rate regardless of age. All eligible children in a family will also be enrolled at the cost of one child's subscription. What s more, your subscription rates will not be affected by the past claim amounts of your company. 7. Access to lifelong cover With access to lifelong protection when they retire or have a change of employment, our group members can enjoy peace of mind. Members have the option of transferring to our designated individual health insurance scheme regardless of their health condition. All eligible illnesses developed during their group membership will be covered for life under the individual scheme. 8. Fast and easy claims We make claims processing fast and easy. It is our service pledge to settle claims within five to seven working days after full documentation is provided to us. When the claim is settled, we will send out a SMS to notify your employee. To reimburse the expenses, we simply credit the payments directly to your employee s bank account. 9. Hassle-free enrolment No medical examinations, individual underwriting or health declarations are required for enrolment of new members. 10. Continual support with attentive and convenient services With our helpful and convenient services, managing your scheme is a breeze. Our Customer Care Advisors are available 24 hours every day to answer customer enquiries quickly and accurately. You can also use our online service to view claim statements and add or remove members, while members can view membership details, search for network doctors (if applicable) and track claims. 5. 多種免費保障 我們特設的 及 免費住院現金保障, 為所有會員提供額外保障, 應付昂貴的醫療費用 會員若在海外緊急住院, 免費保柏國際援助計劃 可提供支援服務 此外, 已投保 門診保障 的會員可享有 免費牙科保障 6. 保費平穩更有預算 我們讓同一計劃等級下所有僱員, 不論年齡一律享有劃一保費, 令計劃更物超所值 每個家庭只須繳付一名子女的保費, 所有合資格子女均獲受保 此外, 您的保費不會受公司過往的索償金額影響 7. 可獲終生續保 我們的團體會員在退休或轉換工作後, 不論健康狀況如何, 也可選擇將其會籍轉移至指定的個人醫療保障計劃, 令他們安枕無憂 所有於團體計劃會籍生效期間所患的合資格受保疾病均可在該個人醫療保障計劃內獲終生保障 8. 索償快捷簡便 我們的索償程序快捷簡便 保柏的服務承諾是在收妥所需文件後於 5 至 7 個工作天內支付賠償 我們在賠償辦妥後會發出短訊通知您的僱員 支付方法亦很簡便, 賠償款項會直接存入僱員的銀行賬戶 9. 投保方便 加入新會員於此計劃, 無需身體檢查 個別核保或填寫健康聲明 10. 持續支援, 服務體貼周到 保柏為您提供方便周的服務, 讓您輕鬆管理計劃 我們的客戶服務主任每天 24 小時為您服務, 快捷準確地回答客戶的查詢 您亦可使用我們的網上服務, 瀏覽賠償單及增減計劃會員 而會員則可瀏覽會籍資料 搜尋網絡醫生 ( 如適用 ) 和查閱索償進度 Subject to the co-payment, if applicable. Reimbursement percentage of 80% or 100% depending on plan. Members who have been covered under Bupa's group insurance for a minimum of six months are entitled to the transfer option, subject to the required process and terms determined by Bupa. The upgrade of plan level or addition of benefit items will require Bupa's underwriting approval. To enjoy the SMS notification service, employees will need to provide Bupa with an up-to-date mobile phone number. 視乎是否須要支付自負費, 如適用 賠償率為 80% 或 100%, 視乎計劃而定 會員只須受保於保柏團體保險最少六個月及依照保柏訂定之所需程序及條款, 便可轉移其會籍 提升計劃等級或增加保障項目須由保柏核保審批 僱員必須向保柏提供最新手機號碼, 方可享用短訊通知服務 4
The World of Bupa 環球保柏 BUPA GROUP Established in the UK in 1947 Leading international healthcare group serving over 22 million customers in more than 190 countries Diversified healthcare services include health insurance, hospitals, primary care and diagnostic centres, dental centres, workplace health services, home healthcare, health assessments, chronic disease management services, nursing and residential care for elderly people With no shareholders, we invest our profits to provide more and better healthcare and fulfill our purpose of longer, healthier, happier lives BUPA S PRESENCE IN HONG KONG Bupa is a leading provider in healthcare funding and provision with two independent units, Bupa Hong Kong and Quality HealthCare. Bupa Hong Kong Health insurance specialist since 1976 Expertise in healthcare has gained the trust of more than 350,000 individuals and 2,700 companies Recommended by the Hong Kong Government to provide health insurance to civil servants for 18 consecutive years Offers a wide choice of doctors with one of the largest provider networks in Hong Kong Quality HealthCare A leading private medical network in Hong Kong and has become part of Bupa group since October 2013 Services span across diagnostics, primary healthcare and day-care specialties Network of 100 multi-specialty centres and approximately 500 affiliated clinics offering Western Medicine, Traditional Chinese Medicine, Diagnostics & Imaging, Dental, Physiotherapy and other healthcare services 保柏集團於 1947 年在英國成立 領先於同業的國際醫療保健集團, 在名客戶服務 球 190 多個國家為 2,200 萬 提供多元化的醫療保健服務, 包括醫療保險 醫院服務, 基層醫護及診斷中心 牙科護理中心 職場健康 家居醫療護理 健康評估 慢性疾病管理服務 看護服務及長者家居護理服務 我們不設股東, 因此可將所有盈餘投資於業務當中, 以提供更廣及更佳的醫療保健服務, 實踐我們活出更長壽 更健康和更愉快人生的目標 保柏於香港的業務保柏透過旗下兩間獨立營運的公司 - 保柏香港及卓健醫療, 為市民提供醫療保險及醫療保健服務, 兩者皆具領導地位 保柏香港於 1976 年成立, 為本港醫療保險專家專業醫療保險服務為超過 35 萬名會員及 2,700 間公司所信賴連續 18 年獲香港政府推薦, 為本港公務員提供醫療保險透過龐大的本港醫療網絡, 給您更多醫生選擇 卓健醫療香港領先的私營醫療中心聯網服務商, 於 2013 年 10 月正式加入保柏服務涵蓋診斷 基層保健及日症專科服務透過 100 間綜合醫療中心及近 500 間聯營診所, 提供西醫 中醫 放射診斷 牙科物理治療及其他保健服務 KEEPING YOU HEALTHY Keeping our members well is as important to us as protecting them when they become unwell. We provide free online health information and tools, from health information factsheets to health risk calculators and fitness apps, using the expertise of Bupa s medical consultants in the UK and Hong Kong. 助您保持健康 保柏不單在會員患病時提供保障, 我們認為助他們保持健康同樣重要 因此, 我們提供免費網上健康資訊及工具, 包括疾病資訊 健康風險評估和健體應用程式, 所有資訊均由英國及香港的保柏專業醫學顧問提供 Use our free services 使用我們的免費服務 www.bupa.com.hk Join Bupa s community 加入保柏 Facebook 及微博專頁 Bupa Hong Kong 保柏香港 5
GENERAL EXCLUSIONS 不受保障項目 We want to help you understand the coverage before enrolment. Below are the general exclusions: Pre-existing conditions. Treatment, medical service, medication or investigation which is not medically necessary. Any illness or bodily injury for which compensation is payable under any laws or regulations or any other insurance policy or any other sources except to the extent that such charges are not reimbursed by any such compensation, insurance policy or sources. Any charges for accommodation, nursing and services received in health hydros, nature cure clinics, convalescent home, rest home, home for the aged or similar establishments. Any charges in respect of surgical or non-surgical cosmetic treatment, Hair Mineral Analysis (HMA), health supplements or body weight control (unless approved by Bupa) Any charges in respect of preventive measures, including but not limited to routine blood tests, general check-ups, vaccinations or inoculations, hearing tests, eye refraction including but not limited to routine eye tests or any cost of fitting of spectacles or lens. Congenital conditions, developmental conditions or hereditary conditions. Treatment that commenced during the first five years from the coverage commencement date and which in any way arises from, is attributable to, or is consequential upon Human Immunodeficiency Virus Infection. Sexually transmitted (venereal) diseases or their sequel. Treatment relating to pregnancy, including diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage; birth control or sterilisation of either sex; infertility including in-vitro fertilisation or any other artificial method of inducing pregnancy; or sexual dysfunction including but not limited to impotence, erectile dysfunction and premature ejaculation, regardless of cause. Misuse or overdose of drugs or being under the influence of alcohol, selfinflicted injuries or attempted suicide. Treatment relating to any illness or bodily injury resulting from participation in criminal activities. Alternative treatment including but not limited to Chinese Medicines treatment, acupuncture, acupressure, Tui Na, hypnotism, rolfing, massage therapy and aromatherapy (unless benefit is available). Senile Dementia (including Alzheimer s disease), Parkinson s disease, psychological or psychiatric condition(s) of any and all kinds, including but not limited to psychoses, neuroses, depression, anxiety, anorexia nervosa, schizophrenia, behavioural disorders, delirium, insomnia and neurasthenia. Any charges for the procurement or use of special braces and appliances, including but not limited to spectacles, hearing aids and other equipments such as wheel chairs and crutches. Any treatment or investigation related to dental or gum conditions (unless benefit is available) except for emergency treatment (not followup treatment) arising from accidents or the extraction of impacted wisdom teeth during hospital confinement. Treatment arising from war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection or military or usurped power or terrorist acts. Non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes (except the Value-Added Tax or Goods and Services Tax for medical services), medical report charges and the like. Experimental and/or new medical technology or procedure not yet approved by Bupa. Engaging or taking part in naval, military or airforce or any operation with any armed force; or any form of professional sports. 我們想讓您在投保前清楚了解保障範圍, 因此列出所有不受保障項目如下 : 已存在病症 不是醫療必需的治療 醫療服務 藥物或檢驗 任何在法例下或其他保險計劃內或從其他途徑可獲賠償之治療疾病或損傷費用, 除非此等費用未能在該等補償 保險計劃或途徑獲得賠償 在水療中心 天然治療中心 康復院 療養院 老人院或似機構所提供之住宿 護理或服務的費用 手術性或非手術性整容或整形治療 毛髮礦物質含量分析 健康補品或體重控制 ( 經保柏批准則除外 ) 的費用 預防性措施, 包括但不限於常規驗血 例行檢驗 預防注射或接種疫苗 聽覺測驗 因視力不正常而引致之治療, 包括但不限於常規視力測驗或所需之眼鏡或鏡片費用 先天性疾病 發育異常或遺傳性疾病 由保障開始日起首 5 年內, 因感染人體免疫力缺損病毒所引致的治療 性病及其後遺症 與懷孕有關的治療, 包括診斷性產科檢查 生育 墮胎或小產 ; 與男女任何一方的節育或絕育有關的治療 ; 由於不育而直接或間接進行的治療, 包括體外受孕, 任何非自然受孕或人工受孕 ; 與性機能失常有關之治療, 包括但不限於陽萎 不舉及早泄 ( 不論任何原因導致 ) 誤用或服用過量藥物或受酒精影響 蓄意自傷身體或意圖自而直接或間接引致的治療 任何因參與犯罪活動而引致之疾病或損傷 另治療, 包括但不限於中藥治療 針灸 穴位按摩 推拿 催眠治療 羅爾夫按摩療法 按摩治療 香薰治療 ( 計劃內已包括之保障除外 ) 老年性痴呆 ( 包括亞爾茲海默氏病 ) 帕金森氏病 心理病或精神病症, 包括但不限於精神病 神經機能病 抑鬱 焦慮 神經性厭食 精神分裂 行為失常 譫妄症 失眠 神經衰弱等直接或間接引致的治療 購買或使用輔助器具, 包括但不限於眼鏡 助聽器及其他設備例如輪椅 枴杖的費用 任何與牙齒或牙肉疾病有關的治療或檢查 ( 計劃內已包括之保障除外 ), 因意外引致緊急入院治療或住院脫除阻生智慧齒則除外 但不包括該住院後之跟進治療 因戰爭 入侵 外敵行動 開戰 ( 不論是否已宣戰 ) 內戰 暴動 革命 叛亂或軍人奪權 恐怖活動等直接或間接引致的治療 非醫療性服務, 包括但不限於客人膳食 收音機 電話 影印 稅項 ( 就醫療服務所徵收的增值稅或商品及服務稅除外 ) 醫療報告等費用 所有未經保柏批准之實驗性及 / 或最新治療 從事或參與海軍 陸軍或空軍任務或任何武裝部隊之行動 ; 或從事或參與任何形之專業運動 6
Bupa (Asia) Limited 保柏 ( 亞洲 ) 有限公司 18/F, Berkshire House 25 Westlands Road, Quarry Bay, Hong Kong Telephone 電話 :(852) 2517 5175 Facsimile 傳真 :(852) 2548 1848 MP045/10/1114/5K Printed on recycled paper 以再造紙印刷 Care homes Cash plans Dental insurance Health analytics Health assessments Health at work services Health centres Health coaching Health information Health insurance Home healthcare Hospitals International health insurance Personal medical alarms Retirement villages Travel insurance www.bupa.com.hk Bupa Hong Kong 保柏香港