Cambodia, Indonesia, Laos, Benefits Table · 1/1/2020 · Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam. Benefits Table . effective 1/1/2020. Southeast Asia

Your Health First

AdministratorsA Plus International Services LimitedRoom 4, 17th Floor, Westlands Centre, 20 Westlands Road, Quarry Bay,Hong Kong China S.A.R.Tel: + 852 2891 3608Fax: + 852 2891 3229Email: [email protected]

Concepts and trademarksare licensed from

A Plus International Insurance Development AGCH-8032 Zurich, Switzerland

www.aplusii.com

Exclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam

Benefits Table effective 1/1/2020

Southeast Asia

Exclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam

Benefits Table - effective 1/1/2020Note: The General Conditions can be provided upon request or downloaded from

www.aplusii.com

Important notice:1) Only expenses which are ‘reasonable & customary’ can qualify for reimbursement. (for all

plans and options)2) Unless indicated otherwise, all ceilings mentioned in this table are applicable per Insured

and per Insurance Year.3) For definitions of the terms used in this table, reference is explicitly made to article 1.2.

(‘Definitions’) of Chapter I of the General Conditions.4) Pre-existing conditions are covered subject to acceptance by the medical consultant at

the time of enrolment. Level of cover is according to the limits of the plan chosen.

Essential Essential Plus Serene Serene Plus

BENEFITS a) Hospitalisation a) Hospitalisation

b) Other benefits

a) Hospitalisation b) Outpatientc) Other Benefits

a) Hospitalisation b) Outpatientc) Other Benefits

Maximum total reimbursement per Insured and per insurance year Premiums and claims shall be payable in US$, which is the same as the policy currency.

$ 500,000 $ 1,000,000 $ 1,000,000 $ 1,350,000


1. Inpatient Care (with overnight stay in hospital)Important : Precertification is always required except in case of emergency (see article 2.1.3.4. ‘precertification’ in General Conditions). Failure to comply with the precertification requirement could lead to a reduction of the reimbursement.

Hospital accommodation

- Room & board (standard private room) Full Cover Full Cover Full Cover Full Cover

- Intensive Care Unit (ICU) Full Cover Full Cover Full Cover Full Cover

- One accompanying parent for child under age 16 having to stay overnight in hospital

Not Covered Full Cover up to 14 days Not Covered Full Cover

up to 14 days

Doctors' fees (including surgeon's & anaesthetist's fees) Full Cover Full Cover Full Cover Full Cover

Other medical expenses, including:- use of operating room and recovery room- lab exams / - medical imaging (X-ray, CT, MRI, etc.)- prescription drugs and dressings- physiotherapy - logopaedic treatment, speech

therapy, occupational therapy and ergo therapy

Full Cover Full Cover Full Cover Full Cover

Cancer treatment (e.g. radiotherapy, chemotherapy) and diabetes, kidney dialysis, excluding all experimental treatments


Psychiatric inpatient hospital care Not Covered Full Cover up to $ 13,500 Not Covered Full Cover up to

$ 13,500

Accidental Damage to teeth (treatment received in an emergency ward of a hospital within 5 days of incurring an accidental damage to sound and natural teeth)


Reconstructive Surgery following an accident Full Cover Full Cover Full Cover Full Cover

Hospital Cash Benefit: daily allowance, only when room, board & treatment costs are not claimed to the policy

Not Covered $ 67.50 per night up to 60 nights Not Covered $ 135 per night

up to 60 nights

Organ transplantWe cover doctors’ fees, hospital accommodation (standard private room) and other related medical expenses during hospital stay.Excluded from cover: costs related to the search for a donor, costs for acquisition of the organ, costs incurred for removal of organ from the donor

Full Cover (Prior approval

from the Insurer’s Medical Consultant)







Rehabilitation and convalescence rest / care (when the admission immediately follows hospitalisation)

Full Cover up to 30 days





2. Outpatient Care

GPFees of a GP (General Practitioner, Family Doctor)

Not Covered Not Covered Full Cover Full Cover

SpecialistFees of a Specialist Doctor


Consultations, diagnostic tests,lab tests, medical imaging (cf. X-Ray, CT, MRI, etc.) by GP and Specialist, Prescribed Drugs, Treatments by Physiotherapists related to inpatient treatments within 15 days prior to admission and up to 30 days following hospital release.

Not Covered

Full Cover up to $ 2,000

if related to Inpatient treatment

Full Cover Full Cover

Outpatient psychiatric care, ergotherapy, logopaedics and / or speech therapy, occupational therapyOnly care prescribed by or performed by a Doctor can qualify for reimbursement. The covered amount includes fees of Doctor and / or (treatment fees of) Medical Practitioner, but does not include prescription drugs which are covered according to the provisions of paragraph below.

Not Covered Not Covered Not Covered 50% up to $1,350

Prescription drugs Only drugs that are prescribed by a Doctor and that are not available without prescription can be reimbursed.


Diagnostic tests, lab tests, medical imaging (cf. X-ray, CT, MRI, etc.) Not Covered Not Covered Full Cover Full Cover

Cancer treatment (e.g. radiotherapy, chemotherapy) and diabetes, kidney dialysis, excluding all experimental treatments


Physiotherapy prescribed by a Doctor Not Covered Not Covered Full Cover up to$ 1,500

Full Cover up to$ 2,700

Medical aids (including hearing aids, orthopaedic appliances & stockings, artificial limbs, wheelchair)

Not Covered Not Covered Full Cover up to$ 2,700


Treatments performed by Complementary Medical Practitioners: Chiropractor / Osteopath / Acupuncturist / HomeopathThese treatments must be prescribed by a registered medical Doctor.

Not Covered Not Covered Full Cover up to$ 1,500


Day-care treatment and Day surgeryFull Cover

(precertification required)

Full Cover(precertification

required)


required)


required)


3. Other Benefits

Local ambulance to nearest hospital Full Cover up to$ 2,025




Dental treatment following an accident (surgical reconstruction covered under hospitalisation benefits)

Covered under Accidental Damage

to teeth


to teeth


to teeth


to teeth

Nursing at home Not Covered Not Covered80%. Annual max. reimbursement of

$ 2,700 up to 60 days

80%. Annual max. reimbursement of

$ 2,700 up to 60 days

Chronic Conditions (not pre-existing): Covered Covered Covered Covered

Complication of Pregnancy Covered Covered Covered Covered

Congenital Conditions Covered Covered Covered Covered

AIDS / HIV Treatment$60,000 Lifetime, 2 years’ waiting

periodCovered

$60,000 Lifetime, 2 years’ waiting

periodCovered

Hormone Replacement therapy Covered Covered Covered Covered

Hospice and palliative care in case of Terminal Illness

$ 50,000 per insured and per

lifetime


lifetime


lifetime


lifetime

4. Medical Evacuation and Repatriation Services ^ (Included for Individuals, Optional for Companies*).Prior Approval from Insurer compulsory

Evacuation / Repatriation Emergency medical evacuation to the nearest hospital or emergency medical repatriation

Full Cover

Transportation of mortal remains or burial at the place of death Full Cover

Compassionate Visit by a relative of the Insured (Applicable when hospitalisation in excess of 5 consecutive days)

One economy class return airfare

Accommodation for compassionate visit by a relative accompanying the insured

Full Cover

$ 125 per day (Max 7 days)

Return of minor children (<19, unmarried and at school) if left alone when Insured is hospitalised. One-way economy class airfare per eligible child Full Cover

Early ReturnOne economy class return airfare Full Cover

Temporary replacement colleague (transport costs) Full Cover

For complete terms and conditions and explanation of benefits, refer to Chapter III of the General Conditions^ Covered by AXA Assistance * Conditions apply

Note: ‘Covered’ means treatment is reimbursed according to the limits of the plan chosen.

Additional Options5. Dental

Eligibility The optional dental cover is only open to persons a) who are accepted into the medical insurance plan and b) who are contracting into the Serene or Serene Plus medical plans. The choice for taking out the dental cover has to be made on per family level in the sense that all members of the same family, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the dental insurance or not (i.e. all family members or none); b) opt for the same Dental plan (Dental Standard or Dental Plus). Benefits Deductibles do not apply to Dental benefits. Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.

Dental Standard Dental Plus

Max. reimbursement per insured per year $1,500 $3,000

Basic dental careIncludes up to 2 periodic check-ups per year, prophylactic treatments, fillings, root canal treatment, extraction, paradental treatment, treatment of paradontosis, treatment of gums, etc.A waiting period of 6 months applies.

80% up to$900

Full Cover up to$2,000

Major dentistryBridges, implants, orthodontic treatment and dental prostheses (dentures, crowns, inlays). The amount covered includes the fees of the Dentist (or Dental Surgeon). Orthodontic treatment is only covered if started before age 17 (seventeen). A waiting period of 12 months applies.

80% up to$600

80% up to$1,000

6. Wellness (Only for Companies of 5 or more employees)

Eligibility The optional wellness cover is only open to employees and dependants a) who are accepted into the medical insurance plan; b) who are contracting into the Serene or Serene Plus medical plans and c) with plans without deductible.The choice for taking out the wellness cover has to be made on per company level in the sense that all members of the same company, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the wellness insurance or not (i.e. all members or none); b) opt for the same Wellness plan (Wellness Standard or Wellness Plus). Benefits Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.

Wellness Standard Wellness Plus

Max. reimbursement per insured per year

$300 $600

Preventive care & wellness benefitsA waiting period of 12 months applies- well baby care- medically required vaccinations (adults & children)- one routine eye test per insurance year- one adult physical examination every 2 years including: - one (bilateral) mammogram and one pap-smear test every 2 years (females as of age 35) - one PSA-test every 2 years (males as of age 50)

7. Routine Maternity (Only for Companies of 5 or more employees)

Eligibility The optional routine maternity cover is only open to employees and dependants a) who are accepted into the medical insurance plan; b) who are contracting into the Serene or Serene Plus medical plans and c) with plans without deductible.The choice for taking out the routine maternity cover has to be made on per company level in the sense that all members of the same company, i.e. the Insured and his / her dependants who are accepted into the medical insurance, have to a) take out the routine maternity insurance or not (i.e. all members or none); b) opt for the same Routine Maternity plan (Routine Maternity Standard or Routine Maternity Plus). A waiting period of 12 months applies. Benefit limits on a per pregnancy basis.

Benefits Only expenses that are ‘reasonable and customary’ can qualify for reimbursement, subject to the limits and ceilings as mentioned in following benefit table.

Elective caesarean surgery is excluded from cover. Routine Maternity Standard Routine Maternity Plus

Pregnancy (pre & post natal fees)

Full Cover up to $3,000 Full Cover up to $5,000 Childbirth The covered amount includes doctors’ fees, hospital accommodation and other related medical expenses during hospital stay.

Prescribed caesarean (in addition to the above benefits) Full Cover up to $1,000 Full Cover up to $2,000

8. Currency Plans are to be subscribed in US dollars.

9. Zone of treatment

Zone A: Worldwide

Zone B: Worldwide excluding USA / Canada

Zone C: Restricted in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand & Vietnam

10. Deductible

US$

Essential Plans Serene Plans

0 0

per insured and per insurance year

300 300

675 675

1,350 1,350

11. Accidental death and dismemberment (AD&D)

This cover will guarantee the payment of a lump sum in case you die in an accident or you incur a permanent disability of at least 20% caused by an accident.

Lump Sum after accidental death- up to a maximum of $ 675,000 with a minimum of $ 67,500- cover is available for you and your adult dependants

Lump Sum after permanent disability- from at least a permanent disability degree of 20%- cash benefit = sum insured x degree of disability

12. Loss of income (TI / PD)

Temporary incapacity (TI)With the temporary incapacity plan option, you will feel more secure knowing your family will be protected financially if you are totally unable to perform your professional occupation due to illness or accident. You can choose the level of income benefit that is appropriate to you and your family:- up to 80% of pre-disability gross monthly salary;- subject to a maximum of $ 13,500 per month and a minimum of $ 1,350.

Income protection during 24 monthsWe will pay you a regular income for as long as you are unable to return to work. After a waiting period of 90 days, the income will start up to a maximum of 24 months. If you are still unable to resume work after 24 months then you will receive a lump sum through the Permanent Disability plan if the PD option below has been contracted.

Permanent disability (PD) (can be taken out only as supplement option to Temporary Incapacity)With this option, you receive a lump sum in case you are affected by a permanent disability of at least 33.33% caused by illness or accident. You can choose the level of sum insured that is appropriate to you:- up to 80% of pre-disability gross monthly salary multiplied by 48 months;- subject to a maximum of $ 648,000 and a minimum of $ 64,800;- when disability is between 33.33% and 66.67%, then cash benefit = sum insured x ((3 x n) - 1), n = degree of disability (%);- when disability is above 66.67%, then cash benefit = sum insured.

Additional payment of $ 33,750If from the start of the disability you need the assistance of a third person to perform the basic activities of daily living (such as feeding, washing yourself) and your degree of disability exceed 66.67%, then an additional sum of $ 33,750 will be paid.

Notes

AdministratorsA Plus International Services Limited

Room 4, 17th Floor, Westlands Centre, 20

Westlands Road, Quarry Bay, Hong Kong

China S.A.R.

Tel: + 852 2891 3608

Fax: + 852 2891 3229

Email: [email protected]

Concepts and trademarks

are licensed from

A Plus International Insurance Development AG

CH-8032 Zurich, Switzerland

www.aplusii.com

Your Health First

Southeast Asia PlansExclusively for residents of Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Thailand & Vietnam

Premium Tableeffective 1/1/2020

mailto:[email protected]

http://www.aplusii.com/

Zone A

Worldwide including USA/Canada

Zone B

Worldwide excluding USA/Canada

Zone C

Restricted only in Cambodia, Indonesia, Laos,

Malaysia, Philippines, Thailand & Vietnam

Deductible 0 300 675 1350 Deductible 0 300 675 1350 Deductible 0 300 675 1350

Essential

<18 2,552 2,033 1,989 1,930 <18 1,179 967 924 819 <18 973 796 783 677

18‐30 3,871 3,197 3,102 2,933 18‐30 1,792 1,501 1,433 1,184 18‐30 1,430 1,178 1,101 938

31‐40 4,515 3,775 3,694 3,481 31‐40 2,091 1,777 1,724 1,425 31‐40 1,654 1,378 1,273 1,126

41‐50 5,582 4,735 4,661 4,377 41‐50 2,584 2,237 2,169 1,821 41‐50 2,024 1,717 1,592 1,425

51 6,306 5,376 5,325 4,976 51 2,919 2,564 2,512 2,057 51 2,286 1,959 1,832 1,619

52 6,659 5,713 5,651 5,292 52 3,084 2,722 2,675 2,196 52 2,411 2,078 1,945 1,704

53 7,051 6,084 6,010 5,641 53 3,265 2,896 2,854 2,354 53 2,550 2,208 2,072 1,801

54 7,483 6,491 6,402 6,021 54 3,464 3,090 3,052 2,531 54 2,702 2,353 2,214 1,909

55 7,956 6,933 6,824 6,438 55 3,683 3,301 3,266 2,729 55 2,868 2,512 2,369 2,028

56 8,470 7,413 7,281 6,883 56 3,922 3,528 3,499 2,946 56 3,050 2,686 2,539 2,163

57 9,027 7,926 7,770 7,367 57 4,180 3,779 3,751 3,184 57 3,247 2,874 2,724 2,310

58 9,629 8,479 8,292 7,882 58 4,458 4,047 4,021 3,444 58 3,459 3,077 2,926 2,471

59 10,274 9,070 8,845 8,432 59 4,757 4,335 4,308 3,727 59 3,685 3,297 3,142 2,650

60 10,966 9,696 9,434 9,015 60 5,075 4,644 4,615 4,030 60 3,928 3,533 3,376 2,843

61 11,701 10,359 10,055 9,633 61 5,417 4,974 4,940 4,355 61 4,187 3,781 3,624 3,053

62 12,483 11,060 10,708 10,283 62 5,778 5,322 5,283 4,702 62 4,460 4,047 3,887 3,282

63 13,306 11,798 11,396 10,966 63 6,161 5,694 5,645 5,071 63 4,749 4,328 4,167 3,528

64 14,173 12,575 12,119 11,685 64 6,561 6,085 6,024 5,458 64 5,052 4,623 4,462 3,794

65 15,081 13,387 12,875 12,439 65 6,981 6,496 6,419 5,869 65 5,370 4,933 4,771 4,077

66 16,030 14,239 13,666 13,226 66 7,421 6,927 6,832 6,296 66 5,702 5,256 5,095 4,377

67 17,017 15,129 14,497 14,053 67 7,879 7,377 7,259 6,742 67 6,046 5,594 5,431 4,698

68 18,038 16,061 15,365 14,914 68 8,352 7,845 7,702 7,204 68 6,402 5,943 5,780 5,034

69 19,092 17,035 16,275 15,818 69 8,840 8,331 8,160 7,682 69 6,770 6,305 6,140 5,387

70 20,179 18,054 17,227 16,765 70 9,342 8,834 8,631 8,173 70 7,146 6,674 6,508 5,755

71 21,290 19,115 18,228 17,757 71 9,856 9,352 9,115 8,675 71 7,534 7,053 6,887 6,138

72 22,421 20,229 19,279 18,800 72 10,380 9,885 9,608 9,190 72 7,926 7,443 7,269 6,531

73 23,571 21,396 20,387 19,899 73 10,913 10,430 10,115 9,711 73 8,328 7,834 7,655 6,936

74 24,734 22,621 21,556 21,058 74 11,450 10,985 10,631 10,236 74 8,730 8,233 8,043 7,348

75 25,901 23,907 22,794 22,285 75 11,992 11,550 11,154 10,767 75 9,137 8,632 8,432 7,764

76 27,071 25,263 24,109 23,588 76 12,533 12,121 11,686 11,296 76 9,544 9,031 8,814 8,180

77 28,233 26,695 25,507 24,975 77 13,072 12,696 12,225 11,822 77 9,950 9,430 9,191 8,592

78 29,382 28,214 27,000 26,459 78 13,605 13,273 12,770 12,344 78 10,350 9,822 9,558 8,998

79 30,511 29,823 28,599 28,050 79 14,125 13,848 13,320 12,858 79 10,744 10,207 9,909 9,388

80+ 31,609 31,540 30,318 29,762 80+ 14,634 14,421 13,874 13,359 80+ 11,128 10,583 10,244 9,760

Evacuation and repatriation included

Essential Plus

<18 2,675 2,137 2,082 2,030 <18 1,239 1,013 948 856 <18 1,014 831 797 705

18‐30 4,078 3,383 3,268 3,102 18‐30 1,887 1,589 1,509 1,251 18‐30 1,503 1,240 1,124 985

31‐40 4,768 4,000 3,899 3,689 31‐40 2,207 1,885 1,818 1,509 31‐40 1,742 1,455 1,337 1,188

41‐50 5,901 5,026 4,926 4,644 41‐50 2,732 2,379 2,294 1,935 41‐50 2,137 1,821 1,679 1,509

51 6,671 5,500 5,430 5,087 51 3,089 2,720 2,651 2,178 51 2,414 2,080 1,933 1,716

52 7,047 5,862 5,785 5,428 52 3,263 2,889 2,824 2,327 52 2,546 2,205 2,055 1,808

53 7,462 6,281 6,189 5,822 53 3,455 3,076 3,015 2,497 53 2,693 2,345 2,189 1,912

54 7,920 6,754 6,642 6,265 54 3,669 3,282 3,225 2,686 54 2,856 2,499 2,337 2,025

55 8,422 7,282 7,150 6,760 55 3,900 3,508 3,455 2,898 55 3,032 2,669 2,504 2,154

56 8,971 7,867 7,707 7,307 56 4,155 3,754 3,706 3,130 56 3,225 2,854 2,684 2,297

57 9,563 8,505 8,316 7,905 57 4,428 4,022 3,974 3,387 57 3,435 3,054 2,880 2,454

58 10,203 9,201 8,973 8,552 58 4,725 4,309 4,263 3,666 58 3,659 3,272 3,092 2,626

59 10,890 9,948 9,676 9,246 59 5,042 4,618 4,570 3,969 59 3,900 3,505 3,325 2,814

60 11,626 10,744 10,425 9,989 60 5,384 4,949 4,900 4,292 60 4,158 3,754 3,572 3,021

61 12,410 11,587 11,217 10,771 61 5,745 5,303 5,246 4,641 61 4,434 4,022 3,836 3,247

62 13,240 12,474 12,048 11,595 62 6,130 5,675 5,612 5,012 62 4,725 4,304 4,116 3,489

63 14,118 13,402 12,915 12,457 63 6,536 6,070 5,997 5,404 63 5,033 4,603 4,413 3,752

64 15,041 14,366 13,818 13,350 64 6,963 6,486 6,402 5,818 64 5,356 4,918 4,728 4,035

65 16,010 15,365 14,749 14,276 65 7,413 6,925 6,822 6,253 65 5,693 5,248 5,059 4,337

66 17,020 16,395 15,709 15,229 66 7,880 7,383 7,259 6,708 66 6,046 5,594 5,403 4,658

67 18,072 17,450 16,693 16,207 67 8,367 7,859 7,713 7,182 67 6,414 5,954 5,763 4,998

68 19,162 18,529 17,702 17,207 68 8,872 8,357 8,183 7,671 68 6,793 6,325 6,133 5,357

69 20,287 19,629 18,728 18,228 69 9,394 8,872 8,668 8,179 69 7,184 6,710 6,517 5,732

70 21,442 20,747 19,775 19,269 70 9,928 9,403 9,165 8,699 70 7,587 7,106 6,910 6,126

71 22,627 21,882 20,841 20,327 71 10,476 9,953 9,676 9,231 71 8,000 7,511 7,312 6,535

72 23,836 23,033 21,926 21,408 72 11,036 10,520 10,201 9,777 72 8,420 7,924 7,720 6,955

73 25,063 24,200 23,034 22,507 73 11,603 11,098 10,740 10,331 73 8,846 8,344 8,132 7,385

74 26,302 25,387 24,167 23,633 74 12,179 11,690 11,288 10,891 74 9,277 8,768 8,546 7,825

75 27,548 26,597 25,329 24,790 75 12,753 12,293 11,849 11,458 75 9,711 9,195 8,959 8,269

76 28,793 27,832 26,530 25,985 76 13,331 12,908 12,421 12,027 76 10,144 9,621 9,367 8,712

77 30,034 29,103 27,774 27,224 77 13,905 13,531 13,004 12,598 77 10,575 10,047 9,769 9,153

78 31,258 30,414 29,075 28,522 78 14,473 14,161 13,598 13,169 78 11,002 10,464 10,160 9,584

79 32,461 31,780 30,446 29,889 79 15,030 14,797 14,204 13,734 79 11,422 10,876 10,535 10,003

80+ 33,629 33,214 31,904 31,345 80+ 15,572 15,435 14,822 14,296 80+ 11,833 11,276 10,891 10,399

Premiums (US$)

Zone A


Zone B


Zone C



Serene

<18 4,609 4,125 3,154 2,181 <18 2,133 1,825 1,211 900 <18 1,701 1,434 901 776

18‐30 7,319 6,799 5,758 4,167 18‐30 3,390 3,027 2,304 1,356 18‐30 2,644 2,309 1,634 1,029

31‐40 8,635 8,111 7,062 5,341 31‐40 3,998 3,630 2,891 1,780 31‐40 3,102 2,748 2,038 1,267

41‐50 11,741 11,226 10,194 8,258 41‐50 5,436 5,073 4,347 2,950 41‐50 4,198 3,828 3,089 1,933

51 13,555 13,051 12,039 10,012 51 6,275 5,909 5,175 3,699 51 4,862 4,478 3,708 2,438

52 14,274 13,772 12,773 10,715 52 6,610 6,249 5,531 4,008 52 5,121 4,736 3,968 2,649

53 15,039 14,544 13,553 11,467 53 6,963 6,613 5,914 4,340 53 5,393 5,012 4,247 2,879

54 15,854 15,364 14,385 12,271 54 7,340 7,002 6,326 4,699 54 5,679 5,300 4,545 3,127

55 16,717 16,234 15,268 13,130 55 7,739 7,416 6,768 5,086 55 5,980 5,608 4,866 3,396

56 17,635 17,160 16,207 14,046 56 8,164 7,857 7,239 5,503 56 6,296 5,933 5,209 3,689

57 18,610 18,140 17,202 15,019 57 8,616 8,324 7,739 5,951 57 6,628 6,276 5,573 4,005

58 19,640 19,181 18,260 16,055 58 9,094 8,819 8,272 6,430 58 6,980 6,640 5,961 4,345

59 20,733 20,282 19,382 17,157 59 9,599 9,345 8,833 6,943 59 7,350 7,024 6,373 4,711

60 21,889 21,449 20,570 18,326 60 10,134 9,899 9,430 7,493 60 7,739 7,431 6,811 5,103

61 23,112 22,684 21,831 19,567 61 10,702 10,485 10,055 8,077 61 8,153 7,859 7,274 5,522

62 24,406 23,991 23,164 20,882 62 11,300 11,104 10,711 8,700 62 8,590 8,315 7,764 5,972

63 25,772 25,373 24,575 22,273 63 11,932 11,755 11,402 9,365 63 9,052 8,795 8,280 6,453

64 27,217 26,834 26,064 23,746 64 12,601 12,441 12,124 10,071 64 9,545 9,305 8,827 6,963

65 28,740 28,373 27,640 25,302 65 13,306 13,163 12,878 10,819 65 10,068 9,846 9,402 7,507

66 30,347 29,997 29,304 26,944 66 14,049 13,921 13,664 11,610 66 10,625 10,418 10,008 8,083

67 32,037 31,709 31,054 28,676 67 14,831 14,716 14,482 12,449 67 11,219 11,026 10,644 8,696

68 33,817 33,510 32,898 30,499 68 15,656 15,548 15,331 13,333 68 11,852 11,674 11,315 9,343

69 35,688 35,404 34,837 32,419 69 16,523 16,419 16,212 14,266 69 12,527 12,358 12,021 10,027

70 37,651 37,391 36,871 34,431 70 17,430 17,329 17,123 15,247 70 13,250 13,087 12,760 10,747

71 39,708 39,473 39,003 36,544 71 18,384 18,278 18,063 16,277 71 14,021 13,859 13,535 11,506

72 41,860 41,650 41,230 38,755 72 19,379 19,265 19,037 17,358 72 14,844 14,679 14,348 12,303

73 44,108 43,924 43,556 41,065 73 20,420 20,293 20,037 18,490 73 15,724 15,550 15,199 13,138

74 46,451 46,293 45,977 43,474 74 21,506 21,359 21,066 19,671 74 16,664 16,473 16,094 14,012

75 48,889 48,756 48,489 45,982 75 22,634 22,464 22,124 20,905 75 17,666 17,453 17,028 14,925

76 51,419 51,310 51,092 48,586 76 23,805 23,606 23,206 22,186 76 18,736 18,492 18,005 15,874

77 54,038 53,951 53,778 51,286 77 25,018 24,782 24,317 23,517 77 19,875 19,593 19,026 16,863

78 56,741 56,675 56,543 54,075 78 26,270 25,997 25,450 24,895 78 21,087 20,756 20,095 17,890

79 59,525 59,475 59,377 56,951 79 27,558 27,242 26,610 26,319 79 22,377 21,989 21,212 18,952

80+ 62,383 62,346 62,272 59,907 80+ 28,880 28,517 27,790 27,788 80+ 23,745 23,288 22,378 20,049

Serene Plus

<18 5,083 4,590 3,600 2,334 <18 2,354 2,032 1,386 962 <18 1,866 1,583 1,015 843

18‐30 8,140 7,617 6,572 4,893 18‐30 3,767 3,401 2,666 1,613 18‐30 2,930 2,580 1,882 1,074

31‐40 9,620 9,096 8,047 6,244 31‐40 4,453 4,083 3,342 2,130 31‐40 3,447 3,085 2,358 1,391

41‐50 13,108 12,598 11,580 9,577 41‐50 6,069 5,716 5,011 3,511 41‐50 4,674 4,306 3,566 2,305

51 15,334 14,836 13,836 11,770 51 7,099 6,747 6,047 4,489 51 5,518 5,134 4,367 2,984

52 16,132 15,638 14,650 12,557 52 7,468 7,131 6,458 4,841 52 5,793 5,415 4,658 3,226

53 16,968 16,480 15,505 13,387 53 7,856 7,534 6,891 5,213 53 6,078 5,706 4,963 3,487

54 17,848 17,368 16,408 14,265 54 8,262 7,959 7,350 5,610 54 6,377 6,012 5,285 3,765

55 18,776 18,305 17,363 15,191 55 8,692 8,406 7,834 6,034 55 6,687 6,334 5,629 4,062

56 19,760 19,298 18,374 16,175 56 9,147 8,880 8,345 6,488 56 7,012 6,674 5,995 4,383

57 20,802 20,351 19,450 17,224 57 9,629 9,382 8,885 6,973 57 7,361 7,034 6,384 4,728

58 21,908 21,470 20,594 18,340 58 10,141 9,912 9,454 7,496 58 7,728 7,417 6,798 5,101

59 23,088 22,663 21,816 19,535 59 10,689 10,477 10,054 8,057 59 8,124 7,829 7,242 5,503

60 24,345 23,937 23,119 20,815 60 11,272 11,077 10,685 8,662 60 8,549 8,272 7,717 5,941

61 25,690 25,298 24,514 22,182 61 11,894 11,714 11,355 9,315 61 9,007 8,745 8,226 6,411

62 27,129 26,754 26,004 23,648 62 12,560 12,394 12,060 10,017 62 9,503 9,260 8,773 6,919

63 28,665 28,308 27,596 25,219 63 13,272 13,116 12,802 10,771 63 10,041 9,813 9,358 7,470

64 30,307 29,970 29,296 26,899 64 14,032 13,883 13,585 11,585 64 10,622 10,408 9,983 8,062

65 32,056 31,739 31,106 28,691 65 14,841 14,696 14,408 12,451 65 11,251 11,053 10,654 8,697

66 33,918 33,622 33,032 30,602 66 15,705 15,560 15,273 13,381 66 11,932 11,744 11,367 9,377

67 35,893 35,618 35,073 32,631 67 16,617 16,472 16,181 14,368 67 12,663 12,483 12,122 10,103

68 37,981 37,729 37,225 34,776 68 17,584 17,435 17,133 15,417 68 13,447 13,273 12,924 10,876

69 40,180 39,949 39,489 37,039 69 18,602 18,444 18,125 16,524 69 14,283 14,111 13,769 11,691

70 42,483 42,273 41,855 39,408 70 19,669 19,499 19,159 17,686 70 15,172 14,999 14,654 12,549

71 44,884 44,695 44,315 41,881 71 20,780 20,598 20,233 18,898 71 16,107 15,931 15,578 13,446

72 47,369 47,198 46,856 44,438 72 21,932 21,734 21,342 20,155 72 17,087 16,902 16,533 14,376

73 49,925 49,769 49,460 47,067 73 23,113 22,904 22,485 21,449 73 18,103 17,909 17,517 15,332

74 52,528 52,386 52,102 49,748 74 24,319 24,097 23,655 22,768 74 19,150 18,941 18,520 16,311

75 55,155 55,022 54,758 52,451 75 25,534 25,305 24,849 24,098 75 20,214 19,986 19,534 17,298

76 57,775 57,648 57,394 55,150 76 26,746 26,516 26,056 25,428 76 21,281 21,035 20,542 18,286

77 60,350 60,223 59,970 57,799 77 27,939 27,717 27,271 26,736 77 22,336 22,070 21,538 19,257

78 62,837 62,706 62,440 60,360 78 29,092 28,886 28,480 28,000 78 23,361 23,074 22,499 20,197

79 65,189 65,042 64,750 62,781 79 30,180 30,010 29,673 29,196 79 24,329 24,023 23,409 21,087

80+ 67,343 67,176 66,840 64,998 80+ 31,176 31,062 30,834 30,294 80+ 25,215 24,892 24,247 21,906

Zone A


Zone B


Zone C



Dental Standard

<18 1,243 <18 621 <18 468

18‐30 1,672 18‐30 837 18‐30 629

31‐40 2,092 31‐40 1,044 31‐40 785

41‐50 2,572 41‐50 1,288 41‐50 968

51‐55 2,847 51‐55 1,425 51‐55 1,070

56‐60* 3,850 56‐60* 1,927 56‐60* 1,448

61‐65* 4,193 61‐65* 2,096 61‐65* 1,576

66‐70* 4,661 66‐70* 2,327 66‐70* 1,752

71‐75* 5,824 71‐75* 2,912 71‐75* 2,190

76‐80* 7,104 76‐80* 3,550 76‐80* 2,669

Dental Plus

<18 2,211 <18 1,106 <18 832

18‐30 2,988 18‐30 1,493 18‐30 1,124

31‐40 3,728 31‐40 1,863 31‐40 1,403

41‐50 4,603 41‐50 2,302 41‐50 1,731

51‐55 5,094 51‐55 2,548 51‐55 1,914

56‐60* 6,891 56‐60* 3,444 56‐60* 2,590

61‐65* 7,495 61‐65* 3,750 61‐65* 2,817

66‐70* 8,330 66‐70* 4,166 66‐70* 3,130

71‐75* 10,408 71‐75* 5,205 71‐75* 3,912

76‐80* 12,696 76‐80* 6,348 76‐80* 4,773

Accidental death and dismemberment (AD&D)

This cover will guarantee the payment of a lump sum in case you die in an accident or you incur a permanent disability of at least 20% caused by an accident

Lump Sum after accidental death

- up to a maximum of $ 675,000 with a minimum of $ 67,500

- cover is available for you and your adult dependants

Lump Sum after permanent disability

- from at least a permanent disability degree of 20%

- cash benefit = sum insured x degree of disability

Premium

Annual Premium

0.23% of the Capital Insured

Capital Insured :

Premium :

Loss of Income (TI / PD)

Temporary incapacity (TI)

With the temporary incapacity plan option, you will feel more secure knowing your family will be protected financially if you are totally unable to perform your professional occupation due to illness or accident. You can choose the level of income benefit that is appropriate to you and your family:

- up to 80% of pre-disability gross monthly salary;

- subject to a maximum of $ 13,500 per month and a minimum of $ 1,350.

Income protection during 24 months

We will pay you a regular income for as long as you are unable to return to work. After a waiting period of 90 days, the income will start up to a maximum of 24 months. If

you are still unable to resume work after 24 months then you will receive a lump sum through the permanent disability option when PD option has been contracted.

Permanent disability (PD) (can be taken out only as supplement option to Temporary Incapacity)

With this option, you receive a lump sum in case you are affected by a permanent disability of at least 33.33% caused by illness or accident. You can choose the level of sum insured that is appropriate to you:

- up to 80% of pre-disability gross monthly salary multiplied by 48 months;

- subject to a maximum of $ 648,000 and a minimum of $ 64,800;

- when disability is between 33.33% and 66.67% then cash benefit = sum insured x ((3 x n)-1), n = degree of disability (%);

- when disability is above 66.67% then cash benefit = sum insured.

Additional payment of $ 33,750

If from the start of the disability you need the assistance of a third person to perform the basic activities of daily living (such as feeding, washing yourself) and your degree of disability exceeds 66.67%, then an additional sum of $ 33,750 will be paid.

Premium

Age

Monthly Sum InsuredAnnual Premium

US$

TI PD TI PD

18-30 11.00% 4.79%

31-40 12.00% 9.66%

41-50 19.00% 35.75%

51-60 27.00% 150.52%

61-65 29.67% 300.14%

Documents

Cambodia, Indonesia, Laos, Benefits Table · 1/1/2020 · Cambodia, Indonesia, Laos, Malaysia, Philippines, Thailand & Vietnam. Benefits Table . effective 1/1/2020. Southeast Asia