Chartis GH BenefitOverviewProductSummary (Final)

8/11/2019 Chartis GH BenefitOverviewProductSummary (Final)

1/12

BENEFIT OVERVIEW PRODUCT SUMMARY

GHSG BO 2011/01

01 of 12

GlobalHealth Advantage Plans offer a wide range of comprehensive personal and family medical insurance products, backed by superior customerservice, GlobalHealth Asia is your trusted insurance partner.

GlobalHealth Asia also offers a wide range of plans to enhance any corporate, organisation, or association employee benefits programs, withflexible structures and cost savings.

Presented to (Name of Applicant):

Signature of Applicant: Date (dd/mm/yy):

Presented to (Name of Advisor):

Signature of Advisor: Date (dd/mm/yy):

Covered Member Gender Age Current Birthday (dd/mm/yy)

I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I

I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I___I

I___I___I/I___I___I/I___I___I

I___I___I/I___I___I/I___I___I

PLAN SELECTED

Advantage 100 Advantage 200 Advantage 300 Advantage 400 Advantage 500

Please note that this is not a summary of contract and the premium is not guaranteed, Chartis Singapore Insurance Pte. Ltd. (Chartis) may at itssole discretion increase the premium from time to time depending on the claims experience of this portfolio. The annual premium is based on theInsured Person's age on the first day of the Period of Insurance and the renewal premium rates as determined by Chartis at the time of renewal,

based on the attained age of the Insured Person. This plan is available to a person from age 15 days to 65 years, residing in Singapore. Applicationis subject to underwriting review and acceptance.

PRODUCT INFORMATION

This is a medical plan and we will pay the compensation as set out in the Schedule of Benefits:

Worldwide Coverage including incidental travelling to North America

Benet Level up to US$2 million per year for Advantage 300, Advantage 400 and Advantage 500; Up to US$250,000 per year for Advantage200; Up to US$250,000 per disability for Advantage100

Range of deductibles are available for all Advantage Plans 30 Days Free Look Privilege

Hospitalisation and Out-patient Surgery

An unmarried child below age 21 or up to 23 years (if enrolled as full-time student) may be enrolled as an Insured Person under a Family Plan

Eligibility:

The following basic eligibility rules apply for the GlobalHealth Advantage plans:

Main applicant must be between age 21 to 65 years at the time of application. Persons to be insured must be between the ages of 15 days and 65 years at the time of application. Persons residing in North America and the Caribbean are not eligible for the GlobalHealth Advantage plans.


2/1202 of 12

The Proposer may add his/her spouse, and any unmarried children below age 21 to the Policy. Children cannot be added to the Policy unlessa parent or a legal guardian is an insured person. An unmarried child who is over 21 but less than 23 may also be added if enrolled in full-timeeducation.

Children born while either parent is an Insured Person may be added 15 days after birth upon request. The new born may enjoy free cover forthe remainder of the policy year.

Standard Benefits Advantage 100 Advantage 200 Advantage 300 Advantage 400 Advantage 500

Plan Maximum $250,000 perDisability

$250,000 per year $2,000,000per year

$2,000,000per year

$2,000,000per year

Hospitalisation & Out-patientSurgery

Hospitalisation &Out-patientSurgery sub-limits:

Hospitalisation &Out-patientSurgery sub-limits:

Room and board including generalnursing care

$250 per day $300 per day

Parental Accommodation (addedbed, same room)

No Cover Fully Covered

Theatre fees; intensive care; X-rays;CT Scans; MRI Scans; Ultrasounds;laboratory tests; Medicines andDrugs; blood and plasma; medical

appliances; rental of wheel chairs,crutches and walkers; standardsurgical implants

Fully Covered Fully Covered

Fully Covered Fully Covered Fully Covered

Surgeons Fees including pre andpost surgical services

$15,000 perDisability

$20,000 per year

Anaesthetist Fees 30% ofSurgeons Fees

30% ofSurgeons Fees

Professional Fees includingphysician, specialist, radiologist,physiotherapist and pathologist

Fully Covered Fully Covered

Pre-hospitalisation

Medical services incurred within 30days prior to a covered Confinementin a Hospital which are providedby or ordered by a Physician as adirect consequence of the coveredDisability which necessitated suchConfinement

Up to $1,000 perDisability

Up to $1,000 perDisability


Post-hospitalisation

Normal follow-up treatment for up

to 90 days following hospitalisation

Physicians and specialists officevisits

Physiotherapist, chiropractor andacupuncturist when certifiednecessary by an attending Physician

Medicines and Drugs; dressings;X-rays; diagnostic laboratory tests;surgical appliances

Fully Covered Fully Covered Fully Covered Fully Covered Fully Covered

Note:All limits and monetary amounts shall in all instances be in US$


3/1203 of 12


Oncology

Chemotherapy and radiotherapy Fully Covered Fully Covered Fully Covered Fully Covered Fully Covered

Renal Dialysis

Kidney Dialysis $15,000 lifetimebenefit

$15,000 lifetimebenefit


Complications of Pregnancy

In-patient treatment necessary as adirect result of Complications ofPregnancy including NewbornAccommodation

Hospitalisation &Out-patientSurgery sub-limitsapply



AIDS/ HIV

Coverage will apply when signs orsymptoms are present for the firsttime after five years continuouscoverage under the plan and anyrenewal thereof






Private Nursing

In Hospital when certified medicallynecessary by an attending Physician

Home Nursing by a registered nurseimmediately following hospitalisationand on the recommendation of theattending surgeon or specialist

Fully Covered

No Cover

Fully Covered

No Cover

Fully Covered

Fully Coveredup to 28 weeksper Disability

Fully Covered


Fully Covered


Mental or Nervous Disorders

Inpatient treatment under the care ofa Psychiatrist

No Cover No Cover $5,000 per year$10,000 lifetimebenefit

$5,000 per year$10,000 lifetimebenefit

$5,000 per year$10,000 lifetimebenefit

Organ Transplant

Transplant of heart, liver, kidney,bone marrow, cornea or lung to alimit of






Hospice Care

Hospice/ Palliative Care No Cover No Cover $10,000 lifetimebenefit



Emergency Benefits

Worldwide emergency assistanceincluding evacuation and repatriation

Local Ambulance to Hospital

Emergency room treatment

Dental treatment for up to 14 daysfollowing Accidental damage tosound natural teeth

Fully Covered Fully Covered Fully Covered Fully Covered Fully Covered



4/1204 of 12


Chronic Conditions

Treatment for a Chronic Conditionreceived while an admitted patient ina Hospital

General Practitioner and specialistconsultations; prescribed Medicines

and drugs;


No Cover


Included inoptional

out-patient

Fully Covered

No Cover

Fully Covered

Fully Covered

Fully Covered

Fully Covered

Out-patient

Physicians and specialistsconsultations

Physiotherapist when certifiednecessary by an attending Physician

Medicines and Drugs;dressings; X-rays; CT Scans; MRIScans; ultrasounds; diagnosticlaboratory tests and medical

appliances

No Cover Optional$5,000 per year

No Cover Fully Covered Fully Covered

Complementary Medicine

Physiotherapist without certificationfrom an attending Physician;chiropractor; osteopath;homeopath; podiatrist; speechtherapist; dietician

Acupuncturist; bone setter andChinese medicine practitioner notexceeding $50 per visit

No Cover No Cover No Cover $500 per year $500 per year

Maternity (deductible does not

apply)

Pre-natal and post-natal services;costs related to miscarriage; costsof delivery including all Hospital andprofessional fees and up to sevendays of nursery care

No Cover No Cover No Cover No Cover $10,000 perpregnancy

Optional Benefits

Dental

Routine Dental Treatment(Examinations; tooth cleaning;normal composite llings; inlay

(excluding gold inlays); onlay(excluding gold onlays); extractions;sealant)

Major Restorative Dental Work(Removal of impacted, buried orunerupted teeth; removal of roots;root canal treatment; removal ofsolid odontomes; apicectomy; new orrepair of bridge work (excluding goldbridge work); new or repair of crowns(excluding all gold crowns); new orrepair of upper and lower dentures)

$700 per year

$1,500 per year

$700 per year

$1,500 per year

$700 per year

$1,500 per year

$700 per year

$1,500 per year

$700 per year

$1,500 per year



5/1205 of 12

Optional Benefits Advantage 100 Advantage 200 Advantage 300 Advantage 400 Advantage 500

Worldwide Cover

Opt to enjoy the benet of electivetreatment in North America with atruly worldwide plan

The Advantage100 is alwaysWorldwide

The Advantage200 is alwaysWorldwide

Optional Optional Optional

Deductible

Range of deductibles available to

reduce your premium

Per Disability

$500$1,000$2,000$5,000

AnnualNil

$500$1,000$2,000$5,000

AnnualNil

$500$1,000$2,000$5,000

AnnualNil

$500$1,000$2,000$5,000

AnnualNil

$500$1,000$2,000$5,000


*Renewal onlyNote:All limits and monetary amounts shall in all instances be in US$Subject to prevailing GST

AGEPer Disability Deductible

500 1,000 2,000 5,000

0-18 813 657 487 223

19-25 833 672 494 230

26-30 872 703 515 238

31-45 992 802 583 264

46-50 1,556 1,254 904 394

51-55 1,709 1,375 988 427

56-60 2,301 1,852 1,328 567

61-65 2,621 2,110 1,507 636

66 - 70* 3,288 2,646 1,892 79871 - 75* 4,538 3,653 2,611 1,103

76 - 80* 7,289 5,866 4,194 1,771

ADVANTAGE 100 (WW)

Worldwide Coverage (WW)If you select Worldwide, you will enjoy coverage anywhere in the world, including the United States of America.

North American Exclusion (NAE)If you select North American Exclusion coverage, coverage will be Worldwide excluding North America. Coverage in North America will be limitedto sudden illness and accidental injury while travelling in North America and the Caribbean for a maximum of 30 days per policy year.Please note that coverage under the Advantage 100 and Advantage 200 is always Worldwide.

PREMIUMS


6/1206 of 12

ADVANTAGE 200 (WW)

AGEAnnual Deductible

0 500 1,000 2,000 5,000

0-18 856 772 624 463 212

19-25 979 883 711 523 254

26-30 1,022 922 743 544 272

31-35 1,155 1,042 842 612 301

36-40 1,155 1,042 842 612 301

41-45 1,155 1,042 842 612 301

46-50 1,780 1,605 1,294 933 407

51-55 1,951 1,759 1,415 1,016 439

56-60 2,306 2,079 1,674 1,200 512

61-65 2,962 2,671 2,150 1,536 648

66 - 70* 3,701 3,338 2,686 1,921 810

71 - 75* 5,088 4,588 3,693 2,640 1,115

76 - 80* 8,138 7,338 5,906 4,222 1,783

In-patient only



0 500 1,000 2,000 5,000

0-18 1,334 1,130 935 725 403

19-25 1,571 1,318 1,088 838 478

26-30 1,638 1,375 1,135 873 506

31-35 1,851 1,552 1,284 983 564

36-40 1,851 1,552 1,284 983 564

41-45 1,851 1,552 1,284 983 564

46-50 2,842 2,386 1,971 1,501 811

51-55 3,113 2,614 2,156 1,638 880

56-60 3,554 2,997 2,470 1,866 986

61-65 4,720 3,962 3,270 2,473 1,316

66 - 70* 5,894 4,982 4,112 3,127 1,686

71 - 75* 8,096 6,845 5,649 4,294 2,320

76 - 80* 12,943 10,941 9,029 6,865 3,706

ADVANTAGE 200 (WW)

In-patient and Out-patient


7/1207 of 12


ADVANTAGE 300 (WW)


0 500 1,000 2,000 5,000

0 - 18 1,044 887 717 532 243

19 - 25 1,177 1,002 808 594 277

26 - 30 1,491 1,272 1,025 751 347

31 - 35 1,555 1,335 1,079 785 356

36 - 40 1,710 1,469 1,187 863 391

41 - 45 1,788 1,535 1,241 903 409

46 - 50 1,978 1,729 1,393 1,005 438

51 - 55 2,177 1,907 1,535 1,102 476

56 - 60 2,665 2,352 1,895 1,358 579

61 - 65 3,574 3,163 2,546 1,818 76766 - 70* 6,330 5,623 4,525 3,236 1,365

71 - 75* 8,440 7,528 6,059 4,331 1,829

76 - 80* 13,186 11,809 9,504 6,795 2,870


0 500 1,000 2,000 5,000

0 - 18 651 553 447 331 152

19 - 25 976 831 670 492 230

26 - 30 1,070 912 735 539 249

31 - 35 1,085 931 753 547 261

36 - 40 1,193 1,024 828 602 273

41 - 45 1,247 1,071 865 630 285

46 - 50 1,442 1,260 1,016 733 320

51 - 55 1,559 1,366 1,099 789 341

56 - 60 1,787 1,578 1,270 911 389

61 - 65 2,765 2,446 1,969 1,406 593

66 - 70* 4,338 3,853 3,101 2,218 935

71 - 75* 6,195 5,526 4,447 3,179 1,343

76 - 80* 9,295 8,324 6,701 4,790 2,023

ADVANTAGE 300 (NAE)


8/12


9/12

ADVANTAGE 500 (WW)


0 500 1,000 2,000 5,000

0 - 18 1,680 1,343 1,176 1,091 840

19 - 25 3,154 2,627 2,318 1,989 1,497

26 - 30 3,778 3,147 2,776 2,383 1,794

31 - 35 3,939 3,280 2,894 2,483 1,871

36 - 40 4,527 3,771 3,327 2,854 2,150

41 - 45 4,646 3,870 3,415 2,929 2,207

46 - 50 4,805 4,000 3,532 3,029 2,282

51 - 55 5,123 4,268 3,765 3,229 2,435

56 - 60 5,912 4,925 4,343 3,727 2,808

61 - 65 7,875 6,561 5,789 4,965 3,741

66 - 70* 10,254 8,717 7,690 6,666 5,127

71 - 75* 13,022 11,068 9,767 8,466 6,512

76 - 80* 18,376 15,619 13,781 11,943 9,188

ADVANTAGE 500 (NAE)


0 500 1,000 2,000 5,000

0 - 18 1,600 1,279 1,119 1,039 800

19 - 25 2,602 2,169 1,913 1,642 1,237

26 - 30 3,301 2,750 2,426 2,081 1,569

31 - 35 3,343 2,786 2,459 2,110 1,589

36 - 40 3,815 3,178 2,805 2,405 1,812

41 - 45 3,846 3,205 2,827 2,424 1,827

46 - 50 4,068 3,388 2,991 2,565 1,932

51 - 55 4,682 3,901 3,442 2,952 2,224

56 - 60 5,350 4,457 3,934 3,374 2,541

61 - 65 6,688 5,573 4,917 4,216 3,178

66 - 70* 8,946 7,605 6,710 5,815 4,473

71 - 75* 12,017 10,215 9,013 7,812 6,009

76 - 80* 16,387 13,929 12,290 10,652 8,194


09 of 12

Optional Dental US$ 400 per person per year


10/12

The following are key product provisions found in the policy contract of this plan. This is only a brief summary and you are advised to refer to theactual terms and conditions in the contract. Please consult your insurance advisor or Chartis should you need further explanation.

(a) Terms of RenewalCoverage may be renewed on the Policy Anniversary Date by payment of the annual premium.

(b) Non-Guaranteed PremiumPremium payable for this coverage is not guaranteed. It may be increased at the sole discretion of Chartis depending on the claims experience

of this portfolio.

(c) Qualifying Period For Sickness CoverEligibility of benefits commences once an Insured Person has been accepted in the plan.

(d) Waiting Period For Maternity Cover

A 12 month Waiting Period for Maternity benets applies to policies when two or more Insured Persons over the age of 19 are covered underthe Advantage 500 plan.A 24 month Waiting Period for Maternity benets applies to policies when a single Insured Person over the age of 19 is covered under theAdvantage 500 plan.

(e) Dental Waiting PeriodsExaminations and Tooth cleaning: No waiting period, Routine Dental Treatment : Three months waiting period, Major Restorative Dental Work:

Six months waiting period

(f) Area of CoverGlobal Health Advantage Plans provides you coverage in North America and the Caribbean for treatment of sudden illnesses and Bodily Injurysuffered while in these countries for a maximum of 30 days per policy year.

(g) ExclusionsThere are certain conditions under which no benefits will be payable. These are stated as exclusions in the contract. The following is a listof some of the exclusions for this plan. You are advised to read the policy contract for the full list of exclusions.

1. Pre-Existing Conditions or any related, associated or consequential Disabilities, unless disclosed to and accepted in writing by Chartis.

2. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering thePolicyholder, Insured, or Insured Person including legislation or insurance coverage relating to occupational death, Injury, illness or disease.

3. Routine medical examinations or check-ups, examinations for employment or travel, routine eye or ear examinations, vitamins, nutritionalsupplements, vaccinations, medical certificates, hearing aids, chelation therapy, hydra colon therapy, counseling, custodial or maintenancecare, rest cures, and services or treatment at home or while a bed patient at any facility that is not a Hospital.

4. Dental work, except that which is explicitly stated in the optional dental plan Benets Schedule as being covered by the Policy, CosmeticSurgery, and reconstructive surgery except for charges for the prompt repair of an Injury. In the case of Injury to teeth, the teeth repairedmust have been sound and natural. In each case of an Injury, the Injury must occur while the person is an Insured Person.

5. Tests or treatment related to fertility, impotence or erectile dysfunction, contraception, sterilisation, birth defects, congenital Illnesses, orany abortion performed due to psychological or social reasons, and consequences thereof.

6. Pregnancy or childbirth including pre-natal and post-natal care, except where Maternity Benets are opted as being covered by the Policy.

7. Prostheses, corrective devices, medical appliances except for surgical implants. Treatment that is either not part of Western (allopathic)medicine, except where Complementary Medicine Benefits are stated in the Benefits Schedule as being covered by the Policy, or whichis not medically necessary, or complications or disabilities consequential thereupon.

8. All costs relating to cornea, bone marrow, muscular, skeletal or human organ or tissue transplant from a donor to a recipient andall expenses directly or indirectly related to organ transplantation (including conditions requiring or likely to require transplantation andstatus-post transplantation) except as provided by the Organ Transplantation Benet when this benet is stated on the Benets Scheduleas being covered by the Policy.

9. Out-patient tests or treatment of psychiatric, psychological, Mental and Nervous Conditions and any physiological or psychosomatic causesor manifestations thereof; self-inicted Injury, suicide or attempted suicide, deliberate exposure to exceptional danger except in an effort tosave human life, excessive consumption of alcohol or narcotics or similar drugs or agents, sleep disorders, learning difficulties, behavioural ordevelopmental disorders, Venereal Disease.

KEY PRODUCT PROVISIONS

10 of 12


11/12

10. Any treatment or test in connection with Human Immunodeficiency Virus (HIV) related Illness including Acquired Immune DeficiencySyndrome (AIDS), AIDS Related Complex (ARC) and/or any mutation, derivation, or variation thereof except when AIDS/HIV Benets arestated on the Benefits Schedule as being covered by the Policy.

11. Experimental or pioneering medical and surgery techniques except with Chartis prior approval in writing.

12. Services which are not recommended and prescribed by the Insured Persons attending Physician except for a Second Opinion prior tosurgery and continuity of fees from a referring Physician after the date on which an Insured Person has been referred to another Physician

or Specialist.

13. Refractive defects of the eye, such as nearsightedness and astigmatism, spectacles, monocles or contact lenses.

14. Injury or illness as a result of duties of employment or profession in Employment Class III or IV, participation in any professional sport, oraviation or aeronautics other than as a fare paying passenger on a duly licensed commercial aircraft unless disclosed to and accepted byChartis.

15. Injury or Illness while serving as a member of a police or military unit of any country or international authority, or War, civil war, invasion,insurrection, revolution, use of military power or usurpation of government or military power, or the intentional use of military force tointercept, prevent, or mitigate any known or suspected Terrorist Act, or any illegal act including resultant imprisonment. Any medicalservices rendered to an Insured Person while he is confined to prison, jail, any other correctional facility including halfway houses or similarfacilities, or any mental institution. Exposure to ionising radiation or radioactive contamination of any kind.

16. Hospital inpatient treatment for convalescence, rehabilitation, supervision or conditions which in the opinion of Chartis Medical Advisor canbe properly treated as an outpatient.

17. Transportation costs in respect of trips made specically for the purpose of obtaining medical treatment, unless in the course of an approvedEmergency Medical Evacuation, and all Emergency Medical Evacuation costs not approved in advance by Chartis or its appointed 24-hourEmergency Medical Assistance Center.

18. Charges, or portions of charges, which are not Reasonable and Customary Costs arising under any legislation which seeks to increasethe cost of medical treatment and services actually received above charge levels which would be considered Reasonable and Customaryin the absence of such legislation.

19. Any costs incurred outside of the Policy Year or for any period for which the appropriate premium has not been paid.

20. We are not liable to make any payments for liability under any coverage sections of this Policy or make any payments under any extension

for any loss or claim arising in, or where You or any beneficiary under the Policy is a citizen or instrumentality of the government of, anycountry against which any laws and/or regulations governing this Policy and/or Us, our parent company or our ultimate holding entity haveestablished an embargo or other form of economic sanction which have the effect of prohibiting Us from providing insurance coverage ortransacting business with or otherwise offering economic benefits to You or any other beneficiary under the Policy. It is further understoodand agreed that no benefits or payments will be made to any beneficiary who is declared unable to receive economic benefits under thelaws and/or regulations governing this Policy and/or Us, our parent company or our ultimate holding entity.

21. This Policy will not cover any loss, injury, damage or legal liability suffered or sustained directly or indirectly by you if you are :

1) a terrorist;2) a member of a terrorist organisation;3) a narcotics trafcker; or4) a purveyor of nuclear, chemical or biological weapons.

Disclosure of Distribution Costs, Charges & Expenses

You may request for information on remuneration, including any commission, fee and other benets that your insurance advisor has received orwill be receiving for providing advice on, or arranging insurance contracts or both, in respect of any accident and health policy.

11 of 12


12/12

Chartis Singapore Insurance Pte. Ltd.

CHARTIS Building78 Shenton Way #07-16

Singapore 079120Email: [email protected]

Web:www.globalhealthasia.comwww.chartisinsurance.com/sg

Co. Reg. No. 201009404M

Documents

Chartis GH BenefitOverviewProductSummary (Final)