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ING SMI PLAN Benefits | ING Small Medium Industry Insurance

ING SMI PLAN

Small Medium Industry Insurance

Schedule of Benefits

MEDICAL : BASIC - HOSPITALISATION

PLAN 350

(RM)

PLAN 200

(RM)

PLAN 150

(RM)

PLAN 80

(RM)

1. In - Hospital Care
1.1 Hospital Room & Board
(i) Ordinary Room

350

200

150

80

( up to 120 days max per disability )
(ii) Intensive Care

500

500

500

500

( up to 20 days max per disability )
1.2 Hospital Miscellaneous Services

Full Reimbursement

1.3 Surgical Fees

Full Reimbursement

1.4 Anesthetic Fees

Full Reimbursement

1.5 Operating Theatre Charges

Full Reimbursement

1.6 In - Hospital Physician Fees

Full Reimbursement

( up to 120 days max per disability )
1.7 Hospital Service Tax

5%

5%

5%

5%

( on eligible Room & Board charges paid )
2. Ambulatory Care
2.1 Pre - Surgical / Medical Diagnostic Services

Full Reimbursement

( within 60 days )
2.2 Pre - Surgical / Medical Specialist Consultation

Full Reimbursement

( within 60 days )
2.3 Second Surgical Opinion

Full Reimbursement

2.4 Follow - up Treatment

Full Reimbursement

( up to 60 days )
2.5 Out - Patient Accidental Treatment

Full Reimbursement

( within 24 hours up to 60 days )
2.6 Daycare Procedure

Full Reimbursement

2.7 Ambulance Services

Full Reimbursement

2.8 Medical Report Fee Reimbursement

80

80

80

80

3. Compassionate Allowance

5000

5000

3000

3000

OVERALL LIMIT

100 000

50 000

30 000

10 000

(max per annum)
NOTE : Overall Limit - The maximum benefit payable within the policy year regardless of number of disabilities

MEDICAL : OPTIONAL RIDER - OUTPATIENT CLINICAL

(RM)

1. Primary Care

(i) Panel GP Clinic Visit

Cash Free

(ii) Emergency Non-Panel Clinic Visit

Full Reimbursement

2. Preventive Screening

Pap Smear ( at Panel GP Clinic only )

Full Reimbursement

( max once per policy year )

3. Specialist Care

With referral from Panel GP Clinic

100

( max limit per visit )

4. Diagnostic Services

X Ray & Laboratory Tests

250

With referral from Panel GP Clinic or Specialist

( max limit per visit )

GROUP TERM LIFE - BASIC

PLAN 1

(RM)

PLAN 2

(RM)

PLAN 3

(RM)

PLAN 4

(RM)

PLAN 5

(RM)

1 Death (all causes)

100 000

80 000

60 000

40 000

20 000

2 Permanent Total Disability (all causes)

100 000

80 000

60 000

40 000

20 000

3 Permanent Partial Disability (all causes - as per Scale of Indemnity)

100 000

80 000

60 000

40 000

20 000

GROUP TERM LIFE : OPTIONAL RIDER - CRITICAL ILLNESS

PLAN 1 - PLAN 5

1. Critical Illness

Lump Sum payment of 50% of the Basic Sum Assured upon diagnosis of a critical illness. Full sum (100%) is payable if death/disability occurs during the remaining period

MEDICAL & GROUP TERM LIFE : OPTIONAL RIDER ¨C

EXECUTIVE SCREENING

1. 18 KS Screening A comprehensive and general blood & urine screening

profile covering 41 test

(max once per policy year)

Cash Free

EXCLUSIONS
Medical

  • Cosmetic surgery or treatment
  • Experimental procedures
  • Treatment for injuries while committing a crime or while under the influence of alcohol / narcotics
  • Treatment for self inflicted injuries
  • Treatment for drug abuse or alcoholism
  • Private nursing care and house calls by doctors for any reasons
  • Treatment and test relating to sexual dysfunction, infertility, pregnancy ( except for miscarriage due to a motor vehicle accident ), childbirth, sterilization and circumcision
  • Sex transformation surgery and sex hormone therapy
  • Treatment for sexually transmitted diseases, AIDS or AIDS related complex
  • Alternative therapies such as acupuncture, chiropractic, osteopath, reflexology etc
  • Vitamins, Food Supplements, Herbal Cures, Anti Obesity / Weight Reducing Agents including any off the counter medications
  • Soaps, shampoos, vitamin creams and vitamin ointment
  • Psychotic, mental, nervous disorders and behavioral conditions including neurosis, physiological or psychosomatic manifestations
  • Treatment for congenital, hereditary diseases / deformities
  • Diseases or disabilities of a newborn child contracted prior to or during birth or within the first 14 days hereafter
  • Blood and topical allergy testing
  • Routine physical examination, health check-ups
  • Speech and Occupational Therapy
  • Eye Refraction
  • Supply of any material ( glasses, lens etc ) for the correction of visual acuity, except for cataract surgery or eye injury
  • Non accidental dental treatment and / or surgery
  • Use, acquisition or rental of external appliances such as artificial limbs, hearing aids, aero chambers, equipment for nebulising, orthopaedic pads except during hospital confinement
  • Treatment for the exposure to ionising radiation, radioactivity contamination and from the use of atomic, biological, nuclear and chemical weapons
  • Treatment for any sickness or injury as a result of terrorism, military, naval or air force operations, direct / indirect participation in strikes, riots and civil commotion or insurrection
  • Illness or injury sustained during air travel except as a fare paying passenger
  • Non-medical services provided by a hospital such as television, telephone, fax, radio etc
  • Outpatient physical therapy or physiotherapy cannot be referred at GP level. Must be referred by Specialist and treatment must be provided by a registered physiotherapist. Member must have Hospitalisation Coverage subject to its limitations
  • Outpatient rehabilitation therapy, chemotherapy, radiation therapy, kidney dialysis, chronic illness unless Member has Hospitalisation Coverage subject to its limitations
  • Preventive vaccinations except for mandatory vaccinations for children
EXCLUSIONS
Group Term LifePermanent Total & Partial Disability (all causes)

  • Suicide or self inflicted injuries while sane or insane or deliberate exposure to unnecessary danger
  • Injury sustained while under the influence or narcotics or illegal drugs
  • Injury sustained while on full-time active duty in the armed forces, naval or military
  • Injuries sustained during participation of dangerous sports such as hunting, mountaineering, racing ( other than foot racing ), diving , parachuting etc
  • Injury sustained during air travel, except as a fare paying passenger on a recognized airline
  • Pregnancy which term includes abortion, miscarriage or related complications
  • War invasion, terrorism, civil was, rebellion, revolution, insurrection, military or usurped power or direct / indirect participation in riots, strikes and civil commotion
  • Atomic, biological and nuclear energy reactions, radiation and contamination
Annual Premium Schedule (RM) - NON CASHLESS PREMIUM

MEDICAL

BASIC : HOSPITALISATION

PLAN 350

PLAN 200

PLAN 150

PLAN 80

Employee Only

616.00

426.00

324.00

198.00

Employee & Spouse

1540.00

1065.00

810.00

495.00

Employee & Children

1540.00

855.00

650.00

395.00

Employee & Family

2464.00

1704.00

1296.00

792.00

OPTIONAL: OUTPATIENT CLINICAL
Premium Per Employee / Dependent

345.00

GROUP TERM LIFE - CASHLESS PLAN

Age

( Nearest Birthday)

Premium Rate per RM 1000

( PTD & PPD )

Premium Rate per RM 1000

( PTD,PPD & CI )

Age

( Nearest Birthday)

Premium Rate per RM 1000

( PTD & PPD )

Premium Rate per RM 1000

( PTD,PPD & CI )

16

1.37

1.58

41

2.36

3.85

17

1.37

1.58

42

2.64

4.33

18

1.37

1.58

43

2.96

4.78

19

1.37

1.58

44

3.35

5.37

20

1.37

1.58

45

3.75

5.93

21

1.37

1.64

46

4.21

6.66

22

1.37

1.64

47

4.72

7.42

23

1.37

1.64

48

5.25

8.21

24

1.37

1.64

49

5.83

9.09

25

1.37

1.67

50

6.47

9.89

26

1.37

1.71

51

7.26

10.98

27

1.37

1.76

52

8.14

12.24

28

1.37

1.77

53

9.15

13.61

29

1.37

1.82

54

10.22

15.03

30

1.37

1.84

55

11.39

16.29

31

1.37

1.91

56

12.61

17.77

32

1.37

1.97

57

13.84

19.44

33

1.37

2.03

58

15.02

21.05

34

1.37

2.08

59

16.24

22.67

35

1.37

2.10

60

17.61

24.62

36

1.57

2.43

61

19.31

26.41

37

1.69

2.64

62

21.40

28.81

38

1.82

2.87

63

23.78

31.78

39

1.96

3.06

64

26.47

35.73

40

2.14

3.49

65

29.51

39.50

MEDICAL & GROUP TERM LIFE

OPTIONAL : EXECUTIVE SCREENING
Premium per Employee / Dependent

80.00

  • Please note that, except for for companies located in the Free Trade Zones, all business organizations are subjected to 5% Services Tax on insurance premiums which are borne by the organization.
  • Premium rate is based on policy commencement date & individual date of birth. If difference is less than 6 months, the lower age is applicable. Otherwise, the higher age is applicable for any difference of 6 months & above.
Note :PTD - Permanent Total Disability

PPD - Permanent Partial Disability

CI - Critical Illness

PANEL HOSPITAL UPDATED FEB 2011

ING Employee Benefits Group Insurance ING Small Medium Industry Plan

ING SMI PLAN Invest

In Your Employees

The ING SMI Plan is designed to administer Employee Benefit plans for small, medium industries; primarily with 5 - 100 employees. It is a one stop source for all Employee Benefit needs, providing maximum protection against uneventful death / disability, critical illness and escalating medical expenses.

Features/Benefits:
· Medical Provider Network
· Cashless Access to Medical Care (for Outpatient Clinical Only)
· 24 Hours Toll free Assistance
· Flexible Plan Design
· Administrative Ease

ING Employee Benefits Panel Specialist Hospital CENTRALING Employee Benefits Panel Specialist Hospital NORTHERNING Employee Benefits Panel Specialist Hospital SOUTHERN

ING SMI PLAN INVEST IN YOUR EMPLOYEE BENEFITS
Attracting, motivating and keeping exceptional people is a challenge to any employer. As an employer yourself, you recognize that your family of employees’ is the driving force behind your company. It is important then, to invest in your employees’ well being. Invest in the ING SMI Plan and be assured that your employees’ welfare will be well taken care of.

The ING SMI Plan is designed to administer Employee Benefit plans for small, medium employers; primarily with 5 - 100 employees. It is a one stop source for all Employee Benefit needs, providing maximum protection against uneventful death / disability, critical illness and escalating medical expenses.

As the leading provider of Employee Benefits Insurance, let us help you protect and take care of your most valuable asset - your employees.

BENEFITS
Medical Provider Network
Enjoy extensive medical support from our network of GP panel clinics, strategically located nationwide. Our extensive network provides easy access, choice and convenience. The Medical Provider Network also includes all major hospitals nationwide.
Cashless Access to Medical Care ( for Outpatient Clinical Only )

Cashless access to medical care is made possible by presenting your ING Insurance Identity Card at any of our panel clinics. There is no hassle of having to pay first and seek reimbursement later.
24 Hours Toll Free Assistance

Our customer representatives are ready to assist you. Just call 1- 800 - 88 - 7818 if you have any inquiries regarding the coverage purchased.
Flexible Plan Design. Select from a choice of plans, the plan that suits your needs and budget best.

Administrative Ease
Focus on your core business, and leave the administration of your employee benefits to us.

PLAN FEATURES
The ING SMI Plan offers both medical and life coverage in a single comprehensive plan, specially designed with your employee in mind. You also have the option to purchase additional coverage at minimal cost.

Medical Protection
Comprehensive coverage for medical expenses incurred due to hospitalization. You also have the option to purchase outpatient ( GP and Specialist ) coverage. You and your employees can be assured of quality medical care when it matters most.

Term Life Coverage
This benefit provides financial protection in the event of loss of life as result of sickness and accident. In addition, compensation is payable in the event of permanent total and permanent partial disability.

Additional Critical Illness Rider
This is a rider to the Basic Term Life policy. In the event of a critical illness being diagnosed, a lump sum payment of 50% of the Basic Sum Assured ( Term Life ) is payable. The full sum assured (100%) would be paid should death or permanent disability occur during the remaining policy period or the subsequent policy period (if renewed).

Additional Executive Screening Rider
The screening provides valuable information about the health status of an individual. Information that can be used to prevent further sickness and to ensure that all is well.
Coverage for Overseas Treatment (Hospitalisation)

This policy covers emergency or accidental treatment while travelling overseas ( leisure or work ) for not more than 90 consecutive days. This policy also covers medical services provided overseas if it is not available locally ( referral letter from attending doctor that such medical treatment is not available locally is required )

SPECIAL CONDITION
Medical treatment, surgery or hospitalization due to illness occurring within 30 days of the policy date is not payable.

ING SMI Plan imposes only a one year exclusion on the following conditions:

· Hernias of all types
· All types of tumors
· Endometrosis
· Haemorrhoids
· Diseased tonsils requiring surgery
· Abnormalities of nasal septum / turbinates
· Hyperthyroidism
· Sinus conditions requiring surgery
· Calculi of kidney, urethra, bladder and biliary tract
· Hypertension
· Gastric or duodenal ulcer
· Diabetes mellitus

ING SMI PROPOSAL FORMS

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