purple cow 2011 (life & pa)

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What is the purpose of EB? “The purpose of EMPLOYEE BENEFITS is to increase the economic security of employees.” - Wikipedia EB can help your employees become financially secure 2 Purple Cow 2011 EB Primer

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Page 1: Purple cow 2011 (life & pa)

What is the purpose of EB?

“The purpose of EMPLOYEE BENEFITS is to increase the economic security of employees.”

- Wikipedia

EB can help your employees become financially secure

2Purple Cow 2011

EB Primer

Page 2: Purple cow 2011 (life & pa)

1. Paid vacations, 75% 2. Health insurance, 61%3. Paid sick leave, 59%4. Disability insurance, 41%5. Education reimbursement, 39%6. Pension plan, 30%7. Life insurance, 29%8. Dental insurance, 24%

What are the most common EB?

All 4 insurance benefits are offered by Purple Cow!

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- Small Business Poll on Compensating Employees (NFIB, US: 2003)

Purple Cow 2011

EB Primer

Page 3: Purple cow 2011 (life & pa)

What makes Insurance ‘sulit?’ • LIFE INSURANCE provides you with instant cash

in the event of death or total and permanent disability; (.25% of population between 18-65)

• ACCIDENT INSURANCE provides you with instant cash in the event of accidental death or disability; (10% of inpatient & outpatient cases)

• HEALTH INSURANCE (Medical / Dental HMO and/or INS) protects you from losing money in the event of sickness or accident, and treats you as well (if HMO). (10% inpatient / 100% outpatient)

All insurance can make or save you money in multiples

4Purple Cow 2011

EB Primer

Page 4: Purple cow 2011 (life & pa)

Benefits OverviewLIFE – ACCIDENT – HEALTH

LIFE

1. LIFE INSURANCE * Total & Perm. Disability Income

HEALTH

3. MEDICAL HMO * 21,519 MD, 352 hospitals, 358 clinics

4. DENTAL HMO * 775 dentists, 645 clinics

5. Opt. Annual Physical Exam * 124 hospitals, 241 clinics, 31 mobile

6. Health & Wellness Program * 2x/year; tailored to utilization report

ACCIDENT

2. ACCIDENT INSURANCE

a. Accidental Death * Murder

b. Disability * Assault

1Purple Cow 2011

Benefits

Page 5: Purple cow 2011 (life & pa)

Benefits SummaryLIFE – ACCIDENT – HEALTH

1. Life = 5x MBL 13. 100% Pre-Existing Conditions coverage

2. Total & perm. disability income = 5x MBL 14. 100% Congenital Conditions coverage

3. Accidental death = 5x MBL 15. Benefits on top of Philhealth

4. Murder = 5x MBL 16. Special procedures = 30%/100% of MBL

5. Accidental disability = __% of 5x MBL 17. Opt. Outpatient Reimb. for meds, dental, vision

6. Assault = __% of 5x MBL 18. Dental = HMO (775 dentists / 645 clinics)

7. Medical = HMO (21,519 MD / 352 hospitals / 358 clinics) 19. Dental access to major malls in Metro-Manila

8. Access to Big 5 Hospitals & Healthway 20. 1 permanent filling, 2 oral prophylaxes, etc.

9. Combined inpatient & outpatient limits 21. Opt. APE = designated or mobile clinic

10. Max. Benefit Limits per disability per year 22. Health & Wellness Program 2x/year

11. HMO patient for no-cash-out 23. Same benefits for all Employees

12. Private patient for reimbursement (HMO rate) 24. Same benefits for all Dependents

2Purple Cow 2011

Benefits

Page 6: Purple cow 2011 (life & pa)

1. LIFE INSURANCE (worldwide)ASIANLIFE EXCLUSIONS

1. Life1 5x MBL 1. Suicide within the 1st year of coverage

2. Total & Perm Disability Income2 5x MBL

+Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo

1Life insurance = 5x MBL, for death by any cause (suicide covered after 1 year);

2Total & Permanent Disability Income (TPDI) = 5x MBL, in lieu of the Life benefit, after 6 months of TPD, whether sick or hurt. Example:

If MBL = 20T, Life or TPDI = 100,000;

If MBL = 40T, Life or TPDI = 200,000;

If MBL = 60T, Life or TPDI = 300,000;

If MBL = 80T, Life or TPDI = 400,000;

If MBL = 100T, Life or TPDI = 500,000.

Life benefits are payable on top of Accident and Health benefits

3Purple Cow 2011

Benefits

Page 7: Purple cow 2011 (life & pa)

2a. ACCIDENT INSURANCE (worldwide)ASIANLIFE

1. Accidental Death1 5x MBL 3. Disability3 _% 5x MBL

2. Murder2 5x MBL 4. Assault4 _% 5x MBL

+Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo

1Accidental Death = 5x MBL, for death from any type of accident;2Murder = 5x MBL, in lieu of the Accidental Death benefit, for death not due to accident but murder (provoked or not). Example:

If MBL = 20T, Accidental Death or Murder = 100,000;

If MBL = 40T, Accidental Death or Murder = 200,000;

If MBL = 60T, Accidental Death or Murder = 300,000;

If MBL = 80T, Accidental Death or Murder = 400,000;

If MBL = 100T, Accidental Death or Murder = 500,000.

+Principals 18yo-65yo; Dependents 30dy-21yo / 18yo-65yo

3Disability = __% of 5x MBL, according to a long schedule of disabilities;

4Assault = __% of 5x MBL, in lieu of the Disability benefit, for disability not due to accident but assault (provoked or not).Example:

If MBL = 20T, Disability or Assault = __% of 100,000;

If MBL = 40T, Disability or Assault = __% of 200,000;

If MBL = 60T, Disability or Assault = __% of 300,000;

If MBL = 80T, Disability or Assault = __% of 400,000;

If MBL = 100T, Disability or Assault = __% of 500,000.

Accident benefits are payable on top of Life and Health benefits

4Purple Cow 2011

Benefits

Page 8: Purple cow 2011 (life & pa)

2b. ACCIDENT INSURANCE… SCHEDULE OF DISABILITIES

1. Life (same as Accidental Death) 100% 14. Middle finger 6%

2. Both hands or feet or sight of both eyes 100% 15. Ring finger 5%

3. One hand and one foot 100% 16. Little finger 4%

4. Either hand or foot and sight of one eye 100% 17. Metacarpals 1st/2nd - 3rd/4th/5th 3% - 2%

5. Injuries resulting in being perm. bedridden 100% 18. Leg at or above knee 60%

6. Any other injury causing Total Perm. Disab. 100% 19. Leg below knee 50%

7. Arm at or above elbow 70% 20. One foot 50%

8. Arm between elbow and wrist 50% 21. All toes on one foot 25%

9. One hand 50% 22. Big toe 5%

10. Four fingers and thumb of one hand 50% 23. Any toe other than big toe (each) 1%

11. Four fingers 35% 24. Sight of one eye 50%

12. Thumb 15% 25. Hearing - both ears 50%

13. Index finger 10% 26. Hearing - one ear 25%

+Multiple losses from 1 accident will be limited to the highest loss, not to exceed 100%. If a member suffered the loss of 1 hand/foot/eye prior to coverage, the benefit for a subsequent loss of the same will be ½.

Losses refer to total and permanent loss of use or complete severance

5Purple Cow 2011

Benefits

Page 9: Purple cow 2011 (life & pa)

2c. ACCIDENT INSURANCE…EXCLUSIONS

1. Bodily or mental infirmity, hernia, ptomaine, bacterial or viral infection (except pyogenic infection occurring with and through an accidental cut or wound)

12. War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war

2. Disease, sickness, parasite, or disorder of the body/ mind

3. Poison, gas or fumes voluntarily or involuntarily taken

4. Insect bites 13. Serving in the armed forces of any country, or international authority, whether in war or peace5. Earthquake, volcanic eruption or tidal wave

6. Atomic explosion, nuclear fission, or radioactive gas 14. Entering, operating, servicing, ascending or descending from any aerial or submarine device or conveyance, except as provided under a passenger aviation provision7. Pregnancy, childbirth, miscarriage or any complications

8. Accident occurring while or because the Insured is under the influence of alcohol or any drug

15. Hunting, motorcycling or pillion riding, mountaineering which necessitates the use of ropes or pitons, racing of any kind, other than on foot, ice or winter sports, water-ski jumping and tricks, yachting beyond 5 km. off a coastline, underwater activities involving the use of underwater apparatus, or using woodworking machinery driven by mechanical power other than portable tools, applied by hand and used solely for private purposes without reward

9. Suicide or any attempted threat while sane or insane, or any intentionally self-inflicted injury

10. Participation in any brawl, or committing any crime or felony

11. Provoked murder / assault or attempted threat [waived]

6Purple Cow 2011

Benefits

Page 10: Purple cow 2011 (life & pa)

3 Major Employee Benefits in 1 Plan: you get Life, Accident & Health (medical

HMO, dental HMO, optional APE, and Wellness program) – all in one plan.

(Unlike most HMO plans)

You get all the Employee Benefits you will ever need

3Purple Cow 2011

Why Purple Cow?

Competitive Advantage #3:

Page 11: Purple cow 2011 (life & pa)

Life Insurance:your Life insurance benefit = 5x MBL.

Twist: if you don’t die, but you’re totally and permanently disabled, TPDI =

5x MBL.

(Unlike all HMO plans)

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You can get 1 year’s worth of income replacement

Purple Cow 2011

Why Purple Cow?

Competitive Advantage #11:

Page 12: Purple cow 2011 (life & pa)

Accidental Death Insurance (PA): your Accidental Death benefit = 5x MBL.

Twist: if you don’t die by accident, but by Murder, you get 5x MBL.

(Unlike all HMO plans)

You can get another year’s worth of income replacement

12Purple Cow 2011

Why Purple Cow?

Competitive Advantage #12:

Page 13: Purple cow 2011 (life & pa)

Disability Insurance (PA): your Disability benefit = __% of 5x MBL.

Twist: if you don’t get disabled by accident, but by Assault, you get __% of 5x

MBL.

(Unlike all HMO plans)You can get up to 1 year’s worth of income replacement

13Purple Cow 2011

Why Purple Cow?

Competitive Advantage #13:

Page 14: Purple cow 2011 (life & pa)

Same Benefits for Dependents: Dependents can get the same benefits, terms and conditions as Employees

(as well as the same costs in 2011).

(Unlike most, if not all, HMO plans)

Your Dependents are treated like Employees

19Purple Cow 2011

Why Purple Cow?

Competitive Advantage #19: