ReLAY Guaranteed Renewability Conversion

RELAY® is an individual/family policy that targets members who are enrolled in a compulsory scheme and are seeking additional cover and future safety net. It is a product designed to

(1)   complement their group insurance cover for the treatment of critical illnesses and

(2)   allow for a switch from their group insurance to an individual health insurance plan, without worrying about their health condition at the time of conversion.

(3)   an Additional Medical Services benefit.

The territoriality of this product is the Middle-East and Africa (MEA) region.

 

Components

Each component of RELAY® addresses a different need that complements the member’s existing group cover.

1. Conversion Option

The Conversion option is a benefit that ensures the conversion to our Individual Medical Plan, our Individual/Family healthcare insurance product, with a Guaranteed Renewability feature no matter the health status of the insured is at the time of the conversion. So, it is intended for individuals/families insured under a compulsory group plan, wishing to obtain a future local insurance policy with a lifetime Guaranteed Renewability (GR) feature. The conversion is guaranteed to the In-Hospital plan only.

2. Critical Illness Coverage

This coverage is a built-in feature of RELAY®. It covers the treatment cost of the covered illnesses and not a lump sum. The policyholder can select the number of illnesses to be covered (6 or 10), with (USD 3,000 per case per year) or without deductible. The financial limitation under this coverage is USD 300,000.00 per person per year.

The critical illnesses covered are:

1.      Cancer

2.      Coronary Artery (Bypass) Surgery

3.      Stroke

4.      Aorta (Surgery of Aorta)

5.      Heart Valve Replacement

6.      Major Organ Transplantation

 

The additional 4 diseases are:

1.      Heart Attack (Myocardial Infarction) – Acute treatment

2.      Major Burns

3.      Surgical treatment of patients with poly-trauma

4.      Major Septic

3. Additional Medical Services benefit / ALMEDA

These Additional Medical Services are provided by ALMEDA, a sister company of Munich Re, specialized in providing a network of experts for healthcare services and assistance.

These services include:

1.      Medical Assistance such as

a.      Referral to leading medical facilities and hospitals

b.      Organization of ground and air ambulances

c.      Assistance during hospitalization

d.      Physician-to-physician consultation

e.      Medical supervision and monitoring

f.       Air ambulance

g.      Medical air attendance

h.      Body repatriation

i.       Cost containment

j.       Organization of plane and railway tickets, hotel reservation

k.      Cash advances (to be repaid)

l.       Referral to interpreters or/and experts, legal assistance

 

2.      Second Medical Opinion

a.      On behalf of an eligible member, ALMEDA will arrange a personal second opinion report in writing: analysis, treatment options, recommendations

b.      Report is only issued by medical experts whose skills are appropriate for the case.

c.      The VIP med Medical Opinion is based on relevant medical information (e.g. medical reports), enclosed to the request.

d.      Additional services (e.g. Find Expert Care, Translation Service) can be supplemented if desired by the client.

 

3.      Healthcare Hotline

a.      Provides medical information about frequent illnesses, diagnostics and therapy, alternative therapies and suggestions for support in prescribed therapy

b.      Hotlines for special subjects (vaccinations, infectious diseases, prevention)

c.      Explanations about effects and side-effects of medication

d.      Professional and systematic steerage to medical network providers or into Disease Management Programs

e.      Patient support in searching suitable treatment facility

f.       Arrangement of appointments

 

Target Adherents

RELAY® will target adherents that are enrolled under a compulsory health insurance plan. Therefore, the potential adherents for RELAY® are:

·        Expatriates working outside Lebanon. Referred to as category A.

·        Members residing in Lebanon and insured on a mandatory basis under a group scheme. Referred to as category B.

Above potential categories will enroll for RELAY® to fulfill their future need and obtain an individual and/or family plan with the GR feature when they:

1.      Return back home for the category A.

2.      Become free to choose their insurance program for categories B.

3.      Retire from their job and seek an elderly health cover with no specific exclusions and/or limitations for categories A and B.

Underwriting Provisions

1.      Age at enrollment should not exceed 60 years old.

2.      Policyholders of RELAY® should be enrolled under a group medical insurance plan.

Their active insurance should not be elective; thus, they are:

a.      Either expat working abroad and enrolled under a local insurance plan in the country where they reside.

b.      Or residing in Lebanon and enrolled under a group policy on mandatory basis by their employer.

3.      At each renewal date, they will have to submit a proof of their insurance in the underlying group policy.

4.      At the time of enrollment to RELAY®, adherents must have a clean medical questionnaire. Thus they are subject to strict medical underwriting.

5.      The observation period will apply based on the age at enrollment:

a.      01 – 55: 1 year observation period

b.      56 – 60: 2 years observation period

4.      The applicants will obtain the right to convert his policy and to benefit from the critical illness cover at the end of the observation period, provided he/she has a clean medical record and other underwriting conditions mentioned in this document are met.

The conversion from RELAY® to Individual Medical Plan is subject to the following additional conditions:

·        The member will have one month grace period from his underlying insurance expiry date to convert.

·        Conversion should be exercised at the maximum age of 64.

·        The conversion can only be accepted when the underlying cover stops. This is to avoid duplicate cover, so the member cannot convert just to file a claim.

After the conversion, RELAY® can still be purchased to cover the critical illnesses component and the additional medical services up to the age of 70.

The class of coverage for the Critical Illnesses treatment before conversion is class A or equivalent.