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  • Vitality

    Executive Protect Group Insurance Plan

    SME Solutions – Group Medical Insurance

    Period

    Annual

    Employee issue age

    65 or below

    You can buy this from

    YOUR FINANCIAL PLANNER

    Product Nature

    Medical protection insurance plan (Reimbursement)

    Plan Type

    Basic Plan


    WHAT THIS PRODUCT IS ABOUT

    Executive Protect Group Insurance Plan provides your senior executives with superior hospitalisation and surgery cover with no benefit sub-limit for major medical expenses throughout Asia, including Australia and New Zealand.

    Other optional benefits cater to a range of needs, including outpatient, dental, optical and maternity cover as well as option to extend protection to your executives’ family members. Offering valuable support in the face of health challenges, Executive Protect Group Insurance Plan also includes access to personal medical case management services provided by our designated service provider and medical services provided by our high - quality medical network providers. Executives retiring or ending their employment can even opt to convert to specified AIA individual medical insurance plan, for long lasting protection.

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    PEACE OF MIND CORPORATE JOURNEY BEGINS FROM AIA

    EXTENSIVE PROTECTION FOR

    YOUR SENIOR EXECUTIVES

    what does it provide?

    • Comprehensive medical protection for extra peace of mind
      Comprehensive medical protection for extra peace of mind

      Executive Protect Group Insurance Plan is a medical protection insurance plan that provides cover of up to HK$12,500,000. With this plan, your executives will enjoy broad hospitalisation and surgical cover in Asia, including Australia and New Zealand, giving them robust support for long-term peace of mind.

       

      We understand that your executives play the essential roles in your company, that is why we cover various medical expenses for hospitalisation and surgery, including room and board, intensive care unit, in-hospital consultation by general and specialist doctors, private nursing, surgical fee as well as medical appliances implanted during surgery etc.

       

      We also provide extensive benefits for your executives, by extending the benefit items to outpatient consultation before/after hospitalisation, cancer treatment, dialysis, inpatient mental health treatment and more, ensuring your executives extra peace of mind.

       

      Remark: All benefits are subject to a maximum annual limit of HK$5,000,000 per policy year and overall lifetime limit of HK$12,500,000 per life, and the terms and exclusions of the policy. Certain benefits items are also subject to reimbursement percentage / sub-limits as set out in the benefits schedule attached to the policy.

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    • Flexible hospitalisation and surgical benefits
      Flexible hospitalisation and surgical benefits

      No minimum hours of hospital confinement is imposed, and day surgery is covered. This means your executives can choose the most suitable medical solution flexibly according to the doctor’s advice.

    • Worldwide emergency assistance services
      Worldwide emergency assistance services

      Understanding how frequently executives go on business trips, we will cover worldwide emergency treatment expenses and provide extensive worldwide emergency assistance services including:

      • Emergency medical evacuation: the executives who is injured will be transported to the nearest location with appropriate care and facilities available for treatment.
      • Repatriation: if the executives unfortunately passes away, we will arrange the remains to be returned to the place of residence / origin.

    • Compassionate death benefit
      Compassionate death benefit

      If the executive unfortunately passes away while the policy is in force, we will pay a compassionate death benefit of HK$80,000 regardless of the cause of death.

    • Personal Medical Case Management #
      Personal Medical Case Management <sup>#</sup>

      If a serious illness strikes, an expert team is on hand to help. Our designated service provider will render the necessary medical support while keeping your executive updated on his or her condition.

       

      Diagnosis and treatment will be assessed by a specialist, supporting your executive through the difficult times in life. For more information, please refer to the Personal Medical Case Management leaflet.

       

      <sup>#</sup>The providers or an authorised representative of the provider of medical network and Personal Medical Case Management is an independent contractor and is not an agent of the Company. The Company shall not be held liable or responsible to the policyholder or the insured member for any act or omission of such provider or an authorised representative of the provider arising from or in connection with services provided or advice given by the provider or its authorised representative(s).

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    • Quality medical network privilege #
      Quality medical network privilege <sup>#</sup>

      With Executive Protect Group Insurance Plan, insured members can enjoy convenient access to AIA’s carefully selected network of high-quality medical service providers across various disciplines.

       

      This plan lightens the load by settling the hospital bill or day surgery bill on behalf of your executive. Once the insured member completes a simple application procedure and the service has been successfully approved by AIA, we will settle the medical expenses incurred directly with the private hospital or day surgery centre on behalf of your executive, eliminating the stress of worrying about paying bills and making subsequent claims. Any shortfall can be settled after treatment, leaving your executive to recuperate stress-free. After the final claim amount is settled, any related benefit limits will be reduced accordingly.

       

      <sup>#</sup>The providers or an authorised representative of the provider of medical network and Personal Medical Case Management is an independent contractor and is not an agent of the Company. The Company shall not be held liable or responsible to the policyholder or the insured member for any act or omission of such provider or an authorised representative of the provider arising from or in connection with services provided or advice given by the provider or its authorised representative(s).

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    • Catering to the needs of your workforce
      Catering to the needs of your workforce

      Annual deductible choices for hospitalisation benefits

       

      Executive Protect Group Insurance Plan offers three annual deductible levels so you can tailor the plan to suit your needs.

       

      The deductible is the amount that your executives will pay before a covered claim.

       

      You can opt for a higher deductible for lower premiums, or choose the no-deductible level.

       

      Read More
      Catering to the needs of your workforce
    • Optional benefits to suit your workforce
      Optional benefits to suit your workforce

      For more comprehensive protection, you can add the following benefits for your executives:

       

      Outpatient benefits

      To cater the individual medical needs of your executives, we provide reimbursement for a range of outpatient medical expenses, including outpatient consultation by general and specialist doctors, diagnosis and laboratory tests, physiotherapy, chiropractic treatment, Chinese medicine and more.

       

      For the precious moment – maternity benefits

      • Prenatal & postnatal check-ups up to 14 days after delivery
      • Room & board and nursing charges during hospitalisation
      • Obstetrician's fee
      • Infant’s hospitalisation for the first 7 days

       

      For healthy teeth – dental benefits

      • Oral examination
      • “Scale & polish” dental cleaning (twice per year)
      • Routine dental X-ray
      • Tooth fillings with amalgam or composite materials
      • Simple tooth extraction
      • Surgical removal of wisdom tooth under local anaesthesia
      • Periodontal treatment
      • Crown and bridges
      • Root canal treatment

       

      For better eye care – optical benefits

      • Optical test (once per year)
      • Contact lenses or one pair of glasses with standard lenses
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    • Extended protection beyond employment
      Extended protection beyond employment

      If your company has 10 employees or more, you can select Conversion Option for your executives, which allows employees aged 65 or below, who passed the medical underwriting at the time of application for this plan and have been covered in the same plan for at least two consecutive years, to convert to a specified AIA individual medical insurance plan when they retire or end their employment without requiring additional health information. The features of the new plan might be different from Executive Protect Group Insurance Plan. Please contact your financial planner for more information.

    • Insured member services
      Insured member services

      Online services

      Insured members can access important and practical information via this quick and convenient online platform.

       

      By using the online platform, the insured members can:

      • view the benefit summary
      • view the updated claim status
      • view the eStatement
      • download online insured member guide and forms
      • submit eClaims (if offers optional outpatient benefits)

      Insured members can also access some of the online services via our mobile app.

       

      Direct services for your executives

      We handle claims and other transactions directly with your executives or their family members to minimise the administrative burden on you or your HR department.

       

      NurseLine

      We understand your executives or their family members might need to check for medical-related information or seek for assistance anytime. Therefore, we provide a “NurseLine” which is manned by registered nurses to answer relevant questions.

       

      Remark: Nurseline is not medical advice and shall not be used as a substitute for advice from your medical practitioner or other health professional. You should obtain professional advice from a medical practitioner or other appropriate health professional in relation to your own personal circumstances or in relation to the diagnosis or treatment of any medical condition. If necessary, you should consult with such a professional. Importantly, the advice from Nurseline cannot replace any advice from a doctor or other health professional.

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    insurance lingo explained

    Emergency Medical Evacuation

    Transportation of the member to an appropriate location for the medically necessary treatment in case of serious sickness or injury while traveling overseas.


    Repatriation

    Transportation of mortal remains of the member to his place of residence/origin in case of his death while travelling overseas.


    Staff Replacement Benefit

    The sum of money paid to the employer to cover the cost of a temporary replacement if one of their staff has to stop working due to illness or injury.


    Notes:
    1. All information here is for reference only. Please refer to the policy contract for the definitions of capitalised terms, and the exact and complete terms and conditions of coverage.

    2. We would like to remind you to review the relevant product materials and proposal illustrations (if applicable) provided to you and seek independent professional advice if necessary.

    3. This plan is an insurance plan without any savings element. All premiums are paid for the insurance and related costs.

    IMPORTANT INFORMATION

    IMPORTANT INFORMATION
    - Collapse + Expand
    ELIGIBILITY

    Number of employees

    • There must be a minimum of 3 full-time employees to join the core benefit plan and each optional benefit.

     

    Age of employees

    • Full-time employees: age 65 or below
    • Employees between the ages of 66 and 69 are allowed to renew their existing policies, but not to enrol for the first time.

     

    Age of employees’ family members

    • Spouse: age 65 or below
    • Spouses between the ages of 66 and 69 are allowed to renew their existing policies, but not to enrol for the first time.
    • Unmarried children: from the age of 2 weeks to 18 years; full-time students are eligible up to the age of 22.

    Excluded industry / organisation

    This plan is not applicable to the below industries / organisations:

    1. Group where other than a single employer or employee relationship exists
    2. Group where eligible employees include seasonal, unskilled, part-time or transient workers
    3. Association of individuals or companies
    4. Bus, taxi or truck driver (Risks involved with driving in mainland China will be excluded)
    5. Construction group
    6. Labour union
    7. Hospital / doctor / nurse / medical or clinic group
    8. Political or religious group
    9. Sports team
    10. Underground mine worker
    11. Farmer / agriculture / animal processing
    12. Employee leasing firm or temporary agency
    13. Window and/or industrial cleaning service
    14. Spa, Turkish bath, massage parlor, gymnasium, health resort or similar enterprises
    15. Theatre, amusement park, dance hall, billiard parlor, and bowling alley or sports promoter
    16. Group which involves special hazards / risks
      • Commercial airline personnel
      • Nuclear power or chemical production plant
      • Police or security officer
      • Fireman
      • Manufacturer or user of ammunition or explosive
      • Military and military related group
      • Collective traveling group (e.g. Professional sports team, air crew, offshore worker, oil rig worker, ship crew, diver or driller (oil, water, underground coal), underground miner)

    Key Product Risks
    1. You need to pay the premium for this plan upon renewal every year.
    2. The insured member will lose the cover when one of the following happens:
      • the insured member passes away; or
      • the aggregate benefits of the insured member reaches the overall lifetime limit.
    3. You may request for the termination of your policy by notifying us in written notice. Also, we will terminate your policy and all the insured members will lose their cover when one of the following happens:
      • you do not pay the premium within 31 days of the premium due date;
      • the number of insured full-time employees falls below 3;
      • the nature of the company’s business changes to another nature that we shall cease to provide cover. For the latest list of the excluded industries / organisations, please refer to the section of “Excluded industry / organisation”; or
      • the company provides incorrect information or is unable to disclose important information regarding the insured members.
    4. The insured member may lose the cover when he or she no longer resides in Hong Kong.
    5. We reserve the right to terminate your policy and all the insured members will lose their cover when the company transfers to operate out of Hong Kong.
    6. Cover renewal is based on the continuing availability of the plan to all existing policies.
    7. We underwrite the plan and you are subject to our credit risk. If we are unable to satisfy the financial obligations of the policy, the insured members may lose their cover and you may lose the remaining premium and levy for that policy year.
    8. The future medical costs will be higher than they are today due to inflation. Hence, the benefit amounts and the future premium rate of this plan may be revised to reflect the inflation.
    9. Your current planned benefit may not be sufficient to meet the future needs of the insured members since the future cost of living may become higher than they are today due to inflation. Where the actual rate of inflation is higher than expected, the insured members may receive less in real terms even if we meet all of our contractual obligations.

    General Exclusions

    Under this plan, we will not cover conditions that result from any of the following events:

    1. expenses that are recoverable from a third party.
    2. any benefit not available under an insured member’s plan or charges exceeding the limits specified in the benefits schedule.
    3. any surgery, treatment, investigation, service or supplies which is not medically necessary or any confinement that is not a reasonable and customary hospital confinement.
    4. any pre-existing condition, unless such condition has been truly, completely and correctly disclosed to the Company in writing on the health declaration form for this insurance and accepted by the Company, and the policy does not expressly exclude treatment relating to such pre-existing condition.
    5. self-destruction, intentional self-inflicted injury or drug abuse.
    6. Injuries arising directly or indirectly from war (declared or undeclared) or warlike operation; any Act of Terrorism where the Insured Person was involved as a terrorist; participation in riot, strike, civil war, rebellion, revolution and insurrection.
    7. AIDS or any complications associated with HIV infection, except for “HIV / AIDS treatment benefit”.
    8. Dentures and related expenses; dental care or surgery unless necessitated by injury caused by an accident to sound natural teeth (except if the dental benefit has been opted for); eye refraction, eye tests or fitting of glasses (except if the optical benefit has been opted for), or surgical correction of nearsightedness (such as but not limited to radial keratotomy and keratoectomy).
    9. consumption of traditional Chinese medicines for general health maintenance and disease prevention: cordyceps / ganoderma / antler / cubilose / donkey-hide gelatin / hippocampus / ginseng / red ginseng / American ginseng / radix ginseng silvestris / antelope horn powder / placenta hominis / agaricus blazei murill / musk / pearl powder
    10. rest cures, services or treatment in any treatment home, spa, health hydro, natural therapy clinic, sanatorium or long-term care facility that is not a registered Hospital, Rehabilitation Centre or registered hospice.
    11. birth control, treatment for infertility or in-vitro fertilisation, or sterilisation of either sex.
    12. purchase or use of special braces, prosthetic appliances, corrective devices, hearing aids, wheelchairs, crutches, prosthetics, denture or any other similar equipment unless specified in the policy.
    13. education treatments such as speech improvement, diabetic classes and nutritional treatments, or group support treatments.
    14. any investigation, treatment or surgery for congenital defect that gives rise to signs or symptoms, or is diagnosed, before the insured member reaches the age of 17.
    15. treatment as a result of proven medical negligence or malpractice.
    16. experimental, investigational or unproven treatment.
    17. injury or illness, treatment or testing which is attributed to venereal diseases or sexually-transmitted diseases.
    18. All treatments considered elective or carried out by a facility not recognised as a hospital or by a relative of the insured member.

     

    The above list is for reference only. Please refer to the policy contract of this plan for the complete list and details of exclusions.


    Premium Adjustment and Product Features Revision
    1. Premium Adjustment
      In order to provide you with continuous protection, we will annually review and adjust the premium of your plan accordingly at the end of policy year if necessary. During the review, we may consider factors including but not limited to the following:
      • Claim costs incurred from all policies under this plan and the expected claim outgo in the coming year which reflects the impact of medical trend, medical cost inflation and product feature revisions;
      • expenses directly related to the policy and indirect expenses allocated to this product.
         
    2. Product Features Revision
      We reserve the right to revise the benefit structure, terms and conditions and/or product features, so as to keep pace with the times for medical advancement and to provide you with continuous protection.

     

    We will give the policyholder a written notice of any revision before any policy anniversary or upon renewal.


    Product Limitations
    1. Cover for HIV/AIDS treatment will be effective 5 years after the insured member’s insurance commences.
    2. We only cover the charges or expenses of the insured member on medically necessary and reasonable and customary basis.

      “Medically necessary” means that the medical services, diagnosis and/or treatments are:
      • delivered according to standards of good medical practice;
      • necessary; and
      • cannot be safely delivered in a lower level of medical care.
      Experimental, screening, and preventive services or supplies are not considered medically necessary.

      “Reasonable and customary” means:
      • the medical services, diagnosis and/or treatments are medically necessary and delivered according to standards of good medical practice;
      • the costs of the medical services and the duration of hospital stay are not more expensive or longer than the usual level of charges or duration for similar treatment in the locality of such services delivered;
      • the medical procedure or treatment during hospital stay is not routinely performed on an outpatient basis and could not reasonably be performed on the insured member as an outpatient according to standards of good medical practice; and 
      • does not include charges that would not have been made if no insurance existed.
      We may adjust any and all benefits payable in relation to any hospital / medical charges which is not a reasonable and customary charge.
    3. The insured member will be covered for any room type in which he stays at hospital, but there will be a reduction in his benefit pay-out amount in case the insured members stays in a room type higher than the plan covered. In such a case, the benefit pay-out amount will be adjusted by multiplying the following factor:
    Daily room charge of the covered room type in the hospital admitted by the insured member
    (depends on which country / place the insured member stays)
    =
    Daily room charge of the room the insured member stays
    1. “Asia” means Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, and Vietnam.
    2. If the insured member continuously stays for 365 days in one of the following regions, the medical services and/or treatments provided to the insured member in such region will be permanently reduced to 60% of his benefit pay-out amount. Such reduction applies to all items in the benefits schedule except worldwide emergency assistance services and compassionate death benefit.
    Regions Countries
    Australia Australia
    New Zealand New Zealand
    North America
    (For emergency treatment only)
    United States and Canada
    Western Europe
    (For emergency treatment only)
    Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Vatican City

    * If the insured member is a US citizen and stays in the United States for a period of or periods aggregating 182 days in the 12 consecutive months immediately prior to any covered emergency treatment, such treatment provided to the insured member in such region will be reduced to 50% of his benefit pay-out amount. Such reduction applies to all items in the benefits schedule except worldwide emergency assistance services and compassionate death benefit.

    1. If the eligible expenses have been reimbursed under any law, or medical program or other insurance policy provided by any government, company, other third party or us, such will not bereimbursable by us under this policy.
    2. Medical network services are provided by network doctor. AIA shall not be responsible for any act or omission of network doctor in the provision of medical network services. AIA reserves the right to amend, suspend or terminate these services without further notice.
    3. Worldwide emergency assistance services (except for 24-hour worldwide telephone enquiring services) are covered during the trip only, which are additional benefits. The services are provided by third party service provider(s). AIA shall not be responsible for any act, negligence or omission of medical advice, opinion, service or treatment on the part of them. AIA reserves the right to amend, suspend or terminate the service without further notice.
    Claim Procedure

    If any of the insured members wishes to make a claim, he/she must send us the appropriate form and relevant proof within 90 days of the date the covered event happened. The appropriate claim form can be downloaded from our website: aia.com.hk or obtained from the financial planner. If you wish to know more about claim related matter, you may visit "File A Claim" section under our company website www.aia.com.hk.


    Cancellation Right

    You have the right to cancel the policy by giving no less than 31 days’ prior written notice to us, however this will result in the insured member losing his cover and you losing the remaining premium and levy for that policy year. We also reserve the right to cancel the policy upon the policy renewal by giving you no less than 31 days’ prior written notice.


    Like what you've read? This is just a summary of our product. If you want more information, please contact your financial planner for a financial needs analysis.

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    OTHER RELATED PRODUCTS

    FLEXI CHOICE GROUP INSURANCE PLAN

    SME Solutions – Group Medical Insurance

    Covers a range of benefit levels for hospitalisation and surgical protection, plus comprehensive optional benefits that you can add to your package.

    vitality

    PROMISE

    SME Solutions – Group Critical Illness Insurance

    We pay a lump sum to the employee on diagnosis of any of the 56 covered critical illness, plus 10% of the covered amount to the employer.

    PROTECT

    SME Solutions – Group Medical & Life Insurance

    Comprehensive protection for life, accident, hospitalisation, and outpatient benefits, as well as Worldwide Emergency Assistance Services.

    GPA CHOICE PLUS

    SME Solutions – Group Personal Accident Insurance

    Comprehensive protection for medical expenses, disability and death caused by an accident, for a daily premium from only HK$1.10.

    CEO PRO

    SME Solutions – Group Medical & Life Insurance

    Lifelong global medical protection up to HK$40 million, with full reimbursement of actual expenses.

    PowerEasy

    SME Solutions – Group Medical Insurance

    A group network medical plan offers hospitalisation and surgical protection as well as optional outpatient and dental benefits.

    Contact aia

    We are pleased to announce that effective 22 February 2021, our customer service in Hong Kong will resume normal. However, please take note of the following special service hours for Macau.

    Macau

    • Customer Service Centres & Hotline Service:
      • 10am - 4pm (Monday - Friday)

    Hong Kong

    (852) 2232-8888

    Hong Kong Island
    AIA Wealth Select Centre
    12/F, AIA Tower,
    183 Electric Road,
    North Point, Hong Kong

    Kowloon
    Suite 1313, 13/F,
    AIA Kowloon Tower,
    Landmark East, 100 How Ming Street,
    Kwun Tong, Kowloon, Hong Kong

    Mon-Fri: 8:45am – 6pm
    (Open through lunch)
    Sat, Sun & Public Holidays Closed

    Macau

    (853) 8988-1822

    1903, AIA Tower,
    Nos. 251A-301, Avenida Comercial de Macau, Macau

    Mon-Fri: 8:45am – 5:15pm
    (Open through lunch)
    Sat, Sun & Public Holidays Closed

    Contact aia

    We are pleased to announce that effective 22 February 2021, our customer service in Hong Kong will resume normal. However, please take note of the following special service hours for Macau.

    Macau

    • Customer Service Centres & Hotline Service:
      • 10am - 4pm (Monday - Friday)

    Hong Kong

    (852) 2232-8888

    Hong Kong Island
    AIA Wealth Select Centre
    12/F, AIA Tower,
    183 Electric Road,
    North Point, Hong Kong

    Kowloon
    Suite 1313, 13/F,
    AIA Kowloon Tower,
    Landmark East, 100 How Ming Street,
    Kwun Tong, Kowloon, Hong Kong

    Mon-Fri: 8:45am – 6pm
    (Open through lunch)
    Sat, Sun & Public Holidays Closed

    Macau

    (853) 8988-1822

    1903, AIA Tower,
    Nos. 251A-301, Avenida Comercial de Macau, Macau
     
    Mon-Fri: 8:45am – 5:15pm
    (Open through lunch)
    Sat, Sun & Public Holidays Closed

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