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CS Guide for Group
About Enrollment
Enrollment Guidelines
  1. Group insurance plans are applicable to companies and organizations registered in Hong Kong.
  2. The enrolling company/organization can decide on details of the coverage or they can leave the design of benfit to us. Premiums will be calculated according to the plan benefits.
  3. If the enrolling company/organization has enrolled in other group medical insurance plans in the previous 12 months, relevant claim records must be provided us to prepare the premium quotation.
  4. Premium is assessed on a company basis. Individual claim expenses will not lead to premium adjustment for the individual employee.
  5. The plan is fully paid by the employer. All eligible employees must join the plan.
Eligibility
  1. A minimum of 5 eligible employees.
  2. The employee must have valid Hong Kong Identity Card or Work Permit.
  3. Employees and their spouse of 16 – 65 years old can enroll in the plan. Their children of 15 days to 23 years old are also eligible. (Remark: Children between 19 – 23 years old must provide proof of student identity to be eligible.)
Enrollment Process
  1. The company/organization has to complete and sign the Group Insurance application form, agreement to proposal and list of eligible employees.
  2. We will issue the insurance policy and payment advice accordingly.
  3. The policy becomes effective once the first installment premium is paid.
Policy Renewal
  1. Our company reserves the right to adjust the premium at the time of policy anniversary.
  2. One month prior to the policy anniversary, our company will issue and send to you the “renewal notice”, together with “Insurance Benefits Schedule”, “Employee Details” and “Employee Claims Payment Details”.
  3. We will prepare and issue the policy once we have received your signed copy of the renewal notice.
Amend the Profile
Changes to Enrolled Employees
  1. To add/withdraw an employee from the plan, or change particulars of an enrolled employee, please complete the Employee Change Form and submit to our company within 31 days from the date of change.
  2. Our company will issue an endorsement to effect the changes.
  3. Premium of new member is payable from the date of his/her joining the plan. Unexpired premium for withdrawn members will be refunded.
  4. In the event of death of an enrolled employee, premium paid for that policy year will not be refunded.
How to Submit Claims?
Group Outpatient Medical Claims
  1. The insured employee/claim applicant must complete and send the “Group Outpatient Medical Claim Form” together with original receipts within 90 days from date of treatment to our company for processing. Late submissions will not be processed.
  2. Referral letter of registered physician is required for claims of specialist treatment, X-ray, laboratory tests, physiotherapist and chiropractor treatments.
Group Hospitalization Claims
  1. The insured employee/claim applicant must send the duly completed “Group Hospitalization Claim Form” and “Hospitalization Insurance Attending Physician’s Statement”(completed by the attending registered physician of the insured), together with original receipts within 30 days from date of discharge to our company for processing. Late submissions will not be processed.
  2. Claims within the policy exclusions will not be processed.

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