Group Medical Insurance is a traditional medical scheme with an option for either cashless availment or claims reimbursement. Each benefit has inner limits and professional fees because surgical cases are subject to Relative Unit Value
Basic and Major Medical Benefits include:
- Room and board
- Physician visit
- Surgical fee per schedule of operation
- Anesthesiologist fee (35% of eligible surgeon's fee)
- Miscellaneous hospital expenses
- Specialist's Fee
- Nurse's Fee
Out-Patient Benefits:
- Consultation per visit
- Laboratories and Diagnostics
- Medicines
Additional options that can be included:
- Dental Benefits
- Annual Physical Examination (APE)
What are the information/documents needed for Group Medical Insurance?
- Copy of the contract/schedule of benefits
- 9-month utilization report
- List of employees and dependents with date of birth, civil status, gender, and amount of insurance
- Broker of Record (BOR) – form will be provided by Trinity
- Preferred plan benefits, if possible
- List of employees and dependents with date of birth, civil status, gender, position/job level
- Broker of Record (BOR) – form will be provided by Trinity