WIXLIB

自選牙科保障 Optional Dental Benefits選擇一 : 每年1次洗牙 Option 1: Scaling & polishing once a year選擇二 : 每年2次洗牙 Option 2: Scaling & polishing twice a � / 選擇二：每年2次Option 1 - Once a year/ Option 2 - Twice a yearScaling & polishing口腔檢查及口腔衛生指導Oral exam including oral hygiene instruction銀粉補牙 (大小臼齒蛀牙適用)Amalgam filling for posterior teeth due to decay口腔小X-光片檢查Intra-oral small film radiograph as necessary瓷粉補牙 (前牙蛀牙適用)Composite filling for anterior teeth due to decay牙瘡治療 (非手術性)無限次UnlimitedDrainage of abscesses without surgery辦公時間內緊急止痛服務Emergency consultations & dressings for pain relief藥物 (抗生素及止痛藥)普通脫牙 (手術性及智慧齒除外)網絡牙科診所 Clinic Locations香港 Hong Kong九龍 Kowloon新界 New Territories診症次數 Number of visitsBenefits中環旺角葵芳Medications (Anti-biotics & pain killers)Simple extraction due to decay (not requiring bone resection)CentralMongkokKwai Fong何文田大埔Ho Man TinTai Po屯門大圍Tuen Mun註 Remarks: �務。Members can enjoy preferential rates for other dental services. ould any of the above clinic information be changed, notification will not be sent individually. �個別單張。For Important Information for Dental Benefits, please refer to separate leaflet for details.每年保費 Annual Premium 子女附加保障 - 自選門診保障6選擇一 : 80% 門診賠償保障 (OP1)成員/配偶子女計劃 2Plan計劃 3Plan計劃 4PlanHospital & Surgical Benefits 4,9993,749Optional Supplementary Major Medical Benefits (SMM)Member/SpouseChildOptional Benefits - Out-patient Benefits65494127665741,1408551,8261,369Option 1: 80% Out-patient Reimbursement 372Option 3: Out-patient Network ,4192,659自選牙科保障Dental Options選擇二Option 1558Option 2768選擇一港元 HK 計劃 1PlanBasic Benefits選擇二 : 100% 門診賠償保障 (OP2) Option 2: 100% Out-patient Reimbursement �: 門診網絡保障 (OPN)成員/配偶子女Tai Wai6 �Plan level may be different from Hospital & Surgical Benefits 隨後第二個月的首日生效。Underwriting GuidelinesThe minimum requirements are HK 3,000 premium and at least 3enrolled employees for policy issuance.All full-time employees and their dependants, aged below 65, are eligibleto join the plan.Child should be at least 15 days old and is under 19 years of age andunmarried.Definition of employee categories is allowed to determine different levelsof benefits. Employees under the same classifications should enjoy thesame benefits.Each employee and dependant is required to fill in an "Individual HealthForm". Individual Health Form is waived for groups with 10 insuredemployees or above.If the duly completed application form and the required premium arereceived by YF Life on or before the 20th of the month, the benefits willcome into effect on the first day of the following month, otherwise thebenefits will come into effect on the first day of the month after thefollowing month.

�續期保費與 ��列日期終止 ( 以較早者為準 障屆滿日期。保費寬限期屆滿之日。 �為止，惟暫停工作期間不可多於 12 個月。 �際有限公司 (「萬通保險」) 開支、醫療通脹、醫療趨勢，以及 / 或因修訂保障架構 / ��期為高，保費率及 / 品及情況將不會獲得保障︰1. 在此保障生效前 90 ��在生效日或最近期之診治後 6個月內 ( 以較後者為準 ��何治療或手術；2. 因戰爭 ( 無論是宣佈或未宣佈 ) �如盜竊、販毒或毆鬥等；3. ��器或義肢；4. 美容手術或整形治療；5. ��診治；6. ��或口腔護理 ( 由意外受傷引致生來的牙齒損毀除外 )；7. 因 ��引起的疾病；8. �不育的治療；9. �染的疾病治療；10. �打或針炙等；11. 疫苗或其他預防針注射；12. 物理治療或脊骨神經科治療 ( 除非由註冊醫生書面建議 )。受保成員每次住院必須不少於連續 24 懷孕、分娩、產前護理、小產 �必須的指符合以下所有情況﹕1. �治方法。2. 根據既定之良好醫療守則。3. 用於網絡門診保障 :1. 實驗性質之手術及治療等；2. ��特別護理；3. ��育之治療；4. �療及檢查；5. 特別昂貴 ( �後決定之權利 )或長期藥物 ( 需連續服用十四日或以上之藥物 ��之藥物；6. 先天性之不健全或疾病；7. 任何性病、愛滋病 ( 包括潛伏期 ) 及其併發症；8. 所有精神病或休養性治療；9. �參與者已受保於公司前保險計劃；10. �傷；11. 慢性酒精中毒或濫用藥物；12. �接受之治療 ( 維健特別批核除外）；13. �保險計劃中獲得賠償；14. 洗腎治療；15. �16. �症；17. 補藥、增肥或減肥治療 ( �及未符合這要求的後果在投保時，你 / �期或任何補充文件的簽署日期( 以較後日期為凖 ) 完成。你 / ��保單年期的保費將不獲退還。

Important InformationProduct NatureThis product is a medical insurance plan, with the principle of indemnity in theform of reimbursement.Premium Payment Term and Benefit TermThe first premium shall be payable on or before the Benefits Effective Date andthe subsequent renewal premiums and/or adjustment premiums shall be due andpayable on the renewal of each of the Benefits Coverage Periods, otherwise allcoverages under the policy will be terminated.The benefit term is up to the policy anniversary on or following the InsuredMember’s 65th birthday.TerminationThe insurance of any Insured Member under the policy shall terminate on theearliest of the following dates:- The date on which the policy is terminated.- The date of the expiration of the period for which the last premium payment ismade on account of the Insured Member's insurance.- The date when any premium of the policy is overdue beyond the Grace Period- The date on which the Insured Member shall cease to be a Member. In the caseof an employee benefits policy, cessation of being Actively at Work (or cessationof membership in good standing in the case of a non-employee benefits policy)shall be deemed cessation of being a Member, except that while an InsuredMember is absent from work on account of Sickness or Injury or on leave ofabsence granted by the policy owner for other reasons, the Insured Member’sstatus as a Member shall be deemed to continue until premium payments forsuch Insured Member are discontinued, but not for a period longer than 12months from the date of cessation of being Actively at Work.- YF Life Insurance International Ltd. ("YF Life") reserves the right to terminatethe policy on any Premium Due Date when fewer than the total number ofMembers then eligible for insurance are insured hereunder, if the insuranceplan is non-contributory; or less than 75% of the total number of Members theneligible are insured hereunder, if the insurance plan is contributory.Revision of Terms and Benefits and Premium AdjustmentThe policy will be renewed on each policy anniversary subject to the consent ofYF Life and upon receipt of the payment of the required premium. In order tokeep pace with the medical advancement and to provide you with continuousprotection, YF Life reserves the right to revise the terms and benefits and adjustthe premium on each renewal at any time. The major factors to consider forpremium adjustment include, but not limited to, the claim experience of YF Life,expenses, medical inflation, medical trend and / or revised benefit structure / levelof benefits (if any) which might impact the expected claim costs in the future.Continuity of the PlanIf YF Life decides to no longer offer renewal to the policy owner, a written noticewill be made no less than one month before the policy anniversary date.Inflation RiskThe medical costs in the future are likely to be higher than they are today due toinflation. As a result, the premium rates and / or the benefit levels may be reviewedfrom time to time, and the policy wner might receive less in real terms even if YFLife meets all of its contractual obligations.Credit RiskThis plan is underwritten by YF Life. The insurance benefits are held solelyresponsible by the company and subject to its credit risk.Key Exclusions and LimitationsNo benefit shall be paid for the following services, products or conditions:1. Pre-existing conditions for which the Insured Member received medicaltreatment, diagnosis, consultation or prescribed drugs in respect of Injuries orSickness sustained during the 90 (Ninety) days preceding the effective dateof his coverage, unless during any consecutive six months' period after sucheffective date or the date of his last consultation, whichever is the later, theInsured Member does not undergo any medical treatment or surgical care inrespect of such Injuries or Sickness;2. Injuries arising directly or indirectly from war, declared or undeclared;participation in illegal acts such as but not limited to robbery, drug abuse orassault;3. Special nursing care; non-medical personal services such as radio, telephoneand the like; procurement or use of special braces, appliances or equipment;4. Cosmetic treatment or surgery for purposes of beautification or plastic surgery;5. Routine physical examinations, health check-ups or tests not incidental totreatment or diagnosis of an actual Sickness or Injury or any treatment whichis not Medically Necessary;6. Eye refraction, fitting of glasses, contact lenses or hearing aids; gingivitis;any dental or oral care, treatment or surgery of any nature whatsoever exceptprocedure necessitated by damage to sound natural teeth as a result of anaccidental Injury occurring during the period of insurance;7. Injuries due to insanity or self-infliction; conditions related to functionaldisorders of the mind; rest cure or sanatorium care; treatment of an optionalnature; drug addiction or alcoholism;8. Congenital anomalies; or treatment relating to birth control, sterilization ofeither sex, treatments pertaining to infertility;9. Human Immunodeficiency Virus (HIV) and/or any HIV-related conditionsincluding Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations,derivation or variations, venereal disease and sexually transmitted disease;10. Treatment by any person other than a Registered Medical Practitionerincluding, without limitation, a Chinese bonesetter, herbalist or acupuncturist;11. Vaccination and immunization injections or preventive medication;12. Physiotherapy or treatment by a chiropractor.Each hospital confinement must be for a minimum period of 24 (Twenty-Four)consecutive hours before any benefits hereunder are payable, except that nominimum period of hospital confinement is required if such confinement is inconnection with a surgical operation.No benefit shall be payable, unless otherwise explicitly provided by anEndorsement or Supplementary Contract to this Policy, if the condition ortreatment upon which the claim is based is due to pregnancy which term shallinclude resulting childbirth, pre-natal care, miscarriage, abortion, birth control orany complications arising from pregnancy; no benefit shall be paid for charges inexcess of the general level of charges being made by other providers of similarstanding in the locality where the charges are incurred, when providing like orcomparable treatment, services or supplies for a similar Sickness or Injury.YF Life will cover the Medically Necessary expenses incurred by the InsuredMember. Medically Necessary means all of the following conditions are met:1. Consistent with the diagnosis and customary medical treatment for thecondition.2. In accordance with standards of good medical practice.3. Not for the convenience of the Insured Member or the Doctor.When an Insured Member is entitled to benefits payable under Employees'Compensation Law, any government or public programme of medical benefits,other group or individual insurance, the benefits payable under this Policy shallbe limited to the balance of expenses not covered by benefits payable under theLaw and other insurance and computed in accordance with the Policy Scheduleof this Policy.Besides the above conditions, the below Key Exclusions will also apply to thePanel Network Outpatient Benefit:1. Any treatment or investigation for preventive and/or beautification purposebut not medically necessary such as immunization, health check-up or testsand any cosmetic treatments or any experimental treatment;2. Any dental treatment or diagnosis, eye refraction, the supply of hearing aids,prosthesis, pacemakers, crutches, wheelchair, blood plasma or the provisionof special nursing care;3. Any medical services associated with pregnancy including but not limited toabortion, sterilization, fertility test and contraceptive technique;4. Radiotherapy or investigation or treatment involving radioactive isotopes;5. Any special expensive (Health Maintenance Medical Practice Limited ("HMMP")reserves the right of final decision) and long-term medication (required to betaken continually for 14 (Fourteen) days or more) or medication including butnot limited to anti-cancer and anti viral medication;6. Any condition arising out of congenital defect or disease;7. Sexually transmitted or any venereal diseases, acquired immune deficiencysyndrome, AIDS (including ARC) and their sequelae;8. Any psychiatric disorder or rest cure;9. Any pre-existing condition, except for those members who switch from thepreceding medical plan;10. Injuries arising directly or indirectly from war, declared or undeclared and anywarlike operation;11. Any condition caused by chronic alcoholism or drug addiction;12. Any treatment outside the appointed network unless with special approval byHMMP;13. Any treatment for which benefits are payable under any Employees'Compensation legislation or any other insurance plan covering the Employeeor Dependant;14. Any matters associated with kidney dialysis;15. Tuberculosis associated treatment should be subject to the referral togovernment hospital;16. Any suicide, attempted suicide, self-mutilation and the sequelae thereof;17. Tonics, appetite stimulants, depressants if requested by patient and not bythe panel doctor.Duty of Disclosure and the Consequences of Not Making Full DisclosureYou are required to disclose in the application all information you know or couldreasonably be expected to know because YF Life will rely on what you havedisclosed in this application to accept the risk and the terms of insurance. Yourduty of disclosure ends on the signing date of application or the supplementaryform(s), whichever is later. If you are in doubt as to whether a fact is material,please disclose it in the application. Failure to comply with this requirement mayrender the policy issued voidable.Claim ProceduresFor details of the procedures for making claims, please refer to our website ServicesCancellation of PolicyIf the Policy Owner requests to cancel the Policy on a date other than the PolicyAnniversary, no refund of premium (if any) shall apply.

僱員福利計劃申請核對表 Checklist of Application團體保險申請書 Group Insurance Application Form參加員工資料表格 Member Addition Form商業登記證副本 BR ��上可獲豁免遞交)Individual Health Form (Individual Health Form is waived forgroups with 10 insured employees or above)1. 最少參與僱員人數為3位Minimum three employees are required for application2. 繳付保費 �Premium Payment - Annual payment mode, and payment by company cheque3. �申請表格For Dental Benefits, please submit the relevant enrollment form and 有垂詢，請致電僱員福利熱線 (852) 2533 5511。This brochure contains general information and is for reference only. It does not form part of the policy and does not contain the full terms of the policy. Pleaserefer to the policy document for benefit coverage and exact terms and conditions. For enquiries, please call our Employee Benefits Hotline at (852) 2533 �司 YF Life Insurance International 樓27/F, YF Life Tower, 33 Lockhart Road, Wanchai, Hong Kong僱員福利熱線MKT-075-V3-0321HShould there be any discrepancy between the English and the Chinese versions of this brochure, the English version shall prevail.

MassHealth Employee Benefits Plan provides a broad range of benefits, including four basic hospital and surgical benefits plans, together with a variety of out-patient, dental and preventive health ae las lyes ae free t