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Group Health Plan for QIUP

Outpatient procedure - General Practitioner at ING Panel Clinics


Applies to staff & spouse and students.
Identify ING Panel Clinics near to you. (Check Panel Clinic list uploaded to HR Webpage). At the clinic or before going over, you may enquire to confirm that the clinic is indeed ING Panel Clinic. At the clinic present your ING Medical Card and IC or Passport. Doctor examines and provides treatment. The Clinic Assistant will swipe your ING Medical Card and generate two copies of Receipt. Check to ensure details are correct and sign the Receipt. Clinic will retain the signed copy to claim from ING. Do not pay for treatment at the clinic. Submit the other copy to QIUP HR Division.

Outpatient procedure Specialist Clinics


Applies to staff & spouse and students.
Identify ING Panel Clinics near to you. (Check Panel Clinic list uploaded to HR Webpage). At the clinic or before going over, you may enquire to confirm that the clinic is indeed ING Panel Clinic. At the clinic present your ING Medical Card and IC or Passport. Doctor examines and gives you a Referral Letter to consult a Specialist. The Clinic Assistant at the Panel Clinic will swipe your ING Medical Card and generate two copies of Receipt. Check to ensure details are correct and sign the Receipt. Clinic will retain the signed copy to claim from ING. Do not pay for treatment at the clinic. Submit the other copy to QIUP HR Division. Fix an appointment with the Specialist before going over. At the Specialist Clinic submit the Referral Letter. Specialist Doctor examines and provides treatment. The Clinic Assistant at the Specialist Clinic will produce a bill for consultation and treatment. Check to ensure details of the bill are correct and pay at the Specialist Clinic. The ING Medical Card cannot / must not be used for payment at Specialist Clinics. Obtain an official Receipt for the payment. Submit a copy of the Receipt to QIUP HR Division. Fill up ING Medical Claims Form. (Download from HR Webpage). Attach original Receipt. Submit claim to ING. Reimbursement will be made under your name through QIUP.

Inpatient procedure - ING Panel Hospitals


Applies to staff & spouse and students.
General Practitioner at a Panel Clinic or a Specialist Doctor examines and gives you a Referral Letter to seek treatment at a Panel Hospital. (Check Panel Hospital list uploaded to HR Webpage). Outpatient Procedures for GP Panel Clinic and Specialist Clinic mentioned above have to be fulfilled. At the Panel Hospital submit the Referral Letter during registration. Contact ING Call Centre 1800 88 7818 and request for Guarantee Letter to be sent to the Panel Hospital. Provide full name and IC No. or Passport Number while requesting for Guarantee Letter and the organisation is Quest International University Perak under Blair Education Services. Or, Admissions Department at the hospital will contact ING Call Centre to obtain Letter of Guarantee to be issued to the hospital. In the case of an emergency or serious injury resulting from accident, please go direct to a Panel Hospital During discharge, the Accounts Department of the Hospital will produce a bill for consultation and treatment. Check to ensure details are correct and sign the bill. Do not pay for consultation and treatment at the hospital except if the total amount exceeds the preset limit. Obtain a copy of the bill. Submit a copy of the bill to QIUP HR Division.

GROUP HEALTH PLAN INSURANCE POLICY


Insured: Benefits: The Insured STAFF of the policyholder Group Health Plan ( GHP ) and Extended Benefit ( EXT )

IN HOSPITAL Room & Board Limits Plan Benefits GHP RB 350 RB 200 RB 150 RB 80 EXT RB 350 RB 200 RB 150 RB 80

Plan 001 002 003 004 SMP 1-2

Category

SMP 3-5 / HMP 1 / ACS 1-3 HMP 2 / MMP / ACS 4-7 JMP / GSS / TSS

Note: RB Room & Board

1.
1.1 (A)

SCHEDULE OF BENEFITS
GROUP HEALTH PLAN (GHP) IN-HOSPITAL CARE PLAN 001 RM PLAN 002 RM PLAN 003 RM PLAN 004 RM

The maximum benefits provided under this Policy are as follows:

(a) Hospital Room & Board (Private / Government) (i) Ordinary Room (up to 120 days maximum per disability) 350 500 200 350 150 350 80 350

(ii) Intensive Care Unit (up to 20 days maximum per disability) (b) Hospital Supplies and Service (maximum per disability) (c) Surgical Fees (maximum per disability) Subject to schedule of surgical benefits (d) Anesthetist Fees (maximum per disability) **xx% of Surgical Fees Reimbursement (e) Operating Theatre Fees (maximum per disability) **xx% of Surgical Fees Reimbursement (f) In-Hospital Physicians Visit (up to 120 days maximum per disability) (g) Malaysian Government Hospital Daily Cash Allowance (up to 120 days maximum per disability)

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged 60

As Charged 50

As Charged 40

As Charged 20

(h) Overall Maximum Limit for Malaysian Government Hospital Admission. (not subjected to any limit except for Room & board limit and overall maximum limit per disability / per annum) (i) Hospital Service Tax (on eligible Room & Board charges paid) (B) AMBULATORY CARE

100,000 per disability

75,000 per disability

50,000 per disability

25,000 per disability

As required by the Government of Malaysia

(a) Pre-Surgical / Medical Diagnostic Services (maximum per disability within 60 days prior to hospitalization) (b) Pre-Surgical / Medical Specialist Consultation (maximum per disability within 60 days prior to hospitalization) (c) Second Surgical Opinion (maximum per disability) (d) Post-Hospitalization Treatment (up to 60 days maximum per disability following discharge from hospital) (e) Emergency Out-Patient Accidental Treatment (maximum per disability within 24 hours after the accident and follow-up treatment up to 60 days) (f) Accidental Dental Treatment (maximum per disability within 24 hours after the accident and follow-up treatment up to 14 days) (g) Daycare Procedure -Surgical / Medical (maximum per disability inclusive of all incidental costs, pre-daycare visits up to 60 days and post-daycare visits up to 60 days) (h) Ambulance Fees (maximum per disability for emergency and non-emergency services) (i) Emergency Out-Patient Treatment (j) Medical Report Fee Reimbursement (maximum per disability applicable for InHospital Care Ambulatory Care) Overall Maximum limit per annum Overall Maximum limit per disability

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

As Charged

3500

3000

2500

2000

500

500

500

500

As Charged

As Charged

As Charged

As Charged

250 100 80

250 100 80 -

250 100 80

250 100 80

100,000

75,000

50,000

25,000

1.2

EXTENDED BENEFIT (EXT)

PLAN 001 RM

PLAN 002 RM

PLAN 003 RM

PLAN 004 RM

(a) Compassionate Allowance Benefit (one time payment due to death from all causes within 48 hours) OR (one time payment due to death from natural causes within 48 hours) OR (one time payment due to death from accidental causes within 48 hours) (b) Repatriation Benefit (one time payment due to accidental death outside Malaysia) (c) Lodger Benefit (1 person only) (up to 120 days)

5000 N/A N/A N/A N/A

5000 N/A N/A N/A N/A

5000 N/A N/A N/A N/A

5000 N/A N/A N/A N/A

(C)

OUT PATIENT TREATMENT

PLAN 001 RM

PLAN 002 RM

PLAN 003 RM

PLAN 004 RM

(a) Overall Maximum limit per annum General Practitioner (GP) & Specialist (SP) Per Employee Per Spouse Outpatient GP - Treatment (a) Routine Consultation (b) Medication (c) Injection (d) Diagnostic Lab / X-Ray Procedures (e) Outpatient Surgical Procedures Outpatient GP - Payment (a) Panel Clinic Visit Limit Per Visit (b) Non-Panel Clinic Visit (Emergency) Limit Per Visit (c) Non-Panel Clinic Visit (Non-Emergency) Limit Per Visit

600 600

500 500

400 400

300 300

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A NA/

Outpatient SP - Treatment (a) Consultation (b) Medication (c) Injection (d) Diagnostic Lab / X-Ray Procedures (e) Outpatient Surgical Procedures Outpatient SP - Payment (a) With Referral Letter from Panel Clinic Limit Per Visit (b) Without Referral Letter from Panel Clinic Limit Per Visit

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

Reimburse N/A N/A N/A

Reimburse N/A N/A N/A

Reimburse N/A N/A N/A

Reimburse N/A N/A N/A

(D)

DENTAL BENEFIT (EXT)

PLAN 001 RM 500 As charged

PLAN 002 RM 400 As charged

PLAN 003 RM 350 As charged

PLAN 004 RM 350 As charged

(a) Overall Maximum limit per annum (b) Emergency treatment of dental pain (palliative) with no other treatment given during the same visit (c) Oral examination and diagnostic including prophylaxis (cleaning, scaling and polishing of teeth) (d) Consultation (legally registered dentist) (e) Medicine (f) Extraction (g) Filling (h) Dental X-Ray (i) Root canal treatment (j) Installation of dentures

As charged As charged As charged As charged As charged As charged N/A N/A

As charged As charged As charged As charged As charged As charged N/A N/A

As charged As charged As charged As charged As charged As charged N/A N/A

As charged As charged As charged As charged As charged As charged N/A N/A

2.

SPECIAL CONDITIONS (BASIC GROUP HEALTH PLAN)

The following conditions will be applicable to all Insured Person and their Dependants, if any : Specified Illness No benefits shall be payable for hospitalization, surgery and/or charges incurred which are caused directly or indirectly by Specified Illnesses and its related complications. Specified Illnesses shall mean the following disabilities and its related complications, occurring within the first 120 days of Insurance of the Insured Person: (a) Hypertension, diabetes mellitus and Cardiovascular disease (b) All tumors, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system (c) All ear, nose (including sinuses) and throat conditions (d) Hernias, haemorrhoids, fistulae, hydrocele, varicocele (e) Endometriosis including disease of the reproduction system (f) Vertebra-spinal disorders (including disc) and knee conditions

GROUP HEALTH PLAN INSURANCE POLICY


Insured: Benefits: The Registered STUDENTS of the policyholder Group Health Plan ( GHP ) and Out-patient General Practitioner Benefit ( GGP )

Classification of Insured Persons Plan 001 002 003 004 Category Local Under-Grads Student Local Post-Grads Student Foreign Under-Grads Student Foreign Post-Grads Student Benefit / Plan GHP Plan 120 Plan 120 Plan 120 Plan 120 GGP Prime Plan Prime Plan Prime Plan Prime Plan

1.
1.1 (A)

SCHEDULE OF BENEFITS
The maximum benefits provided under this Policy are as follows: GROUP HEALTH PLAN ( GHP ) IN-HOSPITAL CARE PLAN 001 RM PLAN 002 RM PLAN 003 RM PLAN 004 RM

(a) Hospital Room & Board (Private / Government) (i) Ordinary Room (up to 120 days maximum per disability) 120 350 120 350 120 350 120 350

(ii) Intensive Care Unit (up to 20 days maximum per disability) (b) Hospital Supplies and Service (maximum per disability) (c) Surgical Fees (maximum per disability) (d) Anesthetist Fees (maximum per disability) (e) Operating Theatre Fees (maximum per disability) (f) In-Hospital Physicians Visit (up to 120 days maximum per disability) (g) Malaysian Government Hospital Daily Cash Allowance (up to 120 days maximum per disability) (h) Overall Maximum Limit for Malaysian Government Hospital Admission. (not subjected to any limit except for Room & board limit and overall maximum limit per annum) (i) Hospital Service Tax (on eligible Room & Board charges paid)

As Charged As Charged As Charged As Charged As Charged 35

As Charged As Charged As Charged As Charged As Charged 35

As Charged As Charged As Charged As Charged As Charged 35

As Charged As Charged As Charged As Charged As Charged 35

25,000 per disability

25,000 per disability

25,000 per disability

25,000 per disability

As required by the Government of Malaysia

(B)

AMBULATORY CARE As Charged

(a) Pre-Surgical / Medical Diagnostic Services (maximum per disability within 60 days prior to hospitalization) (b) Pre-Surgical / Medical Specialist Consultation (maximum per disability within 60 days prior to hospitalization) (c) Second Surgical Opinion (maximum per disability) (d) Post-Hospitalization Treatment (up to 60 days maximum per disability following discharge from hospital)

As Charged

As Charged As Charged

(C)

OUT PATIENT TREATMENT

PLAN 001 RM

PLAN 002 RM

PLAN 003 RM

PLAN 004 RM

(a) Overall Maximum limit per annum General Practitioner (GP) Per Student Outpatient GP - Treatment (a) Routine Consultation (b) Medication (c) Injection (d) Diagnostic Lab / X-Ray Procedures (e) Outpatient Surgical Procedures Outpatient GP - Payment (a) Panel Clinic Visit Limit Per Visit (b) Non-Panel Clinic Visit (Emergency) Limit Per Visit (c) Non-Panel Clinic Visit (Non-Emergency) Limit Per Visit

500

500

500

500

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

As Charged As Charged As Charged As Charged As Charged

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A N/A

Cashless N/A Reimburse N/A N/A NA/

3.

SPECIAL CONDITIONS (BASIC GROUP HEALTH PLAN)

The following conditions will be applicable to all Insured Students, if any: Specified Illness No benefits shall be payable for hospitalization, surgery and/or charges incurred which are caused directly or indirectly by Specified Illnesses and its related complications. Specified Illnesses shall mean the following disabilities and its related complications, occurring within the first 120 days of Insurance of the Insured Person: (g) Hypertension, diabetes mellitus and Cardiovascular disease (h) All tumors, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system (i) All ear, nose (including sinuses) and throat conditions (j) Hernias, haemorrhoids, fistulae, hydrocele, varicocele (k) Endometriosis including disease of the reproduction system (l) Vertebra-spinal disorders (including disc) and knee conditions