FOR DISTRIBUTOR USE

ONLY
I. PRODUCT FEATURES

Health Start/ Health Start Family

Plan Type Health Start (single plan)

Health Start Family (Joint plan with Primary Insured and Co-Insured covering
spouse, parent, adult child or sibling)

Payment Period and 10-Pay 20-Pay

Issue Age
Issue Age: 18-65 Issue Age: 18-55

Benefit Period Up to Age 100

Sum Insured Minimum: Php1 Million

Maximum: Php10 Million

Subject to aggregate critical illness limit per life of Php10 Million

BENEFITS
Major Critical Conditions 100% of Sum Insured LESS Minor Critical Illness benefit paid (if any),
Benefit Living benefit paid (if any) and any indebtedness is payable in the event
that at least 1 of the insured individuals gets diagnosed with a major critical
illness.

Covered Major Critical Illnesses are the following:

1. Cancer
2. Heart Attack
3. Stroke
plus Terminal Illness

• Waiting period: No benefit is payable if the major critical illness is

diagnosed within 60 days after the effective date or reinstatement date,
whichever is later.
• Pre-existing conditions are excluded
• Survival Period: none
• For joint plan: The benefit will be given on a first to get diagnosed basis,
policy terminates after

Minor Critical Conditions 20% of the Sum Insured is advanced in the event that at least 1 of the
Benefit insured individuals gets diagnosed with a minor critical Illness. Minor
Critical Conditions can be claimed for a maximum of four(4) times
throughout the lifetime of the policy and should be for different conditions
per life, except for carcinoma-in-situ of different organs.

Covered Minor Critical Conditions

1. Carcinoma-in-Situ
1. Breast;
2. Uterus;
3. Fallopian Tube;
4. Vagina;
5. Cervix Uteri;
6. Testicles
7. Ovary
8. Colon;
9. Rectum;
10. Penis;
 11. Lung;
12. Stomach or
13. Vulva
2. Early stage prostate cancer
3. Early Bladder Cancer
4. Early Chronic Lymphocytic leukemia
5. Insertion of pacemaker or defibrillator
6. Angioplasty and other invasive coronary artery surgery
7. Cerebral shunt insertion
8. Aortic Aneurysm
9. Keyhole Coronary Bypass Surgery

• Waiting period: No benefit is payable if the minor critical illness is

diagnosed within 60 days after the effective date or reinstatement date,
whichever is later.
• Waiting period between two (2) minor critical conditions: none
• Pre-existing conditions are excluded
• For joint life: both co-insureds can claim minor critical illness benefit,
maximum of 4 times for the entire policy.
(Total sum insured decreases by 20% upon payment of this benefit)
Php200,000 is payable in the event that any of the minor child dependent
of the insured is diagnosed of a covered child critical condition. This
benefit can be claimed only once but is not deducted from the Sum
Insured.

Covered Child Critical Conditions:

1. Dengue Hemorrhagic Fever (Grades III & IV)
2. Hemophilia A or Hemophilia B
3. Insulin Dependent Diabetes Mellitus
4. Kawasaki Disease
Child Cover Benefit
5. Osteogenesis Imperfecta
6. Rheumatic Fever with Valvular Impairment
7. Still’s Disease
8. Wilson’s Disease

To be eligible to receive a benefit under any of the above covered child

critical conditions, the covered child must be under age 18. Survival period
of 14 days applies.

Applicable for Health Start and Health Start Family

Return of Premium will be LESS any minor critical illness benefit paid and
any indebtedness. This benefit is paid on the Policy Anniversary nearest
the 75th birthday of the first insured to reach this age.

Return of Premium In case of substandard rating, return of premium will follow the standard
premiums only.

For Issue Ages 50 and above (20 Pay) and Issue Ages 55 and above (10
Pay), 50% of Total Premiums Paid LESS Minor Critical Illness Benefit paid.
Death Benefit 100% of Sum Insured LESS Minor Critical Illness Benefit paid (if any),
Living benefit paid (if any) and any indebtedness.

For joint plan: This is paid on first to die basis and policy terminates after.
100% of Sum Insured LESS Minor Critical Illness Benefit paid (if any),
Living benefit paid (if any) and any indebtedness, with a minimum of 0.
Maturity Benefit
For joint life coverage, this is paid on the first individual to attain age 100.
100% of Cash Value LESS Minor Critical Illness benefit paid (if any) upon
Surrender Benefit
surrender of policy
Attachable Supplements
Pay Period Health Start (Single)
10 – Pay Waiver of Premium
20 – Pay Waiver of Premium &
Care

No applicable riders for Health Start Family.

OTHER PLAN DETAILS

Mode of Payment Annual/Semi-Annual/Quarterly/Monthly

Current Modal Factors will apply:

➢ Annual – 1.00
➢ Semi-Annual – 0.52
➢ Quarterly – 0.27
➢ Monthly – 0.095
Simplified Issue Offer for Php 1 to 4 Million Sum Insured

SIO Questions:

1. Have you ever had or received medical advice or treatment or

medication for any of the following?
(1) Chest pain, high blood pressure, heart attack, stroke, diabetes, kidney
disease, liver disease, elevated cholesterol or any heart/blood/vascular
disorder, AIDS or infection with HIV?
(2) Cancer, mass, tumor, lump / polyp / cyst / growth of any kind?
If yes please provide details:

2. Are you currently intending to seek or have been advised to seek

medical treatment or take medication for any health problem (other than
for common cold) or are you waiting for the results of any test or
investigation?
If yes, please provide details:

3. Has your biological mother, father, or any sister or brother been

diagnosed prior to the age of 60 with any of the following?
Underwriting (1) Cancer; or
(2) Heart Attack; or
(3) Stroke?
If yes, please provide details:

4. Has your child or any of your children been diagnosed or undergone

treatment for, or been suspected by the doctor of having any of the
following?
(1) Hemophilia A and/or Hemophilia B
(2) Insulin Dependent Diabetes Mellitus
(3) Osteogenesis Imperfecta
(4) Wilson’s Disease
(5) Kawasaki Disease
(6) Rheumatic Fever
(7) Still’s Disease
If yes, please provide details:

SIO Underwriting:
Must be no to questions 1-3, accept (Substandard rating, occupational
rating not applicable)
 Regular Underwriting:
• For those with YES in questions 1 - 3, will be subject to regular
Underwriting
• For Sum Insured application of above Php 4 Million to Php 10 Million
• For applications with riders
• Allowable Substandard Ratings – Until +150 e.m. or Class F only for
age 0-65
Change of Policy Owner/Beneficiary
• Allowed anytime while the policy is in-force (Not applicable for
Joint life to change PO)

Increase/Decrease of Sum Insured

• Increase Sum Insured – Allow increase within 12 months from
policy inception, subject to underwriting and effect as from policy
inception
Policy Administration • Decrease Sum insured – Allow decrease at modal point and
reduced Sum Insured should meet the minimum issue
requirements

Addition/Deletion of Riders
• Addition of Riders - Allowed within 12 months from policy
inception, subject to underwriting
• Deletion of Riders – Allowed anytime, while the policy is in effect

For Joint Life, there will be 2 sets of beneficiary/ies asked, 1 set for
Beneficiary principal insured and 1 set for co-insured. They may choose to have
similar beneficiaries.
Allowed to be applied against 100% X [Cash value less any minor CI
Automatic Premium Loan
conditions paid out]; once exhausted, Policy will terminate
➢ Extended Term Insurance (ETI)
Policies under the ETI option will not be entitled to the maturity
Non-Forfeiture Options benefit. ETI will only cover Death Benefit
➢ Automatic Premium Loan
➢ Cash Surrender Value
Lapsation 31-days Grace Period

• Up to 3 years from the lapse date, Payment of back premiums

will be required and subject to evidence of insurability
Reinstatement • If reinstatement within 18 months from policy effective date, no
evidence of insurability is required.*
*Underwriting guideline for reinstatement applicable to all products
Policy Loan Up to 85% x Cash Value

COMMISSIONS/NBC
Commissions
(Agency) Pay Period Commission Rate
10-Pay 30%/10%
20-Pay 35%/10%/5%/5%/5%

• NBC (as % of Commission) 100%

• Bonuses & Overrides: Follow existing guidelines
New Business Credit NBC as % of FYP
(BankAssure)
Pay Period Rate
10-Pay 30%
20-Pay 35%

TAXES
Premium Tax 2% of the Annual Premium
Local Government
0.02% of the Annual Premium
Tax
Documentary Stamp One time DST based on the following schedule
Tax (DST)
Documentary Stamp
Amount of insurance (Php)
Tax
SA ≤ Php100,000 Php0.00
Php100,000 < SA ≤
Php20.00
Php300,000
Php300,000 < SA ≤
Php50.00
Php500,000
Php500,000 < SA ≤
Php100.00
Php750,000
Php750,000 < SA ≤
Php150.00
Php1,000,000
SA >Php1,000,000 Php200.00
II. COVERED CONDITIONS

MAJOR CRITICAL CONDITIONS

No. Illness Definition

Name
1 Cancer The first unequivocal diagnosis of any malignant tumor characterized by the
uncontrolled growth of malignant cells and invasion of tissue, and positively
diagnosed with histological confirmation by a specialist and/or by Our medical
director or authorized medical consultant. The term malignant tumor includes
leukemia, sarcoma and lymphoma except cutaneous lymphoma (lymphoma
confined to the skin).

Breast carcinoma in situ with subsequent radical mastectomy and radiotherapy

is covered.

For the definition shown above, the following are excluded:

1. All tumors which are histologically classified as benign, carcinoma in
situ, pre-malignant, non-invasive, having borderline malignancy or
having low malignant potential;
2. Tumors treated by endoscopic procedures alone and urinary bladder
tumors that have not Invaded the muscle layer (Tis and Ta)
3. Tumors of the skin with the exception of malignant melanoma greater
than 0.7 mm Breslow and/or histologically described by the AJCC
seventh edition TNM classification greater than stage T1aN0M0
4. All prostate tumors unless histologically classified as having a Gleason
score greater than 6 or having progressed to at least clinical TNM
classification T2N0M0
5. Thyroid tumor in its early stages that measures less than 2cm in
diameter and histologically described as T1N0M0 from TNM
classification of the AJCC Seventh Edition
6. Chronic lymphotic leukemia unless histologically classified as having
progressed to at least Binet Stage A

2 Heart Attack Death of heart muscle due to inadequate blood supply that has resulted in ALL
of the following evidence of acute myocardial infraction:

• New typical ischemic changes in the electrocardiograph:new ST-T

changes or new left bundle branch block or new pathological Q waves;
• The characteristic rise of cardiac biomarkers or Troponins recorded at
the following levels or higher:
Troponin T > 200ng/L (0.2 ng/ml or 0.2 ug/L)
AccuTnl > 500ng/L (0.5 ng/ml or 0.5 ug/L)

The following are excluded:

• Other acute coronary syndromes

• Angina without myocardial infraction

3 Stroke Stroke means the death of brain tissue caused by hemorrhage, embolism or
thrombosis resulting in permanent neurological deficit with persistent clinical
symptoms. There must be clear and obvious abnormalities of sensory or motor
functions during the physical examination performed by a neurologist and/or by
Our medical director or authorized medical consultant. The incident must be
demonstrated by Magnetic Resonance Imaging (MRI), Computerized
 Tomography (CT) or other reliable imaging techniques approved by the
Company.

The following are excluded:

• Transient ischemic attack
• Brain tissue damage caused by head injury
Death of tissue of the optic nerve or retina / eye stroke
4 Terminal The life Insured must be suffering from a condition, which in the opinion of a
Illness specialist and/or by Our medical director or authorized medical consultant,
according to Our guidelines, will lead to death within twelve (12) months.
MINOR CRITICAL CONDITIONS

No. Illness Definition

Name
1 Carcinoma- Carcinoma-in-situ is defined as a focal autonomous new group of carcinomatous cells
in-situ which has not yet resulted in the invasion of normal tissue. Invasion means an infiltration
and/or active destruction of normal tissue beyond the basement membrane. Diagnosis of
carcinoma-in-situ must be supported by a histopathological report and a positive result of a
microscopic examination of fixed tissue, and confirmed by a biopsy result. Clinical
diagnosis does not meet this standard.

For the purpose of this policy, carcinoma-in-situ is limited only to the following 13 organs:
(1) Cervix Uteri* (8) Colon
(2) Uterus (9) Lung
(3) Breast (10) Penis
(4) Vagina (11) Rectum
(5) Fallopian Tube (12) Stomach
(6) Ovary** (13) Vulva
(7) Testicles

*For carcinoma-in-situ of cervix uteri, it must be at a grading of not less than CIN III and be
positively diagnosed upon the basis of a microscopic examination of fixed tissue from a
cone biopsy or colposcopy with cervical biopsy.
**For carcinoma-in-situ of ovary, the tumors should be capsule intact, with no tumor on the
ovarian surface, classified as T1aN0M0, T1bN0M0 (TMN classification) or FIGO 1A, FIGO
1B (The Federation Internationale de Gynecologie et d’Obstetrique).

In order to qualify for a benefit under this illness for the second time, the Carcinoma-in-situ
of the second claim must be a Carcinoma-in-situ of the organs that is different from the
organ of the first claim for which benefit has been paid.

For the avoidance of doubt, for those organs with both left and right component (including
but not limited to breast, ear, eye, fallopian tube, kidney, lung, ovary and testicle), the left
component and right component of the organ shall be considered as one and the same
organ.
2 Early Stage A prostate malignant tumor which is histologically classified as T1a, T1b, T1c according to
Cancer of the TNM classification system or another equivalent classification, and having a Gleason
Prostate score below 7. The diagnosis must be based on histopathological features and confirmed
by a Specialist. Pre-malignant lesions and conditions, unless listed above, are excluded.

3 Early Stage Bladder cancer which is histologically described using TNM classification as T1N0M0 as
of Urinary/ well as Papillary micro-carcinoma of Bladder. Diagnosis must be supported by
Bladder histopathology report.
Cancer
4 Early Stage Chronic Lymphocytic Leukemia (CLL) RAI Stage 1 or 2. RAI stage CLL 0 or lower is
of Chronic excluded.
Lymphocytic
Leukemia
5 Insertion of The undergoing of insertion of a permanent cardiac pacemaker or a cardiac defibrillator to
Pacemaker correct serious cardiac arrhythmia which cannot be treated via other methods. The
or insertion of the cardiac pacemaker or cardiac defibrillator must be certified to be medically
Defibrillator necessary by a specialist in cardiology and/or by Our medical director or authorized
medical consultant, according to Our guidelines.
6 Angioplasty The actual undergoing of balloon angioplasty, atherectomy or laser treatment to correct
and Other narrowing in major coronary arteries (defined as being greater than 50% stenosis in 2 or
Invasive more major coronary arteries; or being greater than 75% stenosis in 1 or more major
Treatments coronary artery by angiogram). The treatment must be considered medically necessary by
for Coronary a specialist and/or by Our medical director or authorized medical consultant, according to
Artery Our guidelines, either to relieve exercise limiting symptomatology which is not responding
Disease adequately to medical therapy or in order to achieve a prognostic benefit. For purposes of
this definition, “major coronary artery” refers to any of the left main stem artery, left anterior
descending artery, circumflex artery and right coronary artery (but not including their
branches).

In order to qualify for a benefit under this illness, there must be:

(1) History of symptoms which are sufficiently severe to indicate that the Life Insured’s
future level of exercise tolerance would be restricted, despite medications, to a minimal
level without percutaneous intervention; and
(2) Medical evidence including all of the following:
2.1 Report from attending specialist; and
2.2 Evidence of significant and relevant ECG changes (ST segment depression of
2 millimeters or more); and
2.3 Angiographic evidence to confirm the location and degree of stenosis in major
coronary artery.
7 Aortic The diagnosis of a large abdominal or thoracic aortic aneurysm as evidenced by
Aneurysm appropriate imaging technique. The aorta must be enlarged greater than 50 mm in
diameter and the diagnosis must be confirmed by a specialist in cardiology and/or by Our
medical director or authorized medical consultant, according to Our guidelines. For this
definition, aorta means the thoracic and abdominal aorta but not its branches.
8 Keyhole The undergoing for the first time for the correction of the narrowing or blockage of one or
Coronary more coronary arteries with bypass grafts via "Keyhole" surgery. The surgery must be
Bypass considered medically necessary by a Specialist. All intra-arterial catheter-based techniques
Surgery are excluded from this benefit.
9 Cerebral The actual undergoing of surgical implantation of a shunt from the ventricles of the brain to
Shunt relieve raised pressure in the cerebrospinal fluid. The need of a shunt must be certified to
Insertion be medically necessary by a specialist in neurology.
CHILD COVER BENEFIT CRITICAL CONDITIONS

No. Illness Name Definition

1 Dengue This severe grade of dengue is characterized by circulatory failure (Dengue Shock
Haemorrhagic Syndrome DSS – WHO DHF grades III and IV), in addition to the 3 symptoms below:
Fever
(Grades III 1) High fever;
and IV) 2) Hemorrhagic phenomena;
3) Hepatomegaly.

The diagnosis of Dengue Hemorrhagic Fever must be confirmed by a specialist and/or

by Our medical director or authorized medical consultant, according to Our guidelines.
Non-Hemorrhagic Dengue Fever is excluded.
2 Hemophilia A The covered child or children must be suffering from severe hemophilia A (VIII
OR deficiency) or hemophilia B (IX deficiency) with factor VIII or factor IX activity levels less
Hemophilia B than one percent (1%). Diagnosis must be confirmed by a specialist and/or by Our
medical director or authorized medical consultant, according to Our guidelines.
3 Insulin Diabetes mellitus is chronic hyperglycemia, caused by defective insulin secretion.
Dependent Insulin Dependent Diabetes Mellitus is characterized by the continuous dependence on
Diabetes exogenous insulin for the preservation of life as diagnosed by a specialist and/or by Our
Mellitus medical director or authorized medical consultant, according to Our guidelines, and such
dependence must persist for at least 180 days.
4 Kawasaki This is acute, febrile and multisystem disease of children, characterized by non-
Disease with suppurative cervical lymphadenopathy, skin and mucous membrane lesions. Diagnosis
Heart must be confirmed by a specialist and/or by Our medical director or authorized medical
Complication consultant, according to Our guidelines, and there must be echocardiograph evidence or
any other imaging test showing cardiac involvement manifested by dilatation or
aneurysm formation in the coronary arteries which persists for at least 180 days after the
initial acute episode.
5 Osteogenesis This is a genetic disorder characterized by brittle, osteoporotic, easily fractured bones.
Imperfecta The covered child or children must be diagnosed as a type III Osteogenesis Imperfecta
confirmed by the occurrence of all of the following conditions:

1) The result of physical examination of the covered child or children by a Doctor

that the covered child or children suffers from growth retardation and hearing
impairment; and
2) The result of X-ray studies reveals multiple fracture of bones and progressive
kyphoscoliosis; and
3) Positive result of skin biopsy.

Diagnosis of Osteogenesis Imperfecta must be confirmed by specialist and/or by Our

medical director or authorized medical consultant, according to Our guidelines.
6 Rheumatic A confirmed diagnosis by a specialist and/or by Our medical director or authorized
Fever with medical consultant, according to Our guidelines, of acute rheumatic fever according to the
Valvular revised Jones criteria for its diagnosis. We only cover the case where there is
Impairment involvement of one or more heart valves and at least mild valve incompetence or stenosis
attributable to rheumatic fever as confirmed by quantitative investigations of the valve
function by a qualified cardiologist acceptable to Us.
7 Still's Disease The occurrence of Still's Disease, a form of Juvenile Idiopathic Arthritis (JIL), where all of
the following conditions are met:

1) There is widespread joint destruction as a result of the disease necessitating hip

or knee replacement; and
2) The diagnosis has been confirmed by a specialist and/or by Our medical director
or authorized medical consultant, according to Our guidelines.
8 Wilson’s A potentially fatal disorder of copper toxicity characterized by progressive liver disease
Disease and/or neurologic deterioration due to copper deposit. The diagnosis must be confirmed
by a specialist and/or by Our medical director or authorized medical consultant, according
to Our guidelines, with liver biopsy and the treatment with a chelating agent must be
documented for at least 180 days.
III. OTHER IMPORTANT INFORMATION

1. EXCLUSIONS:

We will not pay the Major Critical Condition, Minor Critical Condition or the Child Cover Benefit under
any of the following:
a. the Insured is suffering from any Major or Minor Critical Conditions within sixty (60) days
following the Policy Effective Date or last reinstatement date of this Policy, whichever is
later
b. Any act of War (whether declared or not), invasion or acts of foreign enemies, civil war,
revolution, rebellion, civil commotion assuming the proportions of, or amounting to, an
uprising against the government, riot or insurrection, strike, or terrorist acts
c. Nuclear, biological or chemical (NBC) contamination
d. Any self-inflicted injury or suicide or any attempt thereat, whether sane or insane
e. Any unprescribed drug or alcohol abuse
f. Under Child Cover Benefit, we will not pay if the child is suffering from any covered child
conditions within sixty (60) days following the Policy Effective Date or last reinstatement
date of this Policy, whichever is later or the Child Critical Condition resulted to death
within fourteen days from its diagnosis.
g. Pre-existing conditions as defined is permanently excluded

2. PRE-EXISTING CONDITION: means a condition for which the Insured received medical advice,
consultation or treatment, or whose signs or symptoms are evident, or should have been evident to
the Insured, even if the Insured did not seek medical advice, consultation or treatment for it prior to
the Effective date of this Policy or date of effectivity of its last reinstatement, if any. “Condition” means
any type of illness, specific injury, disease or infirmity including all underlying or related conditions and
any manifestation thereof, whether in one (1) or more than one body system.

3. COOLING OFF PERIOD: Policyholder may return or cancel the contract within 15 days from the date
the contract is received. The amount paid will be retuned in full.