PREMIUM VEGETABLE OILS SDN BHD

INSURANCE BRIEFING
SEPTEMBER 2023
 benefits that truly benefit

Agenda

1 Roles of Marsh and Provider

2 Group Hospital & Surgical

Businesses of Marsh McLennan

 benefits that truly benefit

ROLES OF MARSH & PROVIDER

Businesses of Marsh McLennan

 benefits that truly benefit

Roles of Marsh & Provider

Mercer Marsh Benefits acts as an Insurance Broker & Consultant to Premium Vegetable Oils

Sdn Bhd

Group Policies:

• Group Hospital & Surgical, GHS (Great Eastern Life Assurance (M) Berhad )

Businesses of Marsh McLennan

 benefits that truly benefit

GROUP HOSPITAL SURGICAL

Businesses of Marsh McLennan

GROUP HOSPITAL SURGICAL

Policy Coverage / Benefits

 Period of Insurance: 1st April 2023 to 31st March 2024
 24 hours, Worldwide Cover
 Against accident, sickness, disease or illness

 Eligibility:
 Employee : Min. entry age of 17 years old age next birthday up to 65 years old age next birthday
 Spouse : Min. entry age of 17 years old age next birthday up to 65 years old age next birthday
 Dependent : Min. entry age of 15 days but below 19 years old age next birthday
(The coverage can be continued up to age 21 years old age next birthday if still on full time higher education and
who is not gainfully employed)
 Definition of Dependents
 Spouse: One Legally Married Spouse
 Children – unmarried, attained the age of 15 days old but below 19 years old next birthday

Copyright © 2021 Mercer Limited. All rights reserved. 6

GROUP HOSPITAL SURGICAL
Coverage Highlights
BENEFITS PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5
a) Hospital Room & Board
 Up to 150 days 300 230 150 100 100
 Charges for room, food & general nursing services-
b) Intensive Care Unit
 Up to 30 days As Charged
 Confined as a bed-patient in ICU
c) Hospital Miscellaneous Services
 Charges for X-Ray, ECG, Laboratory Test, Drugs, medicine, As Charged
dressings, registration fees, admission fees and medically
required internal implants
d) Surgical Fee
As Charged
 Charges levied by the Surgeon for operation
e) Daycare Procedure
 Surgery & Medical procedures performed as an out-patient
 Medical procedure includes Endoscopy & Angiographic
procedures as medically required
As Charged

Copyright © 2021 Mercer Limited. All rights reserved. 7

GROUP HOSPITAL SURGICAL
Coverage Highlights
BENEFITS PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5
f) Anaesthetist Fee
 Charges by the anesthesiologist incidental to the surgical As Charged
procedure
g) Operation Theatre
As Charged
 Charges for use of operating theatre
h) In-Hospital Physician Fees
 Physician’s daily visits up to 150 days As Charged
 Subject to maximum 2 visits per day
i) Pre-Hospitalisation Diagnostic Services
 Recommended by a qualified Medical Practitioner
As Charged
 X-ray, lab test for diagnostic purposes
 Within 60 days prior to Hospitalization
j) Pre-Hospitalisation Specialist Consultation
 Recommended by a qualified Medical Practitioner
As Charged
 First consultation with a specialist
 Within 60 days prior to Hospitalization

Copyright © 2021 Mercer Limited. All rights reserved. 8

GROUP HOSPITAL SURGICAL
Coverage Highlights
BENEFITS PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5
k) Second Surgical Opinion
 Consultation with 2nd specialist
As Charged
 Subsequently must be hospitalised for treatment
 Within 60 days prior to Hospitalisation
l) Ambulance Fees
 For the road ambulance services and subsequently As Charged
hospitalised in that hospital
m) Post-Hospitalisation Treatment
 Follow-up treatment by the same physician As Charged
 Within 60 days after discharge
n) Emergency Out-Patient Accidental Treatment
 For accidental injury only
As Charged
 Max per disability within 24 hours & max 30 days from the date of
Accident in any period of insurance
o) Accidental Dental Treatment
 Charges for emergency dental treatment to sound natural teeth
As Charged
 Within 24 hours after the accident
 Follow-up treatment up to 14 days with same physician

Copyright © 2021 Mercer Limited. All rights reserved. 9

GROUP HOSPITAL SURGICAL
Coverage Highlights

BENEFITS PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5

q) Emergency Sickness Treatment
 Emergency Treatment in 24 hours clinic as
150
outpatient
 Consultation between 10pm to 6am
r) Medical Report Fee Reimbursement As Charged
s) Good & Service Tax 6% of eligible Room & Board
t) Daily Cash Allowance at Govt Hospital (Daily Max up to
70 50 40 35 25
150 days)
Overall Maximum Limit per Annum Per policy year 150,000 80,000 50,000 20,000 12,000

Copyright © 2021 Mercer Limited. All rights reserved. 10

MAJOR EXCLUSIONS

Copyright © 2021 Mercer Limited. All rights reserved. 11

MAJOR EXCLUSIONS

Copyright © 2021 Mercer Limited. All rights reserved. 12

MAJOR EXCLUSIONS

Copyright © 2021 Mercer Limited. All rights reserved. 13

MAJOR EXCLUSIONS

Copyright © 2021 Mercer Limited. All rights reserved. 14

ADMISSION TO PANEL HOSPITALS (Guarantee Letter)

Copyright © 2021 Mercer Limited. All rights reserved. 15

DISCHARGE PROCESS

Copyright © 2021 Mercer Limited. All rights reserved. 16

REIMBURSEMENT CLAIMS

Copyright © 2021 Mercer Limited. All rights reserved. 17

REIMBURSEMENT CLAIMS (Hardcopy)

Copyright © 2021 Mercer Limited. All rights reserved. 18

OPERATIONS & FUNCTIONS

Copyright © 2021 Mercer Limited. All rights reserved. 19

OVERSEAS HOSPITALIZATION

Copyright © 2021 Mercer Limited. All rights reserved. 20

OPERATIONS
& FUNCTIONS
Live Great Corporate e-Medical
Card
It is valid for use in approximately 120 panel
hospitals across Malaysia.

This card does not apply to non-panel hospitals

and government hospitals

If admitted to a non-panel hospital, the Member

must pay for themselves upon discharge, and seek
reimbursement after

Copyright © 2021 Mercer Limited. All rights reserved.

MEDIEXPRESS CALL CENTRE (24 HRS)

Copyright © 2021 Mercer Limited. All rights reserved. 22

Thank you
Q&A

Copyright © 2021 Mercer Limited. All rights reserved. 23