Page 27 - MEDICAL AND HEALTH INSURANCE
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MEDICAL AND HEALTH INSURANCE
A small group generally refers to less than 50 members and a large group
can be of any size above the small group number. The benefits vary among
the small group and large group and are subject to their negotiation with
the insurer for coverage desired.
THE INDIVIDUAL MARKET
The individual market for PMI started as a rider to the life insurance policy
covering a small amount of medical expenses. During these early years of
development, the products were generally sold by life insurers.
Subsequently, as demand for medical care increased, insurers began to
offer standalone individual products for PMI and general insurers began to
enter the market. Today all three groups of insurers, that is, life, general
and takaful operators, offer from basic to comprehensive individual PMI
products.
Individuals generally arrange for their coverage through their agents or
directly with the companies. Coverage is usually arranged on a single,
married or with-child/children basis.
The minimum entry age varies among different PMI individual products
and generally it is before 60 years and coverage is up to minimum 70 years
and more. As for children, the eligible coverage age is generally 30 days
and above with some even offering coverage of 15 days.
The premium is paid by the individual and can be yearly for a standalone
policy or monthly if attached as a rider to a life policy. The premium is
individually rated according to the age or on an age-band rate basis. If on
an age-band, the individual products will have a minimum of 5 age-bands
for differentiation. The age-band will generally be a band 5-10 years apart
depending on the type of products and will have been decided upfront,
during the product development process.
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