Page 44 - MEDICAL AND HEALTH INSURANCE

MEDICAL AND HEALTH INSURANCE

Similarly, some insurers may have tailor-made such small groups and

priced these accordingly. However, owing to the nature of the small group

size, insurer may not allow the flexibility of the benefit structure and

choice of the range of additional services as compared to those on offer
with large group schemes.

Personal Declaration may be required and generally not waived.

Underwriters may impose exclusion on pre-existing conditions or any

related conditions are totally excluded and not covered by additional
premium payment.

The premium charged may be age-band or level premium across the group

regardless of age and may differ from insurer to insurer. Payment of

premium is on an annual basis.

2.2.2 LARGE GROUP/SCHEMES POLICIES

Generally, such policies are tailor-made according to the group's needs,

which generally are quite comprehensive in cover and competitive in

pricing due to the large premium generated from the large group. The

premium is level premium across all ages and can be in 3 or 4-tiers of
categories as follows:

• 3-tier premium categories: Employee, Spouse, and Child

• 4-tier premium categories: Employee, Employee and Spouse,

Employee and Children, Employee and Family.

The premium is generally computed on experience rating and is also

termed as 'community pricing'.

Payment of premium is on an annual basis or half yearly or quarterly
depending on what is negotiated. An experience refund may be given to

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