Employee Benefits Plan

Protect Your Employee’s Welfare by providing coverage that has been made easy through our Employee Benefits
Plan. By doing so, your employees will know that you care and their family will be taken care of should an unfortunate or
unexpected event befall.

Employee Benefits Plan is a simple and affordable group insurance Why our Employee Benefits Plan?
plan that is specially tailor-made for small and medium-sized • You only need 2 employees to incept this group plan.
enterprises (SME). It mainly covers your employees’ medical cost • Eligible employees will be covered immediately upon
in the event of an illness or injury, whether they are at work or at enrolment as no medical examination is needed.
leisure. • Renewal premium rates are not based on individual company’s
claim experience but are based on the entire portfolio within
Your employees will be covered for: this plan.
a) Group Personal Accident • Flexible and affordable.
b) Group Hospital & Surgical with Major Medical Benefits
c) Group Outpatient- General Practitioner (Optional)
d) Group Outpatient- Specialist Practitioner (Optional)
e) Group Dental (Optional)

Group Personal Accident

With life full of uncertainties, this plan provides financial protection when an accident occurs unexpectedly:

Plan Type Plan 1 Plan 2 Plan 3 Plan 4 Plan 5

Sum Insured S$500,000 S$300,000 S$200,000 S$100,000 S$50,000

Classification of Occupation ANNUAL PREMIUM PER ELIGIBLE MEMBER (INCLUSIVE OF GST)

Class I S$243.00 S$145.80 S$97.20 S$48.60 S$24.30

Class II S$297.00 S$178.30 S$118.80 S$59.40 S$29.70

Class III S$405.00 S$243.00 S$162.00 S$81.00 S$40.50

Annual Premium inclusive of prevailing GST

January 2023
Group Hospital and Surgical with Major Medical Benefits
With the rising medical costs, this plan helps you to pay for your employees’ cost of hospital confinement and surgery when an
illness or injury strikes, relieving you of the financial burden:

Benefits Schedule
Plan 1 Plan 2 Plan 3 Plan 4 Plan 5
(Maximum Limit Per Disability)

Room & Board 6-Bedded

1. 1-Bedded 2-Bedded 4-Bedded 6-Bedded
(Daily, up to 120 days inclusive of ICU) GRH* only

2. Intensive Care Unit (ICU) S$10,000 S$10,000 S$10,000 S$10,000 S$10,000

3. Hospital Miscellaneous Services

Surgeon’s Fee
4. (Subject to Schedule of Surgical except for
S$25,000 S$20,000 S$15,000 S$10,000 S$7,500
Singapore Government/ Restructured Hospitals)

In-Hospital Physician’s Visit

5.
(Daily, up to 120 days inclusive of ICU)

Pre-Hospitalisation Specialist Consultation

6.
(Leads to hospitalisation within 90 days)

Pre-Hospitalisation Diagnostic Services

7. S$2,500 S$2,000 S$1,500 S$1,000 S$750
(Leads to hospitalisation within 90 days)

Post Hospitalisation Treatment

8.
(Within 90 days immediately after discharge)

9. Emergency Accidental Outpatient Treatment S$2,500 S$2,000 S$1,500 S$1,000 S$750

10. Miscarriage Benefits S$1,000 S$1,000 S$1,000 S$1,000 S$1,000

Outpatient Kidney Dialysis & Cancer Treatment

11. S$24,000 S$20,000 S$18,000 S$15,000 S$10,000
(Per policy year)

Daily Hospital Cash Income

12. S$150 S$100 S$75 S$50 NA
(Daily, up to 30 days if admitted to GRH)*

13. Special Grant S$5,000 S$5,000 S$5,000 S$5,000 S$5,000

14. Major Medical #

a) Surgical Implants S$5,000 S$4,000 S$3,000 S$2,000 S$1,000
b) Overall maximum limit per Policy year S$50,000 S$40,000 S$30,000 S$20,000 S$10,000
c) Co-insurance by insured member 20% 20% 20% 20% 20%

* GRH refers to Singapore Government Restructured Hospitals.

# Payable only if hospital confinement exceeds the limits in the Group Hospital & Surgical plan and (a) hospitalisation is more than 20 days or
(b) surgical percentage is 75% or more per incision.
Note: Only an employee who is a Singapore citizen can opt for Plan 5.

Plan Type Plan 1 Plan 2 Plan 3 Plan 4 Plan 5

Age Band (Age Next Birthday) ANNUAL PREMIUM PER ELIGIBLE MEMBER (INCLUSIVE OF GST)

30 and below S$386.64 S$257.04 S$203.04 S$168.48 S$102.60

31-35 S$406.08 S$289.44 S$232.20 S$193.32 S$119.88

36-40 S$425.52 S$318.60 S$261.36 S$218.16 S$133.92

41-45 S$459.00 S$356.40 S$278.64 S$235.44 S$143.64

46-50 S$624.24 S$475.20 S$388.80 S$336.96 S$213.84

51-55 S$788.40 S$613.44 S$514.08 S$454.68 S$297.00

56-60 S$972.00 S$842.40 S$656.64 S$557.28 S$367.20

61-65 S$1,393.20 S$1,056.24 S$918.00 S$820.80 S$518.40

66 – 70 (Renewal only) S$2,019.60 S$1,531.44 S$1,331.64 S$1,190.16 S$751.68

Annual Premium inclusive of prevailing GST

January 2023
Group Outpatient – General Practitioner (GP) Benefits
This rider helps to cover the outpatient consultation, treatment and medication prescribed by a panel GP.
Benefits Schedule (Limit Per Visit) Plan 1 Plan 2
1. Panel GP Clinics As Charged As Charged
2. Singapore Government Polyclinics As Charged As Charged
3. Accident & Emergency (A&E) Departments S$100 S$100
4. Overseas Outpatient Treatment S$35 S$35
Co-payment (applicable to all benefits) Nil S$5
Plan Type Plan 1 Plan 2
Annual Premium per Eligible Member
Age Band (Age Next Birthday)
(inclusive of GST)
Up to age 65 S$270.00 S$237.60
66 – 70 (Renewal Only) S$378.00 S$332.64
Annual Premium inclusive of prevailing GST

Group Outpatient – Specialist Practitioner (SP) Benefits

This rider helps to cover the outpatient consultation, treatment and medication prescribed by a SP, subject to referral by a GP.
Benefits Schedule (Maximum Limit Per Policy Year) Plan 1 Plan 2
1. Specialist Consultation, Diagnostic, X-Ray & Laboratory Test S$1,500 S$1,000
2. Physiotherapy (referred by a SP) S$500 S$500
Plan Type Plan 1 Plan 2
Annual Premium per Eligible Member
Age Band (Age Next Birthday)
(inclusive of GST)
Up to age 65 S$172.80 S$129.60
66 – 70 (Renewal Only) S$241.92 S$181.44
Annual Premium inclusive of prevailing GST

Group Dental Benefits

This rider reimburses the eligible dental expenses incurred in a panel dental clinic.
Benefits Schedule (Maximum Limit Per Policy Year) Plan 1 Plan 2
Maximum Limit per Policy Year S$1,500 S$1,000
1. Consultation
2. Medication (including administrator of Local Anaesthesis)
3. X-Rays
Prophylaxis
4. i) Scaling / Polishing
ii) Flouride application
5. Amalgam Restorations - Fillings
6. Tooth-Coloured Restorations - Fillings
7. Extractions (inclusive of LA)
Oral Surgery (inclusive of LA) As Charged As Charged
8. i) Surgical Root Removal
ii) Surgical Removal of Wisdom Tooth
Pulp / Root Canal Treatment
9. i) Pulp Capping
ii) Root Canal Treatment (inclusive of temporary fillings)
Periodontal Treatment
10.
Root Planning
Miscellaneous Treatment
11. i) Sedative Dressings
ii) Retention pins - restoration of tooth
Co-payment (applicable to all benefits) 20% 20%
Plan Type Plan 1 Plan 2
Annual Premium per Eligible Member
Age Band (Age Next Birthday)
(inclusive of GST)
Up to age 65 S$205.20 S$172.80
66 – 70 (Renewal Only) S$287.28 S$241.92
Annual Premium inclusive of prevailing GST

January 2023
 APPLICATION FORM - Employee Benefits Plan
IMPORTANT NOTICE - Under Section 25(5) of the Insurance Act (Cap. 142), or any subsequent amendments thereof, you must disclose in this proposal
form, fully and faithfully, all the facts which you know or ought to know in respect of the risk proposed; otherwise the policy issued hereunder may
be void.

Agent / Broker Code Period of Insurance

From To

PARTICULARS OF PROPOSER

Company Name Company Reg. No.

Is the Company a GST registered company?

Yes (please indicate GST Reg. No. ) No

Address Postal Code ( )

Contact No. Email

(Office) (Fax)

Nature of Business

TABLE OF BENEFITS AND PLANS FOR ELIGIBLE MEMBERS

Plan type 1 2 3 4 5

Group Personal Accident (GPA) – Compulsory

S$500,000 S$300,000 S$200,000 S$100,000 S$50,000
Cover

6-Bedded
Group Hospital & Surgical with Major Medical 1-Bedded 2-Bedded 4-Bedded 6-Bedded
(GRH)
Beneifts (GHS) – Compulsory Cover S$50,000 S$40,000 S$30,000 S$20,000
S$10,000

Nil S$5
Group Outpatient – General Practitioner (GP) – – –
Co-payment Co-payment

Group Outpatient – Specialist Practitioner (SP) S$1,500 S$1,000 – – –

Group Dental Benefit S$1,500 S$1,000 – – –

Plan 5 is strictly meant for employees who are Singaporean

BASIS OF COVERAGE / ELIGIBILITY FOR EMPLOYEES

Plan Chosen (1, 2, 3, 4 or 5) Date of Eligibility

Dependant’s
Category of Employee (Date of employment or upon
Cover (Refer to
(Manager/ Executive/ Clerical etc) confirmation with probationary
GPA GHS GP SP Dental Dependant Code)
period of months)

Dependant Code for GHS: EO (Employee only), ES (Employees & Spouse), EC (Employee & Children) and EF (Employee & Family)

PERSONAL DATA COLLECTION STATEMENT

I agree and consent, and if I am submitting information relating to another individual, I represent and warrant that I have the
authority to provide that information to EQ Insurance, I have informed the individual about the purposes for which his/her personal
information is collected, used and disclosed as well as the parties, as set out in the clauses contained below, to whom such personal
information may be disclosed by EQ Insurance, and the individual agrees and consents that EQ Insurance may collect, use, disclose
and process my/his/her personal information (collected in this form, or in any document provided, or to be provided to us by you or
from other sources) to evaluate, process and administer this application or transaction.

January 2023
 1. Purpose of Collection
The personal data belonging to you and your insured/s may be collected, used and disclosed for the purposes of:
a. carrying out identity checks
b. carrying out No-claim discount (NCD) and claims verification from third-parties;
c. communicating on purposes relating to an application or policy;
d. deciding whether to insure or continue to insure you and your insured persons;
e. providing advice for product recommendation based on your profile;
f. providing ongoing services and respond to your inquiries or instructions;
g. making or to settle payments;
h. investigating and to settle claims efficently;
i. recovering any debt owed to us;
j. detecting and preventing fraud, unlawful or improper activities;
k. conducting market research and statistical analysis;
l. coaching employees for customer service quality assurance;
m. reinsuring risks for reinsurance administration; and
n. complying with all applicable laws, including reporting to regulatory and industry entities.
2. Disclosure of Data
The personal data belonging to you and your insured/s may be disclosed for the purposes set out in Section A above to the parties
below:
a. Third party service vendors, suppliers, agents, reinsurers, or intermediaries;
b. Medical Professionals and Institutions;
c. Local or overseas service third party vendors that provide us with services such as printing, mail distribution, data storage,
data entry, marketing and research, disaster recovery or emergency assistance services;
d. Debt collection agencies;
e. Dispute resolution parties;
f. Parties that assist us to investigate, administer and adjudicate claims;
g. Financial institutions;
h. Credit reference agencies;
i. Industry associations; and
j. To any regulatory, government and statutory body to comply with applicable, laws or regulation or upon their valid request.
3. Personal Data Access and Amendments
You can request access to your personal data collected by us, and to make any corrections to your personal data so as to keep it
updated. We may charge you a reasonable fee for providing you with the service.
4. Marketing Option
Please indicate if you wish to receive marketing or promotional materials on our products or services via the following modes of
communication. ;
Telephone call Text Message Mail Email
If you do not indicate your option here, we will follow any existing option you may have indicated previously.
5. Withdrawal Option of the collection and use of your personal data
You may make your request to withdraw your consent, access or correct your personal data by writing to: The Data Protection
Officer, EQ Insurance, 5 Maxwell Road, #17-00 Tower Block, MND Complex, Singapore 069110. Alternatively, you can email to
dpo@eqinsurance.com.sg. Neither EQ Insurance nor any of its employees shall be liable for any loss or damage suffered by you or
any user as a result of any disclosure of any personal data which you have consented to us and/or any of its employees disclosing.
Altering on this “Personal data collection statement” is strictly prohibited. Any attempt to do so will be of no effect.

PROPOSER’S DECLARATION

1. We have declared to the best of our knowledge and belief that all the answers given in this Proposal are true and correct and we
have not withheld any information likely to affect acceptance of this Proposal.
2. We agree that this Proposal shall be the basis of the Contract between us and the Company and we further agree to accept the
Company’s policy subject to the terms exclusions and conditions expressed therein, endorsed thereon or attached thereto.
3. We agree that if a material fact, likely to influence the assessment and acceptance of this application, is not disclosed, the Policy,
if issued, may be null and void and no benefit may be paid.
4. We have been given a copy of the Product Information, the contents of which have been explained to us to our satisfaction.

Signature of Authorised Officer & Company Stamp Signature of Intermediary

Name: Name:
Designation: Contact No:
NRIC No.:
Date:

EQ Insurance Company Limited, 5 Maxwell Road, #17-00 Tower Block, MND Complex, Singapore 069110 • Tel: 6223 9433 • Fax: 6224 3903
• Email: distribution@eqinsurance.com.sg • Website: www.eqinsurance.com.sg (Co. Reg. 1978-00490-N) January 2023
 EMPLOYEE BENEFITS PLAN - ELIGIBLE MEMBERS LIST
Benefit / Plan / Annual Premium
Date of Birth Occupation
Full Name (as in NRIC/ Member NRIC/ Sex Category of Total
(dd/mm/ Class GPA GHS GP SP Dental
Passport) code * Passport No M/F Employee # Premium
yyyy) (I, II or III)
Plan Prem Plan Prem Plan Prem Plan Prem Plan Prem

Sub - Total S$
* Member Code - E (Employee), S (Spouse) and C (Child)
# Manager / Executive / Clerical
Total (INCLUSIVE OF GST) S$

PREMIUM PAYMENT

Cheque payable to “EQ Insurance Company Limited” (Bank & Cheque No.: ) Date:

FOR OFFICIAL USE

Accepted by

EQ Insurance Company Limited, 5 Maxwell Road, #17-00 Tower Block, MND Complex, Singapore 069110 • Tel: 6223 9433 • Fax: 6224 3903 • Email: distribution@eqinsurance.com.sg • Website: www.eqinsurance.com.sg (Co. Reg. 1978-00490-N)
January 2023
Our Underwriting Guidelines
A. Eligibility E. Territorial Limit
Insured Member: All full time, permanent and actively at • 24 hours, worldwide coverage.
work employees of the Policyholder, who is aged between 16
F. Period of Insurance
to 65 and a Singaporean, Permanent Resident (PR) or with a
valid employment pass. • Period of insurance is for 12 months and renewable annually.
Dependents G. Participation Requirement
a. Legal Spouse up to age 65 who is not divorced or legally • Both Group Hospital & Surgical with Major Medical Benefits
separated from the insured member at the policy and Group Personal Accident must be purchased together as
commencement date or at any renewal date. a package.
b. Unmarried and unemployed child(ren) aged between 15 • Group Outpatient – General Practitioner (GP) & Specialist
days old (not being in hospital) and 24 years old at the Practitioner (SP) and Group Dental Benefits are riders to the
policy commencement date or at any renewal date. Group Hospital & Surgical with Major Medical Benefits.
Dependent’s plan must be the same as that of the insured • Group Outpatient – Specialist Practitioners (SP) must be
member’s and must apply to all eligible employees within the purchased together with Group Outpatient – General
same basis of coverage. Practitioner
B. Classification of Occupation (All benefits are available H. Plan 5 Restriction
only to Occupational Class 1 to 3) • Only a full-time, permanent and actively at work employee who
Class I – Persons engaged in indoor and non-manual work is a Singaporean can be covered in this plan.
in non-hazardous place, e.g. Accountants.
I. Participation Requirement
Class II – Persons engaged in work of an outdoor or
supervisory nature or involves manual work whose • Premium rate is based on individual’s age next birthday, if
duties do not involve the use of tools or machinery applicable.
or exposed to any special hazards, e.g. Outdoor • Mode of payment is annual.
Sales Person. • Prevailing GST is applicable to all plans.
Class III – Persons engaged in manual work not of particularly
J. Declined Risks
hazardous nature but occasionally involving the
use of tools and machinery, e.g. Builders and Industrial workers using heavy machinery; woodworking
Contractors. related occupation; any occupation involving aviation
activities; armed services personnel, police force personnel
C. Key Policy Exclusions (please refer to policy contract for and fire fighters; construction or unskilled workers; ship
the full lists and details of exclusions) crew or workers on board vessels, stevedores, shipbreakers;
Group Hospital & Surgical with Major Medical Benefits occupations involving diving, platforms, oil and gas rig and /
•
All pre-existing conditions are excluded for the first 12 or offshore work; occupation involving heights, underground
months of coverage, except for outpatient kidney dialysis heat and handling of hazardous chemical or electricity;
and cancer treatment benefits, for which pre-existing professional sports team; professional divers and jockeys;
conditions will be permanently excluded. welders and the like.

• Major Medical – All pre-existing conditions are permanently K. Application Documents

excluded. • Application Form.
• Pregnancy, childbirth or abortion. • Insured Members’ Enrolment List.
• Cosmetic or plastic surgery unless it is necessary for the • Personal Health Declaration (if required by EQ Insurance).
repair of damage in view of an accident.
• Accounting and Corporate Regulatory Authority (ACRA).
• Emotional, stress, psychiatric or psychological disorder.
• List of authorised personnel to sign on Insurance Acceptance
Group Outpatient-General Practitioner (GP) (Rider To Group (names, designation, NRIC No.).
Hospital & Surgical)
• Any specialist medical treatment or services. Call us today:
• All treatment including and relating to kidney dialysis and /
or organ transplants.
Group Outpatient – Specialist Practitioner (SP) (Rider to
Group Hospital & Surgical)
•
Treatment by Panel Specialist without a referral from a
registered Panel General Practitioner.
Group Dental Benefit (Rider to Group Hospital & Surgical)
•
Expenses incurred for replacement of any lost or stolen
denture.
• Treatment or services not stated in the Schedule of Benefits.
Group Personal Accident POLICY OWNERS’ PROTECTION SCHEME: This policy is protected
• Suicide or self-inflicted injuries. under the Policy Owners’ Protection Scheme which is administered
by the Singapore Deposit Insurance Corporation (SDIC). Coverage
• Participating in any kind of speed contest or racing (other
for your policy is automatic and no further action is required from
than on foot).
you. For more information on the types of benefits that are covered
• Participating in any professional sports. under the scheme as well as the limits of coverage, where applicable,
D. Minimum Group Size please contact EQ Insurance or visit the GIA/LIA or SDIC websites
(www.gia.org.sg or www.lia.org.sg or www.sdic.org.sg).
• Only 2 employees to incept this policy.

Important Note: This brochure is for general information only and is not a contract of insurance. The precise terms, conditions and exclusions of this
insurance product are specified in the policy contract.
January 2023
 IMPORTANT NOTICE ON GST FOR MEDICAL, ACCIDENT & MOTOR CAR INSURANCE
st
(Effective for policies commencing 1 October 2021 onwards)
Regulations 26 and 27 of the GST (General) Regulations (Strictly applicable to a GST-registered Company)
 If you are a GST-registered company, please complete a “YES” answer on IRAS prescribed Declaration Form
below and submit it with your confirmation instruction to commence this policy coverage with us.
 By your answering “YES”, you are reaffirming your awareness that you are NOT ALLOWED to claim input tax
incurred on the accident & medical insurance premium and motor car insurance premiums - as stipulated by
the said Regulations.

Policyholder Name : ______________________________________________________________

Policy No : ______________________________________________________________

Is the policyholder a GST registered company/person? ☐ YES, GST Reg.No:____________________

☐ NO
If “YES”, as required by IRAS, please complete the declaration below:
Declaration of Entitlement to Claim Input Tax on Insurance Policy by GST
Registered Policyholders

To : EQ INSURANCE COMPANY LIMITED

Date : ________________________________

As a GST-registered person at the effective date of the insurance policy, I hereby confirm the following:
YES NO
1) Am I blocked, by virtue of Regulation 26 and 27 of the
Goods and Services Tax (General) Regulations*, from ☐ ☐
claiming the GST incurred on the insurance premiums?
* The blocked input tax claims under Regulation 26 and 27
would include (but not limited to) the following:

a) Medical and accident insurance premiums incurred

for your staff, unless the insurance or payment of
compensation is mandatory under the Work Injury
Compensation Act (“WICA”) or under any collective
agreement within the meaning of the Industrial Relations Act; and

b) Motor car insurance premiums.

Please click on the links or scan the QR code provided above if more information is required on the
particular legislation(s) concerned.
Name of GST-registered
company/person:
Name & Signature of
Authorised Person:
Designation of Authorised
Person:
Email address and contact
number of Authorised Person: