Local Deductible (Annual) $ 12,000

Co-insurance 80/20
Over-aged Dependent Coverage YES
*1
Initially, amounts are paid from the basic benefit listed at 80% of
cost. Once exhausted, amounts are paid directly from MM at 80%
of cost, by reimbursement, after first satisfying the deductible.
*2
Benefits are paid directly from MM at 80% of cost up to the maxi-
mum amounts listed.
*3
Benefits are paid at 100% of cost up to basic maximum, then goes
into MM at 80% of cost after satisfying the deductible.

Executive Health Plus Premiums - A grace period of thirty-one (31)

days without interest charge will be allowed for the payments of the EXECUTIVE HEALTH PLUS is one of the solu-
premium due under the Policy on any due date except the first. If any tions offered by Sagicor to help you attain your financial goals.
premium is not paid before the expiration of the grace period the Policy Please ask your Sagicor representative how our products can
shall terminate at the end of such period.
form part of a wise approach to your complete financial well-
being.
OPTIONS
• Individual
• Individual + 1 (Spouse or Child) THINGS YOU SHOULD KNOW
• Family

PAYMENT FREQUENCY Who are your dependents?

Annual or Semiannual • Your spouse (married or unmarried).
• Your children, stepchildren and legally adopted children

EXECUTIVE
CLAIMS & EXCLUSIONS up to their 19th birthday.
All claims must be submitted within ninety (90) days of the service
date. Benefits are subjected to exclusions. (Kindly see policy contract Is coverage available for my child after age 19?
for details) Yes. Your policy includes over-aged dependent coverage for
your child up to their 23rd birthday if attending a tertiary
SPECIAL CONDITIONS
• The maternity benefit is optional for women 51 years and over.
institution on a full time basis. A letter is required from the
Nine (9) months waiting period for maternity - All maternity local or overseas tertiary institution each year. H E A LT H P L U S
related expenses, including doctor’s visits, are paid from the
maternity benefit. When can I change my spouse on my health insurance plan?
• Twelve (12) months waiting period for all pre-existing You can cancel a spouse at any time. Change of spouse is
conditions. usually allowed only at the plan’s anniversary but is allowed at
• Six (6) months waiting period for major medical any time if spouses are legally married. A marriage certificate
benefits (surgery, major diagnostics (MRI, CAT scan) &
is required to effect the change.
hospitalization), except for medical emergencies.

KEY TERMS & DEFINITIONS When can I add my newborn baby?

R&C (Reasonable and Customary) Fees: You can add your baby 14 days after birth. However, if the
These are the rates charged by an individual provider or institution in newborn is still hospitalized at the date of eligibility, the
keeping with the going rate or charges for these medical services. The effective date will be the day following the date of discharge
rates are applied according to a pre-determined schedule. from the hospital.
MM (Major Medical):
An additional benefit which provides funding for major medical
expenses arising from catastrophic illness, injury, or costly diagnostic
procedures. This benefit is in addition to the amounts payable from Sagicor Life Jamaica Limited
the basic benefit after satisfying the annual deductible.
H.O.: 28-48 Barbados Ave., New Kgn. P.O. Box 439, Kingston 5
LTM (Lifetime Maximum):
This refers to the maximum amount payable over the lifetime of the
Tel.: (876) 929-8920-9, Fax: (876) 929-4730
insured, from the Major Medical benefit. www.sagicorjamaica.com
 Services Maximum Services Maximum
THE BEST LIVES ARE BUILT ON Benefit Benefit
THE STRONGEST FOUNDATIONS DOCTORS VISIT HOSPITAL BENEFITS
Office Local Room & Board $ 3,000 per day
$ 1,800
(10 visits per disability, per policy year)
Room & Board (MM) $ 2,500 per day
Annual Wellness Check-up (120 days per disability, per policy year)
$ 2,000
(1 visit per policy year)
Hospital Miscellaneous $ 35,000*3
Consultation - on referral (Charges related to hospital confinement) per disability
IS EXECUTIVE HEALTH PLAN FOR YOU? (1 visit per disability; 4 visits per policy year)
$ 3,500
Are you between the ages of 19 and 64 years and desire Hospital Out Patient $ 17,500 per
Specialist (Hospital care provided without admission) disability
quality health insurance coverage at a price you can af- $ 2,500
(5 visits per disability, per policy year)
ford? This plan is for you! Executive Health is a compre- Doctor’s Hospital Visit $ 3,000
Psychiatrist (MM) - on referral $3,500 (1 visit per day, 120 days per disability per policy
hensive non-group health plan that offers a wide range of
Dietician - on referral $ 3,500 year)
benefits for you and your family. Overseas emergency and
(3 visits per year; paid by reimbursement)
non-emergency benefits are also provided for medical care SURGICAL BENEFITS
while in other Sagicor territories. OTHER BENEFITS Surgeon’s Fee 80% of R&C
Prescription Drugs $ 15,000 +MM*1 (Maximum basic amount per procedure)
CONVERSION PRIVILEGE Dental & Optical (combined) $ 22,000 Assistant Surgeon’s Fee 30% of Sur-
If you are on a Sagicor group plan and experience changes Benefit restrictions include: (Maximum basic amount per procedure) geon’s Fee
in your employment, you can continue your coverage by •1 oral exam and dental cleaning every 6 months Anaesthetist 40% of Sur-
transferring to this individual plan within thirty (30) days of •1 eye exam and 1 pair of lenses per 12 month (Maximum basic amount per procedure)
period
geon’s Fee
the employment change. If you transfer within this period •1 frame per 24 month period Intensive Care (MM) 100% of cost
you will not be required to do a medical and there is no (5 days per disability, per policy year) up to
Physiotherapy - on referral $ 3,500
waiting period for pre-existing conditions, if the benefits (10 sessions per disability, per policy year) $30,000 per day
on your group plan were equivalent or superior to those of Nursing Services - on referral $ 3,000
Speech Therapy $ 1,800
Executive Health Plus. (10 sessions per disability, per policy year) [Registered Nurse only]
(Private duty per 8 hour shift - maximum of 15
Lab, X-Ray, ECG, etc. $ 12,000 +MM*1 shifts)
COORDINATION OF BENEFITS
Ultra Sound, CAT Scan & MRI 80% of Cost
If you or your dependents are covered under another health OVERSEAS EMERGENCY BENEFIT
plan, National Health Fund (NHF) or JADEP, your benefits Renal Dialysis (MM) 80% R&C up to
(2 sessions per week; 52 weeks per year)
Coverage is available for first 30 days per trip for US$ 100,000
may be coordinated so that you pay less out-of-pocket for $ 10,500 medical emergencies. (per policy year)
per session (Maximum of 90 days per policy year)
medical expenses.
Chemotherapy (MM) $ 600,000 N.B. Failure to contact CMN may result in reduc-
tion of benefits.
per annum*2
UTILIZATION MANAGEMENT Repatriation of remains US $ 10,000
Radiotherapy (MM) $ 600,000
Keys to keeping your premiums down: Close relative travel benefit US $ 10,000
per annum*2
• Your card must ONLY be used by you. Do not lend
your card to anyone. Podiatry (5 visits per policy year) $ 1,500 OVERSEAS NON-EMERGENCY BENEFIT
[Paid directly from MM]
• Do not use your card for anything other than medical Chiropractic (5 visits per policy year) $ 1,500
expenses. Overseas Room & Board J$ 15,000
Acupuncture (5 visits per policy year) $ 1,500
• Protect your plan. Report abuse or loss of your card Immunization (up to age 12 years) $ 2,000
Hospital Miscellaneous/ Diagnostic/ 80% of R&C
promptly to any Sagicor office. Surgery
Tubal Ligation/Vasectomy $12,000
• Never sign a claim form unless it is completely filled Overseas Deductible US $ 1,000
out by the provider. Local Ambulance $1,500
Co-insurance 80/20
• Do not use your card just to exhaust an existing bal- MATERNITY BENEFITS including Pre-Natal and Delivery Air Transport (per round-trip) J$ 20,000
ance before the anniversary of the plan. Normal Delivery $ 40,000 (Maximum of 2 round-trips per policy year)
C/Section $ 80,000 MAJOR MEDICAL
Miscarriage $ 20,000 Lifetime Maximum $ 6,000,000