premierLife

Table of benefits

For help in understanding your benefits, questions and general plan
guidance, please contact our Member Care Team:
+44 808 101 3483 or +44 333 405 3003
member-care@integraglobal.com
CLAIMSintegra@medical-administrators.com
For 24/7 pre-authorisation and guarantee of payment requests:
All hospital stays, outpatient surgery, medical transportation (except for local emergency transportation) or medical procedures must be pre-authorised. Pre-authorisations are easy and only take a few minutes of your time.
Please allow at least 2-5 business days for the pre-authorisation to be processed. You must notify us at least five business days prior to a scheduled or elective admission or treatment plan. For an emergency hospitalisation please notify us within 48 hours of admission.
+(33) 184 780 368
hospi@medical-administrators.com
EMERGENCY MEDICAL ASSISTANCE and SAND (security and natural disaster)
quoting code number NGSINTEGR01
+44 20 7183 8910
Back-up mobile: +44 7785 627 433
ops@northcottglobalsolutions.com
US CLAIMS AND PROVIDER INFORMATIONTo find a provider in the US, visit: www.welcometouhc.com/us1
Utilising the UHC Network ensures that preauthorisation procedures are followed. If using hospital or provider outside of UHC Network in the US you or your provider must follow pre-authorisation procedures and contact: +1 800 268 5041

Professional counselling support and consultation available worldwide, day or night, 365 days a year. The EAP benefit reflects our continuing commitment to your well-being and privacy. We encourage you to use the EAP anytime you need it. Please note that any onward referral will be at your own cost.

CALL
Call Morneau Shepell and identify yourself as part of Integra Global
Europe: 00 800 2685 2111 (freephone)
Malaysia: 1 800 815 560 (freephone)
South Korean: 00 800 226 0195 (freephone)
Phillipines: 00 800 2685 2111 (freephone)
Thailand: 001 800 2685 2111 (freephone)
Indonesia: 001 803 018 0195 (freephone)
Or call Canada and reverse the charges: 905 886 3605
ONLINE E-COUNSELLINGwww.workhealthlife.com
Search for Integra Global
MY EAP APP
Download the Morneau Shepell My EAP app
Apple App Store
Google Play
Blackberry World
Table of benefitsPremierLife
Maximum lifetime plan benefit$5,000,000 | €3,750,000 | £3,000,000
Annual maximum plan benefit$2,000,000 | €1,500,000 | £1,250,000
Table of benefitsPremierLife
AccommodationPrivate room
Inpatient treatment, daypatient, operating theatre and recovery room, prescribed medicines, drugs and dressing for inpatient or daypatient treatment100%
Intensive care unit100%
Inpatient ancillary services including
physical and occupational therapy as
daypatient or inpatient
100%
Surgeons’ and anaesthetists’ fees100%
Inpatient consultation by specialist 100%
Emergency room100%
Pathology, radiology, and diagnostic tests 100%
MRI, CT and PET scans100%
Private duty nursing (Lifetime maximum)$15,000 | €12,500 | £10,000
Skilled nursing facility (Lifetime maximum)$15,000 | €12,500 | £10,000
Home health care (Lifetime maximum)$15,000 | €12,500 | £10,000
Hospice care services (Lifetime maximum)$20,000 | €15,000 | £13,000
Emergency dental treatment (as a result of accident)100%
Cancer treatment100%
Child and companion accompaniment N/A
If the insured person is a child under 16 who requires hospitalisation, we will pay for necessary overnight accommodation for one parent in the same hospital, or when no such accommodation is available, for necessary bed and breakfast accommodation in a nearby hotel.
Pre-approval is necessary.
MANAGED TRANSPLANT PROGRAMMETransplant must be pre-certified and approved by us. Failure to comply will result in treatment not being covered by your policy.
Organ transplants maximum lifetime$500,000 | €400,000 | £300,000
Tissue transplants (as part of the overall organ max.)$250,000 | €200,000 | £150,000

Transplant must be pre-certified and approved by us. Failure to comply will result in treatment not being covered by your policy. A 24-month waiting period applies for all transplants.

Table of benefitsPremierLife
Surgery as outpatient100%
Physician office visits and specialist fees100%
Diagnostic and therapeutic services
(as outpatient, per visit)
100%
Physical therapy
(as outpatient, per visit)
100% | $75 | €60 | £50 policy year max 50 visits
Occupational therapy
(as outpatient, per visit)
100% | $75 | €60 | £50 policy year max 50 visits
Chiropractic services
Policy year maximum for chiropractic services
Referral letter required from medical physician
100% | $1,500 | €1,250 | £1,000
Complementary medicine
Including TCM, bonesetting, acupuncture,
herbal medicine, homeopathy and osteopathy
100% | $1,500 | €1,250 | £1,000
PRESCRIPTION PROGRAMME
In US
(no deductible applies)
100% generic | 90% brand
All other countries
(deductible applies)
100%
DENTAL
Routine dental$1,500 | €1,250 | £1,000
Diagnostic and preventive dental100%
Dental plan option availableYes
See dental options

Table of benefitsPremierLife
Pregnancy normal deliveryN/A
Complicated pregnancyN/A
Routine nursery, included under Maternity Benefits as any other treatment including room and board, physician charges and circumcision for males prior to discharge.
New born cover
Included in New Born Cover are premature births, congenital conditions and birth anomalies. New Born Cover is only available for a covered pregnancy.
N/A

Table of benefitsPremierLife
ADULTS
Per policy year
$750 | €600 | £500
Routine physical exams in connection
with overall health and wellbeing
100%
Pap smear100%
Mammograms: ages 35-39 one baseline exam; ages 40-49 one exam every one or two years for asymptomatic women, but no sooner than two years after baseline; age 50 and over one exam annually; any age whenever prescribed by a physician100%
Prostate cancer screening: one test per policy year for males age 50 or over100%
Immunizations and vaccinations100%
CHILD(REN)
Maximum per policy year: birth to age 12 monthsN/A
Maximum per policy year: 13 months and overN/A
Routine medical exams and immunizations and vaccinationsN/A
Child preventive care servicesN/A
Hearing testsN/A

Six-month waiting period applies to all Wellness Benefits, but waits are waived for policies that are paid annually. Deductible does not apply to Wellness Benefits. Overall Wellness Benefit maximums apply to all routine and Wellness Benefits for adults and children.

Table of benefitsPremierLife
Vision care cover100%
Maximum per 24-month period
Six month waiting period applies to Vision
Care Cover but waits are waived for policies
that are paid annually.
$300 | €275 | £225
Table of benefitsPremierLife
Medical evacuation and assistance100%
24/7 Emergency medical assistance hotlineYes
Repatriation of mortal remains100%
Family emergency travel100% | $5,000 | €3,500 | £3,000
Repatriation accompaniment100% | $5,000 | €3,500 | £3,000
Repatriation family accompanimentN/A

Access to our specialist representatives provide a 24/7 international emergency response in events such as security crises, political unrest and natural disasters. The services include assistance in arranging evacuation, contingency planning, remote medical abilities, crisis management and tracking services. Any costs incurred are the responsibility of the insured person, and must be paid by you to the service provider.

Table of benefitsPremierLife
Best possible outcome programmeYes
A dedicated diagnosis verification and treatment planning care management programme. In the event that you are diagnosed with a specified critical illness, the programme provides access to an appropriate specialist who will remotely review your medical reports to confirm your diagnosis and advise, in conjunction with your treating physician on your treatment options, to provide the best outcome.
Advanced health screening programme100%
Ages 40-50 one high level physical examination every three years$1,000 | €750 | £650
Ages 50+ one high level physical examination every three years$1,500 | €1,250 | £1,000
eHealth records accountYes
Table of benefitsPremierLife
Mental Health Benefits100%
Lifetime maximum for mental health benefits (inpatient and outpatient)$25,000 | €20,000 | £15,000
Policy year mental illness, maximum
(out-of-hospital) 15 visits
$2,500 | €2,000 | £1,500 per policy year
Lifetime mental illness, maximum per insured (in-hospital)60 days
Lifetime maximum for mental health benefits (out-of-hospital)80 visits

Mental health benefits do not count towards out of pocket maximum.

Table of benefitsPremierLife
Expatriate Assistance ProgrammeYes

Operated by Morneau Shepell, provides assistance with the following types of issues often faced by expatriates: how to cope with isolation and loneliness, adapt across cultures, identify and cope with culture shock, address the personal impact of the relocation, strengthen relationships, improve communication, work towards life goals, deal with stress, anxiety and depression, address alcohol and drug misuse, resolve marital and relationship difficulties, find solutions for work-related issues, access crisis and trauma support while on assignment, discover ways to improve your nutrition in your new environment, focus on your health with natural healing strategies.

Table of benefitsPremierLife
HIV/AIDS treatmentYes
Lifetime maximum$25,000 | €20,000 | £15,000
Table of benefitsPremierLife
Durable medical equipmentYes
Lifetime maximum$20,000 | €15,000 | £13,000
Table of benefitsPremierLife
Chronic conditionsYes

Chronic conditions are treated like any other condition under the policy.

Table of benefitsPremierLife
Lump sum in case of death
All causes
$10,000 | €10,000 | £10,000
Table of benefitsPremierLife
Individual deductibleYes
Family deductibleNo
Deductible options are:$0 | €0 | £0
$100 | €75 | £65
$200 | €150 | £125
$500 | €400 | £300
$1,000 | €750 | £650
$5,000 | €4,000 | £3,000
Table of benefitsPremierLife
Family$3,000 | €2,250 | £2,000

Functions just like the individual out of pocket except this is protection for the entire family. If the family out of pocket maximum is reached regardless of whether the individual out of pocket limit is reached the entire family under cover has their 90% benefits switched to 100% for the remainder of the policy year (unless where indicated). For Premier Plans out of pocket while technically possible is not practical due to the 100%. The only area where a maximum out of pocket could be reached is in the US prescriptions for brand name drugs. All other qualified benefits are at 100%.

Cover Region 1 – Worldwide including US and Canada and their territories.

For Cover Region 1 – please note that benefits listed above are only applicable when using our Preferred Provider Network. Benefits outside of network are reduced to 70% and co-insurance does not count toward out of pocket max.

Please note that Cover Region 1 is limited to 180 days in the US in any 12-month period.

Cover Region 2 – Worldwide but excluding US and Canada and their territories.

For Cover Region 2 – does not include any cover for US and Canada and their territories.

Optional benefits planPremierLife
Individual deductible$50 | €40 | £30
Family deductible$150 | €125 | £100
CLASS I EXPENSES
Diagnostic – general preventive
Included under your Premier medical plan
CLASS II EXPENSES
Restorative (basic); endodontics; periodontics; prosthodontics – removable (maintenance); fixed bridge (maintenance); oral surgery
90%
CLASS III EXPENSES
Restorative (major); endodontics;
prosthodontics – removable (installation);
fixed bridge (installation).
60%

Orthodontic and Class III services are available after six months of continuous enrolment in the Dental Plan. Orthodontic services are only available for children under 18 years of age.

Optional benefits planPremierFamily
Policy year maximum
(per insured person)
$3,000 | €2,250 | £2,000
Orthodontic lifetime maximum$2,500 | €2,000 | £1,500

In the event of an accidental death or dismemberment of the primary insured the insurer pays a lump sum benefit equal to the principal sum subject to a maximum benefit multiplied by a percentage as shown below.

Optional benefits planPremierLife
Loss of life100%
Loss of sight of both eyes100%
Loss of both hands or arms100%
Loss of both feet or both legs100%
Loss of one arm and one leg100%
Loss of sight of one eye50%
Loss of one foot or one leg50%
Loss of one hand or arm50%

N.B. Benefits cannot exceed two times annual salary. See rate sheet for benefit sums available.