Your life and medical insurance plan with ABL Life, Hanwha & Dongbu Insurance Life & Accident plan (under ABL Life & Hanwha)
Health plan (under Dongbu Insurance)
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Applicable for all permanent employees directly employed by Agoda. Accidental Death & Disability – 3 times annual salary Death or more than 80% disability due to illness – 1 time annual salary Critical Illness (cancer / stroke / myocardial infarction) – KRW 20,000,000
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Outpatient, Hospitalization & Surgery, Prescription Medicine Deductible applies Dependent enrollment possible at employee’s cost; please contact compensation team for the rate
BENEFITS Inpatient (exclude 3 special clauses)
Room & board, surgeon fees, pre & post-hospitalization specialist fees
Up to ￦10,000,000 per accident / illness R&B: 50% of superior room charge with average payable limit ￦ 100,000 per day Deductible: 10% for NHI Items and 20% for Non-NHI Items.
Outpatient (exclude 3 special clauses)
GP consultation fee Specialist consultation fee
Up to ￦250,000 per day Deductible: either total of 10% for NHI items & 20% for non-NHI items, or Clinic ￦10,000 / Hospital ￦15,000 / General Hospital ￦20,000, whichever is higher.
3 Special Clauses
1.Non-NHI Manipulation therapy / Extracorporeal shock wave therapy / Vegetative treatments 2.Non-NHI Supplementary injections 3.Non-NHI MRI / MRA
Up to ￦3,500,000 per year, max 50 visits Deductible: 30% of actual amount, but Min.￦20,000
Claim Process Submit Claim Documents to JLT Korea via fax (82-2-730-0725/6) or email and JLT Korea will request to provide the original ones if necessary.
Required Documents • Claim Form • Receipt & itemized bill of treatment or prescription medicine • Detailed treatment report (for hospitalization, surgery or outpatient claims) • Death certificate (for death claim) • Certificate of disability claim (for disability claim)
Claim Enquiry For claims status enquiry: H S Jeong 정혜승대리 Tel : 82 2 397 8125; Email : JHS@jltasia.com For insurance benefits enquiry: Y S Lim 임양순이사 Tel : 82 2 397 8111; Email : Lim_Y_S@jltasia.com
FAQs Q: What is the effective date of my insurance cover? A: Your insurance coverage begins on your hire date. If you enroll a dependent during renewal period in September each year, the coverage is effective on 1st October of that year.
Q: Do I have to pay for it? A: This is 100% subsidized by the company for full time employees and you will be automatically enrolled on your hire date. If you wish to enroll a dependent, the premium will be deducted from your monthly pay.
Q: I want to add my dependent on the insurance plan, what should I do? Is there any due date for that? Can I change the plan during the year? A: You can enroll dependents at your own cost for spouse and child below 18. Please contact compensation team for the monthly premium. There are only 3 allowed periods to enroll dependents: (i) within 30 days from your hire date, (ii) during open enrollment in September each year, and (iii) if you have a life status change, i.e. marriage or child birth. All these can be done through Workday.
Q: What do I need to do to claim my treatment expenses if I forgot my medical card? A: You just need to make payment first, and make sure you have the receipt, medical record, charge list and the claim form. You will need to submit the original documents to the administration team and AIA will collect those for further process. Your claim should be settled within 6 to 8 weeks.
Q: Do I have to submit the original documents for every treatment? A: It is only necessary if you forget to use the medical card after treatment, or for some treatment that cannot be deducted directly at the hospital and needs further assessment by the insurer.
Q: How do I submit my claims? A: Please refer to the previous page on the claim process.
Q: How will I receive my medical claims? Is it through my payroll? A: Medical reimbursements are transferred to your bank account directly from the insurance provider. You will receive a notification from them when your claim is approved & when you can expect to receive your reimbursement. The reimbursement process usually takes 6 to 8 weeks.
Q: I travel frequently. Can I claim medical treatments that are done overseas? A: Your medical plan is limited within S. Korea only. Worldwide coverage only applies for life insurance plan
Q: I have more questionsâ€Śwho can I contact? A: You may contact Agoda_Korea@jltasia.com
Published on Mar 13, 2018