April International Limited
MyHealth - For companies with up to 20 Adults:
Here APRIL groups together a collection of its MyHealth individual plans.
IF you have 10 or more adults to insure, APRIL offers to disregard medical history and will also offer a guarantee for staff to be able to continue cover as an individual, on leaving the company.
At renewal, APRIL will apply renewal rates that reflect the claim experience of April's portfolio of all its individual MyHealth plans.
When it comes to claims over USD800, APRIL requires you to post them a copy of the original receipt.
IF you are facing a hospital claim that likely to take you over your deductible, you are required to seek pre-authorization, as APRIL still need to ascertain eligibility or your expected claim, for reimbursement.
YourHealth - For companies with more than 20 Adults:
April's 'YourHealth' group product is a totally customizable plan where you determine the level of benefits your company needs and can afford.
At renewal your company will be offered renewal terms that reflect your company's claim experience.
Portability
Providing April agrees at the beginning of the policy year, April will offer an individual Policy to Group members and all their dependants covered under their company Policy, following the termination of and employee's:
- employment with,
- engagement by
- or partnership
of the policyholder/company.. providing the empllyee has been insured with his/her dependents for a full year.
Any request under this provision must be made within thirty (30) days prior to the last day on which the Insured Person will be covered under this Policy (the “Group Policy Deletion Date”), and must be accompanied by a completed Application.
If it was not reasonably possible to make such request prior to the Group Policy Deletion Date, the Insured Person may make a late request, but under no circumstances shall the company be required to consider any member‟s request made more than thirty (30) days after the Group Policy Deletion Date.
In the case of death of an eligible insured person, applications for portability by the deceased‟s dependants will be considered for up to sixty (60) days following the death of the eligible insured person. The effective date shall be the day following the Group Policy Deletion Date.
The following special conditions apply to this provision:
1) April shall not be required to offer a policy to any individual who:
a. would not be eligible for coverage based on their usual country of residence on the Group Policy Deletion Date, as stipulated in the most up to date Liberty Hong Kong Business Acceptance Guideline document at the time of leaving the group;
b. has achieved the age of 66 years on the Group Policy Deletion Date or,
c. has been included on the namelist for less than one year on the Group Policy Deletion Date or has not met any other waiting period criteria set at the outset of the policy.
2) This provision shall have no effect and we shall not be required to offer a continuation policy if this Policy:
a. has been terminated; or
b. the new policy does not cover all eligible dependants covered by the Group Policy on the Deletion Date.
3) Benefits and policy terms will be based on the closest equivalent MyHEALTH Individual policy benefits on the Group Policy Deletion Date. The definition of 'closest equivalent´ will be at April's sole discretion.
Any requested upgrades in benefit in excess of the 'closest equivalent' policy will be subject to full medical underwriting.
4) Premiums for the first year after an Insured Person transfers to an individual policy under the terms of this endorsement, will be the published rates in force at the time of leaving the group policy. Renewal premiums for the individual policy, if renewed, will be determined according to the claim experience of all policies in the appropriate individual product pool.
5) April shall have the right to refuse to offer a Policy if they determine, in their sole discretion, that the member, while remaining or continuing to be employed, reemployed or engaged by the policyholder in any way, was terminated and/or deleted from this Policy, primarily for reasons of ill health or claim history; or to reduce the risk of medical claims under this Policy.
6) Individual underwriting will be conducted in respect of each applicant. Special terms may then be applied, limited to a maximum medical loading of 50% of the prevailing published rate for the MyHEALTH Individual 'closest equivalent' policy.
