Health Insurance Benefits 2015- 2016

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1 © Nokia Solutions and Networks 2015

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Employee Health Benefit

Program IndiaPolicy terms & conditions for Employee / Parents (2015-16)




For internal use

Employee’s Mediclaim

policy• Hospitalization coverage

• Coverage upto Rs. 3 Lacs

under family floater scheme

• Corporate Buffer Rs. 1.5 cr

sub limited to per family SI.

• Employee & immediate

family members (self +

spouse + 2 dependant

children

India Employee Health Benefit Program

Parent’s Mediclaim Policy

• Hospitalization coverage for

parents

• Optional policy (as chosen

by employees)

• Coverage for Rs. 2 / 3 / 5

Lacs available

• Policy negotiated by Nokia

Network, Premium paid by

employees as per choice

Accident insurance Policy

• Worldwide Accidental

Insurance coverage

permanent & partial

disability due to accident

• Sum insured

Min - Rs.10 Lacs Max - Rs.

1.2 Crores

• Insurance money paid to

the employee in case ofpermanent disability

Life insurance Policy

• Life Insurance coverage for

employees

• Sum insured - 5 X Annual

Basic Salary

• Sum insured Band

• Min - Rs.20 Lacs Max - Rs.

1.5 Crores

• Insurance money paid to

the nominee in case of

death of employee




For internal use

Employee & Parents Mediclaim Policy




For internal use

• Insurer: United India Insurance Co. Ltd

• Third party administrator: Family Health Plan Ltd.

• Policy period: 1 October ‘15 – 30 September ‘16

• Pre-existing diseases covered and new joiners covered from day 1

• Maternity covered for first 2 pregnancies- no waiting period

• New born babies covered from birth (new born to be enrolled within 30 days of birth on MyHRportal)

• Pre and post hospitalization covered – 30 day prior admission till 60 days post discharge

• Dental coverage – Rs.5000 (root canal/ extraction/ implant/ bridges/ fillings)

• Maternity Limit is 75K maximum for Normal & C-sec delivery. (Pre/Post not covered in maternity)

• Ambulance services offered for emergency cases only max. upto 4000 per case one way from home to hospital

• Special day care procedures included

• Robotic surgeries to be paid as per normal manual charges of the treatment• Corporate buffer for critical illness for another Rs. 3 Lacs per family (aggregate limit INR 1.5 crs)

Employee Mediclaim PolicySalient Features




For internal use

Log on to www.fhpl.net select logins click on E Card login , put your Corporate ID as 984 for employee policy & 995 for

parents policy User ID & password, Click on the name of the member & E card option will appear on the left side of the

webpage

For Current Year (2015-16) FHPL E card

NOTE: By default User ID & Passwords are : User ID – Employee’s NSN ID, Password – wil l be shared directly by FHPL through

email. After first t ime log in, Passwords can be changed by clicking on Password change option.

For any password related assistance, write to [email protected]

IMP NOTE: Dependents addition in case of newly married / new born needs to be done by the employee on MyHRportal within 30

days of the event. Accord ingly dependents will get covered in the policy within next 45 days or coverage will not be extended in

current policy.




For internal use

• Insurer : United India Insurance Co. Ltd

• Third party administrator: Family Health Plan Ltd.

• Policy period: 1 October’15 - 30 September’16

• Pre-existing diseases covered & new joiners option at the time of joining

• Coverage option of 2-3-5 Lacs

• Room rent- Maximum up to single standard AC room and ICU on actual.

• Dental coverage - Rs.5,000 (Root canal/ extraction/Implant/Bridges/ Fillings)

• Ambulance services offered for emergency cases only max. upto 4000 per case one way from home to hospital

• Special day care procedures included

• Robotic surgeries to be paid as per normal manual charges of the treatment

• Pre & post hospitalization covered - 30 day prior admission till 60 days post discharge

• Maximum age- 80 years

Parent’s Mediclaim PolicySalient Features




For internal use

Parents for new Joiners are covered upon the basis of their details / declaration on FHPL website in next month of

joining, Premium to be paid by Employee.

Note : There is no refund after employee’s exit from Nokia, in case employee has submitted any claim under Parents

mediclaim policy . Complete annual premium is applicable to an employee if he has filed a claim against the policy.

Premium Applicability Under Parents Mediclaim Policy

Sum Insured Annual PremiumFirst Installment

(60% deduction in Nov' 15 payroll)

Second Installment

(40% deduction in Apr' 16 payroll)

2 Lacs 18,584+S.T. @14.5% 11150 + S.T. @14.5% 7434 + S.T. @14.5%

3 Lacs 25,254+S.T. @ 14.5% 15152 + S.T. @14.5% 10102 + S.T. @14.5%

5 Lacs 37,726+S.T. @ 14.5% 22636 + S.T. @14.5% 15090 + S.T. @14.5%

65% of the above premium will be charged in case if only Single parent (2nd parent is not alive) is covered.




For internal use

Please select Network hospital for any treatment.

Diagnostic services are not covered under Mediclaim.

24 hours hospitalization required for coverage under Mediclaim, except for the following:

• Dialysis / Radiotherapy

• Chemotherapy

• Tonsillectomy

• Eye surgery / Cataract• Dental surgery

• D&C

• Stone removal

• Oral Chemotherapy if met with day care conditions

Employee’s and Parent’s Mediclaim PolicyExample of Day Care Surgeries




For internal use

Exclusions Under The Policy

Diseases In-Patient treatment Others

Plastic surgery (cosmetic)

Laboratory expenses not consistent with

treatment.

Spectacles, contact lens, hearing aid, injection

avastin and lucentis

Orthodontics treatmentVitamins, tonic inconsistent with treatment,

vaccinationsUse of intoxicating drugs / alcohol

Sterility/ venereal disease/ circumcisionSpecial diet and extra diet for patients (unless

prescribed by the doctor)

Naturopathy, ayurvedic treatment other than Govt.

hospital

Intentional self injuryExternal implants. E.g. an operation to remove a

6th finger Age related macular disease

AIDS Supports and accessories, e.g. Crutches, walker,belt etc.

RQMFR

Congenital diseases (external) E.g. an operation

to remove a 6th finger, skin grafting

Health drinks: e.g. Horlicks, Complain etc. Food

and beverage for relatives. Damage done by the

patient (accidentally) Damage charges not

covered.

Registration feeds, admission fees, food and

beverages, telephone/ fax TV , laundry, extra bed,

photocopy

Convalescence/ general debility/obesity (weight

loss program)Service, maintenance and surcharges.

Medical records/ stationary, Xerox or certifying

charges

Diagnostic expenses (only for out-patient) Abortion done for voluntary reasons and before 12weeks

Special nursing charges, attendant charges




For internal use

Treatment Others

Lasik Surgery (laser barrage etc.) / Refractiveerror correction

Genetic Disorder / Stem Cell RelatedTreatment

Psychiatric / Psychosomatic Admission for investigation / evaluation

Baby Vaccination Charges Pre / Post Hospitalization under maternity

Hormone Replacement Therapy Cost incurred to replace batteries or leads of

pacemaker

Weight Control programme Cochlear implant

Donor screening chargesMultifocal lens under Cataract treatment

Scaling, Polishing, Crowning under Dental Home visit charges

Exclusions Under The Policy




For internal use

Employees and Parents MediclaimClaim Process

Need for

hospitalization

Cashless

You’re at a

Network hospital

Hospital send

cashless request to

TPA (FHPL)

TPA checks

eligibility /

coverage

Planned treatment

Employee to

request for pre-

approval

TPA checks

eligibility/ coverage

Reimbursement

Emergency or at a

non-Network

hospital

Avails treatment,

makes payment

Applies through

reimbursement

process

Sends authorization

to the hospital

Send authorization

to the hospital

Employee to pay

Employee to pay

Upon approval

direct payment to

employee

Not approved, no

payment

Network Hospitals Link : ht tps: //fhpl.net/NetworkHospitals/NWHospitals.aspx

Intimation is necessary in case of hospitalization / treatment in non network hospi tal.

Claim documents to be submitted within 15 days from the date of discharge from hospital (Reimbursement claims)

yes

yes

no

no




For internal use

Compulsory Documents For Reimbursement Process

• Original detailed discharge summary on hospital letterhead

• Original investigation/lab reports along with bill & doctor prescription

• Original Hospital Bill-consolidated & detail breakup of every component on hospital letter head

• Incase of surgical packages - detail breakup of the package

• Medicine bills along with doctor prescriptions

• Claim Form – (https://www.fhpl.net/Forms/UIIC_ClaimForm.pdf) Patient FHPL card copy & Patient Photo ID Proof. In

case of >1 Lac claim, provide Patient’s address proof as well

• MLC Certificate from the hospital in the case of Road traffic accident. Or a certificate from the treating doctor

mentioning that the patient was not under the influence of alcohol at the time of Accident.• Obstetric history (GPLA) in the case of maternity claims

• Payment receipt for the payment done to the hospital either advance/balance/final amount

• In case of Parents if single parent has been declared in the GMP then Death certificate of the expired parent to be

produced along with the claim documents.

• In Dental, proper doctor prescription with separate bill & receipt is required for treatment taken with breakup

• Consultation receipts with Doctor Prescription of same

• Hospital Registration Certificate in case of non network hospital of FHPL




For internal use

Family Health Plan Contact Details

Hyderabad

040-23556464

Delhi / Gurgaon

0124-4867500

Mumbai

022-24918062

Kolkata

033-24659421Chennai

044-28293222

Jaipur

014.51-5170501

Pune

020-24488360

Guwahati

09864108389

Bangalore

080-22356256

Chandigarh

0172-6533002

Ahmedabad

079-266441773

Bhubaneswar

0674-2534560

Kochi

0484-2350115/2374374

Bhopal

0755-2559646

Nagpur

0712-3296446

Visakhapatnam

0891-6632901

Indore

0731-4038503

Lucknow

0522-2419880




For internal use

FHPL Helpdesk at Nokia Network Premises

Sr. No Location Contact Person Designation E-mail ID Mobile No. Visit Day Visit time

1 Chennai Srikanth Gunasekaran Executive [email protected] 9282132324 Wednesday 10 am to 1 pm

Mr. Srinivas Kamineni Account Manager [email protected] 9282329404

2 Mumbai Ms. Geeta Executive [email protected] 9223329009 Tuesday 3 pm to 5pm

Mr. Manoj Rewale Account Manager [email protected] 9223719195

3 Bangalore Mr. Suresh P Executive [email protected] 9243479820 Wednesday 10 am to 12 pm

Mr. Jom george Account Manager [email protected] 9243353882

4 Gurgaon Mr. Deepak Sahni Account Manager [email protected] 9212002882Tuesday &

Thursday

10 am to 3 pm

5 Noida Mr. Dhananjay Pandit Executive [email protected] 9212256979 Friday 3 pm to 5 pm

Mr. Deepak Sahni Account Manager [email protected] 9212002882

6 Kolkata Mr. Rajkumar Ghosh Executive [email protected] 9230101520 Friday 12 pm to 1 pm

Mr. Sumit Banerjee Account Manager [email protected] 9231001006




For internal use

Emergency Contact

Level 1: FHPLDeepak Sahni +91 9212002882

Level 2: FHPL

Inderjeet Singh +91 9212256976

Level 3: Marsh India

Amit Mishra +91 7838815243

Escalation- Marsh India

Eima Azim +91 9873415159




For internal use

Employee Accident Insurance Policy




For internal use

• Insurer: United India Insurance Co. Ltd

• Policy period: 1 October ’15 – 30 September ‘16

• Accidental coverage for employees – 24 x 7, worldwide

• Sum insured – 5x annual basic salary (min Rs. 10 lacs, Max Rs.1.2 Crores)

• Permanent disability – 100% of sum insured

• Temporary disability – coverage as per loss of earning capacity table

• Accidental medical expenses – Rs. 10,000

• Weekly benefits as per table

• Exclusions as per table

Accident Insurance Pol icySalient Features




For internal use

• Injury or disease directly or indirectly caused by or arising from or attributable to War or War-

like situations

• Service on duty with any armed force

• Intentional self injury, suicide or attempted suicide

• Influence of intoxicating drink or drugs

• Aviation other than as a passenger (fare paying or otherwise) in any duly licensed standard

type of aircraft any where in the world• Nuclear radiation or nuclear weapons material

• Any consequence of war, invasion, act of foreign enemy, hostilities (whether war be declared

or not), civil war, rebellion, revolution, insurrection, mutiny, military, or usurped power,

seizure, capture, arrest, restraint, detainment’s of all kings, princes, and people of whatever

nation, conditions and qualities so ever

Accident Insurance Pol icyExclusions




For internal use

Compulsory Documents For Reimbursement Process

• •Dismemberment/ Disablement claims

• Completed claim form

• Doctor's Report

• Disability Certificate from the Doctor

• Investigation/ Lab reports (x-ray etc.)

• Original Admission/ discharge card, if hospitalized.

• Police Inquest report, wherever applicable

Weekly benefits

• Completed Claim form

• Doctor's Report

• Disability Certificate from the Doctor, if any

• Investigation/ Lab reports (x-ray etc.)

• Original Admission/discharge card, if hospitalized

• Employers Leave Certificate & Details of salary




For internal use

Employee Life Insurance Policy




For internal use

• Insurer: MetLife insurance Co. Ltd.

• Policy period: 1 October ‘15 – 30 September ‘16

• Life coverage for employees – 24 x 7

• Death coverage – natural / accidental including terrorism

• New joiners covered from day 1

• Sum insured – 5 x annual basic salary

• Min insurance coverage of Rs. 20 Lacs

• Max insurance coverage of Rs. 1.5 Crores

• In case of death- insurance money paid to the nominee as per PF document.

Employee Life Insurance PolicySalient Features




For internal use

Employees Life InsuranceIllustration

Annual Basic 5 X Annual Basic Minimum cap Maximum cap Applicable insurance

amount

50,000 250,000 2,000,000 15,000,000 2,000,000

100,000 500,000 2,000,000 15,000,000 2,000,000

500,000 2,500,000 2,000,000 15,000,000 2,500,000

4,000,000 20,000,000 2,000,000 15,000,000 15,000,000




For internal use

Nokia Networks strives to provide the opportunityfor achieving a healthy work / life balance.

Prevention is better than cure, take care of yourhealth and be healthy.




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