MyBenefits Plus FAQ

General questions

What is the minimum number of employees needed to start MyBenefits Plus policy?

We will need a minimum of two employees to start MyBenefits Plus policy.

What is the maximum entry age for my employees?

The maximum entry age is 69 years old at age next birthday.

Can my employees choose the products and the level of coverage based on their preference?

No. The company's representative will decide the products and level of coverage, either the same for all employees or differentiated by job category.

Can my employees insure their dependants (spouse and children)? If yes, what level of coverage are they covered?

Yes. Your employees' dependants (the relationship must be substantiated legally) will be covered with the same level of coverage as the employee plan. 

Can I cover my employees who are based outside Singapore?

No. This coverage is only for employees and dependants (if any) based in Singapore.

Products

Life and Accident cover

Can the coverage for Group Term Life plan and Group Living Care rider be the same?

Yes, it has to be the same. Unless your insured employee is covered at Plan 6 for Group Term Life, he/she will automatically be insured under Plan 5 of Group Living Care rider. 

Can the sum assured of Group Personal Accident plan be more or less than Group Term Life plan?

Yes. The sum assured of both plans are independent of each other.

What are the main exclusions for Group Term Life, Group Living Care and Group Personal Accident?

Please refer to the following Appendix 1:

Group Term Life

1. We will not pay any Term Life Benefits under this Policy if the claim is due to or arising directly or indirectly, wholly or partly, from any Pre-Existing Condition unless: 

  • the Pre-Existing Condition was declared by the Insured Person and specifically accepted by Us in writing to be covered under this Policy; or
  • the Pre-Existing Condition was not excluded from the Policy by Us in writing and the Insured Person has been insured under this Policy continuously for at least 18 months from the Effective Date.

2. Suicide is excluded for 12 months from the Effective Date.

Group Living Care

We will not pay any Living Care benefit under this Policy for any Critical Illness caused directly or indirectly, wholly or partly, by any of the following:

  • Pre-Existing Condition unless the Pre-Existing Condition was declared by the Insured Person and specifically accepted by Us in writing to be covered under this Policy; or
    • sexually transmitted diseases or viruses, Acquired Immune Deficiency Syndrome (AIDS), AIDS-related complexes and all illnesses or diseases associated with the human immunodeficiency virus (HIV), except AIDS due to blood transfusion as provided in this Policy;
    • invasion, riot, civil commotion or rebellion, any war (declared or undeclared) or act of war; violation or attempted violation of the law or resistance to arrest;
    • suicide or any attempted suicide or self-inflicted injury or illness, whether the Insured Person is sane or insane unless such suicide occurs 12 months after the Effective Date.
    • over-indulgence in alcohol;
    • drug-taking unless taken under the direction of a Registered Medical Practitioner.

Group Personal Accident

This Policy does not cover any Accidental Injury caused directly or indirectly, wholly or partly, by any one of the following occurrences:

  • Suicide or any attempted suicide or self-injury whether the Insured Person is sane or insane.
  • War, any acts of terrorism involving, directly or indirectly, the use of nuclear radiation and/or biological and/or chemical agents, hostilities or any warlike operations (whether war be declared or not) or civil war; military or naval or airforce service while under orders for warlike operations.
  • Participation in a riot; commission of an assault or criminal offence.
  • Participation in competitive racing of any kind other than on foot; travelling in any type of aircraft other than as a fare-paying passenger on a regularly scheduled flight of a commercial airline.

 

Group Medical

Group Medical (Group Outpatient Medical, Group Basic Medical and Group Major Medical)

We will not pay any benefit under this Policy for any of the following occurrences:

  • Pre-existing Conditions, the cause or pathology of which already existed prior to the Effective Date, whether the Insured Person was aware of it or not; unless he has already been insured continuously for 12 months
    • under this Policy; or
    • under any Group Hospital & Surgical Insurance Policy issued in Singapore immediately prior to the Effective Date. This waiver is not applicable if You have less than 11 Insured Persons at the Policy Commencement Date.

The above exclusion is not applicable to Group Outpatient Medical.

Pre existing Conditions which existed prior to the commencement of insurance coverage of the Insured Person under this Policy whether known or unknown to the Insured Person will be permanently excluded under Group Major Medical.

  • Suicide or attempted suicide or intentional self-injury whether the Insured Person is sane or insane (including suicide or attempted suicide or intentional self-injury attributable to psychological, emotional or mental problems or conditions of the Insured Person; alcoholism or drug addiction of the Insured Person).
  • Congenital anomalies or genetic defects, including hereditary conditions of the Insured Person present at or existing from the time of his birth irrespective of when the Insured Person discovered or underwent treatment or surgical procedure for the same.
  • Treatment relating to birth control, infertility and impotency including treatment or surgical procedures done at fertility clinics, in-vitro fertilization clinics, reproductive medicine or assistance clinics or centres or any treatment or procedures occasioned by or resulting from pregnancy, childbirth and abortion including any complications arising from any of the above.
  • Any dental work or treatment, oral surgery, orthodontics and orthognathic surgery or temporo-mandibular joint disorder unless it is due to an injury sustained in an Accident.
  • Eye examination, surgical procedure for correction of eye refraction, procurement or use of contact lenses or eye glasses, (surgical procedure or treatment for correction of squint or other eye misalignment (unless the Insured Person is below 8 years old) and cosmetic or plastic surgery except to the extent that such surgery is necessary for the repair of damage caused solely by bodily injuries sustained in an Accident.
  • Treatment of xanthelasma, syringoma, acne, alopecia, cosmetic skin surgeries, inguinal hernia, hydrocele (including any complications) unless treatment for inguinal hernia and hydrocele is for an Insured Person who is more than 5 years old.
  • Services (irrespective of whether there is Hospital Confinement) for the primary purpose of diagnosis, medical check-up, genetic or health screening and Outpatient treatment and Rehabilitation Services (except for Post-Hospital Confinement / Surgery Follow-up Treatment), immunotherapy, alternative medicine including accupunture, chiropractice, osteppathy, herbal medicine, homeopathy and the like and other unconventional medical practices not normally practiced by a Registered Medical Practitioner.
  • Rest cures, sanatoria care or special nursing care or any treatment or services that are not medically necessary or reasonably required for Illness or bodily injury caused by an Accident.
  • Treatment for sleep apnea, obesity, weight reduction or weight improvement even if it is caused by a medical condition which is otherwise payable under this Policy.
  • Circumcision (except where it is medically necessary) or treatment relating to the same.
  • Sexually transmitted diseases, Acquired Immune Deficiency Syndrome (AIDS), AIDS related complexes and all illnesses or diseases associated with the human immunodeficiency virus (HIV).
  • Injuries and disabilities sustained from direct participation in a strike, riot or civil commotion, insurrection, hostilities or any war-like operations (whether war be declared or not) or in the commission of any criminal offence.
  • Implants (homograft, heterograft, artificial) and prosthesis (except as provided under PART III – BENEFIT PROVISIONS, Section 2 - Benefits, Clause 2A(xiv) under Hospital Miscellaneous Services); procurement or use of wheel-chair, dialysis machine and any other hospital-type equipment.
  • Any expenses, administrative or other charges of a non-medical nature in the course of obtaining medical supplies or services.

Group Dental

No benefit shall be payable under this Supplementary Contract in respect of:

  • Any treatment for corrective purposes (such as crowns and bridges) or for the replacement of any lost or stolen denture, unless the Insured Person is covered under Superior Plan 2 as specified in the Schedule of Dental Benefits and such treatment is specifically covered under Superior Plan 2.
  • Any treatment provided before the commencement of insurance coverage for an Insured Person under this Supplementary Contract.
  • Any treatment provided after the termination of insurance coverage for an Insured Person under this Supplementary Contract.
  • Treatment or services not specified in the Schedule of Dental Benefits.

 

Medical

Will my employees be covered under outpatient medical treatment without Group Basic Medical plan?

No. Group Outpatient Medical is a rider to Group Basic Medical.

Are my employees' specialist visits covered?

To enjoy this benefit, you must have the Group Outpatient Medical cover (rider to Group Basic Medical). The specialist visit must be referred by a GP and the conditions do not fall under the exclusion list for the claim to be admissible.

Can I request to change the limits of the benefits in each plan or terms and conditions of the policy?

No. The terms and conditions as well as the limits are fixed and non-customisable.

How can my employees enjoy the cashless service during their panel General Practitioner (GP) visit?

Your insured employees can simply flash their e-card via the Aviva ClaimConnect mobile app at the clinic counter during their visit. 

Where can we find the list of Panel GP?

Employees can log in to Aviva ClaimConnect mobile app and locate the nearest clinic via the clinic locator from the app.

What are the other cashless services available?

There is only the Panel GP facility, which offers cashless service.

How does the pro-ration factor work under the Group Basic Medical plan?

Pro-ration factor means the percentage stated in the Benefits Schedule applied in the event that the Insured Person is admitted in Private hospital when entitled to admission to Singapore Government/Restructured Hospitals under this Policy. The percentage is applied on the hospital bill incurred and the bill is reduced to the Singapore Government Restructured Hospital equivalent.

Does the medical coverage includes a co-insurance?

Yes. There is a 20% co-insurance under the Group Major Medical, there is no co-insurance for the rest of the medical products.

Group Dental

Can I only purchase Group Dental rider?

No. Group Dental is a rider to Group Basic Medical plan.

Can my employees visit their preferred dentist and seek reimbursement from Aviva?

No. We recommend your insured employees to visit the dentists registered under our panel. You may find the list of panel dental clinics here.

If I am buying for my employees and their family members, the annual limit is applicable on per insured basis or per family basis?

The annual limit is applicable on per insured basis.

Premium Rates

How is the premium charged or refunded for employees who join or leave midway during the policy period?

­­­­­New hires: We will charge the additional premium by the number of days starting from the effective date of coverage to the end of the policy period.

Leavers: We will refund the excess premium by the number of days beginning from the effective date of termination to the end of the policy period. 

Underwriting

Is underwriting required for group policies?

When the sum assured exceed S$150,000 for Group Term Life and Group Living Care, underwriting will be required.

What is the usual requirement for underwriting?

The requirement includes but not restricted to the following:

  • Completion of Health Declaration Form dated  within three months from the submission date.
  • Medical examinations requested by Aviva. 
  • Questionnaires of medical conditions to be declared.

Can my insured employee use the report of his/her health screening to replace medical examination?

Yes. As long as the health screening was done within six months from the submission date.

In an unfortunate event that my employee pass away during the underwriting period, how will the death benefit be paid out?

Your employee will be covered at a sum of S$150,000 or the last accepted sum assured, whichever is higher.

Does the employee have to pay for the underwriting requirement?

Aviva will pay for the underwriting requirement. For cases when the employee wishes to appeal for declined cases to be accepted, the cost of the underwriting will be borne by the employee.