MediSave Accreditation Instructions on Preparing the Documents Required

for Submission to CPF Board

February 2020

1. Process Flow Chart For Newly Accredited Medical Institutions

Note: If the documents are submitted in order, the average time for a Medical Institution to complete the accreditation process is 40 working days from the date CPF Board receives the full set of documents. The process may take longer should there be delay between steps 2 to 6.

2. CPF Board Contact Details on Accreditation Matters

Contact Details

Telephone 6202 4140

Email Address medclm@cpf.gov.sg

Mailing Address

MediSave and Healthcare Claims DepartmentAttn: DOI TeamCentral Provident Fund Board238B Thomson Road#08-00 Tower B Novena SquareSingapore 307685

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3. Documents required for each Business Entity Types

You may “Ctrl” click the documents required in the table below to bring you to the relevant pages on where information on how to prepare the document may be found.

Business Entity Type Documents required

1. Company (Private Limited)

a. Board Resolution (A1) [Please refer to Pages 4 - 8]

b. Certified True Copy of the Memorandum of Articles and Association (MAA) / Constitution (B1) [Please refer to Page 9 - 10]

c. Bank Forms (D1) [Please refer to Page 12 - 19]

2. Sole Proprietorshipa. Photocopy of NRIC (Front and Back) of the

sole-proprietor.

b. Bank Forms (D1) [ Please refer to Page 12 - 19]

3. Partnership

a. Certified True Copy of Legal Partnership Agreement or Letter Agreement signed by all partners (C1) [Please refer to page 11]

b. Photocopy of NRIC (Front and Back) of all the partners / Photocopy of passport details Certified True Copy and signed by a 3rd Party.

c. Bank Forms (D1) [ Please refer to Page 12 - 19]

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Documents required to be submitted by Private Limited Company

A1 - Board’s Resolution – Preparation Guide

Below is a template of the Board’s Resolution which a Private Limited Company will need to complete and submit to CPFB.

You will need information found in your company’s ACRA BizFile , Memorandum and Articles of Association/Constitution and the MOH License, to help you complete the Board’s Resolution. Each number denotes a key and you may “Ctrl” click the number to bring you to the relevant pages on where the information may be extracted.

A soft copy of the Board Resolution template is also found here.

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Board’s Resolution – Preparation Guide (Cont’)

① <<Private Company Name>>

(Incorporated in Singapore)

DIRECTORS' RESOLUTION IN WRITINGPASSED PURSUANT TO [ *ARTICLE/PARAGRAPH ② <<000>>] OF THE *ARTICLES OF ASSOCIATION/CONSTITUTION

SIGNING OF DEED OF INDEMNITY WITH CENTRAL PROVIDENT FUND BOARD

RESOLVED -

THAT the Company [of business registration number ③ <<2019XXXXXA>>] is the owner of the clinic(s) known as ④ <<Name of Clinic and Address stated in the MOH licence>>.

This resolution is passed to allow the above clinics to participate in the MediSave /MediShield Life Schemes with effect from the accreditation date given by the Ministry of Health.

THAT ⑤ <<Name of one of the authorised Directors to sign>> (Nric No: <<___________>>) and ⑤ <<Name of one of the authorised Directors to sign or Secretary or a witness>> (Nric No: <<___________ >>) (the “Authorised Directors”) be and are hereby authorised to sign and execute on behalf of the Company all relevant documents or instruments required by the CENTRAL PROVIDENT FUND BOARD for the purpose of the Company’s participation in the MediSave Scheme.

THAT the Company does furnish a Deed of Indemnity to the CENTRAL PROVIDENT FUND BOARD for participation in the MediSave scheme, upon all the terms and conditions enumerated in the said Deed of Indemnity.

THAT the Deed of Indemnity shall be signed on behalf of the Company by:a) an Authorised Director and a secretary of the Company*;b) at least 2 Authorised Directors of the Company*; ORc) an Authorised Director in the presence of a witness who attests the signature*.

______________________ Signature <<Name of 1st Director>> (Nric No: <<____>>)

______________________ Signature <<Name of 2nd Director>> (Nric No: <<____>>)*

______________________ Signature <<Name of 3rd Director>> (Nric No: <<____>>)*

Dated: <<Day Month Year>>

*Please delete whichever is not applicable.

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① Name of Company

The information can be obtained from your ACRA BizFile (refer to Company Name).

② Article/Paragraph number of the Memorandum and Articles of Association (MAA) / Constitution

Please refer to the Article number/ paragraph number that states “Resolution in writing by Directors” in your Company’s MAA or Constitution.

For companies with only one director, you should refer to the main article number/ paragraph that states the resolution in writing by directors.

③ Business Registration Number

The information can be obtained from your ACRA BizFile (refer to Registration No).

④ Name of Medical Institution

This is the name of the Medical Institution as stated on the MOH License (refer to the Name of Premises).

⑤ Name and NRIC number of Directors

To appoint at least two authorised directors to sign the Deed of Indemnity. The two directors appointed must be existing directors as stated in your ACRA BizFile.

Alternatively, you may also appoint one authorised director and a secretary (as stated in your ACRA BizFile, or one authorised director and one witness.

⑥ Directors required to sign the Board’s Resolution

Depending on the provisions in your Company’s MAA or Constitution in ②, the Board’s Resolution should be signed by the appropriate number of directors.

If all directors are required to sign the resolution, please ensure that all directors who are stated in the ACRA BizFile signed on the Board’s Resolution.

If a majority of the directors are required to sign the resolution, please ensure than more than 50% of the directors who are stated in the ACRA BizFile signed on the Board’s Resolution.

Number of Directors stated in ACRA BizFile

Majority of Directors required to sign on the Board Resolution

One OneTwo Two

Three TwoFour ThreeFive Three

⑦ The date of the Board’s Resolution signed by the Directors.

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Board’s Resolution – Preparation Guide (Cont’)

- ACRA BizFile

1Board’s Resolution – Preparation Guide (Cont’)

- MOH Licence

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B1 - Certified True Copy of the Company’s Memorandum and Articles of Association (MAA) / Constitution’s Cover Page.

Note: The Director or Secretary of the company in accordance to the ACRA BizFile can Certify True Copy and sign on MAA/Constitution.

Sample as shown below:

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If you do not have the cover pages of the Constitution / MAA, you may provide the first page of your Constitution / MAA.

Sample as shown below:

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B1 – Certified True Copy of the Company’s Memorandum of Articles and Association (MAA) / Constitution’s “Resolution in writing by Directors”.

Sample as shown below:

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C1 – Documents required to be submitted by Partnership

Certified True Copy of Legal Partnership Agreement or Letter Agreement Signed by all partners.

Note: If there is no legal partnership agreement, please provide a letter agreement

Letter of Agreement

Sample as shown below:

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XYZ ClinicBlk 321 Jalan Mango #03-21 Singapore 000321

20 February 2019

Dear CPF Board

RE: Partnership Agreement

This is to inform you that the partnership of XYZ Clinic between Dr Alpha Bravo (NRIC S0123456A) and Dr Charlie Delta (NRIC S9876543B) was forged on 1 January 1998.

Regards

Alpha BravoDr Apha Bravo Dr Charlie DeltaS0123456A S9876543B

Documents required to be submitted by All Business Entities

D1 - Bank Forms Required by CPF Board

You will need to complete a total of THREE bank forms as part of your Medical Institution (MI)’s participation under the MediSave/MediShield Life Schemes. They are as follows:

Name of Bank Form Purpose Form

a. Credit MediSave/MediShield Life payments using Direct Credit Authorisation (DCA)

For CPF Board to credit the payment of approved MediSave and/or MediShield Life claims submitted by the MI into the MI’s bank account.

b. Pay MediSave Refunds, Interest and Fees Using Direct Debit Authorisation (DDA – MediSave Charges)

For CPF Board to debit the MI’s bank account for MediSave refunds, interest and administrative fees (other than financial penalties) owed by the MI

c. Pay Financial Penalty/ Interest Using Direct Debit Authorisation (DDA – Financial Penalty)

For CPF Board to debit the MI’s bank account for administrative financial penalty or interest for the late payment of the penalty imposed on the MI.

The following pages will show you templates of the bank forms to submit. Each number on the template denotes a key and you may “Ctrl” click the number to bring you to the explanation of each field or where the information may be extracted.

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DCA Form - Credit MediSave / MediShield Life payments using Direct Credit Authorisation

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Please refer to the set of guidelines below on how to complete both the DCA and the DDA bank forms.

DCA Form ① Name of Medical Institution

This is the name of the Medical Institution as stated on the MOH License (refer to the Name of Premises).

② CPF Submission No.This is the number you use to transact with CPF Board e.g. making CPF payments, paying foreign worker levies and making any request relating to employer matters.

Note: This is only applicable to Incorporated Business (Pte Ltd) or Society / Co-Operatives/ Partnership/ Limited Liability Partnership.

③ AddressTo fill in the billing address of the MI.

④ Contact No.To provide contact number of the person-in-charge (PIC) of the MI’s application for MediSave accreditation, billing and/or general administrative matters.

⑤ EmailTo provide company email address of the MI and/or its PIC.

⑥ Name (as in Bank Account)The Account Name that is registered with the bank for business transactions.

Note: The name of the bank account for Incorporated Business (Pte Ltd) should be the company’s name (e.g. ABC Dental Pte. Ltd.) and not a personal bank account. For Sole-proprietorship and Partnership, it may be the business owner’s or clinic’s or partners’ name (e.g. Anne Lim).

⑦ Bank NameName of MI’s registered bank.

⑧ SWIFT CodeYou may refer to the list of SWIFT Codes for most banks provided in Annex A.

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⑨ Bank Account No.Bank Account number according to the bank’s record.

⑩ Signature/ Right Thumbprint of Bank Account Holder (s) (as in Bank’s record)Please provide the authorised signatures according to your bank’s records.

⑪ Bank Officer’s Signature and Bank StampYou will need to obtain your bank’s endorsement (i.e. bank officer’s signature and bank’s stamp) before submitting the form to CPF Board.

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DDA Form - Pay MediSave Refunds, Interest and Fees Using Direct Debit Authorisation

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DDA Form - Pay Financial Penalty / Interest

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DDA Forms (For both MediSave Refunds, interest and fees, and financial penalties)

① Name of Medical Institution This is the name of the Medical Institution as stated on the MOH License (refer to the Name of Premises).

② Hospital CodeThis is the first 7 figures of the license number stated on the MOH License (refer to the license number 1234567/XX/XXX)

③ Name (as in Bank Account)The Account Name that is registered with the bank for business transactions.

Note: The name of the bank account for Incorporated Business (Pte Ltd) should be the company’s name (e.g. ABC Dental Pte. Ltd.) and not a personal bank account. For Sole-proprietorship and Partnership, it may be the business owner’s or clinic’s or partners’ name (e.g. Anne Lim).

④ Bank’s NameName of MI’s registered bank.

⑤ Bank Account No.To provide the Bank Account number according to the bank’s record.

⑥ Contact numberTo provide the contact number of the person-in-charge (PIC) of the MI’s application for MediSave accreditation, billing and/or general administrative matters.

⑦ EmailTo provide the company email address of the MI and/or its PIC.

⑧ Signature/ Thumbprint (as in Bank’s record) Please provide the authorised signatures according to your bank’s records.

Bank Name and SWIFT Codes

Bank Name SWIFT Code

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DBS/ POSB DBSSSGSGBank of China BKCHSGSG

Barclays Bank PLC BARCSGSGCIMB Bank Singapore CIBBSGSG

Citibank CITISGSGGCBDeutsche Bank DEUTSGSGCUS

HSBC HSBCSGS2Maybank MBBESGSG

OCBC OCBCSGSGRHB RHBBSGSG

Standard Chartered Bank SCBLSGSGState Bank of India SBINSGSG

UOB UOVBSGSG

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