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LICs HEALTH PLUSLICs HEALTH PLUS
ByBy
G N Agarwal, E.D (Actuarial) &G N Agarwal, E.D (Actuarial) &
Appointed ActuaryAppointed Actuary
In Conference of RMs (Mktg) on 7.1.2008In Conference of RMs (Mktg) on 7.1.2008
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AGENDA
Introduction
Policy Fund
Eligibility Conditions
Benefits
Other salient features
Intermediaries Remuneration
Charges Tax opinion
Target Group
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INTRODUCTION
Pure Health Insurance, hence no
mortality cover
A unit-linked product Premium paid will be subject to allocation
charge
Balance credited to Policy Fund Account
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POLICY FUND A UNIT-
LINKED ACCOUNT
Policy Fund Account will be subject to
Health cover charge plus service tax
Policy charge
These charges shall be deducted onmonthly basis
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POLICY FUND A UNIT-
LINKED ACCOUNT (Contd)
Policy fund will be invested as per below
Not less than 50% in Govt. securities/Govt.guaranteed securities & Corporate debt
Not less than 10% & not more than 50% -
Equity
Balance Money Market instruments
Single fund - no choice of funds, no switching
NAV declared daily
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What is the cost?
MINIMUM PREMIUM
single life Rs.5000p.a (or)
6 times the HCB
2 lives Rs.7500p.a (or)
(6 times the HCB of PI +
3 times the HCB of others)
>2 lives Rs.10000p.a (or)
(6 times the HCB of PI +3 times the HCB of others)
WHICHEVER IS HIGHER.
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ELIGIBILITY CONDITIONS
Premium : Max. Premium No limit
Min. Premium (p.a)
Rs.5,000 for single life (6 times the HCB of PI)
- Rs.7,500 for 2 lives (6 times the HCB of PI & 3times the HCB of other insured)
- Rs.10,000 for more than 2 (same as above) -In multiples of Rs.500/-
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ELIGIBILITY CONDITIONS
Age :
Min. entry age : 18 for PI & Spouse (lbd)
3 months for children Max. entry age : 55 for PI & Spouse
17 years for children
Max. cover ceasing age : 65 for PI & Spouse25 for children
Max. premium ceasing age: 65 for PI
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BENEFITS
Following health covers shall be provided
Hospital Cash Benefit (HCB)
Major Surgical Procedures (MSP) Policy fund shall also provide
Domiciliary Treatment benefit (DTB)
Any excess spent on treatment than what isavailable on hospitalisation/surgical procedure
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BENEFITS (Contd) Covers can be taken for
self (Principal Insured (PI))
spouse
dependent children (no ceiling of number)
Any eligible existing spouse/children if not
covered cannot be covered in future
Any subsequent spouse (on marriage/remarriage) or children (on birth/adoption) can
be covered within one year from policy
anniversary
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BENEFITS (Contd)
On death of PI : - Premium stops
- If other lives are there
cover continues if at least,
3 years premiums have been paidotherwise balance in policy fund paid
On death of
other members : No change except
charges for them stop
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BENEFITS (Contd)
Benefits : Hospital Cash Benefit
(HCB) - Min. Rs.250/-Max. Rs.2,500 for PI & Rs.1,500
for others (in multiples of Rs.50)
-For others benefit cannot be
more than that of PI
-In case of ICU double
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BENEFITS (Contd)
HSB (Contd)
Inflation/Increase : 5% p.a. subject to max.
150% of initial benefit
1st year maximum : 18 days which may
include 9 days ICU
Subsequent year max.: 60 days which may
include 30 days ICU
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BENEFITS (Contd)
Maximum life time : 365 days
Waiting period: 180 days except
accident
Exclusions : Usual
Qualified per day: After 2 days every
day or part (4 hrs
or more)
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BENEFITS (Contd)
Max. life time : 3 times of S.AWaiting period : 180 days
Exclusions : Usual
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BENEFITS (Contd)
Domiciliary Treatment Benefit (DTB)
Benefit can be claimed after payment of 3rd
year premium (i.e. after 2 years) Not more than twice in a year
Equal to actual expenses subject to
minimum of Rs.2,500/- at a time
Not more than 50% of policy fund at a time
Leaving at least one annualized premium in
policy fund after payment
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OTHER SALIENT FEATURES Surrender equal to policy fund after
completion of 3 years
Partial withdrawals not allowed
Loan not allowed
Revival within 2 years of first unpaidpremium
Alteration not allowed
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OTHER SALIENT FEATURES Increase in premium permitted
without increase in benefits
Reduction in premium permitted
without reduction in benefits (within
conditions of minima/maxima) Premium holidays permitted subject
to conditions
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INTERMEDIARIES
REMUNERATION Commission to Agents : 10% (+4% Bonus)
in first year
5% thereafter
Commission to Brokers: 15% in first year
5% thereafter
LIC employees : 90% allocation in first
year & 100%
thereafter
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CHARGES
Allocation charge - 30% in F.Y
6% in SYs
Policy Charge - Rs.75/- p.m in FYRs.25/- p.m in SYs
HCB & MSB charges - Competitive rates
Service Tax - Actual (12.36%presently)
Fund Mgt. charges - 1.25% p.a. of unit fund
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TARGET GROUPTARGET GROUP
Young married/unmarried
Income tax payers
Covered/Not covered under a mediclaimpolicy
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TARGET GROUPTARGET GROUP
Policy provides complete health solution for the
family with/without mediclaim
Along with mediclaim, one may opt for lower
HCB/HSB so that maximum amount goes inpolicy fund from which expenses for DTB may
be claimed as and when needed.
If one is already covered under mediclaim, then
also the policy shall provide Benefit which will
take care of additional expenses incurred by the
family for which no bills might be available
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TAX OPINION
Premium paid under the policy shall
qualify for 80D
Benefits received under HCB, MSB andDTB not taxable
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T H A N K Y O U
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