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Our mission

At Cigna, we are dedicated to improve the health, well-being, and peace of mind of those we serve.

ABOUT CIGNA CORPORATION

Remarks:1 The above data is for informational purposes only and may not relate to a particular subsidiary of Cigna Corporation. Data is based on Cigna internal reporting as of December 31, 2018 and is subject to change.

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Sales capability in over 30 countries and jurisdiction1

US$49 billion total revenue1

More than 160 million customer relationships1,2

74,000 employees around the world1

More than 1 million relationships with

healthcare providers, clinics and facilities1

Ranked 73rd on the 2018 Fortune

500 list

Named a ‘Caring Company’ for the 16th consecutive year by the Hong

Kong Council of Social Service

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WE UNDERSTAND WHAT YOUR COMPANY NEEDS

Boost your competitive edge to retain talentEffective employees can drive immense business growth, especially for small and medium-sized enterprises (SMEs).

However, intense competition makes good talent hard to retain, especially as employees expect attractive – and

expensive – benefit packages. What SME employers need is a cost-efficient group solution that will allow them to

compete with the market’s top employers and drive better staff retention.

At Cigna, we understand that attracting and retaining good talent is a top priority for SMEs. With an effective

employee benefits package that fully utilizes the company’s budget and administrative capabilities, this can be

achieved.

HOW CAN WE HELP? To help local SMEs attract and retain talent, Cigna SMart Entrepreneur Group Medical Plan is a one-stop group medical package

that can be customized to fit your budget. Your employees receive inpatient and outpatient

protection, as well as a selection of wellness benefits catering to their individual needs,

available through options provided by the employer. Application is simple, with no health

declarations1 required for company with 5 or more full-time employees, while an online

management portal allows members and employers to administer policies anytime,

anywhere.

Note:1. For SMEs with 3 to 4 full time employees, a simple health declaration is required for each applicant, which is subject to approval by Cigna; for SME with 5 or more employees, no health declarations are required.

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HOW CAN YOU AND YOUR EMPLOYEE BENEFITS FROM CIGNA SMART ENTREPRENEUR GROUP MEDICAL PLAN?

Our SMART one-stop group medical package gives you a competitive edge – at an affordable budget. Discover why

SMart Entrepreneur Group Medical Plan is right for you and your employees.

› Simple application No health declarations are required for SMEs with 5 or more full-time employees.

› Simple benefit structure Reimbursement limits for major hospital expenses apply per disability, with no itemized limit

on surgery types, making it easier for you and your employees to understand their coverage.

› Simple administration Employers can manage policies anytime, anywhere, via Cigna’s online portal. With Cigna’s

online portal, the person insured can submit claim inquiries on benefits and chat with our

customer representatives.

› All-rounded protection Inpatient and outpatient needs are both covered under the Basic Benefits, with a range of

plan levels for you to choose from. Optional benefits are also available, rounding out your

employees’ protection even further.

› Reliable claim services All hospitalization and other outpatient claims will be settled within 7 working days after full

documentation is received.

› More coverage Employees and spouses are eligible for special extended coverage to age 691 without the

need for a health re-assessment.

Simple

All-rounded

Reliable

More

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› Tailored budget Customize the plan to fit your budget by choosing from 3 plan levels, 2 reimbursement

percentage options, and a range of optional Wellness Benefit, which the person insured can

opt for according to their needs.

› Tailored benefits Once you enrol in the Wellness Benefit in your policy, the person insured can redeem the

wellness services at appointed QHMS clinics each policy year based on their preference. The

choice of wellness options includes different health check-up plans or Ginseng Tianjiu.

› Tailored assistance If the person insured needs emergency medical attention while traveling, our SOS Worldwide

Emergency Assistance Services provide up to US$1,000,000 towards arranging and paying

for emergency medical evacuation to an appropriate location for medical treatment, or

repatriation to Hong Kong for a serious medical condition.

› Tailored support The Employee Assistance Program (EAP) offers hotline services with professional counselors

that can assist with personal or work-related problems that may impact your employees’

emotional well-being.

Tailored

Remarks:1. Extended coverage is applicable for those who were insured under the policy before attaining the age of 65 and no additional

application is required.2. The Worldwide Emergency Assistance Services and the Employee Assistance Program hotline service are provided by designated service providers appointed by Cigna.

PRODUCT HIGHLIGHTS

No medical underwriting

for 5 full time employees

or above

Wellness benefit

options to suit varying

employee needs

Major hospitalization

reimbursements are limited

per disability, with no itemized

limit, making the cover easy to

understand

Extended cover for

employees and spouses

up to age 69

Employee Assistance

Program (EAP) hotline

5% first year premium discount.

An extra 5% special discount

if more than 10 employees are

covered under the policy

Online portal

for the person

insured’s use

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PLAN AT A GLANCE

PARTICIPATION GUIDELINE• Only employees employed and based in Hong Kong are eligible, and all eligible employees within the company

must participate;

• Employees within the same eligibility group must be enrolled in the same plan level (including in the same Hospital

& Surgical Benefits, Outpatient Benefits level and Optional Wellness Benefit);

• If the dependent cover is selected, all eligible dependents must participate, and they must join the same plan level

as that of the relevant employee (including in the same Hospital & Surgical Benefits, Outpatient Benefits level and

Optional Wellness Benefit).

Basic Benefits › Hospital & Surgical Benefits› Outpatient Benefits

Optional Benefits › Wellness Benefit

Enrollment Age

Employee / Spouse Unmarried children

Age 16-64Age between 15 days to 18 or age 22

for full time students

Maximum Cover Age Age 69 Age 19 or 23 for full time students

Medical Underwriting

Company with 3 to 4 full time employees

Company with 5 or more full time employees

Health declaration is required for underwriting

No medical underwriting

Protection Period 1 year and yearly renewable1

Premium Payment Frequency Annual

Policy Currency HKD

Remarks: 1. Cigna reserves the right of not renewing the policy on any policy anniversary date by giving no less than 1 month’s prior written notice. Cigna also reserves the right to revise the premium and terms of the policy upon renewal.

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BENEFIT SCHEDULE The followings are for reference only. The benefits are payable on ‘Reasonable and Customary’ basis. Please refer to the policy provision for details.

Basic Benefits - Hospital & Surgical Benefits

Area of Cover Worldwide

Accommodation Room Type Ward Semi-Private Standard Private

Plan Level Level 1 Level 2 Level 3

Reimbursement percentage 80%

Plan Level Level 4 Level 5 Level 6

Reimbursement percentage 100%

Benefit Items Maximum Amount per Person Insured (HK$)

(Per disability) › Room & Board (up to 120 days)

› Intensive Care Unit

› Miscellaneous Hospital Expenses

› Inpatient Doctor Visit (up to 120 days)

› Surgical Benefits

(Covers the surgeon fee, anaesthetists fee and operating theatre fee on inpatient and outpatient basis)

› Post-Hospitalization Outpatient Visit

(Covers post-hospitalization follow-up clinic visits within 90 days after discharge from hospital or after the performance of surgery in the Registered Medical Practitioner’s clinic)

$120,000 $250,000 $450,000

Hospital Cash for Hong Kong Government Ward Bed (up to 120 days) $400 / day $800 / day $1,000 / day

Remarks:

1. No benefit will be payable for hospital confinement in VIP suite or deluxe suite.

2. The following adjustment factor will apply if the actual level of accommodation is higher than the entitled level of accommodation:

Entitled Level of Accommodation Actual Level of Accommodation Adjustment Factor

Ward Semi-Private 50%

Ward Standard Private 25%

Semi-Private Standard Private 50%

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Basic Benefits – Outpatient Benefits

Area of Cover Worldwide

Plan Level Level 1 Level 2 Level 3

Reimbursement percentage 80%

Plan Level Level 4 Level 5 Level 6

Reimbursement percentage 100%

Benefit Items Maximum Visits per Policy Year Maximum Amount per Person Insured (HK$)

1. Outpatient Doctor’s Visit (per visit)

30 $150 $250 $330

2. Outpatient Specialist

(per visit) 10 $300 $500 $660

3. Physiotherapist or

Chiropractor (per visit) 5 $250 $350 $400

4. Chinese Herbalist / Chinese Bonesetter / Acupuncture Treatment (per visit)

5 $120 $150 $200

5. Diagnostic Laboratory

Test & X-Ray

(per policy year)

Not applicable $800 $2,000 $3,000

Remarks: Referral letter from Registered Medical Practitioner is required for outpatient specialists, physiotherapists / chiropractor treatment and diagnostic laboratory test and X-ray.

1. Maximum 30 visits per policy year for aggregate number of visits under items 1-4. 2. Items 1 - 4 cover expenses for consultation and treatment incurred, and only one visit per day is entitled to

reimbursement.

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Optional Benefit – Wellness Benefit

Benefit Items Maximum Amount per Person Insured (HK$)

Person Insured can enjoy ONE of the following wellness services at appointed QHMS clinics: › Basic check-up › Male check-up › Female check-up › Ginseng Tianjiu

For details, please refer to the Wellness Benefits Details table below.

Fully covered for any one of the services(once per policy year)

Remarks:

The above services are provided by Quality HealthCare Medical Services Limited. Cigna and relevant service providers reserve the rights to revise the details of the services.

Wellness Benefit Details (HK$):

1. Basic check-up (Original Price: $930) › Physical exam done by doctor › Kidney function: Urinalysis, Serum Creatinine,

Serum Urea › Liver function: SGOT, SGPT, Serum Bilirubin › Diabetes Screening: fasting blood glucose › Blood Lipids: Total Cholesterol, Triglycerides › Chest: X ray › Follow up consultation

2. Male check-up (Original Price: $1,403) › Physical exam done by doctor › PSA › Total cholesterol › HDL,LDL, Triglycerides › Cholesterol/HDL Ratio, Glucose

3. Female check-up (Original Price: $825) › Physical exam done by doctor › Breast exam › Pap smear

4. Ginseng Tianjiu (Original Price: $1,120) › Sanfu Tianjiu on the three specific hottest

days of the year in July and August (maximum 3 visits)

› Sanjiu Tianjiu on the three coldest days of the year in December and January (maximum 3 visits)

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CONVENIENT ONLINE SERVICES

Employees can login to “MyCigna” mobile app or website to access the following information or services:

MessagerMessage Cigna through Live Chat

My PolicyView benefit

information

My ClaimSubmit claim

and check claim

status online

HOW TO GET STARTED

Submit the following completed and signed documents to us:

Application Form

New Employee Enrollment Form

Photocopy of Business Registration

The following list is for reference only and it is not a full list

of exclusions. Please refer to the policy provisions for the

complete list and details of exclusions.

Cigna shall not be liable to pay any claim or expenses

incurred directly or indirectly resulting from or consequent

upon or contributed by the following items:

1. Any sickness or bodily injury for which the Person Insured

has received medical treatment, diagnosis, or prescribed

drugs during the ninety (90) days preceding the effective

date of his coverage (i.e., pre-existing conditions) unless

the Person Insured affected by these conditions has been

insured under this policy continuously for twelve (12)

months.

2. Bodily injuries arising directly or indirectly from riots or

war, declared or undeclared.

3. Routine physical examinations, or health check-ups or

test not incident to treatment or diagnosis of an actual

sickness or bodily injury (this exclusion is not applicable to

Wellness Benefit).

4. (a) Eye refractions, fitting of glasses, contact lenses;

(b) hearing aids; and

(c) gingivitis, any dental or oral care, treatment or

surgery of any nature whatsoever except procedure

necessitated by damage to sound natural teeth as

a result of an accidental injury occurring during the

period of insurance .

5. Bodily injuries due to insanity, self-infliction or participation

in illegal acts or terrorism; conditions related to functional

disorders of the mind or psychiatric disease; rest cure or

sanitaria care (e.g. neurasthenia, anxiety state, anaemia);

treatment of an optional nature (e.g. anorexia, acne); drug

addiction or alcoholism.

6. Congenital conditions.

7. (a) Treatment occasioned by or resulting from pregnancy,

childbirth, miscarriage or abortion.

(b) Treatment relating to birth control, infertility or

sterilization of either sex.

8. Any venereal disease or AIDS disease.

9. Any bodily injury or sickness for which compensation is

payable under any laws or regulations or any other health

insurance policy or scheme except to the extent that such

charges are not reimbursed by such laws or regulations or

other policy or scheme.

10. Not Medically Necessary.

KEY EXCLUSIONS

Notes:

“Cigna”, “the Company”, “We”, “our” or “us” herein refers to Cigna Worldwide General Insurance Company Limited.

This product brochure is also available in Chinese. You may request for the Chinese version from us.此產品小冊子同時備有中文版本，閣下可向本公司索取中文版本。

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Cigna Worldwide General Insurance Company LimitedTel: (852) 2560 1990

www.cigna.com.hk

Issued by Cigna

The above insurance plan is underwritten by Cigna Worldwide General Insurance Company Limited, an authorized insurer to carry on general insurance business in or from Hong Kong. This brochure is intended to be distributed in Hong Kong only and shall not be construed as an offer to sell or a solicitation to buy or provision of any products of Cigna outside Hong Kong. It is designed to provide you with a brief summary of the named insurance plan, its terms, conditions and exclusions, and is not a contract of insurance. You are recommended to seek professional advice from your independent advisors if you find it necessary. For complete details of terms, conditions and exclusions, please refer to the policy provisions. If there is any conflict between the policy provisions and this brochure, the policy provisions shall prevail.

This policy is excluded from the application of the Contracts (Rights of Third Parties) Ordinance (the “Ordinance”). Other than the Company and the policyholder, a person who is not a party to the policy (including, but not limited to, the person insured or the beneficiary) shall have no right under the Ordinance to enforce any term of this policy.

Cigna reserves the right to change any of the details in this brochure. In case of any disputes about the content of this brochure, Cigna’s decision shall be final.

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