PROTECTION

AIA DENTAL PPO-PLUS

Giving you and your employees a reason to smile AIA Dental PPO-Plus is a comprehensive and low cost group dental care plan – the perfect gift for your employees.

AIA.COM.SG

Giving you and your employees a reason to smile It is never too late to radiate your work environment with smiles of truly happy employees. Let sincere, confident smiles welcome your clients every day and give your corporate image the boost it needs. Now for a mere 60 cents a day for each employee, you are able to offer your entire organization the joy of cost-free dental visits. Give your employees an added incentive to work…and to smile their loveliest, literally. Brought to you by AIA, AIA Dental PPO-Plus is a comprehensive and low cost group dental care plan – the perfect gift for your employees.

Why AIA Dental PPO-PLUS? The following illustration provides you with an indication of how AIA Dental PPO-Plus works. Typical Annual Charges for Basic Dental Care* Consultation Charges (Per Visit)

.........................................................

S$55 – $99

Filings (Each)

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S$45 – $100

Extractions (Each)

.........................................................

S$40 – $60

Scaling & Polishing (Twice A Year)

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S$80 – $180

Fluoride Treatment (Twice A Year)

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S$40 – $80

Total charges for Basic Dental Care .........................................................

S$260 – $519

Annual Premium For AIA Dental PPO-Plus

S$218 (w/o GST)

Net savings per employee

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S$42 – $301

* This illustration is based on the assumption of annual dental care required by a typical individual visiting AIA panel of dentists. The market rates indicated are also based on an approximate range of charges.

The savings described are derived from basic dental procedures and exclude possible surgical procedures like wisdom tooth operations and root canal treatments. We all know that costs for such procedures can be exorbitant. With AIA Dental PPO-Plus, during visits to AIA's panel of dentists, your employees may get to enjoy the services absolutely Free of Charge.

AIA Dental PPO-PLUS at a glance •

Low Premium Rate Of Less Than $0.60 Per Employee Per Day.

•

Reduced / Zero Administrative Costs For Your Organisation – Dental Claims Etc.

•

Hassle-free Application – One Premium Rate With No Checkups Required.

Excellent Tool To:

Comprehensive Dental Coverage:

•

Enhance Organisation’s Image.

•

Fillings

•

Root Canal Treatments

Complete Employee’s Remuneration

•

Simple and Surgical Extractions

•

Excision Of Tumours

•

Scaling and Polishing

•

Jaw Fractures

•

Fluoride Treatments

•

Wisdom Tooth Extractions

•

Package. •

Monitor Organisation’s Annual Dental Expenditure.

Conditions For AIA Dental PPO-PLUS Voluntary participation is not allowed. The minimum group size is 11 insured members.

And More…

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More reasons to smile A Limitless And Cashless Experience It may sound too good to be true, but your employees get to decide how many trips to the dentist they want to make in one policy year. Every visit is cashless up to the Schedule of Allowances, if they visit our panel dentists strategically located islandwide. This translates to reduced administrative costs for your organisation. What’s more, there are no annual claim limits for dental benefits. Wholesome Dental Care Be it a routine scaling and polishing, surgical extraction or even a jaw fracture, AIA Dental PPO-Plus offers an extensive list of covered dental procedures, right down to the initial tooth examination and X-rays. Even for non-covered dental procedures, your employees will still get to enjoy substantial savings of 10 – 35 % discount from our panel of dentists. A World Of Convenience, Anytime 24 hours a day, anywhere in the world, your employees are covered by AIA Dental PPO-Plus. In Singapore, our panel of 60 dental clinics are conveniently located near town centres and MRT stations. Anyone, Everyone This dental plan is open to all employees, even those with pre-existing dental conditions. Coverage can also be extended to the immediate family members of your employees. Hassle-free, Always There are no claims procedures when your employees visit our panel dentists – your administrative work is reduced. Savings Every Way! As a group policy, economies of scale are generated, thereby reducing dental expenditure and bringing more savings to everyone! Your employees receive a comprehensive dental care package for a mere annual premium of S$218.00 (w/o GST) per insured.

Frequently asked questions Is there any geographical restriction? There is no geographical restriction on the coverage, whether in Singapore or other countries. AIA Dental PPO-Plus also does not have any restriction on nationality. Will there be any pre-existing exclusion? All employees can enrol for the plan, even if they have pre-existing dental problems. Can I include my dependants? Yes you can, it will be based on the same premium rate. Is there any restriction on the number of visits? There is no restriction on the number of dental visits in any one policy year. What happens if I do not visit a member clinic from the AIA panel of dentists? You will still be reimbursed for your dental visits. The reimbursement will be based on the Schedule of Allowances.

Affordable rates and simple procedures... there’s never a better time to keep those pearly whites sparkling

Schedule of Allowances Benefit

Schedule of Allowances

Examination Initial (no more than one in every six consecutive months)

15.00

X-ray Intraoral Bitewing Panorex

12.00 12.00 32.00

Test & Laboratory Biopsy & examination of tissue

48.00

Prophylaxis (Cleaning, Polishing, Scaling And Flouride Treatment) Routine Complex

40.00 60.00

Filing (Silver) - For Posterior Teeth Only Amalgam – one surface Amalgam – two surfaces Amalgam – three or more surfaces Reinforced Pin

16.00 24.00 32.00 9.00

Filing (Tooth-coloured Material) One surface Two surfaces Three or more surfaces

30.00 40.00 50.00

Pulpotomy Pulpotomy Pulp cap

40.00 20.00

Root Canal Treatment Single root canal filing Double root canal filing Three or more canals

150.00 220.00 350.00

Extractions Routine (simple) - each tooth

30.00

Surgical Extractions Erupted tooth or root Soft tissue impaction Part bony impaction Completely bony impaction

120.00 160.00 250.00 320.00

Alveoplasty Per quadrant, in connection with extractions Per quadrant, not in connection with extractions Complete alveoplasty involving more than one quadrant

30.00 42.00 160.00

Excision Of Tumour Excision of Tumour

76.00

Fracture Of Jaw Simple Compound

500.00 600.00

Repair Of Prosthetic Appliance Repair of broken, complete or partial denture Repair of denture and replace broken tooth Adding tooth to partial denture to replace extracted tooth Adding tooth to partial denture plus clasp

20.00 40.00 27.00 54.00

Space Maintainers Fixed band type (uni or bilateral) Removal in acrylic (uni or bilateral)

135.00 67.00

Annual Premium Rates

per insured: 218.00 Amounts are in SGD before GST

Notes: • We reserve the right to modify/withdraw our quotation if there is any material change in underwriting information. • GST is not reimbursable. • Duration of coverage is for 1 year, renewable annually. • Period of validity is 60 days from date proposed. • Free look is not applicable. • Premium rates are not guaranteed and may be increased at the full discretion of the Company.

• • • • • •

Renewals are not guaranteed. This programme can be sold as a standalone. Minimum group size of 11 employees. Medicine is not included under this scheme. Voluntary participation is not allowed. The above rates are subjected to 7% GST.

Important Notes 1. This insurance plan is underwritten by American International Assurance Company, Limited (AIA) and all applications are subject to AIA's acceptance. 2. This brochure is not a contract of insurance. The precise terms and conditions of the plan are specified in the policy contract. 3. Premium rates are not guaranteed and may be increased at policy renewal at the full discretion of the Company. 4. Information is correct as at 1st September 2008.

AIA DENTAL PPO-PLUS Please type/write clearly in CAPITAL letters. Please read terms & conditions carefully. Please tick ( ) in boxes 

Application Form Important Notices 1.

Statement pursuant to the Insurance Act or any amendments thereof: You are to disclose in this Form, fully and faithfully, all the facts that you know or ought to know, otherwise, the policy issued may be void and you may receive nothing from the policy.

2.

Neither the brochure nor the Application Form is a contract of insurance. However, your warranties, declarations and disclosures therein and herein shall form the basis of the Policy. The specific terms, conditions and exclusions applicable to the insurance are set out in the Policy, a copy of which is available upon request.

Commencement Of Insurance Coverage Effective Date _______________________________ For New Employees  date of employment _______________________________________  date of confirmation with a probationary period of:  1 month  3 months  6 months Dependent’s Coverage

 Yes

 No

Remarks _____________________________________________________________

Payment Details By cheque to: American International Assurance Company, Limited Bank / Cheque No. _______________________________ Amount S$ ____________________________________________________ Company Particulars Name of Company (herein the policyholder) ________________________________________________________________________ Nature of Business ____________________________________________________________________________________________ Addresss ______________________________________________________________ Postal Code ___________________________ Authorized Person in Charge ____________________________________________________________________________________ Office / Fax No. ________________________________ Email Address ___________________________________________________ The Policyholder / Applicant hereby agrees: 1.

To furnish all information regarding each Insured Member / Dependent required by AIA for the purpose of calculating premiums or benefits.

2.

That the statements in the employee data form and enrolment form, the information received by AIA as to the employee’s subsequent changes in Class shall form a part of this application, and shall be the basis for the underwriting thereof.

3.

All individuals, for whom application for insurance is submitted, or maybe submitted during the continuance of the policies, shall be full-timed salaried employees working for the applicant.

4.

After effective date of the policy, the applicant shall notify AIA by written notice in the current month of additions and termination of the employees, and such shall be effective with immediate effect unless otherwise stated. Changes of plan or insurance amount shall be effective only on policy anniversary and may be subject to satisfactory evidence of insurability as required by AIA.

5.

The policy shall not take effect until it has been delivered and first premium has been paid to AIA. If there is any untruth in furnishing the application or other statement in connection with the insurance on the employees, AIA has the right to reject all indemnity filed by the Policyholder / Applicant.

6.

That AIA may and is hereby authorised to use and disclose any information collected or held (contained in this application or otherwise attached) to enable AIA, its associated individuals / organisations or independent third parties, within or outside Singapore, with regard to any matters pertaining to the Application / Policy including but not limited to processing this application and providing subsequent services to the Policyholder / Applicant / Insured Member / Dependent and to provide advice or information concerning products or services which AIA believes it may be of interest to the Policyholder / Applicant / Insured Member / Dependent or to communicate with any one of them for any purpose. The Policyholder / Applicant shall and shall procure that the Insured Member and Dependent shall, provide their respective consent for AIA to carry out all such disclosures and hereby specifically waives their respective right to bring a claim of any nature against AIA in respect of any abovementioned disclosure or any disclosure in the nature of disclosure described above. ____________________________________ Authorized Signatory & Company Stamp

____________________________ NRIC No.

____________________________ Designation

AIA Financial Service Consultant (FSC) / Broker’s Details  FSC DETAILS Name of FSC ______________________________________________

 BROKER’S DETAILS Name of Broker __________________________________

Name of Agency - SP ________________________________________

Broking House ___________________________________

Agency Code _______________ Agent Code _____________________ FSC Location  Alexandra# ___________  Changi# _____________  Tampines# ____________  Tanjong Pagar# __________

_________________________________

______________________

_________________________________________

Signature of FSC

HP of FSC

Signature of Broker

For Official Use Policy Number

Approval

Corporate Solutions 1 Robinson Road, AIA Tower, #11-00, Singapore 048542 AIA.COM.SG

AIA DENTAL PPO-PLUS Members listing (please complete) Name of company: ____________________________________________ Name of Insured Member / Insured Dependent (same as ID card / Passport)

IM ID

NRIC / Passport Number

Gender

Date of Birth (dd / mm / yy)

M O C E B TO

IM - Insured Member ID - Insured Dependant

Nationality

Date of Employment (dd / mm / yy)

Occupation

D E T PLE

________________________________ Authorized Signatory & Company Stamp