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Coporate Quotation Form

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Plans for Coporate/Teachers
  1. Gold Superior Routine Dental - Highest level of international cover, 100% cover both for in-patient and out-patient, including full health screen, optical and dental
    *Recommended for Top Management staff
  2. Gold + Routine Dental - 100% in-patient cover, and most out-patient treatments, dental is covered but no optical
    *Recommended for Middle Management staff.
  3. Gold - Same as Gold RD but without the dental coverage
    *Recommended for Middle Management staff.
  4. Classic - 100% In-patient and specialist consultations on out-patient basis covered. No cover for family doctor/GP or prescribed drugs and dressing
    *Recommended for Line Management staff
  5. Essential - In-patient cover only.
    *Recommended for Regular staff. 

Please enter estimated headcount of staff under respective plans.
Essential Classic Gold Gold superior
Aged 20 & below
Aged 21-24
Aged 25-29
Aged 30-34
Aged 35-39
Aged 40-44
Aged 45-49
Aged 50-54
Aged 55-59
Aged 60-64
Aged 65-69
Aged 70-74
Aged 75-79
Aged 80 & above
Plans for Oil & Gas Industries
  1. Gold - Highest level of oil cover for both in-patient and out-patient treatment. Cover for family doctor/GP or prescribed drugs and dressing(subject to limits)
    *Recommended for Senior Management staff.
  2. Classic - 100% In-patient and specialist consultations on out-patient basis covered. No cover for family doctor/GP or prescribed drugs and dressing
    *Recommended for Line Management staff
  3. Essential - In-patient cover only.
    *Recommended for Regular staff. 

Please enter estimated headcount of staff under respective plans.

Gold Essential Classic
Aged 0-20
Aged 21-64
Aged 65+
Include Routine dental ?
* Select "Yes" if you would like us to include routine dental into your quotation.
Annual Optional Assistance Cover
Under aged 21 Over aged 21
Evacuation
Repatriation
Plans for Maritime
Please enter estimated headcount of staff under respective plans.
0 - 65 years old
Worldwide
Please type in the number of employees included in this plan.
Worldwide excluding USA
Please type in the number of employees included in this plan.
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