Family Crises Health Plan for the Presented by PSG Konsult
Covers principal, spouse and all children Funeral Cover Covers principal, spouse and all children R50 per family per month Travelers Cover Hospital Cover Membership is compulsory for all Contract Cleaners This is not a medical aid! HIV Cover Emergency Transport
Contribution The monthly contribution is R50 per family per month Subsidy = 2.5% of salary with the balance subsidised by the employer 4 Month Maternity waiver No contributions = no cover
Family Eligible spouse means the spouse of the principal insured person Where a person shares an abode with a principal insured person and has done so for six months and live together in the manner of a legally married couple the person shall be regarded as a spouse Eligible child means any child including a legally adopted or step child including any child that is fully dependant on the principal insured person who has not attained the age of 21 (25 if unmarried and studying full time) No age restriction for children who are mentally or physically handicapped and fully dependant on the principal member
Hospital Cover Pays R100 per 24 hour admission in hospital Pays R150 per 24 hour admission in ICU Pays R200 per 24 hour admission in hospital where more than one family member is hospitalised for the same incident Sub-limit of R5 000 per member per annum iro TB to a maximum of R25 000 per family per annum
Travelers Cover This plan will provide a lump sum benefit for accidental death as a result of making use of any form of registered public transport, ie taxis, trains, busses and registered vehicles The benefit will be as follows: Principal member and Spouse = R30 000 Eligible child = R12 000
Funeral Cover Upon the death of an eligible member, the following benefit shall be paid upon receipt of all required documentation Member Benefit Principal Member R5 000 Spouse Child 14 - 21 Child 6 - 13 R4 000 Child 0 - 5 R3 000 Stillborn R1 000
HIV Help Line 0860 102 993 In the event of accidental exposure to the HIV Virus, the member will have unlimited free access to the Lifesense Trauma Line which provides 24 hour professional counselling and guidance for Reporting of any incident Obtaining HIV information and advice Advice on how to access AZT and 3TC starter packs, the morning after pill and STD medication Combination anti-retroviral therapy for 28 days (upon the initial Elisa test being negative)
Emergency Medical Transport 084 124 Only via ER24 Only for medical emergencies In certain high crime areas, members will be asked to get to the nearest police station where the ambulance will meet them
How to Claim Contact the PSG Konsult Member Support Unit on 0860 100 296 and request a claim form Submit the claim and all the necessary documentation within 6 months of the incident (claim will not be paid if it is older than 6 months) Death claims will be paid within 2 to 3 working days (upon receipt of all documentation) Hospital claims will be paid within 7 to14 working days (upon receipt of all documentation)
For all queries please contact the PSG Member Support Unit on 0860 100 296 or send your e-mail queries to msu@psgkonsult.co.za