Hospicare Flexible & Ambucare Flexible (hospitalisation and outpatient cover)

Specifics

1. Hospicare Flexible offers your employees several types of high-quality cover:
   • Hospitalisation: reimbursement of medical costs in the event of hospitalisation (including day care).
   • Outpatient care: reimbursement of outpatient medical care for a period of 1–3 months before and 2–6 months after hospitalisation (provided these costs are linked to the reason for hospital admission).
   • Serious illnesses: reimbursement (with no deductible) of outpatient medical care for 30 serious illnesses, whether or not requiring hospitalisation.
   • Cover abroad: cover and assistance in the event of emergency hospitalisation anywhere in the world.
2. In addition to these four attractive guarantees, you can opt for:
   • Medi-Assistance: a third-party payment system. The principle is straightforward: your employee reports the hospitalisation – ideally in advance – and the hospital bill is paid directly.
   • Delta: a supplementary cover package (reimbursement of certain alternative medicines, fertility treatments, etc.).
3. Depending on your budget, you can choose which guarantees you want to offer and whether or not to apply a deductible. Cover can be extended to the family members of each employee affiliated to the contract.
4. You can supplement Hospicare Flexible with Ambucare Flexible – outpatient insurance that covers all the medical costs arising outside the hospital admission and linked to:
   • Outpatient medical care (consultations, radiology, physiotherapy, etc.);
   • Pharmaceutical products, orthopaedic and optical equipment (medications, bandages, frames, etc.);
   • Dental care and prosthetics (radiography, bridges, crowns, etc.);
   • Paramedical treatments (psychologist, dietician, homeopath, etc.).
5. You pay a premium based on the profile of your population (age, gender, etc.).

Advantages

Employer:

• The premium you pay enjoys beneficial tax and social security treatment: you do not have to pay any social security contributions on the premium. The premium is not, however, deductible as a professional expense.
• Hospicare Flexible and Ambucare Flexible enhance your pay package (motivational HR policy), boosting your staff retention and helping persuade new candidates to join your business.

Employee:

• Your employees are not taxed in any way for the benefit offered by the cover.

Good to know

• If an employee leaves your company, you can help them maintain their healthcare cover on an individual basis, although the premium they will pay will be higher than that of their contract. You are required by law to inform them of this.
• Which risks are not covered? This policy contains a number of exclusions. Medical costs resulting from a ‘serious error’ (e.g. reckless behaviour or the abuse of alcohol, drugs or prescription medicines) are excluded from the cover. Treatments that are not medically necessary, such as cosmetic procedures, contraception and preventive examinations and check-ups are also excluded. General caps and reimbursement rates also apply.
• A contract is concluded for a period of one year, tacitly renewable at the end of every year. The precise scope of the guarantees is set out in the contract conditions. These General Terms and Conditions, together with a premium calculation and an offer contract are available free of charge via the website www.agemployeebenefits.be.
• The insurance contracts are subject to Belgian law.
  In the event of a complaint, please contact the AG Insurance Complaints Department (tel: +32 (0)2 664 02 20, e-mail: customercomplaints@aginsurance.be
  If the proposed solution is not to your satisfaction, your complaint may be submitted to the Insurance Ombudsman (35 Square de Meeûs, 1000 Brussels, tel.: +32 (0)2 547 58 71 – fax: +32 (0)2 547 59 75 – http://www.ombudsman.as

Useful link(s)

AG Employee Benefits website

AG Insurance sa/nv – 53 boulevard Emile Jacqmain, B-1000 Brussels – RPM/RPR Brussels – VAT BE 0404.494.849 – www.aginsurance.be. Accredited insurance company licenced under code number 0079, under the supervision of the National Bank of Belgium, 14 boulevard de Berlaimont, 1000 Brussels.

BNP Paribas Fortis sa/nv, 3 Montagne du Parc, B-1000 Brussels – RPM/RPR Brussels – VAT BE 0403.199.702, registered with the FSMA under n° 25.879A and acting as a contractually appointed insurance agent on behalf of AG Insurance sa/nv.