Companies who want to offer this category of employees suplementary heqalth care insurance have the following options to choose from.
These are the most popular options which are ususlly chosen by the employer:
- options F and F3 ( reserved for single individuals ) which guarantees hospitalization reimbursement, diagnostic testing therapy and preventive dental care;
- options G and G+ (reserved for single individuals ) and H, extend coverage over the above services to include specialist medical visits, home care, diagnostic testing, lab anaylsis, conservative dental care.
PREVIDIR also offers a number of additional options for those enmployers who have over 100 employees.
For Middle Management, there are also formulas available for employees where the National Labor Contract “CCNL” regarding service industries,distribution companies, and services offers some benefits for thoee employees enrolled in the QUAS program .As supplementary healthcare insurance over QUAS, coverage may be extended to the family memvbrs of the insured . In this case, there are 11 options from which the individual may choose from.
For those employees who do not participate in any labor contractual fund, full coverage options are also available, to include the employee and the relative family members. Also in this case, the individual may choose one of the 11 options available for “options regarding full coverage“.
When granting these benefits to employees, it is advisable to take advantage of the appropriate regulation directive (unilateral employer’s act) or company agreement provided for under article 51, 2nd paragraph, (a) of the Italian DPR issued on 22/12/ 1986 n, 917 (TUIR) known as the Italian Tax Directive , allowing for the tax deductibility up to a maximum limit of EURO 3,615.20.
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Non domicilied family members
Insureds participating in these programs have the option to include their nion resident dependent family members in this supplementary medical program , when choosing one of these options described in the relative prospectus.
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Increased hospitalization amounts insured: € 5.000.000
When an insured is interested in increasing these amounts insured for hospitalization, the request may only be presented at the beginning of the enrollment period. Coverage become operative once the primary limits of coverage have been consumed.
It is also possible to extend this limit to family members who are not dependent only if the principal member is to benefit.
Compensation for the share of the excess expenditure over the primary choice for coverage shall always be made in a refund, after having exceeded the limits of the first option for limits of coverage chosen by the insured.
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Service reimbursements for health benefits in extra insurance form
Direct reimbursements managed by PREVIDIR for the following services may be activated at the beginning of each insurance period:
- medication/pharma costs, fisiotherapy, lens, eyeglasses, specialist visits, dental care; hospitalization
This option is binding for the entire policy period.
Alternative solutions / options with different limits can be evaluated on an individual basis , when regulated by an employer’s Corporate contract, agreement, regulation. These limits , which can be combined and cancel any edecuctibles and / or overdrafts can be activated at the request of the policy holder and shall require an up front payment to be paid to the fund within three months of the renewal or first registration date to which a contributuion for management must be included.
By April, after having received the payment for the requested modifications, PREVIDIR shall make adjustments at the company level equal to the differencebetween what is anticipated and what has actually been paid, within the limits of the chosen limits of coverage, having deducted the contribution for the relative operating expenses.
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How to request reimbursements
QUAS employees: If the employer has selected a supplementary healthcare plan, the employee must first submit his claim to the QUAS fund which shall release a copy of the health / medical documents and medical invoices indicating the amounts reimbusred to the insured . Once defined with QUAS , the employee needs to forward to PREVIDIR the documentation for the additional reimbursement directly to the employee, less any deductibles or overdrafts which may apply.
In all other cases, refunds shall follow the reimbursement procedures indicated in the claims handling area of the PREVIDIR website.
