Employee Benefit Manual

1 Employee Benefit Manual 2021-2022 Employee Benefits Manual Medical InsuranceUST Medical InsuranceThis Manual has details of insurance coverage to UST employees and dependents for expenses related to hospitalization due to illness, disease or Manual covers the following: What s New/Enhanced this year Employee and Dependents Coverage Details For Employee Base Policy Maternity Benefits For Employee Base Policy Top Up Employee PolicyWhat s New/Enhanced Employee and Dependents Co-Payreductionby5%forallcategories HomecaretreatmentpackageforCOVID UptoINR5,000permemberandINR10,000perfami ly. ZeroCo-PayforCOVID claims ICUchargescoverdoubledforCOVID hospitalisation IntroducedNon-MedicalExpense(NME)coverag eforCOVID hospitalisationuptoINR40,000perfamily RoomRenteligibilityforemployeesincreased to150%forthosewhoavailTopUpof10 LakhINRatSubsidisedPremiumofINR3406+Taxe s EnhanceyourFamilyPolicyupto24 LakhsSIwithsubsidisedpremiumfromrangingf romINR1175toINR7635 IntroducedNewTopUpoptionsof15 Lakhand20 Lakhforemployees Ambulanceservicesenhanced:INR5,000/event ;COVID-19ambulanceupto10,000perfamilyCov erage Details For Employee Base PolicyPolicy ParameterInsurerThe New India Assurance Company LimitedTPAMedi Assist Insurance TPA Pvt.

2 Start Date31stMay 2021 Policy End Date30thMay 2022 Coverage TypeFamily Floater (1+4) - Employee , Spouse, 3 Dependent ChildrenSum InsuredINR 4 Lac FloaterMaximum no of Members insured in a family1 + 4 EmployeeYesSpouseYesChildren Yes SiblingsNoOthersNoMid Term enrollment of existing DependentsDisallowedMid Term enrollment of new joiners (New employees +their Dependents)AllowedMid term enrollment of new dependents (Spouse/Children)AllowedNote: New born and Newly married spouse should be added in the Medibuddy portal within 30 days of event. Death of any dependent should be informed within 30 days to deactivate from portal Mid-term addition/deletion of Top-up for Employee and parents policy are disallowedCoverage Details For Employee Base PolicyBenefits / Extensions CoverageDomiciliary HospitalizationNot CoveredPre-Post Hospitalization days and 60 daysPre and Post Natal IPD cover of 10,000 & OPD cover of 5,000.

3 OPD payable only if medically recommended by a gynecologist in a registered hospitalWell Baby ExpensesWithin maternity limitRoom Rent Capping including boarding and nursing expenses, DMO/RMO chargesNormal INR 4,000/-for Kerala and 5,000/-for rest of the states. ICU is INR 8,000/ per day. In case of Covid, ICU limit is INR 16,000/-per dayCopay 5% Co-pay for Employee ; 10% Co-pay for spouse & child on all claims. In case of Covid, no co-pay applicableBenefits / Extensions CoverageStandard HospitalizationYesTPA servicesYesPre existing diseases YesWaiver on 1styear exclusionYesWaiver on 1st30 days benefits Normal 50k & C-Sec 70 KBaby cover day 1 YesAmbulance ServicesINR 5,000/-per event, Covid Ambulance INR 10,000 per familyExisting Employees + DependentsCommencement Date31stMay 2021 Termination Date30thMay 2022 New joiners + DependentsCommencement DateDate of joiningTermination Date30thMay 2022 New Dependents (Marriage/Birth)

4 Commencement DateDate of eventTermination Date30thMay 2022 Coverage Details For Employee Base PolicyBenefits / Extensions CoverageRoom Rent Limits including boarding and nursing expenses, duty medical officer/resident medical officer chargesNormal INR 4,000/-for Kerala and 5,000/-for rest of the states. ICU is twice the sum insured. If the member is compelled to move to a higher category of room, proportionate clause waiver upto 20,000/-of the proportionate expenses or actuals, whichever is lowerCovid Home Care TreatmentTreatment availed by the Insured Person at home for Covid on positive diagnosis of Covid in a Government authorized diagnostic Centre, which in normal course would require care and treatment at a hospital but is actually taken at home upto a maximum up to 14 days. Per member limit of INR 5,000/-and family limit of INR 10,000.

5 Applicable for all employees and dependentsNME for Covid HospitalizationNME shall be payable upto a maximum of INR 40,000/-per member Emergency care for employeeCoverage of OPD treatment/emergency care if the Employee falls sick during the workplace (Annual limit of 2,000/-per Employee )Genetic TreatmentCovered upto 50% of sum insured, hospitalization is mandatorySleep ApneaCovered with 50% copay, machine cost shall not be coveredBiodegradable StentCovered under hospitalizationKidney TransplantDonor expenses coveredCochlear ImplantCovered with 50% copaySurrogacy CoverCovered upto maternity sum insuredMedical Termination of pregnancyCovered upto 10k over and above maternity limit, medically certified by gynecologistCoverage Details For Employee Base PolicyBenefits / Extensions CoverageLife Threatening CasesLife threatening cases for Maternity claims coverage upto family sum insuredCancer BenefitFirst Time Cancer Detection.

6 In addition to the current Benefit of INR 25,000 Employees can avail for the treatment in the subsequent year policy for INR 25,000 , Benefit can be claimed only once in a year and maximum twice in two years. (This extension is not given for Dependents, they are eligible for First Time Detection Cover of )HIV TreatmentHIV Disease Covered Up to INR 100,000 Infertility TreatmentInfertility coverage upto INR. 50,000 on IPD basis onlyStem Cell TreatmentStem Cell covered upto INR. 50,000 per family, Applicable on IPD basis onlyPsychiatric TreatmentPsychiatric & Psychosomatic disorders covered upto INR. 50,000 on IPD basis only, Applicable only for EmployeesAyurvedic TreatmentINR 50,000 on registered Ayurvedic Hospitals on admission onlyCoverage for SiblingsMentally physically challenged siblings are covered under the policyPower CorrectionVision correction cover +/-7 power correction done by Lasik surgery is coveredBariatric SurgeryBARIATRIC surgery for age less than 35 years is covered under the policy.

7 Limit upto family sum insured. Only for those employees whose body mass index is over 35. Not applicable to ChemotherapyOral Chemo Covered upto INR 50,000 including Hormonal Therapy. Applicable only for EmployeesCongenital ExternalExternal Congenital 10% of the sum insured ,000/-per family for a maximum of 50 families per policy period (over and above the sum insured)Maternity Benefits For Employee Base PolicyBenefit DetailsBenefit AmountINR50kForNormal&INR70kForC-section Restriction on no of childrenMaximum of 2 children9 Months waiting periodWaived offPre and Post NatalIPD cover of ,000 and OPD cover restricted to ,000 only per family. OPD Scan payable only if medically recommended by gynecologist in a registered hospitalWell Baby ExpensesWithin maternity limit These benefits are admissible in case of hospitalization in India. Covers first two children only. Those who already have two or more living children will not be eligible for this Benefit .

8 Expenses incurred in connection with voluntary medical termination of pregnancy during the first 12 weeks from the date of conception are not Up Employee Policy The sum insured is INR 1 Lac, 2 Lacs, 3 Lacs, 6 Lacs, 10 Lacs, 15 Lacs & 20 Lacs for Employee , Spouse & Children The top up plan is placed with the same insurer and TPA who underwrites the Group Medical Policy for operational efficiency Nomination for top up policy is done once a year & not in between the policy period except for the new joiners When the main medical plan sum insured is exhausted, only then the top up plan pays for the claim (amount over and above it). The top up sum insured could be utilized for ailments, except for MaternityEmployee Top Up Premium Chart (2021-22)Additional Sum InsuredPremium (Exclusive of GST)INR 1,00,000 INR1,175 INR 2,00,000 INR 1,762 INR 3,00,000 INR 2,056 INR 6,00,000 INR 2,545 INR 10,00,000 INR 3,406 INR 15,00,000 INR 6,069 INR 20,00,000 INR 7,635 Kindly note that the room rent limit shall be enhanced by of your base policy limit if you opt for 10 lac, 15 lac or 20 laccoverVoluntary Parental PlanUST Voluntary Medical InsuranceThis Manual has details of voluntary insurance coverage to UST Employee s Parents and Parents-In-Law for expenses related to hospitalization due to illness, disease or Manual covers the following.

9 What s New/Enhanced this year Parents / Parents In Law Coverage Details For Parental Base Policy & Premium Rates Parental Top Up PolicyWhat s New/Enhanced this year Co-Pay reduction by 5% Home care treatment package for COVID Up to INR 5,000 per member Non-Medical Expense (NME) coveragefor COVID hospitalisation up to INR 7,500 per parent Reduced Co-Pay limits Increase in Room Rent eligibility Reduced Top Up Premiums Ambulance services enhanced:INR 5,000/ event; COVID-19 ambulance up to 10,000 per familyCoverage Details For Parents Base PolicyPolicy ParameterInsurerThe New India Assurance Company LimitedTPAMedi Assist Insurance TPA Pvt. Start Date31stMay 2021 Policy End Date30thMay 2022 Coverage TypeDependent Parents / Dependent Parent In LawsSum InsuredOption of 2 lacs, 3 lacs & 4 lacsParental BasePremium Chart (PremiumExcl GST)Sum Insured31-3535-4041-4546-5051-5556-6061- 6566 & AboveINR 2,00,0003,7123,7124,6386,5257,5218,5309, 71310,754 INR 3,00,0005,1805,1806,4659,28810,74912,226 14,00415,705 INR 4,00,0006,4596,4598,79911,84014,98915,65 417,97819,971 Coverage Details For Parents Base PolicyBenefits / Extensions CoverageCovid Home CareCovid Home Care Upto INR 5,000 per member (Only on reimbursement mode.)

10 On submission of proper doctor recommendation & prescriptions along with all proper bills) Room Rent Capping including boarding and nursing expenses, duty medical officer/resident medical officer ,000andmaximumofINR5, ,000andmaximumofINR5, ,ifnowopttoCoverParentinlawsalso-Copayap plicablewillbe15% ,ifnowopttoCoverParentsalso-Copayapplica blewillbe15% ' / Extensions CoverageStandard HospitalizationYesTPA servicesYesPre existing diseases YesWaiver on 1styear exclusionYesWaiver on 1st30 days Limit24,000/-per eyeAmbulance ServicesINR 5,000/-per event, Covid Ambulance upto INR 10,000/-per familyExisting Employees + DependentsCommencement Date31stMay 2021 Termination Date30thMay 2022Co Pay & Proportionate ClauseWhat is co-pay? How does it work? Co-payment is the portion of the claim which associates needs to bear and remaining balance would be paid by the insurance company A co-pay of 15% shall be applicable on the differential claim amount where the aggregate of all admissible claims if Employee has covered the parents in previous year policy A co-pay of 20% shall be applicable on the differential claim amount where the aggregate of all admissible claims if Employee has not covered the parents in previous year policyRoom Rent Eligibility Norms & Proportionate DeductionsRoom rent will have an upper limit of of the SUM INSURED and ICU rentals to of the SUM INSURED and applicability ofproportionate clause if higher room rents are opted.