Group Health Benefits

To show you care for your employees and to meet your needs as an employer, we offer tailor-made group health plans and specially designed package plans.

To show you care for your employees and to meet your needs as an employer, we offer tailor-made group health plans and specially designed package plans. To show you care for your employees and to meet your needs as an employer, we offer tailor-made group health plans and specially designed package plans.

To show you care for your employees and to meet your needs as an employer, we offer tailor-made group health plans and specially designed package plans.

Your employees are the key to your success. Show them you care by offering them Sun Life’s group health insurance benefits. We conduct a comprehensive study of your employees’ insurance needs before offering you tailor-made group health insurance plans and specially designed package plans.

Some of the key features of our tailor-made plans are:

  • Client-oriented and tailor-made plans that suit the needs of companies of different sizes, from SME to multinational corporations.
  • Comprehensive hospitalization and out-patient covers
  • Simple application procedure with no proof of health nor underwriting is required under most tailor-made plan settings
  • Easy administration - claims will be paid directly to the employees' designated bank account. Before policy renewal, a detailed claims report will be provided for employers' information
  • Injuries arising from terrorism are covered
  • Complimentary Sun Life Financial Privilege Care Card
  • Quality medical services provided designated medical networks and physicians. Sun Life only partners with reputable medical network and medical services providers with consistent quality reviews
  • All benefits can be extended to your employee's spouse and children at an affordable cost
  • 24-hour worldwide cover

Some of the benefits of our tailor-made plan:

  • Hospitalization and Surgical Expenses Benefit, including room and board, surgical fees and miscellaneous hospitalization expenses
  • Optional Supplementary Major Medical Benefit
  • Out-patient Clinical Expenses Benefit, including doctor's consultation fees, physiotherapy and chiropractic treatment as well as diagnostic X-ray and laboratory tests, which are referred by a general practitioner
  • Optional Maternity Benefit
  • Optional Dental Benefit

Our SunMaster Group Medical Package and ClinicSME Plans are packaged medical insurance plans specially designed for small to medium-sized enterprises with as few as 5 employees.

SunMaster Group Medical Package

Some of the key features of SunMaster Group Medical Package:

  • All-round medical coverage includes hospitalization and surgical expenses, as well as optional major medical benefits and clinical expenses benefits
  • Flexible combination of benefits allowing you to combine your choice of hospitalization and clinical benefits into one tailored package
  • Offer medical card to eligible members for panel doctor clinics and hospitals to save the hassle of claim administration
  • Complimentary China Medpass Service and Worldwide Emergency Assistance Benefit provide additional protection covering overseas travel

ClinicSME Plan

Some of the key features of the ClinicSME Plan:

  • Comprehensive coverage includes general practitioner and specialist out-patient consultations, with additional accidental insurance providing a full range of hospitalization and surgical expenses benefits, a daily hospital cash benefit and accidental death and dismemberment benefits
  • Hassle-free administration - no need to lodge a claim after each clinical consultation
  • One premium rate for all members - no occupational or age loading
  • Complimentary China Medpass Service and Worldwide Emergency Assistance Benefit provide additional protection to cover overseas travel

Downloads Product brochure for Solutions for SME Markets

 SunMaster Group Medical Package

 ClinicSME Plan

Downloads Application form for Solutions for SME Markets

SunMaster Group Medical Package

ClinicSME Plan

Colonoscopy and Gastroscopy Services at Day Surgery Centres

(Applicable to insured employees and their insured dependents (the “Insured”) under Sun Life’s group health insurance tailor-made plans, and SunMaster Group Medical Package Plan)

Sun Life Hong Kong Limited ("Sun Life") has teamed up with UMP Healthcare Group and its healthcare network ("Provider") to provide a convenient process of having colonoscopy and gastroscopy services at day surgery centres. Only a few simple steps, the Insured can receive professional medical services without any pre-authorization required.

For details, please refer to the Guide to Colonoscopy and Gastroscopy Services at Day Surgery Centres.

Worldwide Emergency Service

All insured employees of our group health and group life plans can enjoy coverage when they travel overseas through the 24-hours Worldwide Emergency Assistance Benefit. This comprehensive coverage – provided free of charge for all insured employees of our group health and life plans - includes:

  • medical evacuation and repatriation home after treatment
  • emergency transfer to a hospital
  • pre-paid deposit of up to HK$40,000 for hospital admission (applicable to group health plans only)
  • telephone medical advice, evaluation and referral appointment
  • transportation of essential medicine and medical equipment
  • medical monitoring
  • repatriation of mortal remains/ashes
  • compassionate visit by a family member or designated person
  • return of any unattended dependent children to their home country of residence

All services under the Worldwide Emergency Assistance Benefit are provided by Inter Partner Assistance Hong Kong Limited and are subject to its terms and conditions. This benefit is not guaranteed renewable. Please refer to the Endorsement for more details.

SwissLife Network

The Swiss Life Network is an international association of 50 leading local life insurance companies, known as Network Partners. Operating in over 60 countries worldwide, the Swiss Life Network and its Partners provide international employee benefit solutions for multinational corporations and their subsidiaries in the areas of pensions, risk and long-term savings schemes.
 

Sun Life is the representative insurer and benefits provider of the Swiss Life network. Sun Life already provides employees benefits to a large pool of multinational clients and their employees.

Administration Service Highlights

  • Quote your Group Medical Policy Number in all your correspondence to us.
  • The employee’s Hong Kong Identity Card Number will be used as the certificate/reference number of the member/insured
  • Enroll an employee/dependent within two (2) months upon he or she becomes eligible to join the Group Medical Insurance Plan.
  • Advise us any changes of your employee/dependent records, using appropriate administration form, on a regular basis (i.e. weekly, bi-weekly or monthly).
  • Verify all the invoices and statements and advise us at once whenever discrepancies are found.
  • Send us the premium due within fourteen (14) days upon receipt of our invoice, claim payments may be delayed or suspended if premium due is not settled promptly.
  • Submit all the claims to us, using the appropriate claim forms together with the original receipts, through your Personnel Department or the authorized personnel, on a regular basis (i.e. weekly, bi-weekly or monthly).
  • Collect the shortfall payment within fourteen (14) days upon receipt of the shortfall reminder letter.
  • Quote your Group Medical Policy Number in all your correspondence to us.
  • The employee's Hong Kong Identity Card Number will be used as the certificate/reference number of the member/insured under the Group Medical Policy.
  • Enroll an employee (for both MediSME & ClinicSME) / dependent (for MediSME only) within thirty (30) days upon he or she becomes eligible to join the Group Medical Insurance Plan.
  • Advise us any changes of your employee (for both MediSME & ClinicSME) / dependent (for MediSME only) records, using appropriate administration form, on a regular basis (i.e. weekly, bi-weekly or monthly).
  • Verify all the invoices and statements and advise us at once whenever discrepancies are found.
  • Send us the premium due within fourteen (14) days upon receipt of our invoice, claim payments may be delayed or suspended if premium due is not settled promptly.
  • Submit all the claims to us, using the appropriate claim forms together with the original receipts, through your Personnel Department or the authorized personnel, on a regular basis (i.e. weekly, bi-weekly or monthly).
  • Collect the shortfall payment within fourteen (14) days upon receipt of the shortfall reminder letter.

Health Benefit Claim Procedures

  1. A Group Hospitalization & Surgical Insurance Claim Form should be obtained from Sun Life.
  2. The patient shall advise the surgeon/attending physician to complete Part C of the Claim Form before or after the hospital discharge. However, they should be aware that some surgeon/attending physician may charge a professional fee for the completion of Claim Form if the form is completed after the hospital discharge.
  3. Point 2 can be waived if the staff is confined in the public ward of the Hospitals under Hospital Authority and is provided with a “Discharge Slip (Patient Copy)” with diagnosis after discharge from the hospital. We may request the claimant to provide further medical information for our claim assessment when we deem it necessary.

  1. The staff is required to obtain the Group Clinical Insurance Claim Form and provide the following information to facilitate the claim settlement.
    • HKID Card number
    • Name of Employer (Policyowner) stated on the Group Clinical Insurance Claim Form
  2. For consultation in private clinic or private hospital, the original receipt must show the consultation date, name of patient, amount of expenses, diagnosis, doctor’s stamp and signature.
  3. For consultation in public clinic or public hospital, the Attendance Certificate / Medical Certificate must show the consultation date, name of patient, amount of expenses, diagnosis, doctor’s name and signature. Expenses over the benefit limit have to be borne by the individual staff.

Our Service Standards

We promise to offer comprehensive cover with no-hassle administration, quick claim payments and service standards you can rely on.

Service Service Standards
Quotation for new schemes (standard cases) Within 5 working days

Issue of your policy:

Packaged plans

Tailor-made plans for 50 members or less

Tailor-made plans for more than 50 members

 

Within 5 working days

Within 8 working days

Within 12 working days

Quotation for renewal of your scheme with new proposed benefits

Group health plans

Group life plans

 

Within 3 working days

Within 5 working days

Issue of your renewed policy

Packaged plans

Tailor-made plans for 50 members or less

Tailor-made plans for more than 50 members

 

Within 5 working days

Within 10 working days

Within 13 working days

Medical claims

Out-patient claims

Hospitalization claims

Claims for panel doctors

 

Within 6 working days

Within 10 working days

Within 20 working days

Death and disability claims

Cheque issue after all required documents are received

 

Within 7 working days

The above service standards apply to group life and group health insurance plans and are the target turnaround time that we strive to achieve under normal circumstances. These service standards are subject to change without notice according to the operation rules specified by us from time to time. No representation to that effect is given or intended by Sun Life Financial and we do not accept any liability in any circumstances for any loss suffered from reliance on these service standards.

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