ГРУПОВО ЗДРАВНО ЗАСТРАХОВАНЕ

GROUP HEALTH INSURANCE

The insuring party under the policy is a legal entity (employer).

Usually three or more persons who have similar legal relations with the Insuring party are insured.

The insured persons are the employees – Bulgarian citizens or foreign citizens residing in the country, at the age of 18 to 65 years as at the time of making the insurance.
Members of the family/household of a person insured under a group contract may be insured under the conditions of the insurance contract.

Insurance cover:
The insurance cover is comprised in main and additional insurance packages. Covered medical services and goods are grouped in different clauses: for example such as Standard and Premium, and each clause comprises specific type, scope and amount of medical services and goods:

Main insurance packages (IP):
•  IP Outpatient Medical Care with the following divisions:
o  Outpatient medical care – examinations and consultations; emergency medical care; laboratory and instrumentation (apparatus) tests, including highly specialized tests; manipulations, physical therapy, outpatient surgical operations, preparation for hospitalization, etc.
o  Reimbursement of expenses for medical goods for outpatient medical care: medications, medical consumables, aids, including dioptric glasses and lenses, etc.

• IP Combined Medical Care with the following divisions:
o  Outpatient medical care – examinations and consultations; emergency medical care; laboratory and instrumentation (apparatus) tests, including highly specialized tests; manipulations, physical therapy, outpatient surgical operations, preparation for hospitalization, etc.
o Hospital medical care: hospital stay, examinations and consultations, laboratory and instrumentation (apparatus) tests, manipulations, treatment, including surgical operations, rehabilitation, physical therapy, sanatorium treatment, hospital transport, etc.
o Reimbursement of expenses for medical goods for outpatient medical care: medications, medical consumables, aids, including dioptric glasses and lenses, etc.

Additional insurance packages (IP):
•  IP Health improvement and disease prevention – organized prophylaxis:
The insurance package comprises agreed prophylactic examinations and tests that are provided once and are organized by the Insurer under a schedule in healthcare establishments it has entered into contract with, including in case the performance of such prophylactic examinations is part of the employer’s obligations under the Health and Safety at Work Act.

•  IP Medical services for pregnant, with the following divisions:
o Pregnancy follow-up: registration/ identification of pregnancy, examinations and tests for follow-up of normal and risk pregnancy, medications
o Delivery: hospitalization, choice of team, consumables, medications

•  IP Outpatient dental care:
Prophylactic, therapeutic, surgical, orthopedic dental care, x-ray diagnostics, dental physical therapy, emergency medical care, medication treatment

Conditions for provision/ use of insurance cover:

•  Subscription service (SS) – the insured person visits the respective healthcare establishment the Insurer has entered into contract with, and the Insurer directly pays the healthcare establishment for the expenses for provided medical services.
•  Reimbursement of Expenses (RE) – the insured person pays the expenses for the required medical goods and for used medical services in the healthcare establishment he/she has chosen and then submits a claim to the Insurer for the reimbursement of such expenses.

Insurance amount (limit of liability):
The Insurer’s liability is limited up to the amount of the agreed limits for the respective cover, irrespective of the number of occurred events during the period of the insurance cover and submitted claims.

Insurance premium:
The insurance premium depends on the number of insured persons, selected clause, limit of liability, etc.

Term of validity of the insurance: 1 (one) year.

What are the benefits for your employees?
• Calmness and security
• Medical assistance by 24/7 Call center and insurer’s employees
• Cashless service in healthcare establishments with which the respective Insurer has entered into contract
• Quick solution of your medical problem – no waiting for medical referral
• Option for use discounts for other types of insurances

What are the benefits for you, as an employer?
• Modern social program
• Use of tax relieves under article 208 of the Corporate Income Tax Act;
• Cares for the employees’ health result in quality increase and proper working process, motivation and loyalty of employees.

For further information, please contact us on:
E-mail: vkuncheva@zbkbalkan.com
Telephone: +359 882 447 701

How can we help you?

Contact our chosen office from the CONTACTS page or make an online inquiry.

I am very pleased! I recommend it!

Nikolay Chavdarov
CEO, SPEED UP

There are still honest insurance brokers – this is one of them!

Milen Petrov
ET Milen Petrov, Accountant

Always correct and responsive.

Stefan Popov
Freight forwarder, BORDER SERVICES

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