Red Flag / Green Flag
(True or False)
(True or False)
TRUE OR FALSE: SME Choice is a box-type, packaged product that Sales can modularize depending on the account's requirement.
True
The Government Worker Healthcare Program is designed for government entities eligible for a ₱_____ allowance.
₱7,000
Which plan has embedded GLI?
A. SME Choice
B. SME Flex
C. SME Lite
D. Government 7K
A. SME Choice
IDENTIFY THE CORRECT STATEMENT:
A. SME Choice is for 1–50 employees
B. SME Choice is for 5–199 employees
B. SME Choice is for 5–199 employees
Who is responsible for uploading the Client Information Sheet (CIS) to SharePoint?
Sales Teams/Channels
TRUE OR FALSE: The Government Worker Healthcare Program (Govt 7K) includes hospitalization, outpatient, preventive, emergency, and dental coverage.
False (no dental coverage)
Dependents must follow the _____ rule when enrolling.
hierarchy rule
SME Flex pricing is:
A. SME Choice base + 10%
B. SME Choice base + 20%
C. SME Choice base + 50%
D. Fixed rate
B. SME Choice base + 20%
IDENTIFY THE CORRECT STATEMENT:
A. SME Flex excludes government agencies
B. SME Flex includes unions
A. SME Flex excludes government agencies
Who must Sales reach out to for product design, specifications, clarifications and all other concerns?
Products Team
TRUE OR FALSE: For CHPA embedding GLI, the lowest MFA amount MediCard can offer is ₱10,000.
False - lowest is ₱20,000.
SME Flex applies an additional _____ % loading on SME Choice base rates.
20%
Which is not a group product?
A. SME Lite
B. Government 7K
C. MediCard H.E.R.O.
D. SME Choice
C. MediCard H.E.R.O.
IDENTIFY THE CORRECT STATEMENT:
A. GLI embed requires AMLA documents
B. GLI embed requires 10 employees minimum
C. GLI embed requires medical exams
D. GLI embed has no separate onboarding documents
D. GLI embed has no separate onboarding documents
Who must Sales escalate to when an account belongs to an ineligible group under SME Choice?
Underwriting (for proper review and evaluation)
TRUE OR FALSE: SME Choice allows upgrading/downgrading of plans anytime during the contract.
False
SME Flex is designed for selected high‑risk industries such as _____, miners, and divers.
Nuclear/chemical/gas/electrical workers
Which of the following is not eligible under Government 7K?
A. University of the Philippines
B. LGU of Bacoor
C. Bureau of Corrections
D. DOST
C. Bureau of Corrections (considered as high-risk)
IDENTIFY THE CORRECT STATEMENT:
A. For SME Choice, eligible employees are regular and full‑time employees of the employer who are actively at work.
B. For SME Choice, probationary, part‑time, and project‑based employees are automatically eligible regardless of employment status.
A. For SME Choice, eligible employees are regular and full‑time employees of the employer who are actively at work.
When a client requests GLI customization for ineligible groups, which team must Sales contact?
Angelo Vidal from AIA CS Team
TRUE OR FALSE:
The choice of enrolling dependents must follow the hierarchy below:
Married Employee: Spouse first must be enrolled followed by the eldest child down to the youngest
Single Employee: Eldest sibling must be enrolled first, followed by parents, then youngest sibling
Single Parent: Parent followed by eldest child
False
Married Employee: Spouse first must be enrolled followed by the eldest child down to the youngest
Single Employee: Parents (anyone ahead of the other) must be enrolled first followed by the eldest sibling down to the youngest
Single Parent: Eldest child must be enrolled first down to the youngest
SME Choice follows the Underwriting cut-off dates:
Date of receipt of application/Endorsement: 11th to 25th of the month, effectivity date is _______.
Date of receipt of application/Endorsement: 26th to 10th of the month, effectivity date is _______.
Date of receipt of application/Endorsement: 11th to 25th of the month, effectivity date is 1st of the following month.
Date of receipt of application/Endorsement: 26th to 10th of the month, 16th of the same month.
For GLI Embed, this team will validate the AIA bill and invoice to be forwarded to MediCard Finance for processing.
A. Underwriting team
B. Actuarial team
C. Sales team
D. No validation needed
C. Sales team
IDENTIFY THE CORRECT STATEMENT:
A. Government 7K has payment first control policy which states that if the account has already paid in full before the effective date, the account will be covered on hospitalization.
B. Government 7K has payment first control policy which states that if the account has already paid in full before the effective date, the account will be covered on all benefits.
B. Government 7K has payment first control policy which states that if the account has already paid in full before the effective date, the account will be covered on all benefits.
If a client requests onboarding documents to be modified or combined differently from the standard CHPA + GLI bundle, who must approve the deviation?
SCAG Team