Group Health Plan: Large Groups
Group Medical Plan for Large Groups
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Products offered by MAPFRE LIFE INSURANCE COMPANY OF PUERTO RICO are designed to meet the highest industry standards and provide peace of mind to our members by having a comprehensive health plan. Our Large Group health plans in Puerto Rico known as Excel, Choice, and Administration Service Only (ASO) adapt to group needs and budget. In addition, the employer can set copays and coinsurance that best adjust to employee needs. For the US Virgin Island territory we have the VIE policy.
Among the benefits that these products offer, are the following:
- Medical expenses: free selection plans with a wide variety of benefits and an extensive network of providers.
MAPFRE’s medical plans Excel, Choice, Administration Service Only (ASO) and VIE allow peace of mind by offering a comprehensive policy that provides coverage to the employee and family, according to the established general terms, conditions and limitations in the policy.
The general terms, conditions and limitations of MAPFRE’s health services informed users which coverage’s they may access, the benefits and additional advantages, as well as the requirements and restrictions established by the Company.
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MAPFRE’s health insurance includes a series of requirements and restrictions that users must be aware of in order to know what coverage’s may be accessed according to the general terms and conditions established in the agreement. Some are:
- Excluded are losses resulting from an insurrection or war, declared or not, any incidental act of said insurrection or war, or participation in any disturbance or civil disobedience.
- Excluded are losses due to cosmetic surgery, unless reconstructive surgery to restore damaged tissue due to sickness, including the reconstruction of mama after a mastectomy, or corporal accident, lesion or surgery to correct a sickness or congenital anomalies, including oral defect of a newborn.
- Excluded are those services that exceed the policy limits established in the general conditions and limitations.
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MAPFRE recommends that all interested in participating in the Excel, Choice, Administration Service Only (ASO) and VIE health insurance coverage pay special attention to the policy’s general terms, conditions and limitations to obtain the maximum benefit under their plan.
Recommendations when using theses medical plans:
- If someone needs orientation or information they can contact the specialized phone operators that are available 24/7.
- It is recommended that members identify the period in which the insurance will remain in force to know when they can access coverage’s under their policy.
- Members should know the different processes established by MAPFRE in order to access certain coverage’s in accordance to the policy’s general terms, conditions and limitations.