HEALTHCARE - Is the cost of screening and testing for coronavirus also reimbursed?
If you took out hospitalisation insurance for your employees through AG Employee Benefits, then the cost of these treatments is
reimbursed if they are an essential part of a curative treatment, that is executed by a legally recognised doctor and falls under the regulatory acceptance by the Belgian Social Security.
Preventive screenings – except for colon cancer – do not fall under these conditions and are therefore
not covered by our insurance policies.
UPDATE: The government has given instructions not to charge for COVID-19 screening tests. The cost of such testing will be covered in full by the INAMI/RIZIV.
HEALTHCARE (UPDATE) - Given the extraordinary circumstances, general practitioners may diagnose patients with symptoms of coronavirus infection by telephone. Will these teleconsultations be refunded?
Teleconsultations will temporarily be recognised by the INAMI/RIZIV as a specific type of doctor's appointment. These consultations will be billed directly by the doctor to the patient’s Sickness Fund. As the patient will not be charged any co-payment or additional out-of-pocket expenses, there are no costs to claim back from AG.
HEALTHCARE - What if my employee is put into quarantine because of coronavirus? Is he/she covered by the hospitalisation insurance in that case?
If your employee must spend a certain time in
quarantine because of coronavirus,
without being sick however, these expenses are
not covered by the hospitalisation insurance. The quarantine is preventive and does not involve any hospitalisation. In principle, the cost is borne by the local or Belgian authorities.
If your employee is or becomes sick and he/she must be hospitalised - whether or not in quarantine - , then the hospitalisation insurance will reimburse the hospital expenses.
HEALTHCARE (UPDATE) - Hospitals are postponing admissions for non-life-threatening conditions and operations in order to prioritize care for coronavirus patients. How does this affect refunds for pre-admission outpatient care expenses incurred in connection with these hospitalisations?
If your staff member's scheduled admission has been postponed due to the coronavirus outbreak,
AG will temporarily refund outpatient care expenses incurred in the pre-admission period applicable to the initially scheduled inpatient stay. Outpatient care expenses incurred between the initially scheduled admission and the new admission date will also temporarily be covered. Outpatient care expenses during these periods will be reimbursed in accordance with the above-mentioned conditions, provided that our medical department has already received advance notice of the admission (e.g. via Medi-Assistance).
Sample case: Imagine your staff member's inpatient stay scheduled for 1 April 2020 has been postponed by the hospital to 15 May 2020 due to coronavirus measures. If your hospital plan includes pre-admission coverage for up to one month prior to the scheduled inpatient stay, the plan will refund outpatient care expenses associated with the admission from 1 March 2020 until the new admission date (15 May 2020) set by the hospital.
We do, however, request that your staff member
notifies us as soon as possible of the new admission date set by the hospital.
HEALTHCARE – LIFE/DEATH – GUARANTEED INCOME (UPDATE) - What happens to my insurance cover(s) if my staff member is temporarily unemployed as a result of the coronavirus crisis?
In the event of a temporary layoff, your staff member's employment contract will be suspended. Under normal circumstances, as an employer, you must report the temporary unemployment to AG, and premium payments will then cease.
But circumstances these days can hardly be considered normal. That's why
you don't need to inform us if you have temporarily had to lay staff members off in the wake of the coronavirus (COVID-19) outbreak. This means that your staff members will remain enrolled in the supplementary pension/healthcare/income protection plans that you have taken out for them, and that the
covers provided will remain intact. Premium payments will continue as planned.
Still want to cancel your staff member's covers if s/he has temporarily been laid off? Then send us all the information via the usual channels and add the % career break. Please do so within one month of the start of the temporary unemployment. In this case, we will stop sending out premium notices, and all covers will be cancelled. Keep in mind that if your staff member wants to file a claim against your AG Employee Benefits plan(s) during this period, s/he will not be entitled to a refund or any other form of compensation. Make sure you comply with all formalities and statutory obligations towards your staff member, such as the requirement to offer the opportunity to continue the hospitalisation coverage on an individual basis (Verwilghen Act).
We have come up with this extraordinary measure because this unprecedented situation calls for positive solutions. Together with you, we can
protect your staff members and provide them with much-needed peace of mind. It will also save you and your colleagues valuable time as well as significantly lighten your administrative burden. Note that this measure will be valid until 30 June 2020 and will be further evaluated in the light of the measures taken by the government.
GUARANTEED INCOME - What if my employee cannot work for a longer period of time due to coronavirus? What about his/her pay?
If your employee is sick and/or unable to work for a longer period of time due to coronavirus, he/she is considered
unfit for work.
During the first month of incapacity, the employer pays the employee’s salary.
Afterwards your employee has recourse to the Belgian National Social Security scheme.
- If you took out guaranteed income cover for the employee, AG Employee Benefits will supplement the employee’s pay under the Income Care plan, in addition to the social security contribution.
LIFE/DEATH - What if things do go wrong? Does the Death benefit cover of the group insurance still apply in that case?
In the event of death, the (supplementary) death benefit cover of our occupational benefit plans (supplementary pension second pillar) still applies. The group insurance plans of AG Employee Benefits do not provide for exclusion in the event of death due to a pandemic or epidemic.
If your employee dies due to coronavirus, the death benefit will be paid out to the beneficiary/ies.
Attention: if your employee is sick for a longer period and is no longer paid a salary (incapacity), the premium payments for the group insurance plan are often also stopped after 1 month. In that case, the supplementary death benefit no longer applies unless you took out a Waiver of Premiums benefit for your employees.
Do you have other questions?
Your employee can find a detailed overview of the covers of your insurance plans online in
My Global Benefits.
Do you have a question about the cover of your insurance plans? Besides My Global Benefits, you can always talk to your
usual contact at AG Employee Benefits and/or your broker.
This page will be updated if there are new relevant developments about the coronavirus outbreak.