Coronavirus and your employee insurance plans - AG Employee Benefits

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Published on 14/04/2021

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Coronavirus (COVID-19): what does this mean for your insurance with AG Employee Benefits?

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​The coronavirus (COVID-19) has hit Europe and has grown into a pandemic. This has already led the Belgian government to take drastic measures. In the meantime, employers have been contacting us with a number of questions about the covers they have with AG Employee Benefits. You'll find an overview of the situation below. 


This page will be updated every time there are new developments about the coronavirus outbreak.​ (latest update: 14/04/2021)


You can reassure your employees: they are properly protected in case of an epidemic or pandemic. And not just by their hospitalisation insurance.​​


COVERAGE ABROAD - What happens to coverage abroad in the various zones (green, orange, red)?

If you have a staff member travelling abroad, s/he will be entitled to coverage in the event of an illness, accident or repatriation.   

It is very important, however, that your staff member strictly complies with all instructions given by the local and Belgian authorities (see https://diplomatie.belgium.be/en), in red zone destinations as well as elsewhere. 

The Belgian federal government further wishes to sensitise travellers to the fact that new COVID-19 outbreaks abroad can significantly impact their travel plans, and that repatriation cannot be guaranteed if commercial flights are cancelled or borders closed. 

At the current time, code red means that travel to a country with this colour code is strongly discouraged by the Belgian federal government, or that the authorities of the country in question prohibit non-essential travel from Belgium or impose restrictions (testing, quarantine, etc.). ​

HOSPITALISATION​ – LIFE​/DEATH – GUARANTEED INCOME - What happens to my insurance cover(s) if my staff member is temporarily unemployed as a result of the coronav​irus 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 insurances (supplementary pension/hospitalisation/outpatient care/guaranteed income/waiver of premiums) that you have taken out for them, and that the covers provided will remain intact until 30 June 2021.

Premium payments will normally​ continue as planned, but as an employer, you have the option to defer premium payments for coronavirus-related furloughed staff members until 30 June 2021​.​



HOSPITALISATION - RETIREMENT/DEATH - GUARANTEED INCOME - What happens to the insurance covers if my employees takes coronavirus parental leave?

Due to the coronavirus outbreak and the resulting school closures, parents with a child under the age of 12 or a disabled child under the age of 21 were entitled to take coronavirus parental leave until 30 September 2020. This measure has not been extended​

AG considers coronavirus parental leave to be the equivalent of ordinary parental leave. This means that the rules for ordinary parental leave also apply to coronavirus parental leave. 

Make sure that you inform your staff member of the consequences this leave may have on his/her insurance covers (retirement, death, hospitalisation, guaranteed income and waiver of premiums).


HEALTHCARE - Does my hospitalisation insurance cover medical expenses related to epidemics or pandemics such as coronavirus (COVID-19)?​

All ​hospitalisation insurance plans of AG Employee Benefits​ reimburse these medical expenses.​ This includes treatments in Belgium or abroad, but only in the event of a hospitalisation.

The treatment must be curative and fall under the regulatory acceptance by the Belgian Social Security. 

If you have taken out outpatient care insurance for your employees, then all medical expenses outside the hospital are also covered, if they fulfil the above conditions.​


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.

AG's hospital plans do not refund the cost of testing carried out on an outpatient basis.

T
he National Institute for Health and Disability Insurance (INAMI/RIZIV) will cover the cost of COVID-19 testing according to certain criteria.

Below are the refunds provided by the INAMI/RIZIV for COVID-19 testing:​

  • For a molecular diagnostic test (RT-PCR test): a refund of EUR 46.81
  • For an antibody test (blood test): a refund of EUR 9.60.
  • ​For an antigen test (rapid diagnostic test): a refund of EUR 16.72.
These amounts include all test-related costs: test materials, equipment, reagents, investment costs, quality control, payroll, supervision, protective equipment, transport costs, etc.


HEALTHCARE
 - Given the extraordinary circumstances, many medical professionals may now 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. The cost for consultations with a general practitioner will be billed directly to the patient’s Sickness Fund. The patient will not be charged any co-payment or additional out-of-pocket expenses for these consultations. This also means there are no costs to claim back from AG.

For other consultations, the usual terms for claiming a refund will apply. The services or treatment must be prescribed by a doctor and recognised by the INAMI/RIZIV as curative therapy. Any entitlement to a refund and the amount that may be claimed will depend on the type of plan (hospitalisation or outpatient care coverage). 


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 - 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 15 December 2020 has been postponed by the hospital to 15 January 2021 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 15 November 2020 until the new admission date (15 January 2021) 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.


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. ​ 

Here you can find more information about the insurance covers for incapacity for work​ and what you can do to assist your employee as much as possible. ​ 


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.​