You can reassure your employees: they are properly protected in case of an epidemic or pandemic. And not just by their hospitalisation insurance.
UPDATE: HOSPITALISATION – LIFE/DEATH – GUARANTEED INCOME - 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 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. Premium payments will continue as planned. However, as an employer we are enabling you to defer your premium payments for the staff members concerned until 30 September 2020.
Talks are currently ongoing between Assuralia and the competent ministerial cabinets and institutions to translate all of this into a legal framework.
What does this entail?
- The group supplementary pension plans, healthcare insurance plans (hospitalisation, outpatient care expenses), occupational incapacity plans (guaranteed income, waiver of premiums) and solidarity schemes (including as part of sector-wide plans) are to be automatically continued for the staff members concerned during the time they are temporarily unemployed as a result of the corona crisis. Both in case of full or partial unemployment due to the coronavirus.
- To continue to provide the best possible protection for your employees the way things stand, continuing the covers is the default choice. No contract amendments or annexes need to be prepared to the various regulations either. All of which means that, for now, you are not required to take any kind of action. We will get in touch with you should this be necessary.
- You may defer the premium payments for the covers of your temporarily unemployed staff as a result of the corona crisis up to and including 30 September 2020. This option solely applies for the duration of the time of temporary unemployment. If you would like to exercise this option, please let us know at your earliest convenience.
The solutions also apply to the employee-paid personal contributions and to the covers of the family members of the employees concerned who are enrolled in the supplementary healthcare and/or occupational incapacity plans set up by the employer.
We would advise to duly inform your staff members of the decision you have made in respect of the group plans and the premium payments.
As an employer, are you allowed to derogate from this solution?
As an employer or as a sector you are free to suspend the covers for the duration of the temporary unemployment of your workers as a result of the coronavirus.
If you would like to suspend the covers for the employees who have been made temporarily redundant as a result of the corona crisis, please notify us before 31 May. In that case we will jointly discuss the further terms and procedures. We will stop sending out premium notices, and all covers will be cancelled. This means 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 members, such as the duty to inform them of the option to continue the hospitalisation insurance on an individual basis (Verwilghen Act). So be sure to inform your employees if you suspend the covers.
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. This measure will be valid until 30 June 2020 and will be further evaluated in the light of the measures taken by the government.
HEALTHCARE - Does my hospitalisation insurance cover medical expenses related to epidemics or pandemics such as coronavirus (COVID-19)?
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.
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 - 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 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.
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.