Employee Benefits for

BITOPI ADVERTISING LTD.

Policy number: 60724
Current policy cycle: 01/06/2023 to 31/05/2024

Shafayet Bhuyian
Employee Benefits Department, MetLife Bangladesh
 Confidential – for MetLife internal use only

Disclaimer :

The information contained in this presentation supports the promotion and

marketing of insurance products. This is not a contract and the Policy Document, if
issued, would contain enforceable terms and conditions. In case of any
discrepancy between the Policy Document and this presentation, the Policy
Document shall prevail.

The information provided herein is proprietary to MetLife and can only be shared
on a strictly need-to-know basis within the company for which this is designed.

Information about MetLife Preferred Provider Organization (PPO) network provided

herein is subject to any future change in the arrangement/agreement with
concerned PPO.

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 Confidential – for MetLife internal use only

Presentation Topic

❑ Group Life Benefit (GL)

❑ Accidental Death Benefit (AD)
❑ Accidental Permanent Total Disability (APTD)
❑ Accidental Permanent Partial Disability (APPD)
❑ In-patient Hospitalization Benefits
❑ Salient Features of Hospitalization Benefit
❑ Coverage Exclusions
❑ Out patient
❑ MetLife’s Managed Care Facilities (PPO)
❑ PPO Hospital List
❑ Claim Procedure & Re-imbursement
❑ Service Team of MetLife
❑ Q&A

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 Confidential – for MetLife internal use only

Section-1:

Life and Disability Benefits

Who is covered? Employees only

Age Limit 18 – 65 Years

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 Confidential – for MetLife internal use only

Group Life (GL)

BDT 500,000 for Each Eligible Employee

One lump sum payment for Death due to any cause.

Group Life Insurance coverage provides for a lump-sum i.e., one time,
payment of the amount of Life Insurance Coverage as per the schedule of
benefits or insurance plan to the beneficiary designated by the Policy
Holder/Insured, in the event of death of an Insured Employee from any
cause, except-

• Suicide within first year of coverage

• “AIDS” or “AIDS” related diseases.

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 Confidential – for MetLife internal use only

Accidental Death (AD)

BDT 500,000 for Each Eligible Employee

If an employee sustains an injury through

accidental means and due to such injury
he/she suffers the loss of life as a direct
result of such accident within 180 days of
his/her accident, the amount for such loss
shall be 100% of the Insurance Coverage.

** Benefit will not be applicable in case of Travel to or Stay

in following countries: Iraq, Afghanistan, West Africa, North
Korea, Chechnya, Burma, Sudan, Libya, Iran, Cuba.

This Benefit is in addition to Group Life benefit.

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 Confidential – for MetLife internal use only

Permanent Total Disability due to Accident (APTD)

BDT 500,000 for Each Eligible Employee

APTD Insurance provides payment if the

insured becomes totally & permanently
disabled from bodily injury so as to be wholly
prevented from performing any occupation for
remuneration or profit.

This benefit is payable in in one lump sum

following a 12 months disability waiting
period.

** Benefit will not be applicable in case of Travel to or Stay

in following countries: Iraq, Afghanistan, West Africa, North
Korea, Chechnya, Burma, Sudan, Libya, Iran, Cuba.

** Benefits are payable in lieu of the Life Insurance benefit.

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 Confidential – for MetLife internal use only

Dismemberment, Loss of Sight, Hearing & Speech Indemnity

due to Accident (APPD)
BDT 500,000 for Each Eligible Employee

APPD Insurance coverage provides

payment in the event of complete and
irrecoverable physical loss or loss of use
of specific parts of the body.

Benefits are paid in lump sum as a

percentage of Group Life depending on
the kind of loss incurred as per following
schedule.

** Benefit will not be applicable in case of Travel to or Stay

in following countries: Iraq, Afghanistan, West Africa, North
Korea, Chechnya, Burma, Sudan, Libya, Iran, Cuba.

** Benefits are payable in lieu of the Life Insurance benefit.

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 Confidential – for MetLife internal use only

Accidental Permanent Partial Disability (APPD)

Schedule of Benefit under Accidental Permanent Partial Disability (APPD)

RIGHT LEFT

For total loss of an upper member 70% 60%

For total loss of the hand or forearm 60% 60%
For total loss of a lower member above knee 60% 60%
For total loss of a lower member at the level of the knee or below 50% 50%
For total loss of a foot 40% 40%
For total loss of the thumb 18% 16%
For total loss of the index finger 14% 12%
For total loss of the pinky 12% 10%
For total loss of the middle finger 08% 06%
For total loss of the ring finger 08% 06%

For total loss of the big toe 05%

For total loss of any other toe 03%
For total deafness of one ear 10%
For total deafness, both ears 40%
For total loss of visual acuity of one eye 25%
For total loss of visual acuity of both eyes 100%
For total loss of speech 100%

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 Confidential – for MetLife internal use only

Section-2:

Medical Benefits

Who is covered? Employees

Age Limit Employees 18 – 65 Years

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 Confidential – for MetLife internal use only

In-patient Hospitalization Benefit

Group Hospitalization Benefits are designed to provide Benefits to the Employee in the event of
CONFINEMENT in a HOSPITAL because of Injury or Sickness.

Our Group Hospitalization Insurance Plans are basically

REIMBURSEMENT TYPE Plans wherein Insured
Employees / Dependents make Out-of-Pocket Payments and
submit the Actual Expenses Bills to MetLife for
Reimbursement per Max Limit of the Approved Plan for the
Employer or Employee concerned. However, we have Credit
Arrangement with leading Hospitals in Bangladesh through
which we arrange NO CASH Treatment under our Managed
Care Program on the basis of PRIOR APPROVAL for
Emergency Hospitalization

More flexibility in terms of frequency due to ‘per Disability’ feature! Fresh limit for every
new Disability. 90 days limit applies for the same Disability.

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 Confidential – for MetLife internal use only

In-patient Hospitalization Plans

Max Hospitalization Benefit per insured per Disability

Max Hospitalization Benefit Per Insured Per Disability BDT 300,000

A) Room & Board Total Limit per Disability including ICU BDT 120,000

Room & Board Daily Limit BDT 5,000

Daily Intensive Care Unit (ICU) No. of Days Limit per Disability 14 DAYS

B) Other Hospitalization Expenses / Services Total Limit per Disability

(includes Surgeries, Medicine, Anesthesia, Investigations, Doctor’s BDT 180,000
consultation etc. during Hospitalization)

Maternity / Dental / Vision / Psychiatric Benefits Not available

PRE-APPROVAL for NON-EMERGENCY Hospitalization Mandatory

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 Confidential – for MetLife internal use only

Salient Features of Hospitalization Benefit

1. Overseas Treatment is allowed any where in the world and the cost is
reimbursed per “Reasonable & Customary Bangladesh Standard” subject to
overall Plan Limits in BDT.
2. Cashless treatment in our wide network of Preferred Provider Organization
(PPO) Hospitals.
3. Post Hospitalization Physiotherapy up to one month sessions, if necessary
after an orthopedic surgery.
4. Day Care surgery are covered under IP hospitalization plan.
5. Professional Nursing care during post-hospitalization period, if necessary &
advised by a physician.
6. Post hospitalization Antibiotic medicine advised on discharge from the
hospital up to 10 days.

For details, please refer Insurance Policy Document

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 Confidential – for MetLife internal use only

Salient Features of Hospitalization Benefit

7. Ambulance Services to & from hospital in case of Medical Emergency.

8. Exclusion of Pre Existing conditions for In-Patient Hospitalization are waived

for existing Insureds & new joiners.

9. Post Hospitalization two follow-up visits covered.

10. Major Accidental Dental Surgery within six months of Accident.

11. Artificial Limbs & Eyes, Casts, Braces, Splints and Crutches provided.

12. Treatment by Radiotherapy & Chemotherapy.

For details, please refer Insurance Policy Document

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 Confidential – for MetLife internal use only

Coverage Exclusions

1. Self-inflicted injury while sane or insane; treatment of chronic alcoholism, drug addiction,
desensitization and allergen tests or nervous or mental disorders;
2. Injury or illness resulting from insurrection or war, declared or undeclared, or as a result of
a riot, strike or civil commotion;
3. Rest cures, sanitaria or custodial care or periods of quarantine or isolation;
4. Cosmetic or plastic surgery for beautification also products.
5. Hearing aids, contact lenses, laser treatment.
6. General health examinations; examinations for check-up purposes not incident to, or
necessary to, diagnosis of a sickness or accidental bodily injury;
“7. AIDS” and/or “AIDS” related diseases
8. Take Home Medicines
9. Ayurvedic treatment, Homeopathy treatment; Herbal medicines, Acupuncture, Vaccinations,
Preventive treatment, Circumcision,

For details, please refer Insurance Policy Document

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 Confidential – for MetLife internal use only

Coverage Exclusions
10. Hirsutism, Podiatrist services, Dietician services. Expenses related to uncovered
conditions including any complication arising therefrom, sexual disorders, expenses incurred
on account of the following items which include but are not limited to : Durable medical
appliances (e.g.,nebuliser), Anorexia, obesity, insomnia, baldness; Contraceptive measures,
Ovulation induction, Vitamins.

11. Transportation other than local licensed ambulance service.

12. Food, Telephone Charges, Laundry, Tissue, Pampers, Food Supplements e.g. Vitamins,
Milk, Energy Drink, etc.

13. Treatment for Sterility, In Vitro Fertilization (IVF).

14. Maternity and dental benefit not covered under IP benefit.

15. any investigation, treatment or surgical operations or any complications arising from
congenital anomalies/birth defects

For details, please refer Insurance Policy Document 16

 Confidential – for MetLife internal use only

General Outpatient Benefit

Medical Out-patient Benefits provide for reimbursement of actual Medical expenses- up to
certain yearly limits against-
❑ Consultations;
❑ Investigations; and
❑ Prescribed Medicines

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 Confidential – for MetLife internal use only

General Outpatient Plan

Employee only per year

Maximum Benefit Per

Description
Member Per Year

Out- Patient Maximum Per Year BDT 15,000

i) Maximum Consultation Fee per Insured Per Year BDT 4,500

General Practitioner Visit BDT 500

General Practitioner Home Visit BDT 600

Specialist Visit BDT 1,500

ii) Investigation Maximum per Year (X-Ray, Lab, ECG, Path. etc.) BDT 6,000
BDT 4,500
iii) Medicine Maximum per Year
10% Co-insurance applicable

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 Confidential – for MetLife internal use only

Overseas Treatment
Worldwide Coverage 24/7

MetLife will cover treatment anywhere in the World but only up to the necessary and
Reasonable Cost as per Bangladesh Standard. Also, all overseas cases will require
prior approval from MetLife.

For Example, if Mr. X has an operation for

Appendectomy in Bangkok, then he will get
reimbursed as per Bangladesh “necessary and
reasonable” cost, predetermined by MetLife
Bangladesh before his departure to Bangkok.

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 Confidential – for MetLife internal use only

MetLife’s Managed Care Facilities (PPO)

Cashless Facility in the PPO Network through Pre-approval

Each insured employee/spouse/child will be

provided a MEDICAL CARE PROGRAM
CARD presenting which he/she will be able to
avail Cashless facility from the Hospitals within
the MetLife Preferred Provider Organization
(PPO) network. In this case, the hospital will
bill MetLife directly and therefore, the
Insured's will not need to pay anything to the
hospital if the expenses are within the policy
limits.

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 Confidential – for MetLife internal use only

MetLife’s Managed Care Facilities (PPO)

Sample Medical Care Program Card

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 Confidential – for MetLife internal use only

Hospital Admission Assistance

3 Ways to get Pre-approval in the PPO Network Hospitals

1 Call at 01713 043 043

Or
Our
Network
2 SMS at 01713 043 043 Doctor is
ready to
Or
assist
Email at
3 Preapproval.Admission@metlife.com.bd

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 Confidential – for MetLife internal use only

6 Information for Hospital Admission

Assistance
When Call / SMS / Email to MetLife Network Doctor, please provide:

1 Policy Number: 60724

2 Company Name: Bitopi

3 Employee ID number

4 Patient Name

Reason of hospitalization / Nature of

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sickness

6 Hospital Name
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 Confidential – for MetLife internal use only

Section:

Medical Claim Enquiry

Group Policy number: 60724

Online claim submission video tutorial

https://youtu.be/llbEP6ZEcSs

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Online Group Claim Submission (Contd.)
▪ Go to www.metlife.com.bd

▪ Place your cursor on the “Claims” menu item and click on the Online Claim Submission icon

▪ You will be directed to the claims online submission page

(https://eclaims.metlife.com.bd/public/online/claim-submission)
▪ Ensure that your data, including your mobile number, is updated with MetLife
Online Group Claim Submission (Contd.)
Online Group Claim Submission (Contd.)
Online Group Claim Submission (Contd.)
Online Group Claim Submission
Online Group Claim Submission
 Confidential – for MetLife internal use only

For Medical Claim Enquiry

Please call MetLife Call Center by taking following 3 steps:

Step – 1: please dial 16344 or +8809666716344

Step - 2: please press 1 when automated voice gives you

multiple options

Step - 3: please press 5 when automated voice asks for

Group Policy Medical Claim

16344 or
1 5
+8809666716344

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 Confidential – for MetLife internal use only

Section-4:

Your MetLife Team at Service

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 Confidential – for MetLife internal use only

Other Service Team Members of MetLife

Pre-Approval (24/7) For Cashless Facility during Hospitalization
Dr. Fahim Ahmad
Claims Department
Call/SMS: 01713-043043, Email: Preapproval.Admission@metlife.com.bd

Medical Claims Services / Discrepancies / Requirements and Follow Up

M. Zahurul Haque
Claims Department
Tel: 09666716344/16344, Ext. 248, Email: Zahurul.Haque@metlife.com.bd

Account Manager
Shafayet Bhuyian
Employee Benefits
Tel: 09666716344/16344, Ext. 471, Email: Shafayet.Bhuyian@metlife.com.bd

Overall Coordination
Mushfiqur Raihan, AVP & Head of Account Management
Employee Benefits
Tel: 09666716344/16344, Ext. 471, Email: Mushfiqur.Raihan@metlife.com.bd

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Any Question?
Thank You