Voluntary Medical Plan

Of Concentrix Services Bulgaria LTD

Version 2.0

May 2016

Table of Contents

1.Introduction

Revision/Approval History

1.1.Purpose

1.2.Scope

1.3.Responsible Party

2.Eligibility Rules

3.Health Insurance Packages...... 5

4.Employee Contribution...... 6

5.Enrollment Process...... 7

6.Contribution Process...... 7

7.Withdrawal Process...... 9

8.General Guidelines for using GENERALI services...... 9

9.Annual Prophylactic Tests and Examinations...... 10

10. Expense Reimbursement...... 10

11.Personal Data...... 11

12. Point of Contact...... 11

13. Appendices...... ...... 12

14. Document Control Information…………………………………………………………………….27

1. Introduction

Revision/Approval History

Version number / Approval Date / Summary of changes / Last Revised by: (name and role) / Approved by:
(name and role)
1.0 / 01.05.2014 / Initial Version / E. Tsoneva/HR Business Partner / I. Dinchev/Center Lead
2.0 / 06.08.2015 / - The possibility for existing employees as of 01.05.15 and their dependents to enroll in the plan at any time during the contract is no longer applicable.
- The cost for dependents is no longer deducted from employee’s monthly payment.
- The coverages have pre-determined limits, which are prorated to the services used in the remaining period of the contract. / E. Tsoneva/HR Business Partner / I. Dinchev/Center Lead
3.0 / 01.05.2016 / - Dependents can enroll only the first 2 months of starting the contract
- Existing employees can enroll in the first 4 months of starting the contract / E. Tsoneva/ HR Business Partner / Clive Linssen/ Center Lead

1.1. Purpose

The purpose of the Medical Plan process is to ensure employees’ wellbeing by giving them the opportunity to take advantage of additional health insurance packages for themselves and their family members.

This process sets out the actions that should be taken when an employee of the company or a family member want to participate in the voluntary Medical Plan.

It is designed to provide clear guidance for CNX employees so that they can benefit from the coverages included in the Medical Plan.

Employees must ensure they are familiar with the Medical Plan process and to refer to it in case needed. Health Care Provider for 2016-2017 is GENERALI.

Medical Plan is fully aligned with the country legislation (Regulation of Ministry of Health and supporting normative acts) and follows all its requirements.

1.2. Scope

The Medical Plan applies to all employees at CNX Bulgaria on any level and position, even those in probation period. The enrolment is voluntary and follows the rules set in this policy documents.

1.3. Responsible Party

This document is stored in the HR Department and available upon request from Employees and Managers. Refer to the author if you are in any doubt about the currency of this document.

Author / HR Team Concentrix Services Bulgaria
Process Owner / HR Team Concentrix Services Bulgaria
Contributor / Delivery Team Concentrix services Bulgaria
This document has been distributed to:
Name / Title
Evelina Tsoneva / HR Business Partner, Concentrix Services Bulgaria
Ramakrishna Devanathan / Delivery Operations Lead, Concentrix Services Bulgaria
Ivan Dinchev / Centre Manager, Concentrix Services Bulgaria

2. Eligibility Rules

The Voluntary Medical Plan covers:

  • All full-time regular employees;
  • All part-time regular employees;
  • All full/part time employees on leave (paid, unpaid, maternity)

Employees are allowed to enroll members of their families (dependents) under the negotiated insurance packages by Concentrix described in the following section of the document. The full cost for dependents is covered entirely by the employee; the cost for the employees is a percentage contribution of the full cost, described in details on p.6.

Insured persons:

- Employees – without age restrictions and

- Family members as described here can be insured under the same T&C within the following age frames:

  • spouse and partners – from 18 up to 64 years old
  • children- from 2 months up to 26 years old
  • brothers, sisters, parents up to 64 years old

In case of contract termination, employees’ participation in the Plan will be discontinued with the same effective date. The dependents will remain in coverage until the end of the contract or until the payments coverage.

3. Health Insurance Packages

  1. “Health improvement and disease prevention” – includes the following exams once per year:
  • Prophylactic examinations and tests for men and women
  • Common tests for men and women.
  • Screening with a questionnaire for high blood pressure, ischemia and myocardial infarct
  1. “Out-of-hospital medical aid”- up to 2000 BGN per one insured per insurance year - all kind of medical examinations and tests, on medical prescription.
  2. “Hospital medical aid”- up to 10 000 BGN per one insured per insurance year , including:

- Choice of a team in case of surgery (acc. Regulation of Ministry of Health) – annual limit up to 900 BGN

  1. Dental care – up to 150 BGN / a year (without co-financing)
  2. Reimbursement of expenses for medicines and auxiliary means – up to 150 BGN / a year ( without co-financing) incl. dioptric glasses or lenses, incl. change in diopters of 0,5, up to 80 BGN annually)

Note: The above amounts may vary based on the period of enrollment in the plan

Chronic and past diseases are covered.

For further information about the services included in the package and the exclusions from the plan, please refer to Appendix 1.

4. Employee Contribution

For the year 2016/2017 the employee contribution scheme will be as shown:

  1. Percentage distribution between employee and Concentrix Services Bulgaria

Employee / Children / Spouse / Parents
Employee contribution / 25% / 100% / 100% / 100%
Concentrix contribution / 75% / 0% / 0% / 0%
  1. Cost distribution between employee and Concentrix in BGN

Employee / Children / Spouse / Parents
Insurance Cost / Year / 421.18 BGN / 421.18 BGN / 421.18 BGN / 421.18 BGN
Concentrix Cost /Year / 315.88 BGN / 0.00 BGN / 0.00 BGN / 0.00 BGN
Employee Cost / Year / 105.30 BGN / 421.18 BGN / 421.18 BGN / 421.18 BGN

5. Enrollment Process

  1. The Medical Plan membership is voluntary and requires personal contribution.
  2. Enrollment should be made by completing the following set of documents:
  • Authority form – to be completed by every employee who wants to enroll in the Plan; by signing the Authority form, you authorize Concentrix Services Bulgaria to apply payroll deduction to your net salary.
  • The form must be filled in, sign off and sent to Vesela Alexandrova via e-mail:
  1. Insurance coverage under the current Plan starts on 01.05.2016 up to 30.04.2017.
  2. Employees can subscribe within the first 4 months of the contract by presenting the signed off Authority Form to HR by 20th of each month.
  3. Employees can enroll family members no later than 2 months from the beginning of contract (01.05.2016) by submitting a signed off Authority Form to HR by 20th of the month
  1. HR submits the initial list of participants and updates to GENERALI on a monthly basis.
  2. Enrolled employees and dependents will receive personal Insurance Card issued by GENERALI containing name, insurance number and insurance start/ end date, as well as the contacts of GENERALI Call Center.
  3. The newly hired employees have the right to subscribe during the entire period of the contract as their family members can be included with them.

6. Employee Contribution

a. Employee contribution is processed as payroll deduction by Concentrix upon receiving a signed off Authority form by employee.

b. The number and amount of employee contribution deductions depend on the month of enrolment in the Plan and are specified below.

c. The insured employees pay the full premium for their family members.

Employees – all amounts are in BGN

Start Date of Enrolment / Insurance Coverage / 1st Payroll Deduction / 2nd Payroll Deduction / Total
Payroll Month / Amount / Payroll Month / Amount
01.05.2016 / 12 months / May - 2016 / 52.65 / Nov - 2016 / 52.65 / 105.30
01.06.2016 / 11 months / Jun - 2016 / 43.88 / Nov - 2016 / 52.65 / 96.53
01.07.2016 / 10 months / Jul - 2016 / 35.10 / Nov - 2016 / 52.65 / 87.75
01.08.2016 / 9 months / Aug - 2016 / 26.32 / Nov - 2016 / 52.65 / 78.97
01.09.2016 / 8 months / Sep - 2016 / 17.54 / Nov - 2016 / 52.65 / 70.19
01.10.2016 / 7 months / Oct - 2016 / 8.76 / Nov - 2016 / 52.65 / 61.41
01.11.2016 / 6 months / 0.00 / Nov - 2016 / 52.65 / 52.65
01.12.2016 / 5 months / 0.00 / Dec - 2016 / 43.88 / 43.88
01.01.2017 / 4 months / 0.00 / Jan - 2017 / 35.10 / 35.10
01.02.2017 / 3 months / 0.00 / Feb - 2017 / 26.32 / 26.32
01.03.2017 / 2 months / 0.00 / Mar - 2017 / 17.54 / 17.54
01.04.2017 / 1 months / 0.00 / Apr - 2017 / 8.76 / 8.76

Family Members – all amounts are in BGN

  • The family member pays 100% of the total cost, or 35.10 BGN a month
  • The monthly payment of 35.10lv to be submitted no later than 11th of each month to

GENERALI’s bank account:

UNICREDIT BULBANK,

BRANCH SOFIA,

IBAN BG17UNCR76301001 GNRL ZO,

BIC UNCRBGSF

The following requisitions to be included in the payment document:

  • full name of the employee
  • full name of the insured family member
  • personal ID number of the insured family member
  • contract number 610022200000.

7. Withdrawal Process

  1. Voluntary withdrawal of employees and/or dependents from the Plan is possible on a monthly basis. Authority Form with Withdrawal option should be checked and sent to by 20th of each month.
  1. In case of labor contract termination, employees’ participation in the Plan will be discontinued with the same effective date. Family member’s coverage will be continued as long as the due payment is made.
  2. In case of withdrawal the paid employee contribution amount is not reimbursable. No further deductions are to be made in this regard.
  3. In case of withdrawal of a family member, no further payment to be transferred to GENERALI.
  4. In case of withdrawal, employee/family member is obliged to return his/her/family member’s health insurance card to HR. Otherwise, the insurance coverage will not be terminated and the employee will be accountable for the contributions.
  5. If the employee is leaving the company and the card is not properly returned to HR, he/she is obliged to reimburse to GENERALI for any expenses that may occur for usage of services after the labor contract termination date.

8. General Guidelines for using GENERALI services

  1. Each enrolled person under the Plan can use the services described in Appendix 1 in a predefined list of medical centers. In such cases, the insured person does not need to pay anything to the medical institution; the insured only needs to provide his/her membership card for identification.
  2. The current list of medical providers can be found at the link below and is the insurer’s obligation to update the list on a regular basis:
  1. Participants have the right to visit a medical institution which is NOT INCLUDED in the List of the Insurer but it is within the coverage of the Medical Plan. In this case, the insured person needs to pay for the services used and then submit an expense reimbursement claim to GENERALI (please, refer to Expense Reimbursement section).

9. Annual Prophylactic Tests and Examinations

  1. Prophylactic tests and examinations are organized once per year.
  2. Each enrolled employee/family member can visit the prophylactic exam.
  3. The prophylactic examinations and medical tests will be organized in Sofia and Varna and in convenient locations.
  4. HR organizes the prophylactic tests and examinations and communicates the details agreed with GENERALI to employees.
  5. The scanned results from examinations and tests will be visualized in the Personal Health Electronic File of the insured person

10. Expense Reimbursement

  1. Expense reimbursement by the Insurer to the insured person is done under the following coverage and limits:
  2. For examinations and manipulations within the packages and options of “Out-of-hospital medical aid” and “Hospital medical aid” performed in medical institutions not included in the list of the Insurer, the insured person may use the service of Reimbursement of expenses base, pay require respective medical service and submit a Request for reimbursement of that expenses he/ she made.
  3. For medicines, dressing materials and contact lenses/glasses from the package “Reimbursement of expenses” – up to 150 BGN annually per adult including 80 BGN annually for dioptric glasses or lenses.
  4. For examinations and manipulations within the packages and options of “Dental treatment” – up to 150 BGN annually per person
  5. Term to file a request for reimbursement expense – up to 45 calendar days from the date of purchasing the medicines or medical supplies and/or used services.
  6. Insured persons should ask GENERALI’s representative for reimbursement form and submit the documents in person during GENERALI’s weekly visits. No documents to be submitted on-line.
  7. Term to buy medicines – within 10 calendar days from the day they have been prescribed, but not later than the validity of GENERALI’s contract.
  8. Terms for reimbursement the expenses: GENERALI pays back approved claims to insured persons within 15 working days from receiving accurate applications by the Insurer
  9. Term to correct documents – If the insured person has not submitted all required documents, GENERALI sends a written notification in official letter. This way GENERALI invites him/her to present the missing documents or to correct the existing items within an additional term of 15 days.
  10. GENERALI’s representative shall visit Concentrix offices in Sofia (Business Park and Capital Fort/ Varna every week to collect requests for refund of expenses of the insured persons. Weekly communication for GENERALI’s visit to be sent by HR.
  11. The detailed procedure for Expense reimbursement is described in Appendix 2.

11. Personal Data

Any personal data of the employees and their family members is strictly confidential and will be used solely for the purposes of this medical plan and the provision of health services to the insured persons under the terms and conditions herein. Personal data such as the address and telephone number of the insured person may be provided to the Insurer in case the health insurance card or the declaration for its loss or theft are not submitted by the insured person in the respective cases.

12. Point of Contact

For any medical and health related questions, please contact GENERALI:

0800 12 712 - 24 hours Call center services in English and Bulgarian

For other questions, please contact Vesela Alexandrova:

13. Appendices

APPENDIX 1

Insurance packages /coverage/
I. “Health improvement and disease prevention"- coverage
1.1. Examination by physician, ECG and Measurement of blood pressure
1.2. Examination by ophthalmologist with examination of visus and colours sensitivity
1.3. Examination by neurologist or otorhinolaryngologist
1.4. Clinical laboratory – complete blood test, ESR and glucose incl. tests of creatinine, cholesterol (HDL, VLDL, LDL cholesterol) and triglycerides
1.5. Chemical urine analysis – albumin, glucose, ketones, urobilinogen, blood and sediment.
1.6. Ultrasonography of mammary glands
1.7. Ultrasonography of thyroid glands
1.8. PSA for men above 40 years of age
1.9. Biochemical screening for diabetes – blood glucose
Section II: Out-of-hospital medical aid up to BGN 2 000 per one insured per insurance year
  1. Initial examination when health aid is requested:
  2. by a doctor – specialist;
  3. by an academic ranked person;

  1. Second examination:
  2. by a doctor-specialist;
  3. by an academic ranked person;

  1. Medical advice and planned consultations by:

3.1. a doctor - specialist
3.2. an academic ranked person
  1. Home visit and monitoring of the patient by a doctor - specialist.

  1. Clinical-and-laboratory tests to diagnose and follow up of the development of a specific health problem

5.1. haematological
5.2. biochemical
5.3. microbiological including antibiogram
5.4. cytological
5.5. hormonal
5.6. enzyme
5.7. haemostasis
5.8. urine.
5.9. tumor markers
5.10. immunological
5.11. serological
5.12. allergy tests
  1. Clinical-and-instrumental tests at a rate allowing diagnostics of the health problem:

6.1. Functional tests (for example functional breathing test, cardiac stress test (ECG-stress test) etc.)
6.2. Image diagnostics:
6.2.1. all kind of ultrasonographic tests, X-ray tests;
6.2.2. computer tomography (CP) and Nuclear magnetic resonance imaging (NMRI) up to 2 times per insurance period
6.3. colposcopy;
  1. Out-of-hospital medical manipulations for handling a specific health problem.

  1. Second examination and monitoring of the health problem with additional tests.

  1. Consultation of the patient with other doctors - specialists.

  1. Preparation and hospitalization of the patient in an agreed medical institution.

  1. Monitoring of a patient with chronic disease by:

11.1. a doctor-specialist
11.2. a doctor-specialist from another medical institution.
  1. Physiotherapeutic procedures - up to 20 procedures annually.

  1. Monitoring of pregnant women and women in child-birth at a gynecological consulting room - by a specialist incl. Pregnancy at risk up to BGN 350, incl. package. The usage is possible only by “Reimbursement of expenses”.

  1. Medical care at night hours, during official holidays and at weekends.

Section III: Hospital medical aid up to BGN 10 000,00 per insurance year per 1 insured employee
1. Hospitalization in stationary wards of medical institutions:
1.1. Internal diseases
1.2. Surgical
1.3. Delivery
1.4. Gynaecological
1.5. Neurological
1.6. Ophthalmologic
1.7. Otorhinolaryngological (ORL)
1.8. Dermatological and Venereal
1.9. Physiotherapy
1.10. For completion of treatment and long-term treatment
1.11. Cardiological
1.12. Pulmonary
1.13. Gastroenterological
1.14. Endocrinological
1.15. Orthopaedic and Traumatology.
2. Acceptance and accommodation of the patient in a room with two or more beds.
3. Examination and prescribing of treatment by doctor on duty.
4. Head of the Ward visit.
5. Consultation with doctors-specialists from the wards of the medical institution.
6. Manipulations as per medical indications
7. Clinical and laboratory and clinical and instrumental tests at a volume allowing the diagnostics and the treatment of the health problem.
8. Treatment
8.1. Medication
8.2. Hormonal
8.3. Physiotherapy
8.4. Surgical operations of small and average complexity, acc. National Surgical Standards
9. Duration of the stay at the stationary – total 30 days per insurance period, but not more than 7 days in an intensive treatment ward.
10. Consumables, medical consumables and implants during surgeries – up to BGN 1 000.00. The usage is possible only by “Reimbursement of expenses”.
11. Possibility to choose the medical team in case of surgery (excl. Delivery) - up to 900 BGN annual limit acc. Ordinance to implement the right of access to medical care.
12. Birth Delivery – all expenses regarding the delivery shall be reimbursed up to BGN 1 200,00 without specific documentation. The usage is possible only by “Reimbursement of expenses”.
13. Stay in a VIP (single) room excluding birth delivery – up to 7 days with maximum amount up to BGN 80.00 per day. The usage is possible only by “Reimbursement of expenses”.
Section IV: Reimbursement of expenses up to 150 BGN annually (without co-financing). The insurers will not reimburse the amounts covered by National Health Fund.
1. Medications and dressings for out-hospital medical aid incl. vitamins and homeopathic drugs, registered in BDA.
2. Auxiliary materials for out-hospital medical aid
2.1. Crutches, walking sticks, catheters, collection bags, urinators
2.2. Dioptric glasses or lenses, incl. change in diopter of 0,5, up to 80 BGN annually
3. Medications and dressings for hospital medical aid
4. Medicinal products - similar according generic name of the prescribed, including generic medicines.
5. Contrast medium used in image diagnostics.
6. Influenza vaccine OR immunostimulant on choice of insured – once per insurance period.
III. “Dental aid" up to 150 BGN annually (without co-financing)
Without restrictions on the activities carried out, excluding only prostheses, replants and implants and preparations for them.
Coverage: Scaling, metalceramic crowns, development of teeth with and without pins
Within the limit are covered: orthodontic activities, treatment of congenital anomalies, teeth whitening and replacement of existing dental restorations and constructions at the moment of signing this contract, in aesthetic and cosmetic reasons.

Exclusions: