Great Eastern Life Malaysia's Interim Measures for Medical Insurance Repricing FAQ

Great Eastern Life Malaysia's Interim Measures for Medical Insurance Repricing FAQ

Frequently Asked Questions (FAQ) 

1. How do I know whether my medical plan is subject to the interim measures?

Medical plans that are subject to rates revision as shown below will be impacted.

Policyholders who attain aged 60 years and above who are covered under the Minimum Option Plan of an impacted medical product will enjoy a temporary pause in premium adjustments during the first year of revision during the interim period. This temporary support is offered to impacted policyholders to ease their financial commitment whilst the broader reforms are being worked on to tackle medical inflation in Malaysia such as implementing more sustainable cost containment strategies to address the financial impact of rising healthcare costs and medical claims.

 

3. I am aged 60 years next birthday. How do I know if I have the Minimum Option Plan?

Please see below table for the Minimum Option Plan of your respective plan:

Plan	Minimum Option Plan
Health Protector	Room & Board 100
Great HealthCare Plan	Room & Board 100
Great MediCare	Room & Board 100
Great MediCare Rider	Room & Board 100
Great MediCare 2	Room & Board 150
Great MediCare Rider 2	Room & Board 150
Great Medic Xtra	Room & Board 150
Great Medic Shield	Room & Board 150
Great Extender	Room & Board 150
IL Health Protector	Room & Board 100
SmartMedic Million	Room & Board 150
Smart Extender	Room & Board: Follows the minimum option plan of the primary medical riders
Smart Premier Health	Room & Board 180
SmartMedic / SmartMedic 99	Room & Board 100
SmartMedic Xtra / SmartMedic Xtra 99	Room & Board 150
Smart Extender Max / Smart Extender Max 99	Room & Board 150

 

4. I have surrendered/lapsed my policy upon receiving the notice of rate revision to my medical plan. What can I do now?

If you have surrendered your policy or if it has lapsed due to rates revision within the period of 1 April 2024 until 31 Dec 2024, you may request to reinstate your policy without underwriting and waiting period, up to 31 August 2025.

 

5. Why does the increase in my premium rates or insurance charges appear higher than the staggered quantum of revision under interim measures?

The rates for medical plans are structured in tiers based on your attained age. The increase in premium rates or insurance charges for your medical plan could also be due to the increase in rates when your age has reached the next age band.

For SmartMedic Xtra / SmartMedic Xtra 99, certain age bands will have higher increase in insurance charges due to the spike in the claims ratio compared to other age bands. This is to ensure the sustainability of the plan and continued coverage for all policyholders.

 

6. I am experiencing an increase in premium and/or insurance charges due to change in age band as well as the revision of rate. How would the interim measure apply?

Please note that the premium / insurance charge increases due to change in age band is not covered by the interim measures. Such increases due to age factors are stated in the policy terms and conditions, which has been disclosed at the point of sale.

 

7. The staggered quantum of revision has been effective since 1 January 2025, what will happen to my policy which has already been charged based on the original rate of revision prior to 1 January 2025?

Adjustments will be made according to the type of medical policy you own. Please refer to the details as below.

Plan	What adjustment will be done and when will it be done
For Traditional Standalone Medical Plans:   Health Protector Great HealthCare Plan Great MediCare Great MediCare Rider Great MediCare 2 Great MediCare Rider 2 Great Medic Xtra	We will refund the excess premium that you have paid prior to 1 March 2025 for the coverage period from 1 January 2025 until the next premium due date. The refund will be credited to your nominated bank account. Please log in to e-Connect to check and ensure your direct credit bank account information is updated in our records for the refund. Otherwise, please register your direct credit bank account online through our customer portal, e-Connect. The timing of the refund will depend on the policy anniversary as well as on the policy’s premium mode e.g. monthly, quarterly, half-yearly or yearly. You will receive payment notification when the refund is credited into your nominated bank account. Example 1: Policy Anniversary: 1 July 2024 Premium frequency: Annual mode Pro-rated premium paid for the period from 1 January 2025 to 30 June 2025 will be refunded to your bank account in end-March 2025. Example 2: Policy Anniversary: 1 November 2024 Premium frequency: Quarterly mode Pro-rated premium paid for the period from 1 January 2025 to 30 April 2025 will be refunded to your bank account in mid-May 2025. Example 3: (if your age next birthday is 60 and above with Minimum Option Plan) Policy Anniversary: 1 July 2024 Premium frequency: Annual mode There will be a pause in the revision of premium during the first year of revision effective 1 January 2025. The revision will resume from the policy anniversary in the second year of interim measure based on the revised quantum in year 2. Excess premium paid for the period from 1 July 2024 to 30 June 2025 will be refunded to your bank account in end-March 2025.
For Investment-Linked Medical Plans: IL Health Protector SmartMedic Million Smart Extender Smart Premier Health	We will refund the excess insurance charges incurred for the coverage period from 1 January 2025 until the next policy anniversary by adjusting the investment-linked units into your policy’s Total Investment Value. The adjustments will be done in batches as per the examples shown below and the unit adjustments will be reflected in your Annual Statement for Investment Linked Policy in the following year. Example 1: Policy Anniversary: 1 July 2024 Excess insurance charge incurred from 1 January 2025 until 30 June 2025 will be refunded latest by October 2025. Example 2: Policy Anniversary: 1 December 2024 Excess insurance charge incurred from 1 January 2025 until 30 November 2025 will be refunded latest by January 2026. Example 3: (if your age next birthday is 60 and above with Minimum Option Plan) Policy Anniversary: 1 July 2024 There will be a pause in the revision of insurance charges during the first year of revision effective 1 January 2025. The revision will resume from the policy anniversary in the second year of interim measure based on the revised quantum in year 2. Excess insurance charge incurred from 1 July 2024 until 30 June 2025 will be refunded latest by October 2025. Please note that the refund will only be made on the insurance charges and not on the premium amount. If you have already authorised / accepted the necessary premium as advised in the previous communications, you may continue paying the premium increment that you have authorised / accepted, which will be allocated to your policy’s Total Investment Value to enhance the sustainability of your policy. If you prefer to pay a lower premium, you may do so by submitting your request through your servicing agent or to the Company directly. However, the revision will only be reflected from the next policy year.

 

8. My policy anniversary is after 1 January 2025, how would the interim measures impact me? Will there be any refund involved for my policy?

 

9. Why does the Company need such a long time to refund the premium / insurance charges?

The charging of premium / insurance charges for insurance policies is a complex process, and the reversal of such charging would require extensive efforts and changes to our system to accommodate to the new requirements within a short timeline. Please be assured that your interest is our priority, and we will strive to minimise any inconvenience that you may experience.

 

10. The premium of my medical plan has been revised to a level which I can no longer afford even with the staggered quantum of revision under interim measures. Is there an alternative for me to continue my medical coverage at a lower premium?

We encourage you to speak to your servicing agent to explore other possible options with lower premiums that still meet your medical coverage needs. The available options include but not limited to the following (where applicable):

a) Downgrade your medical plan/rider to a lower coverage plan type and your downgraded plan will have lower insurance charges, no medical underwriting is required;
b) Convert your medical rider to other investment-linked medical rider that is available on the shelf, subject to the eligible entry age at next birthday and underwriting;
c) Reduce sum assured for the basic plan and Basic Investment Premium (BIP);
d) Reduce sum assured and term coverage for other rider(s);
e) Cancel other rider(s) / supplementary benefit(s);
f) Change the policy’s payment frequency to “monthly” mode; or
g) Cancel the current medical plan and downgrade to another medical plan with deductible and lower coverage, no medical underwriting is required.

 

11. Will this interim measure (staggered quantum revision) impact my existing policy benefits and coverage?

The interim measure will not have any impact on your existing policy benefits and coverage so long you continue to pay premium on time to ensure the sustainability of your policy.

12. How sustainable are these interim measures and how will they affect my premium/insurance charges in the long run?

While spreading the increased premiums/insurance charges over a minimum period of three (3) years provides immediate relief to policyholders, the reality is that the premium/insurance charges will require material adjustments in the near future unless systematic changes are implemented across the healthcare eco-system.

As the current premium/insurance charges are inadequate, insurance and takaful providers may have to step up cost containment initiatives, as part of the industry’s commitment to provide accessible, affordable, and effective healthcare.

 

13. If my policy lapses and is reinstated during the interim period, how does the staggered quantum continue to apply?

The staggered quantum will continue as if there had been no lapsation during the interim period. E.g. policy lapses in Year 2 and is reinstated in Year 3, the staggered quantum in Year 3 will be applied. You will be required to pay the unpaid premiums with interest (if any) which has accumulated up to the date of reinstatement.

14. What will happen if I have paid the staggered quantum of premium as advised for 2 years and thereafter decide to downgrade my medical plan, how would the staggered premium be calculated?

You will pay the prevailing staggered premium based on the downgraded plan. E.g. you downgrade from Plan A to Plan B in Year 2, the staggered quantum for Plan B in Year 2 will be applied.

 

15. My medical policy is on premium waiver status, how would this interim measure be applied on my policy?

The insurance charges of your policy will be staggered accordingly, the top-up option that you have authorised will continue to apply. You may request to make adjustments by contacting your servicing agent or the Company.

 

16. I have received both ‘Annual Sustainability Notice for Investment-Linked Policy’ and this notification on interim measures advising on a different suggested premium increment. Which letter I should refer to for the premium increment?

The purposes of both communications are different:

a) ‘Annual Sustainability Notice for Investment Linked Policy’ is to inform you on your policy status and its sustainability for all benefits attached to the policy up to its full contractual term. If the policy is not sustainable, a suggested premium increment will be provided in the letter. The suggested premium increment stated in this letter is optional; you have a choice to vary the increment amount based on your preference.

b) This notification on interim measures is to inform you about the staggered quantum of premium rates or insurance charges solely on the medical plan/rider affected by the medical repricing. The suggested premium increment stated in this letter is optional; you have a choice to vary the increment amount or maintain the previous premium amount.

Nevertheless, you are encouraged to consider increasing the premium as recommended in the ‘Annual Sustainability Notice for Investment Linked Policy’ and/or the suggested increment in the interim measures notification to ensure better sustainability for your policy.

17. I am a Smart Premier Health customer and entitled to No Claim Discount (NCD). Would the corresponding discount be reflected in this notification on interim measures?

No. The insurance charges shown in this notification is prior to any discount as NCD may vary depending on your claim status.

18. I have received the notification letter on interim measures. However, I noticed that the suggested premium increment during interim period is higher than the suggested premium increment before interim period. Why is that so?

During the interim period, the required upward revision of Insurance Charges is spread out over the next five years. Therefore, the suggested premium increment yearly is corresponding to the upward revision. Kindly note that:

• You may choose to maintain your current premium or reduce your premium.
• The premium increment will be subject to the allocation rate in accordance with the policy and will be used to top up investment value of the policy.
  

 

19. I have received the notification letter on interim measures. However, I noticed that there is a negative amount under the premium increment / Insurance Charge due to change in age band. Why is that so?

This is due to the decreasing premium rate / Insurance Charges from a specific younger age band to an older age band, particularly in a child policy.

Example:

SmartMedic Million

(Occupation Class 1 & 2)

 

20. Is there any specific hotline I can call for more information?

You may contact our dedicated careline for Medical Repricing queries at +603-48133928 from Monday to Friday, 8.30am to 5.15pm (except Public Holiday). Alternatively, you can send an email to wecare-my@greateasternlife.com.

References:

• Link to BNM’s press statement: Interim measures to assist policyholders and to promote continued access to suitable medical and health insurance/takaful products - Bank Negara Malaysia

• Link to BNM’s information on the interim measures: Interim Measures to Promote Continued Access to MHIT Products - Bank Negara Malaysia

• Link to LIAM's press statement: Insurance and Takaful Industry Introduces Interim Measures for Policyholders/Takaful Participants Impacted by Premium/Contribution Repricing

• Link to LIAM FAQs: FAQ-Interim-Relief-Measures-20Dec2024-FinalVersion.pdf

 

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