Collective healthcare insurance 2017

Introduction

Participation

Insurance packages

Medical acceptation

Premium

Personal excess

Application

Declaration

Adjustment

Termination

Information

Appendices

Introduction

The University of Twente has concluded a collective health insurance with Menzis for its (retired) staff members and their families. By so doing, the University believes it can offer you a good-quality and affordable health insurance. The contract of the UT has been registered with Menzis under collectivity number: 20340

As participant in the collective health insurance you will receive a collectivity discount of 8% per month on the premium of the basic insurances Menzis Basis and Menzis Basis Vrij. The discount on the premiums of the additional insurances ExtraVerzorgd 1. 2 or 3 is 10%. This premium discount also applies to the combination package JongerenVerzorgd and the dental insurances TandVerzorgd 250, 500 and 750. There is no premium discount to the basic insurance Menzis Voordelig and the corresponding combination packages Aanvullend and Extra Aanvullend.

Because the university considers a proper health insurance for staff members important, additional arrangements have been made with Menzis on the ‘upgrading’ of the regular additional insurances and the dental care insurances. Against a small extra premium you can claim extra reimbursements.

Even if you have to stay abroad for the UT for a longer period, good cover for healthcare costs is vitally important. The cover provided by a regular Dutch health insurance policy, combined with the collective travel insurance, does not always appear to be sufficient. Therefore, the UT has made agreements with Menzis on a temporary extension of the healthcare insurance cover: the Worldwide Clause. If you stay abroad for the UT for three months or more, the Worldwide Clause provides good cover for healthcare costs all over the world. This also applies to accompanying family members. In order to qualify for the Worldwide Clause, you must be insured with Menzis.

Participation

Staff members and retired staff members residing in the Netherlands

You can use the UT’s collective health insurance if you are employed by the UT or are retired (at the pensionable date or following early retirement). Besides, you and your partner and your children up to the age of 18 as well as and any unmarried children up to the age of 27 who study irrespective of whether they are or are not a member of the household, can also participate in the UT’s collective health insurance.

Staff members residing in Germany

Staff who live in Germany will as a rule have to take out (basic) healthcare insurance in the Netherlands. For this, they can make use of the UT's group healthcare insurance.

If you live in Germany and want to make use of the UT's group healthcare insurance,

use the Application Form Medical Insurance living abroad when registering. You do not need to send a copy of identity papers. If you would like to take out supplementary insurance or dental insurance with Menzis in addition to basic insurance, please indicate your choice of package on the Application Form Group medical Insurance University of Twente. Please staple the forms together and send them to:

Menzis

Team Polis Buitenland

P.O Box 75000

7500 KC Enschede

After registration you will receive an E106 treaty form from Menzis, with which you can also register with a German insurance institution (Krankenkasse). This registration is free of charge. After registration with a Krankenkasse, you can make use of medical care in both the Netherlands and in Germany.

The Krankenkasse reports family members who are also insured with the Netherlands National Health Care Institute.

Family members who are jointly insured are entitled to medical care in accordance with the legislation in Germany. If desired, they can take out supplementary insurance with the Krankenkasse. A nominal premium (treaty contribution) is payable to the National Health Care Institute for the entitlement to medical care of a jointly insured spouse and children above 18 years of age. This premium will be charged to you by the National Health Care Institute. For more information, see the website of the National Health Care Institute.

Do you live in the Netherlands and your family members live in Germany? These family members cannot take out healthcare insurance in the Netherlands. They can often still be jointly insured, however. To this end, you can apply for the E109 treaty form from Menzis. This form should be submitted to a Krankenkasse. If it is established that your family members are jointly insured, you can register them with a Krankenkasse by means of the E106 treaty form.

Family members who are jointly insured are entitled to medical care in accordance with the legislation in Germany. If desired, they can take out supplementary insurance with the Krankenkasse. A nominal premium (treaty contribution) is payable to the National Health Care Institute for the entitlement to medical care of a jointly insured spouse and children above 18 years of age. This premium will be charged to you by the National Health Care Institute. For more information, see the website of the National Health Care Institute.

If you have any questions about health insurance in international situations, please contact the Menzis Team Polis Buitenland: polisbuitenland@menzis.nl or +31 (0) 53 485 34 77.

Retired staff members residing in Germany

As a rule, retired staff members residing in Germany and their families cannot take out health insurance with a Dutch health care insurer. They are only entitled to medical care as provided for in Germany and need to register with the Zorginstituut. For medical care they can turn to a German health care insurer (Krankenkasse). Persons from the age of 18 are due a nominal premium to Zorginstituut. On working days between 8.30 a.m. and 12.30 p.m. retired staff members residing in Germany can contact the Zorginstituut by telephone on 010 4289551.

Insurance packages

In the UT’s collective health insurance you can choose from two basic insurances, several additional insurance packages, dental insurance packages and a combined additional and dental insurance for young people between the ages of 18 and 30. Moreover, under certain conditions you may take out a balanced package of extra reimbursements against a small extra premium.

Click here for a global listing of the compensations of the different packages.

In the Reimbursement summary A-Z you can search by treatment, complaint or reimbursement (in Dutch).

Basic insurance

The Dutch health care system has a statutory basic insurance for everyone residing in the Netherlands or abroad but working and paying wage tax in the Netherlands. Children up to the age of 18 years are co-insured with their parents. Children from the age of 18 years are to take out a basic insurance themselves.

The government establishes the insured package for the basic insurance. The basic insurance compensates a large part of your medical costs, like GP care, specialist medical care, delivery and maternity care, medication, stay in a hospital and patient transport. Regarding the basic insurance, you can choose from three policies under the UT’s collective health care insurance:

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Menzis Basis
Menzis Basis is an in-kind care policy.
This means that Menzis pays the health care costs directly to the care provider. You can obtain care from any care provider with whom Menzis has an agreement. Menzis has agreements with almost all care providers in the Netherlands. If you choose a non-contracted health care provider, you will be reimbursed for 75% of the amount that Menzis has contracted for treatment on average. The rest will be for your own account. If you want to know whether Menzis has an agreement with your care provider, go to the Zorgvinder or call the Client Services department: 088 222 40 40.

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Menzis Basis Vrij
Menzis Basis Vrij is a restitution care policy. This means that you may obtain care from any care provider. If you choose a non-contracted health care provider, you will be reimbursed for 100% of the market-based rate.

Menzis Voordelig
Voordelig is an in-kind care policy in which you arrange a lot of things online. If you choose a non-contracted health care provider, you will be reimbursed for
65% of the amount that Menzis has contracted for treatment on average.

Additional insurance packages

On top of the basic insurance you can choose additional insurance. This additional insurance compensates care that is not or only partly covered under the basic insurance. For example, alternative medicine, physiotherapy and spectacles. You can decide whether and which additional cover you take out in addition to the basic insurance. Children under the age of 18 years do not pay any premium for additional insurance products, provided the package chosen is the same as that of one of their parents.

If you take out the basic insurance Menzis Basis or Menzis Basis Vrij you can choose from three additional insurance packages: ExtraVerzorgd 1, ExtraVerzorgd 2 and ExtraVerzorgd 3. ExtraVerzorgd 3 is the most extensive additional insurance.

Dental insurance packages

In the basic insurance, persons up to the age of 18 years are insured for elementary dental care such as regular preventive dental examinations, anaesthesia, fillings and fluoride treatments. For orthodontics and crowns, bridges or inlays they need to have a dental insurance. Children up to the age of 10 years do not pay any premium for such dental insurance with Menzis.

If you are aged 18 years or older, your dentist costs are not compensated under the basic insurance. You can take out a dental insurance policy for this. Menzis offers three standard dental insurance policies: TandVerzorgd 250, 500 and 750. These dental insurance policies reimburse 100% of the checkup costs and 80% of the costs for all other treatments (excluding missed appointments and external bleaching) up to a maximum total of € 250, € 500 or € 750 per calendar year. The reimbursement for orthodontics is not included under this maximum amount. This is subject to a one-off amount of € 2,000 for policyholders under 18 years of age or a one-off amount of € 500,- for policyholders above 18 years of age.

Combined additional packages

Young people between the ages of 18 and 30 may combine the basic insurances Menzis Basis and Menzis Basis Vrij with a special supplementary insurance package: JongerenVerzorgd. This package is an additional insurance and a dental insurance all in one.

The basic insurance Menzis Voordelig can only be combined with Aanvullend or BudgetBewust Extra Aanvullend. This is also an additional insurance and a dental insurance all in one.

Special UT package

In the collective health insurance of the UT you can claim a special UT package with extra reimbursements if you take out the basic insurance Menzis Basis or Menzis Basis Vrij. These extra reimbursements are in addition to or instead of the reimbursements you are entitled to in the regular additional insurance and dental insurance offered by Menzis. For adults this comprises among other things an ample reimbursement for spectacles/contact lenses and an ample reimbursement for dental costs. For persons up to the age of 18 years TandVerzorgd UT 950 comprises an ample reimbursement for orthodontia.

You will only be eligible for these extra reimbursements if you take out ExtraVerzorgd UT 1, 2 or 3, in combination with TandVerzorgd UT 350, 650 of 950. You pay a small extra premium for the special UT package. This is included in the premium for ExtraVerzorgd UT 1, 2 or 3.

Medical acceptation

It is up to you which health care policy precisely you choose. Menzis accepts all staff members, retired staff members and their family members for the basic insurance and for all supplementary types of (dental) insurance which are part of the UT’s collective health insurance. Also for the extra compensation in the special package variant UT you will be accepted without medical selection. However, a waiting time from 1 year applies to some dental care (crowns, bridges, implants and orthodontics).

Premium

Premie overzicht

Click here for an overview of the healthcare insurance premiums from 1 January 2017.

This is the premium that you pay for a compulsory excess of € 385 per calendar year for the basic insurance.

Payment of premium

You are responsible for a timely and correct payment of premiums to Menzis. Menzis will charge the premium to you monthly in advance. You can authorise Menzis for an automatic collection of the premium from your account. If you do not authorise Menzis, you will receive a giro collection form each month. There are costs associated with this.

Menzis is entitled to suspend the insurance in case of late payment. In extreme cases, Menzis may terminate the insurance.

Reductions

In case of quarterly, half-yearly or annual payment you will receive a payment discount. In case of quarterly payments or half-yearly payments this discount amounts to 1% and for annual payments 2%. This payment discount applies to both the premiums for your basic insurance and the premium for the additional insurance, dental insurance or combined package.

Personal excess

Compulsory personal excess

In 2017 the basic insurance has a compulsory excess of € 385 per calendar year for insured aged 18 years and older. This means that, if in any calendar year you have incurred medical costs, you will pay the first € 385 yourself. If you do not make any medical costs during the entire year, of course you do not pay any excess.

The excess – compulsory and voluntary – does not apply to all medical care. Care provided by the GP, care for children under the age of 18 years, obstetric care and care from an additional insurance or a dental insurance, are not subject to excess.

Voluntarily personal excess

In the basic insurance you can opt for an extra personal excess. In exchange, you receive a reduction on the premium. The higher the voluntarily personal excess, the higher the reduction.

Extra personal excess per year

Reduction per month

Reduction per year

€ 100

€ 3

€ 36

€ 200

€ 6

€ 72

€ 300

€ 9

€ 108

€ 400

€ 12

€ 144

€ 500

€ 20

€ 240

In the basic insurance BudgetBewust you may only opt for a voluntary personal excess of € 500 per calendar year. You will then receive a discount of € 20 per month.

Paying compulsory excess in instalments

Do you expect to use your compulsory excess (to a large extent) and do you want to avoid paying this amount at once? Then you can pay your compulsory excess in 10 monthly instalments. You can request this service before 31 January 2017 through the website of Menzis.

Application

As a rule, your participation in the UT’s collective health insurance can only start as from 1 January of any calendar year. In the following situations, however, you can also apply in the course of a calendar year:

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If you change employer and are able to convert your current collective health insurance with Menzis or another healthcare insurer into the UT’s collective insurance.

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If you are insured abroad and because of your employment with the UT are obliged to take out health insurance in the Netherlands.

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If you are currently uninsured for healthcare costs, but are obliged to take out health insurance in the Netherlands.

Application form

Click here to download the Application Form for UT’s collective health insurance. Completed forms can be sent to:

Menzis

Postbus 75000

7500 KC Enschede

Duration of your insurance

You take out your health insurance for the duration of one calendar year. This period is only deviated from if your health insurance commences in the course of a calendar year. For example, if during the year you take up residence in the Netherlands and until that moment did not fall under the scope of the Health Care Act.

Adjustment

Adjustment cover

It is not possible to adjust the cover of your health care policy in the course of the calendar year. However, there is one exception to this. If a co-insured child reaches the age of 18 years, it must take out his or her own Basic Insurance. If your child is unmarried and a student, he or she can continue to participate in the UT’s collective health insurance and remain on your health care policy. If your child is married or is not a student, he or she must apply for his or her own health care policy. In both situations you can make changes to your child’s additional insurance and the dental insurance. You can also opt for a first risk clause. These changes are to be passed on to Menzis no later than in the month in which your child has reached the age of 18 years. The changes will always be effective from the first day of the month following the month in which your child has reached the age of 18 years.

Changes in your personal or family situation

A change in your personal or family situation may have consequences for your health care policy, for example in case of a birth, death, marriage or divorce. But also if a family member moves to his or her own address. Only family members who move for reasons of study, can remain insured via you. If this is not the case, the family member must take out his or her own health care policy. You are required to pass on any changes in your personal or family situation that are relevant for your healthcare policy to Menzis within 30 days.

Termination of employment

If your employment with the UT ends, you are to pass this on to Menzis. As a rule, your health insurance will be continued for the remainder of the calendar year on the basis of the then applicable individual conditions and individual premium rates. This means that the extras in the specific UT arrangement will cease to apply. The same applies to the collectivity discount over the premiums of the Basic Insurance, additional insurance and dental insurance. There are three exceptions to this rule:

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Your employment ends due to (early) retirement. You and your family members can continue to participate in the UT’s collective health insurance on the same conditions and with the same premium rates. You do not need to do anything.

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Immediately following your employment with the UT you start with another employer in the Netherlands who offers you a collective insurance. You can switch prematurely to the collective health insurance of the new employer. In this case you must cancel your health insurance with Menzis within 30 days after the commencement date of your new employment. The termination of your insurance with Menzis and your new registration with the new health insurer will have no retroactive effect. Both will be effective from the first day of the same calendar month.

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Immediately following your employment with the UT you take up residence abroad and you are no longer obliged to take out health insurance in the Netherlands. After cancellation Menzis will terminate your insurance effective from the day on which this new situation commences.

Amendment Form

Click here to download the Amendment Form. Completed forms can be sent to:

Menzis

Postbus 75000

7500 KC Enschede

Declaration

Menzis will help you with the accurate handling of your claims and will answer any questions in this context. Staff members and retired staff who make use of the collective health insurance of the UT may send their claims by mail to:

Menzis

Afd. Verzekerdennota's

Antwoordnummer 87

7500 WB Enschede

It is also possible to submit claim forms online. To do so, go to Menzis online declaration. Or use the “mobiele declaratie app” (mobile app for claims).

If you have any questions concerning claims, you can contact Menzis via Customer Service between 08:00 and 21:00 on working days: 088 222 40 40 (option 3).

Termination

Without any notice to the contrary Menzis will renew your health insurance each time for one calendar year.

Termination at the start of a new calendar year

If you wish to terminate your insurance with Menzis at the start of a new calendar year, you are to do so in writing before 31 December of the current calendar year. After termination of your insurance you will receive proof of your cancellation. Subsequently you have the time until 1 February of the new calendar year to take out another Basic Insurance with another insurer. This new Basic Insurance will then commence as per 1 January of the new calendar year.

Termination in the course of a calendar year

As a rule, it is not possible to terminate your insurance with Menzis in the course of a calendar year. There are two exceptions:

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Your employment with the UT ends and immediately following you start with another employer in the Netherlands who offers you a collective insurance? You can switch prematurely to the collective health care insurance of the new employer. In this case you must cancel your health care insurance with Menzis within 30 days after the commencement date of your new employment. Your cancellation of your insurance with Menzis and your new registration with the new health care insurer will have no retroactive effect. Both will be effective from the first day of the same calendar month.

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Your employment with the UT ends and immediately following you take up residence abroad and are no longer obliged to take out a Dutch health insurance? After cancellation Menzis will terminate your insurance effective from the day on which this new situation commences.

Information

Do you have any questions about the UT’s collective health insurance or do you wish to pass on information? You can reach Menzis in various ways: via the internet, by telephone, by mail and, of course, at one of the Menzis shops in your area. For more information go to www.menzis.nl

You can reach Menzis by telephone via Customer Service: 088 222 40 40. Customer Service can be contacted on working days between 08:00 and 21:00.

Appendices:

Changes in 2017

Overall Reimbursement Guides

Terms and conditions

UT package 2017