CONTRACT AGREEMENT

FOR THE PROVISION OF MANAGED HEALTHCARE SERVICES

Between
ANCHOR HMO INTERNATIONAL
COMPANY LIMITED
AND
GLOBUS BANK LIMITED

JANUARY 1, 2021
ANCHOR HMO
Gold Crest Plaza, Km 23 Ikota 1st Gate, Lekki-Epe Expressway, Lekki, Lagos
 HEALTH SERVICES MAINTENANCE AGREEMENT

This Health Services Maintenance Agreement is made the Friday, 1ST January 2021.

Between:

1) GLOBUS BANK LIMITED, a company incorporated under the laws of the Federal
Republic of Nigeria with its registered office at 6,Adeyemo Alakija St, Victoria
Island, Lagos, Nigeria (hereinafter referred to as “the Client”), of the one part;
AND

2) ANCHOR HMO INTERNATIONAL CO. LTD, a company incorporated under the laws of
the Federal Republic of Nigeria with its registered office at Goldcrest Plaza, Km 23
Lekki-Epe Expressway, Ikota first gate, Ikota, Lekki, Lagos (hereinafter referred to as
“the HMO”), of the other part.

WHEREAS

a) The Client has agreed to enter into this agreement with the HMO for the provision of
a Health Insurance cover for the employees.

b) The HMO which is a Health Maintenance Organization duly licensed by the National
Health Insurance Scheme agrees to contract with the Client upon terms and
conditions hereinafter provided.

c) The Client hereby appoints the HMO and the HMO hereby accepts and agrees to
provide Health Insurance cover to the Client’s Employees subject to the terms and
conditions stipulated herein.

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CLAUSE 1 - DEFINITIONS & INTERPRETATION

In this Agreement, unless the context otherwise requires, the following expressions shall
have the following meanings:

“Enrollee” means the employee of Client.

‘’Principal’’ means the employees of Client with or without qualified Dependants on the
scheme.

“Qualified Dependants” means Enrollee’s spouse and a maximum of FOUR unmarried

children not exceeding 25 years.

“Children” mean the biological or legally adopted children of the Principal.

“Healthcare Provider or Provider” means the Hospitals and/or Clinics on the network of
the HMO.

“Scheme” means the undertaking by the HMO to provide healthcare services to the
enrollees.

“Force Majeure Event” includes but not limited to any act of war (whether war be
declared or not), emergency, Bomb Blast, strike, industrial dispute, accident, fire,
earthquake, flood, storm, tempest, any act of God or any other cause beyond the
reasonable control of the party affected.

“Emergency” means:

I. A medical condition manifesting itself as acute symptoms of sufficient severity

(including severe pain) such that the absence of immediate medical attention could
reasonably be expected to result in death, serious impairment to bodily functions or
permanent disability.

II. With respect to a pregnant woman who is having contractions – that there is
inadequate time to effect a safe transfer to another hospital before delivery, or that
transfer may pose a threat to the health or safety of the woman or the unborn child.

“Outpatient Visit” means any visit (including visits requiring Dental and Optical care) not
necessitating an enrollee to spend a night at the Hospital.

“Inpatient Care” means the care of enrollee whose condition requires admission at a
Hospital.

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NOW THEREFORE IT IS AGREED AS FOLLOWS:

CLAUSE 2 - EFFECTIVE DATE AND RENEWAL

The appointment shall take effect from 1st day of January 2021 and shall continue in force
for a period of twelve months (12), after which it may be renewed by the Client on such
terms and conditions as may be mutually agreed by the parties in writing, unless
otherwise terminated by either party in accordance with the provisions of this
Agreement.

CLAUSE 3 - UTILIZATION AND COST MONITORING AND RENEWAL

The utilization of services and benefits covered as contained in schedules 1 and 2 of this
agreement shall be monitored through the provision of a utilization report to the Client
by the HMO. The report shall show disease pattern and costs. This report shall help all
parties to this agreement monitor the costs of servicing the population and project into
the renewal year (2022).

CLAUSE 4 - PRICING AND PAYMENT TERMS

PRICING

In consideration of the sum per plan, as described in Schedule 1, made payable in

advance Quarterly on the commencement of this Agreement to the HMO for the period
1st day of January 2021 to 31st day of December 2021 and renewable thereafter for
agreed periods, the parties hereby agree to the terms hereinafter appearing.

PAYMENT TERMS

(a) The HMO’s remuneration shall be at the individual rates negotiated; as stated in
Schedule 1 below.

(b) Premium for each individual shall not be transferable.

(c) Invoicing shall be based on Client’s staff list forwarded to the HMO before the
commencement/renewal of the scheme; and as updated on a periodic basis by
the Client.

(d) Premium payable Biannually.

(e) Initial payment shall be paid in advance before commencement of the scheme
based on a total number of expected enrollees.

(f) Invoicing shall be done 30 days into the first day of the scheme.

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(g) Premium due for an Employee of who joins mid-way into the scheme (after
invoicing and payment has been concluded for the first quarter) shall be prorated
and invoiced alongside the next quarters invoice.

(h) Change of enrollee can be done quarterly in a situation where an enrollee leaves
in a quarter, a replacement can be done in the next quarter.

CLAUSE 5 - OBLIGATIONS OF THE HMO

1. The HMO shall provide to the Client’s Employees such Medical and healthcare
services stipulated in this Agreement (see attached Schedules 1 and 2). The
healthcare Services shall be administered at designated centers (Hospitals and
Clinics) throughout Nigeria ONLY; as may be approved from time to time by the
HMO.

2. The HMO shall provide a list of its network of Providers to enable members register on
the scheme. The hospitals and clinics so recognized and certified for care are listed
on Schedule 3.

3. The Client may introduce Healthcare Providers it requires to be listed to the HMO and
the HMO shall have the obligation of inspecting such Provider. The Provider
Management Unit of the HMO shall visit such a Provider to inspect, accredit (if it
meets the HMO’s minimum standard working requirements) and reach an
agreement for inclusion on the network. Exceptions may be made based on mutual
agreement between the parties which may be determined by the location of the
Client’s operations and the level of Enrollee strength in such locations.

4. The HMO shall undertake to directly register the employees of Client and their
qualified dependents nation-wide, and carry out a pre-operational orientation
programme for all Enrollees at their various locations throughout Nigeria. The
scheduling of orientation programme shall be as agreed by the parties.

5. Following receipt of the filled subscriber data forms by the employees of service
providers, the HMO shall have the obligation of ensuring the provision of membership
card for all registered enrollees on the scheme. The membership cards shall be
provided to the Enrollee within 5 working days of receipt of enrolment forms.

6. It shall be the responsibility of the HMO to ensure that all Enrollees in the scheme have
access to and receive adequate medical care from the selected Healthcare
Providers in accordance with the health plan in schedules 1 and 2.

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7. It shall be the responsibility of the HMO to bear all medical costs incurred directly with
the Healthcare Providers by the Enrollees, for all covered services ONLY as specified
in schedules 1 and 2; in accordance with the provision of this agreement.

8. The HMO shall maintain valid contractual agreements with their healthcare Providers
to ensure that the Providers, their Physicians, Medical staff and personnel are duly
registered as may be required under any applicable law or regulation in Nigeria to
perform and carry out the duties in pursuance of and as contemplated in this
agreement.

9. The HMO shall ensure that the covered healthcare services shall be provided on a
24 hour per day basis throughout the contract year.

10. Removal of hospital from the list of providers shall be communicated to the Client
within 48hrs and not later than 72hrs of such alteration, termination or removal.

11. Where a Staff exceeds the specified number of one Spouse or Four Children allowed
on the scheme, additional premium shall be charged directly to the Employee on
each additional Enrollee. It shall be the responsibility of the HMO to retrieve this
payment directly from the Staff.

12. The HMO shall appoint an Account Manager/Relationship Manager to relate with
the Client on ALL matters relating to this agreement. The Account
Manager/Relationship Manager shall deal directly with the Client on all matters.

CLAUSE 6 - OBLIGATIONS OF THE CLIENT

1. It shall be the obligation of the Client to pay the premium set forth in Schedule 1below,
in accordance with the provision of this agreement.

2. The Client shall advise the HMO with a valid list of beneficiaries before the
commencement of the scheme and provide updates as may be required from time
to time.

3. To register all its eligible members of staff with the HMO immediately on an
appropriate plan that has been selected by The Client from the HMO Plans. The
providers on the HMO network shall not attend to any employee and/or their qualified
dependants, where applicable, not registered on the list provided by the Client.

4. The Client shall ensure that all registered members complete the personal data form
and provide all necessary information as well as passport photographs for those to be
registered on the scheme.

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5. The beneficiaries of The Client who choose to attend or visit any other clinic/Hospital
not on the HMO provider list without the prior knowledge, consent or advice of the
HMO shall be responsible for cost incurred.

6. All Enrollees shall be required to choose a Primary Healthcare Provider as indicated in

the subscriber data forms.

7. It shall be the obligation of the Client to notify the HMO of ALL staff exiting the
Company and retrieve from the exiting staff, the HMO’s membership card. Such cards
retrieved shall be forwarded to the HMO or destroyed by the Client. In the event that
the staff of the Client still accesses care after expiration of the contract, the Client will
bear the cost of the bill incurred if the scheme is not automatically renewed.

8. It shall be the responsibility of the Client to communicate the health plan purchased
to her staff for their knowledge and understanding of the extent of cover and/or
limitations.

9. The Client undertakes that the appended schedules and documents have been read
and understood.

CLAUSE 7 - GENERAL CONDITIONS FOR COVERAGE

1. Enrollees shall be entitled to request for a change of primary Provider during the
tenure of this agreement. Requests for change of Hospital shall be effective after
24hours of said request.

2. Where an Enrollee is dissatisfied with the services received from a Provider, the Enrollee
shall formerly lay complaints to the HMO through her Care Manager, or directly
through the HMO’s call centre or by writing.

3. Parents shall be included as dependants following approval from underwriting

committee based on evaluation of risk and potential exposure of the policy.

a) In such cases, the age limit of parents shall not exceed 60 years.

4. Pre authorizations are approvals for surgeries and or specialists care. These are
requested from hospitals and clinics in order to check abuses and over utilizations.
Authorizations must be obtained from the HMO after all preliminary admission
requirements have been observed 24hrs prior to hospitalizations and surgeries in case
of non-emergent conditions and within 48 hours after emergencies. Pre authorizations
must also be sought in treatment of covered chronic medical conditions.

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5. In the event of life threatening emergencies, registered members can access care
at the nearest Provider, even where the Provider is not under the HMO’s provider
network.

(a) In such cases, the HMO should be notified not later than 48 hours after member
accesses care at the Facility.

(b) In cases of ‘out of station’ need for care, members can access care upon
presentation of their membership ID card at any of the Providers on the HMO’s
network nationwide. However, such an Employee needing care shall contact the
HMO for pre-authorization to access care, unless the case is life threatening where
clause 5 (a) shall apply.

CLAUSE 8 - CONFIDENTIALITY AND NON-DISCLOSURES

The HMO shall during the term of the Agreement and anytime thereafter.

a) Preserve and cause her Employees to preserve the secrecy of all document(s) and/or
information handed over to her in connection with all Clients’ matters.

b) Not disclose such document and/or information to any third party, or place at the
disposal of or use on behalf of any third party.

c) Not utilize any confidential information except with the prior written consent of the
client or its representative.

d) Preserve and cause their Employees to preserve the secrecy of all document(s)
and/or information handed over to them (the HMO) in connection with all Client
matters.

e) Not disclose such document and/or information to any third party, or place at the
disposal of or use on behalf of any third party.

f) Not utilize any confidential information except with the prior written consent of the
client or its representative.

CLAUSE 9 - NOTIFICATION & NOTICES

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1. This agreement shall be valid for the duration of one (1) year and shall be renewable
as agreed by parties.

2. Either party may terminate the agreement during the one (1) year period by giving
to the other party one (1) month notice in writing.

CLAUSE 10 -GOVERNING LAW AND ARBITRATION

1. The Parties shall endeavor to settle amicably any dispute arising from this Agreement
and any dispute which cannot be resolved amicably shall be referred to Arbitration
in accordance with the provisions of the Arbitration and Reconciliation Act, 2004 as
applicable in Nigeria. The proceeding shall be in English language and to be held at
Lagos.

2. This Agreement shall be interpreted and construed in accordance with the laws of
the Federal Republic of Nigeria.

CLAUSE 11 - ALTERATIONS

1. This Agreement or any part thereof shall not be subject to any amendment unless the
parties herein consent to same in writing.

2. All alterations and terminations, change of hospitals shall be communicated to the

HMO.

3. Any such alteration, as mentioned above, shall be implemented only after

confirmation from the Client.

CLAUSE 12 - FORCE MAJEURE

No Party shall be considered in breach of its obligations under this Agreement or be

responsible for any delay in carrying out its obligations, if performance is prevented or
delayed wholly or in part as a (direct or indirect) consequence of a Force Majeure Event.

CLAUSE 13 - NOTICES

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Any notice and other communication required or permitted under the terms and
provisions hereof shall be in writing and shall be given by personal delivery, registered
mail or courier and shall be deemed given when received by the recipient at its following
address:

IN WITNESS WHEREOF the parties have hereunto set their hands and seal the day and year
first above written.

The common seal of ANCHOR HMO INTERNATIONAL COMPANY LIMITED

Is hereby affixed in the presence of

Name: ______________________________ Name: ____________________________

Designation: _________________________ Designation: _______________________

Signature: ____________________________ Signature: __________________________

The common seal of the within named GLOBUS BANK LIMITED hereby affixed in the
presence of

Name: ______________________________ Name: ____________________________

Designation: _________________________ Designation: _______________________

Signature: ____________________________ Signature: _______________________

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PLANS/BENEFITS WELFARE SELECT ULTIMATE EXECUTIVE
PREMIUM (INDIVIDUAL) ₦25,000 ₦30,000 ₦60,000 ₦150,000

PREMIUM (FAMILY of 6) N80,000 ₦100.000 ₦250,000 ₦500,000

General Medical Services

Outpatient Care    
General consultation &
treatment to include
prescribed drugs &    
infusions, case review,
nursing care etc.
Hospital Admissions    
Standard ward Semi Private ward Private ward Private ward
Hospital Ward
To a max of 5 To a max of 10 To a max of 15 days To a max of 18 days
Accommodation days per case days per case per case per case
Routine Diagnostic Test to
include routine laboratory
   
tests, x-rays, pathology &
diagnostic tests
Preventive care &
   
counselling
HIV/AIDs counselling,
testing & provision of ARVs    
at designated centers
Emergency Care
Accidents & Emergency -
Stabilization, Local
   
Evacuation & Emergency
drugs & investigation
Ambulance Rescue
   
Facilitation
Mortuary Benefits    
Specialist Medical Services
Specialist consultation & 
treatment to include GYNAECOLOGY 
prescribed medicines, &   
drugs & dressings, case PAEDEATRICIAN 
review
Specialist Investigations –
E/U/Cr, Lipid Profile, Liver   
function Test, (ECG) etc.


Advanced Investigations -
EEG
EEG, IVU, Barium studies,  EEG
CT scan
CT Scan, MRI ,  CT scan
Echocardiogram
Echocardiogram (at EEG only Echocardiogram
MRI
designated centers) during

emergency)
Physiotherapy
consultation & procedures
2 session 5 sessions 7sessions 10 sessions
(at designated centers)
Annually

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Psychiatric treatment -
Consultation and
outpatient treatment for    
30 days (only after
12month on scheme)
Intensive Care Services Covered up to 24hrs Covered up to 3days
Renal Dialysis
Sessions(Acute Phase 2 sessions 3 sessions
only)
Surgical Procedures
Minor Surgeries    
Appendectomy &  
Herniorrhaphy to Herniorrhaphy
Intermediate Surgeries Covered within Covered within
a limit of N80,000 Only to a limit of
N120,000 limit limit
Minor, Intermediate, Major
 
Surgeries
Covered within Covered within
Anesthesia, Surgical
surgery limit of surgery limit of
supplies/Consumables,
N300,000 N400,000 
administration of blood.
Chronic Medical Conditions Management
Newly diagnosed - Initial
maintenance, Routine
  
check-ups, dressings, 
  
prescribed drugs &
palliative care

Routine Prescribed drugs 3 Times per 6 Times per

Covered
for chronic medication annum annum

Maternity Care
Antenatal care    
Normal, Assisted &
   
Multiple Delivery
Caesarean Section    
Postnatal care    
   
Overall Maternity Limit N100,000 N120,000 N200,000 N250,000
Newborn treatment post
delivery 24hrs 2days
(Excluding SCBU, ICU)

Childhood Immunizations (0-2Years)

Routine Immunizations
(NPI)    
(0-2 years)
Additional Immunizations  
(Non NPI) (0-2 years) (0-2 years)

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Dental Care
Dental consultation,
medical treatment, drugs    
& dressings
Simple Dental Procedures
- simple extraction,    
amalgam filling
Complex Dental
Procedures - Surgical

extraction, composite  


filling, Amalgam filing ,
simple dental procedures
Dental Limit
₦12,000 ₦15,000 ₦25,000 ₦30,000
(Annual limit)
Eye Care
Optical/Ophthalmological
consultation, medical
   
treatment, drugs &
dressings
Investigations - Refraction,
   
CVF, IOP
Provision of lenses &
frames subject to benefit    
limit
Optical Limit
₦12,000 ₦15,000 ₦30,000 ₦40,000
(Biennial limit)
Wellness Benefits
Routine Medical Check-
   
Up (Anchor HMO)
Gym and Spa Access    
Comprehensive Medical

Check-Up (With 
Pathology and
Investigations) Pathology only
imaging

Cancer Care
Routine Examination -
Physical exam of breast,    
prostate & cervix
Fertility Care
Counselling & Basic
Investigations (SFA,
   
Ultrasounds, Hormonal
Profile)
Specialist Investigations
 
(HSG)
Family Planning Services
IUCDs
   
(Non-hormonal)

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Injectable & Implants  
APPENDIX- BREAKDOWN OF MEDICAL SERVICES

DETAILS ON HEALTH PLANS- (Plan and Limit Applies)

PRIMARY OUT-PATIENT CARE

Registration
General consultation
Specialist consultation
Routine laboratory investigation
Prescription and drugs
Physiotherapy
IN-PATIENT CARE
General Physicians review
Specialist review
Admission
Feeding (provided by hospital)
Nursing care
Laboratory investigations
Prescription, drugs and consumables
Services of a dietician
SPECIALISTS
FAMILY PHYSICIAN
PAEDIATRICIAN
GYNECOLOGIST/OBSTETRICIAN
GENERAL SURGEON

OTHER SPECIALISTS
ENT SURGEON
UROLOGIST
ORTHOPEDIC SURGEON
HAEMATOLOGIST
OPHTHALMOLOGIST
PSYCHIATRIST
SUB SPECIALISTS
PAEDIATRUC SURGEON
NEUROLOGIST
ENDOCRINOLOGIST
GASTROENTEROLOGIST
DERMATOLOGIST

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CARDIOLOGIST

RADIOLOGICAL INVESTIGATIONS
Plain x-rays for diagnosis
Ultrasound (abdominal & pelvic)
Transvaginal Scan
Electrocardiogram (ECG) resting/post exercise
CT scan
EEG
Doppler Scan
Diagnostic x-ray (In & Out patient) -
Upper limb e.g. hand/wrist, forearm, elbow, humerus, shoulder,
clavicle
Lower limb e.g. foot/toes, joints, long bones, pelvis & hip
Thorax e.g. chest (AP/PA) - All views
Vertebral Spine e.g. cervical spine, lateral neck (soft tissue),
thoracic spine, thoracic lumber spine, lumboscaral spine

Hematology e.g. haemoglobin, PCV, platelets, FBC, Hepatitis

antigen, Prothrombin time, reticulocyte count, ESR, RBC, WBC,
DIFF, bleeding count, clotting time, malaria, widal, microfilaria, L.E
cells, HB genotype, Blood grouping

Serology e.g. VDRL, Rheumatoid factor, Coombs test, Asotiter,

Heaf test, blood grouping, pregnancy test (urine & blood),HIV 1&2
screening, HIV Confirmation, Hepatitis Antigen and Antibody

Urine chemistry e.g. Urinalysis, Urine M/C/S, creatinine clearance

Blood chemistry e.g. Glucose, Calcium, Phosphorus, Urea,

creatinine, Uric acid, Albumin, Cholesterol, Triglyceride, HDL, LDL,
SGOT, SGPT Serum chemistry, Blood Culture
Hormone Assay e.g. Thyroid hormones, semen analysis, oestrogen
etc

Microbiology e.g. Urine microscopy, culture & sensitivity, Stool

microscopy, culture & sensitivity, Stool occult blood, swab
microscopy, culture & sensitivity, sputum microscopy, culture &
sensitivity, sputum ZN Stain, semen analysis, High Vaginal Swab
(HVS)

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ROUTINE INVESTIGATIONS

Hematology : haemoglobin PCV, platelets, FBC, reticulocyte

count, ESR, RBC, WBC, DIFF, bleeding count, clotting time, malaria,
microfilaria, L.E cells
Urine chemistry e.g. Urinalysis
Pregnancy Test
Plain x-rays for diagnosis
Upper limb e.g. hand/wrist, forearm, elbow, humerus, shoulder,
clavicle
Lower limb e.g. foot/toes, joints, long bones, pelvis & hip
Thorax e.g. chest (AP/PA) - All views
Vertebral Spine e.g. cervical spine, lateral neck (soft tissue),
thoracic spine, thoracic lumber spine, lumboscaral spine
Blood chemistry e.g. Glucose, Calcium, Phosphorus, Urea,
creatinine, Uric acid, Albumin

SPECIALIST INVESTIGATIONS
Lipid Profile: Cholesterol, Triglyceride, HDL, LDL, SGOT, SGPT

Microbiology e.g. Urine microscopy, culture & sensitivity, Stool

microscopy, culture & sensitivity, Stool occult blood, swab
microscopy, culture & sensitivity, sputum microscopy, culture &
sensitivity, sputum ZN Stain, semen analysis, High Vaginal Swab
(HVS)
Liver Function test
Hepatitis antigen, Prothrombin time,
ECG

ADVANCED INVESTIGATIONS
CT scan, Doppler Scan
EEG, IVU, Barium studies
Pap smear
PSA
Hormone Assay e.g. Thyroid hormones

MATERNITY SERVICES
Antenatal care
Normal delivery
Induction of labor

15
Assisted delivery
Elective CS and management
Emergency CS and treatment
Medically indicated C/S and treatment
Post natal care for mums
Preterm delivery
Evacuation- Dilatation and Curettage
FAMILY PLANNING
Injectables
Drugs
IUCD (Non Hormonal)
DENTAL CARE
Dental Consultation
Routine examination
Pain relief/therapy
Amalgam fillings
Composite fillings
Scaling & polishing (annual)
Simple extraction
Surgical extraction
Dental preventive care

EYE CARE
Optical consultation
Routine examination
Treatment of simple/primary infection (e.g. conjunctivitis)
Optical lenses (per year)
Eye glasses or contact lens
Foreign body removal
Refraction

SURGERIES
MINOR SURGERIES AND PROCEDURES -
Surgical drainage of simple abscesses
Surgical drainage of breast abscesses
Surgical drainage of galactocele
Sub-periosteal drainage for acute osteomyelitis
Drainage for septic arthritis

16
Intercostal drainage insertion
Aspiration of joints
Debridement of wounds
Surgical repair of wounds
Excision of tumour on abdominal wall
Proctoscopy
Evacuation of impacted faeces
-Closed reduction of fractures
Closed reduction and immobilization of joint dislocations
Ostectomy
Chondromectomy
Ganglionectomy
Cervical Cauterization
Circumcision
Electro fulguration of condylomataacuminata
Suprapubic cystostomy
Minor Keloid Excision
Venous obstruction-saphenous by pass
Temporary diversion of urine
Skin Traction
Manual Vacuum Aspiration/Dilation and curettage
INTERMEDIATE SURGERIES & PROCEDURES
Tracheotomy
Thoractomy
Adenolectomy
Injection sclerotherapy of varicose veins
Excision-biopsy of breast mass
Biopsy of thyroid gland
Surgical drainage of hematoma of rectus abdominus
Surgical drainage of peritoneal abscesses
Repair of colostomy
Anal sphincteroplasty
Biopsy of breast lump
Biopsy of tumor on abdominal wall
Biosy of bone marrow
Excision-ligation hemorrhoidectomy
Surgical excision of soft tissue tumor
Excision-biopsy of soft tissue tumor

17
Surgical drainage of hand abscesses
Herniorrhaphy
Cervical Cerclage
Major Wound Dressing
Hydrocelectomy
Surgical Drainage of Anal Abscess
Pelvic/Abdominal Abscess Drainage
Wound Repair of Major Laceration
Cervical Laceration Repair
Examination Under Anaesthesia
Appendicectomy

MAJOR SURGERIES & PROCEDURES

Myomectomy
Colostomy
Cholecystectomy
Granuloma Excision
Chalazion Excision
Bowel Resection and Anastomosis
Intussusception Operation
Sub Periostal Drainage of Acute Osteomyleitis
Ectopic Pregnancy Surgery
Repair of Ruptured Uterus
Oesophagostomy
Orchidectomy/ Orchidopexy
Haemorrhoidectomy
Surgical management of Uncomplicated Intestinal Obstruction

CHRONIC AILMENT CARE MANAGEMENT SPECIALIST

Hypertension
Diabetes
Asthma
Peptic ulcer
Hyperlipidemia
Psychosis (depression)
Consultation (general)
Consultation (specialist)
Prescription & drugs

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Counseling
Lifestyle management programme
ADDITIONAL IMMUNIZATIONS
Rotarix
MMR
Chicken Pox
Pneumoccocal
Hepatitis B
IPV
HIB
PREVENTIVE CARE
Annual Comprehensive Medical Check-Up- (Principal enrolee
only)

FBC, Urinalysis, FBS, Lipid Profile, LFTs, E-U&Cr, HbSAg, HIV, Chest X-
ray, PSA (for men > 45 yrs).

19
EXCLUSIONS
1 Services that are not medically necessary
Services performed or prescribed under the direction of a person who is not a certified and
2
registered healthcare practitioner;
Services that are beyond the scope of practice of the healthcare practitioner performing
3
the service.

4 Experimental services.

Medical or surgical treatment for infertility, including investigations, In Vitro Fertilization (IVF),
Ovum transplants and Gamete Intro-Fallopian Tube Transfer (GIFT), Zygote Intra Fallopian
5
Transfer (ZIFT), or cryogenic or other preservation techniques used in these or similar
procedures;

6 Surgical operations of the cranial cavity, brain, spine, spinal cord, heart and chest cavity,

7 Specific treatment of Hepatitis B viral infection

3rd degree burns covering more than 30% of the body surface area and skin grafting
8
procedures.
9 Treatment of pre-existing medical conditions
10 Medical or surgical treatment for obesity;
11 Medical or surgical treatment or regimen for reducing or controlling weight.
12 Cosmetic treatments and surgeries
13 Prostheses and all Orthopaedic aids and appliances
Surgery or related services for cosmetic purposes to improve appearance, but not to
14
restore bodily function or correct deformity resulting from disease, trauma etc.
Any condition, which in the opinion of the Hospital’s Chief Medical Officer is directly related
15 to the Human Immune Deficiency Virus (HIV) including Acquired Immune Deficiency
Syndrome (AIDS) and AIDS Related Complex (ARC). (where applicable)

Injuries and conditions arising from natural disasters, civil unrest, riots, domestic violence,
16
epidemics. (Stabilization care will be given to patient)

17 Injuries arising from extreme sports

18 Drug abuse and addiction, self-inflicted injury

19 Varicella Zooster Diseases and other Herpes Viruses
20 Haemoglobinopathies including HbSS and HbSC
21 Management of renal failure
22 Chemotherapy and Radiotherapy
23 Cardiovascular Accident including strokes
24 Organ/Tissue replacement procedures
25 Treatment for Viral Hepatitis and Hepatitis Immunoglobulin vaccines

20
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