Corporate Plans — BC Flexi Access & FA Plus

Both are corporate medical plans, but they cater to different company sizes. BC Flexi Access is fully customizable for larger groups (typically 20+ employees). BC Flexi Access Plus (FA Plus) is a pre-packaged plan for small and medium businesses (up to 50 employees) that offers premium benefits without complex underwriting.

FA Plus is divided into two categories: FA Plus-S (Small) — for businesses enrolling 3 to 9 employees. FA Plus-M (Medium) — for businesses enrolling 10 to 19 employees (up to 50 max).

You can enroll: Spouses and/or Parents (18 to 65 years old); Qualified Minor Dependents — children or siblings (15 days old up to 23 years old).

No. One of the biggest advantages of FA Plus is that individual health declarations are waived. Employees do not need to declare their medical history to get enrolled.

Pre-Existing Conditions are covered on the very first year, with limits based on company size. FA Plus-S (3-9 employees): both employees and dependents are covered up to 10% of Maximum Benefit Limit. FA Plus-M (10-19 employees): employees get full MBL coverage for PECs; dependents are covered up to 50% of MBL.

Sean can help optimize by restricting Network Access: (1) All Accredited Hospitals — full access, highest premium. (2) Excluding 6 Major Hospitals (Makati Med, Asian Hospital, Cardinal Santos, St. Luke's QC & Global City, The Medical City) — significant discount. (3) Visayas and Mindanao Only — drastic savings for regional teams. (4) Central and North Luzon Only — regional restriction.

The plan includes unlimited consultations with accredited physicians and specialists during regular clinic hours. It covers laboratory examinations, X-rays, diagnostic procedures, treatment of minor injuries, and minor surgeries not requiring confinement.

Yes, for Principal Members (employees), after 6 months of continuous coverage. It includes physical exam, CBC, Fasting Blood Sugar, Chest X-ray, Urinalysis, Stool Analysis, ECG and Pap Smear for 35+. The APE is not available to enrolled dependents.

Yes. The plan allows a reimbursement of up to PHP 500 for the PME once the employee is officially enrolled.

Childbirth, delivery, miscarriage, and abortion are permanently excluded from the base FA Plus plan. However, Out-Patient pre-natal and post-natal consultations are covered. Larger companies on BC Flexi Access can opt to add a specific Maternity Benefit.

If accredited providers were not nearby — Pacific Cross reimburses 100% of eligible amount (based on accredited rates) up to MBL. If accredited providers were accessible but the employee chose non-accredited — reimbursement is capped at ₱30,000 for the first 24 hours.

Yes. Emergency Hospitalization in Foreign Territories covers overseas emergencies for up to 90 accumulated days per policy year (max 30 days per trip). Reimbursement up to ₱30,000 per availment.

Yes. Work-related conditions are covered up to MBL for Principal Members, provided there is certification from the Employees' Compensation Commission (ECC).

Yes, with inner limits. FA Plus-S (3-9): up to 10% of MBL or ₱10,000, whichever is lower. FA Plus-M (10-19): up to ₱20,000 per member per year.

Yes, up to a lifetime limit. FA Plus-S: up to 10% of MBL. FA Plus-M: up to 20% of MBL.

Yes. FA Plus covers Motor Vehicular Accidents up to MBL. It also uniquely covers Provoked and Unprovoked Assaults (including domestic violence) up to the full MBL.

Yes. Physical Therapy and Occupational Therapy — up to 12 sessions per year. Speech Therapy — up to ₱10,000 per member per year.

Yes. Robotically Assisted Surgery is covered up to ₱50,000 per member per year.

Yes. Sleep studies to determine CPAP treatment level are covered up to ₱50,000 per year. However, the actual CPAP machine for home use is not covered.

Yes. Electrocauterization of warts (excluding genital warts): up to ₱2,000/year. Sclerotherapy for varicose veins: up to ₱5,000 per leg/year, if medically necessary.

The plan includes a Room Upgrade Allowance — you may occupy the next higher room category for 48 hours (except Suite Room). Pacific Cross covers the incremental charges with a hospital certification of unavailability.

Yes. Emergency ambulance is covered up to MBL for transfers from the place of occurrence to a hospital, or between accredited hospitals. Non-accredited to accredited transfers: up to ₱2,500 per conduction.

Yes. Administration fee for routine immunizations is covered, plus up to ₱500/year for Flu Vaccine. Also covers antivenom, rabies, and tetanus post-exposure prophylaxis up to ₱40,000.

Yes. The Preventive Healthcare Benefit covers consultations on diet, exercise, health habits, and family planning counseling (except infertility).

All dental procedures must be done within FILDOCS-affiliated clinics. Reimbursement for non-accredited dentists is not allowed. Employers can add Standard or Extended Dental Benefits.

Yes. You can attach an Optional Life Insurance rider with Accidental Death and Dismemberment benefits (₱25,000 or ₱50,000 limits).

Sean acts as a free extension of your HR department. Onboarding & Parsing — he manually processes all application forms and manages employee additions/deletions. Direct Liaising — handles health card releases and direct liaison with Pacific Cross. Claim Escalations — employees can escalate hospital approval issues directly to Sean, who uses his internal channels to resolve bottlenecks. This premium advocacy costs nothing extra.