Co-Payment and Extra Premium Options in BVCare: Rules by Group Size

In the series on Bao Viet corporate health insurance (BVCare new), optimizing benefits for employees and their families is a key focus for many businesses. The general principle of this product is no co-payment (no percentage cost-sharing) under standard coverage. However, when a business chooses to expand eligible dependents, extend age limits, or add extra benefit clauses with extra premiums, specific co-payment and extra premium rules will apply. Understanding these regulations helps businesses budget effectively and choose the best protection for their teams.

📌 General Principle: No Co-Payment, Exceptions Upon Expansion

According to the contract guidelines, the general co-payment rate is not applicable for standard group enrollments. However, to expand insured dependents or add extra benefits, Bao Viet applies specific co-payment and extra premium policies depending on the company’s employee size (grouped into: under 50 employees, 51 to 100 employees, and 101 to 200 employees). These are key rules businesses must note when planning employee health coverage. For a general overview of the corporate product, you can read more here.

👴 Expanding Parents Coverage: 30% Extra Premium & 20% Co-Payment (Groups 51–100 and 101–200)

To expand coverage to employees’ biological parents or parents-in-law, the specific rules are as follows:

• Group of 50 employees or fewer: This expansion is not available.
• Group of 51 – 100 employees: If requested, parents and parents-in-law can be added with a 30% extra premium on the base premium, and a 20% co-payment applies to inpatient and outpatient medical costs.
• Group of 101 – 200 employees: If requested, parents and parents-in-law can be added with a 30% extra premium (with no specific co-payment rule mentioned for this expansion).

Relatives can only join if the employee is also on the insured list, and can only join at a benefit level equal to or lower than the employee’s. For deeper rules on adding family members, refer here.

👶 Age Expansion (Children from 15 days to under 1 year, Adults aged 66–70)

To provide flexible protection for business families, BVCare offers age expansion with corresponding financial and co-payment conditions:

• Group of 50 employees or fewer: Age expansion is not available.
• Group of 51 – 100 employees: Requires a 50% extra premium and applies a 20% co-payment.
• Group of 101 employees or more (specifically 101–200): Two options are available:
  • 30% extra premium with 20% co-payment, OR
  • 50% extra premium with no co-payment.

Additionally, initial health screening conditions still apply to new participants (such as no history of mental illness, leprosy, cancer in the first year of diagnosis, or permanent disability of 80% or more, etc.). For more info on health eligibility rules, check this guide.

🛡️ Extra Clauses with Extra Premiums: Medical Devices & Traffic Violations

In addition to dependents and age limits, businesses can choose the following extra clauses with additional premiums and co-payments:

1. Medical devices/implants for treatment

• Group of 50 employees or fewer: Not available.
• Group of 51 – 100 employees: 40% co-payment, capped at 10 million VND (Vietnamese Dong) per person per year. Applies a 5% extra premium on the accident medical costs and inpatient treatment benefits.
• Group of 101 – 200 employees: 30% co-payment, capped at 15 million VND per person per year. Applies a 3% extra premium on the accident medical costs and inpatient treatment benefits.

2. Traffic violations clause (replacing exclusion clause #5)

This clause applies to cases where the insured is driving a vehicle under the influence of alcohol exceeding 50mg/100ml of blood, using drugs, driving without a valid license, or committing other traffic violations. Benefits are partially paid or subject to limits, provided that:

• Group of 50 employees or fewer: Applies with a 5% extra premium on death, permanent disability, accident medical costs, and income loss allowance benefits (if subscribed).
• Group of 51 – 200 employees: Applies with a 3% extra premium on the corresponding benefits.

Understanding co-payment and extra premium rules when expanding coverage is a crucial step in balancing your budget while offering maximum peace of mind to your employees and their families. For specific premium quotes based on your company size, please contact our consulting team today for dedicated support.