Medical Insurance

These are insurance benefits provided to AUS employees hired on or before February 15, 2004. Faculty and employee's grade 10 and above hired after February 15, 2004 should refer to the Cafeteria Plan Summary for details of their benefits.

American University of Sharjah has contracted via a private insurance carrier to provide comprehensive medical and health coverage for full-time employees and their qualified dependents. To meet the needs of our employees the university offers two plans.

Plan I

Employees covered under this plan may receive medical treatment in the UAE, Arab Countries and South East Asia. They are also covered for emergency treatment worldwide.

Scheduled benefits under Plan I are:

• Maximum limit per person per year is US$ 200,000.
• Maximum outpatient limit per person per year is US$ 10,000
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE.
• Treatment outside UAE is covered with involvement of SOS (within geographical limits).
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, but a co-insurance of 20 percent is applicable for outpatient treatment at Al Zahra hospital networks.
• Outside the network providers, outpatient treatment is covered at 80% based on “Reasonable and Customary” charges
• Co-insurance: 15 percent for pharmaceuticals
• Deductible: As Shown below.

Plan II

Employee electing coverage under this plan may receive medical treatment anywhere, i.e., worldwide coverage. However, employees who avail themselves to elective medical treatment or surgeries in the US, Canada or Europe will pay 20 percent (co-insurance) on the total cost of the treatment, inpatient or outpatient.
Scheduled benefits under Plan II are:

• Maximum limit per person per year is US$ 300,000
• Maximum outpatient limit per person per year is US$ 10,000
• Inpatient treatment is covered at 100 percent, within the network providers in the UAE but a co-insurance of 20 percent is applicable for bills at American Hospital in Dubai.
• Treatment outside UAE is covered with involvement of SOS.
• Outpatient treatment is covered at 100 percent within the network providers in the UAE, but a co-insurance of 20 percent is applicable for outpatient treatment at American Hospital of Dubai and Al Zahra hospital networks.
• Outside the network providers, outpatient treatment is covered at 80 percent based on “Reasonable and Customary” charges
• Co-insurance: 15 percent for pharmaceutical.
• Deductible: As Shown below.

Insurance deductible for consultation visits to doctor (applicable to both plans)
50 dirham for employees in grades 1 to 6
60 dirham for employees in grades 7 to 9
70 dirham for employees in grades 10 and above
70 dirham for faculty
Both plans cover emergency treatment at 100 percent.

Plan II can be opted only by directors on grade 13 and above, academic staff and staff who were recruited from US or Canada.

Emergencies

Emergencies means: A medical emergency constitutes a sudden sickness or injury whose acute symptoms are of such severity that the absence of immediate treatment at the nearest medical provider is medically expected to constitute a serious threat to the life, healt, a bodily function and/or organ of the patient.

Please contact the SOS number on the back of your medical card.
General provisions of the medical plan:

Coverage is mandatory for all employees, unless the employee opts out of the plan in writing giving supporting proof of medical insurance from outside insurance company.

Eligible participants: All regular, full time permanent employees of the university under the age of 70 years for faculty and 65 years for staff who regularly work in a position or office designated at AUS

Dependents

• Legal spouse, residing permanently in the UAE.
• An unmarried child, under age 19, attending school (primary or secondary) full time in the UAE, and whose total maintenance or a substantial portion therefore is provided by the employee.
• An unmarried child under age 23, attending school (secondary, university or college) full time outside the UAE, who normally resides with the employee during school holidays and receives at least 50% of their maintenance from the employee.

Termination of coverage: Coverage will cease when a dependent is no longer eligible to participate in the plan or when an employee’s service at AUS is terminated.

Medical insurance dose not continue as per UAE government policy and the policy of UAE insurance carriers beyond the age of 70 years for faculty and 65 years for staff.

Maternity Coverage

Full time permanent female employees or the spouses of full-time permanent employees are eligible for maternity cover. The maternity cover includes: prenatal care, legal abortion, normal delivery and caesarean.

The maternity benefit will be covered according to the reasonable and customary charges and up to the following limit for all eligible females:

Prenatal care and normal Delivery 8,000 dirham
Prenatal care and complicated/Caesarean Delivery 12,000 dirham
Prenatal care and spontaneous miscarriage /or legal termination of Pregnancy 4,000 dirham
(When it is life threatening to the mother, subject to once during one policy period)
More details on this can be obtained from Human Resource Services Department.

Life Insurance

American University of Sharjah provides, group life insurance for all regular, full time permanent employees, up to the age of 70 years for faculty and 65 years for staff. Coverage begins on the first day of employment. The employee is covered, in the case of natural death, for two times their annual base salary of September 01 of every year. In the event of accidental death, the benefit payable is four times the annual base salary of September 01 of every year.

• Life insurance is compulsory for all staff at AUS
• Life insurance premium calculation is based on September 01, salary for every year.

Personal Accident Insurance

This provision of the plan provides benefits in case of partial or total disabilities, due to an accident or sickness. Benefits coverage included are:

Permanent Partial Disability – pays a percentage of 4 times base salary, per policy scale. Permanent Total Disability – pays 4 times annual base salary.
Total Temporary Disability – pays 100 percent of monthly base salary for a maximum of 12 months. Coverage does not start until after the first 30 calendar days of disability. Accidental Medial Expenses – Expenses to be covered up to 10,000 dirham in one policy year. Repatriation Expenses – Expenses to be covered up to 10,000 dirham in the event of death.

Exclusions are applicable in different situations and may apply.
Please contact Human Resource Services Department and speak with any representative should you have any questions or need assistance.

Updated: Jun 2007