A SECOND LAYER PLAN FOR INDIVIDUALS AND FAMILIES THAT

PROVIDES MEDICAL COVERAGE TO ENHANCE YOUR EXISTING

HMO BENEFITS

FlexiShield

Make the most out of life’s

precious moments.
With Pacific Cross, you can enjoy medical
coverage that helps secure your peace of mind,
wherever life takes you.
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Page 3 of 8 FlexiShield
 When you need it
the most, your
current HMO plan
may not be enough.
Pacific Cross is
#HereForYou.

When illness strikes, your current HMO plan may not be enough. With Pacific Cross, you have a strong ally to help you
carry the financial burden of expensive medical treatment. We offer you FlexiShield.

Some medical conditions, especially those that require confinement, can become quite costly to treat. Worrying about
whether you have enough medical coverage can add anxiety to an already stressful situation. FlexiShield is a second
layer plan that allows you to have ample financial resources should you exhaust your HMO’s maximum benefit limit, so
you can just focus on getting better. Since FlexiShield was purely designed as a top-up coverage to your existing HMO
plan, the premium is more affordable compared to a stand-alone medical plan.

FLEXISHIELD A Product of Pacific Cross Insurance, Inc.

• Additional medical coverage on top of your existing HMO at an affordable premium

• Up to PHP2,000,000 Coverage
• Additional coverage for Members of Corporate accounts, Individuals and Families
who are covered by an HMO Plan as the first layer medical coverage
• Flexible Availment Options (No-cash-out or Reimbursement)
• Free TeleHealth Services, with or without the first layer HMO plan getting exhausted
• Coverage for COVID-19
• Available to persons up to 75 years old
• Exclusive 0% Installment Payment Option

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 FlexiShield Benefits
For the full terms, conditions and limitations, please ask for a specimen contract via e-mail
client_services@[Link]. The contract contains a provision on the Insured Person’s right to Free-Look Period.

IN-PATIENT BENEFITS:

• PHP2,000,000 Per Disability Per Year

• Deductible is the First Layer Plan’s Maximum Benefit Limit (MBL).
In case of change to the First Layer Plan’s MBL at the time of claim, the applicable De-
ductible shall be the amount indicated in the FlexiShield Schedule of Benefits (SOB) or
the first layer HMO MBL, whichever is higher. In no instance will the client be reimbursed
if the applicable Deductible has not been exhausted.
• As charged Private Room
• As charged Miscellaneous In-Patient Charges (including Chemotherapy, Radiotherapy
and Dialysis; Physiotherapy and Speech Therapy only if administered as In-Patient)
• As charged Intensive Care Unit, Coronary Care Unit, Confinement and Miscellaneous
Expenses incurred in the ICU, Operating Theater & Recovery Room.
• Attending Physician’s Visit, Specialist’s Fee, Surgeon’s Fee and Anesthesiologist’s Fee are
subject to inner limits as follows:
1. If no-cash-outlay: using the Company’s Accredited Network Rates or RVS Rates
(surgical procedures)
2. If reimbursement: up to the indicated amount in the Schedule Of Benefit (SOB)

DAILY HOSPITAL INCOME (DHI) BENEFIT:

• Included as a cash assistance per confinement day up to maximum of 30 days per year.
DHI limit is a separate MBL from the PHP2M In-Patient Benefits.
• Claims Payment: Starting confinement Day 1 subject to Flexishield coverage taking
effect (i.e., if In-Patient Benefits of FlexiShield becomes payable, DHI will be paid from
Day 1 of the confinement regardless if Day 1 hospital expenses were covered under first
layer HMO Plan.)

Exclusions:
• Hospital expenses incurred within the limits of the first layer HMO plan. FlexiShield will
provide coverage only after the first layer HMO plan’s Maximum Benefit Limit (MBL) has
been exhausted.
• Pandemic/epidemic (e.g., COVID-19) exclusion will be waived and FlexiShield benefit
will be provided if covered by the first layer HMO Plan up to its MBL exhaustion.

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 CORE BENEFITS

LIMIT (in PHP)

Maximum Benefit Limit (MBL) PHP2,000,000
Maximum Benefit per Disability for each disability per year
Deductible Per Disability Per Year*
First layer HMO’s Maximum Benefit Limit or Annual Benefit Limit for each
disability per year
«First Layer Plan’s MBL»
*In case of change to the first layer HMO’s maximum benefit limit or annual
benefit limit when the claim was incurred, the applicable Deductible shall be
the indicated limit or the first layer HMO’s maximum limit, whichever is higher.
In no instance shall the Insured be covered if the applicable Deductible has
not been exhausted.
Claims Settlement Method
100% reimbursement not to exceed the plan limit or direct settlement by the Company through its Accredited
Network.
The benefits in the Sub-Schedule are IN ADDITION TO any benefits recoverable from PhilHealth or any other
insurances or indemnities.
IN-PATIENT/HOSPITALIZATION BENEFIT
BASIC HOSPITAL BENEFITS
Room and Board including General Nursing Care Private Room
Miscellaneous In-Patient Charges As charged
for required diagnostic laboratory tests; prescribed medicines; physiotherapies;
blood and components; anesthesia and surgical appliances; Intravenous
Chemotherapy, Radiotherapy and Dialysis; therapeutic procedures
(e.g., Physical Therapy, Speech Therapy, etc.) related to the medical
management of the Insured as prescribed by the Attending Physician
Attending Physician’s Visit* As Charged using the
Daily limit of Company’s Accredited
Provider Network Rates
or
Up to PHP4,000
via reimbursement
Specialists’ Fees* As Charged using the
Daily limit of Company’s Accredited
Provider Network Rates
or
Up to PHP4,000
via reimbursement
CRITICAL CARE BENEFITS
Intensive Care Unit, Coronary Care Unit, Telemetry As charged

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SURGICAL BENEFITS
Operating Theater and Recovery Room As charged
Surgeon’s Fee* As Charged using the Company’s
Total fees of the Surgeon(s) including pre-surgical assessment and normal Accredited Provider Network Rates
post-surgical care while the Insured is confined. or
Up to PHP180,000 per Disability per
year via reimbursement
Anesthetist’s Fee* Based on the Company’s
not to exceed 50% of the approved amount payable to the Surgeon(s) Accredited Provider
Network Rates
or
Up to PHP90,000 per Disability
per year via reimbursement
*As charged payment of Professional Fees is based on the Company’s Accredited Network Rate or PhilHealth Relative
Value Scale if claims are directly settled by the Company to the Physician or Hospital. PhilHealth Relative Value
Scale is the table of value per procedure as provided by PhilHealth that the Company applies for the payment of
a particular professional fee in an Accredited Network.
DAILY HOSPITAL INCOME BENEFIT
Claim Settlement Method
100% reimbursement of daily hospital cash assistance benefit resulting from eligible confinement period that is
covered by FlexiShield.
Maximum Benefit Limit (MBL) PHP1,000
Daily limit of
Maximum Number of Confinement Days per Period of Insurance 30 days

Annual Premiums As of 1 April 2024

PHP2,000,000 MAXIMUM BENEFIT LIMIT

AGE FLEXISHIELD 150 FLEXISHIELD 200

DEDUCTIBLE RANGE FROM DEDUCTIBLE RANGE FROM
PHP150,000 TO PHP199,000 PHP200,000 AND UP
0 – 20 PHP8,019 PHP7,291
21 – 35 PHP10,517 PHP8,400
36 – 45 PHP15,131 PHP11,693
46 – 55 PHP22,702 PHP17,685
56 – 65 PHP35,549 PHP27,093
66 – 70 PHP44,442 PHP33,891
71 – 75 PHP53,330 PHP40,669
Notes:
1. Deductible refers to the Maximum Benefit Limit (MBL) of the First Layer HMO which must be for
each disability, per year.
2. Premiums are inclusive of all applicable taxes.
3. Premiums are subject to change depending on the results of the underwriting assessment.

Page 7 of 8 FlexiShield
 Our Companies
Pacific Cross Insurance, Inc. and
Pacific Cross Health Care, Inc.

Pacific Cross is EXCELLENCE.

We are committed to bringing nothing but
the best to our clients. Our decisions are based on
an intricate understanding of our clients’ needs,
demands and expectations. We strive to create
and innovate programs that will best serve our
customers.

Pacific Cross is STABILITY.

We are one of the leading and most financially Get in touch with us today!
stable companies in the industry today. Our Call +63 2 8230-8511
Premiums Earned in recent years put us in the top E-mail info@[Link]
10 non-life insurance companies in the Philippines.
HEAD OFFICE
Pacific Cross is EXPERIENCE. 2nd Floor (Client & Partner Center),
We draw from over 70 years of experience in 8th Floor (Sales Center) and
18th Floor (Operations & Executive Center),
the insurance industry. Our actions are guided by
8 Rockwell Building, Hidalgo Drive, Makati City,
a deep insight brought about by the knowledge we Metro Manila, Philippines
have gained through the years. Tel. No.: +63 2 8899-8001 Fax No.: +63 2 8230-8570
For General Inquiries: info@[Link]
For Travel Inquiries: traveldirect_team@[Link]
Pacific Cross is CUSTOMER SERVICE.
We are rooted in a commitment to ever CEBU
Unit 1 Mercedez Benz Tower, Mindanao Avenue,
improving customer service. We aim to be Cebu Business Park, Cebu City
continuously progressive and professional. Our Tel. Nos.: +63 32 233-5812, +63 32 233-5816
commendable track record and competent support E-mail: cebu@[Link]
staff ensure that you are given immediate and CLARK
excellent service at all times. 2nd Floor, The Medical City Clark, 100 Gatwick Gateway,
Clark Global City, Clark Freeport Zone,
Pampanga, 2023, Philippines
Pacific Cross is a PARTNERSHIP OF TRUST. Mobile No.: +63 914 894-9211
We build and value enduring relationships. We E-mail: clark@[Link]
consistently prove that we are worthy of the highest
DAVAO
confidence — by our strict standards, the integrity 2nd Floor, Left Wing, Door No. 6 Matina Town Square,
of our promises and the results we deliver. In the Mac Arthur Highway, Matina, Davao City
Tel. No.: +63 82 297-7314 Telefax: +63 82 297-7151
event of a crisis, we assure you that Pacific Cross E-mail: davao@[Link]
will be your friend and ally.

We also have Agency Offices in:

Luzon: Cavite | Makati | Manila | Marikina | Muntinlupa | Naga | Novaliches | Pampanga
VisMin: Bacolod | Butuan | Cagayan De Oro | Davao | Dumaguete | General Santos
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