Transcript english instruction for premium calculation and

42390_1216
ENGLISH INSTRUCTION FOR PREMIUM
CALCULATION AND APPLICATION THROUGH
ONLINE FUNNEL
English instruction for premium calculation
and application through online funnel
Step 1:
1. Effective date
2. Date of birth
3. Choose your health insurance with excess. Every insured person from 18 years and older has to pay a mandatory excess of € 385,-. You may choose to raise the excess in order to receive a discount on
your premium.
4. Choose your supplementary insurance.
If you choose the Aanvulling Optimaal, you have to fill in health
questions:
a. Is it to be expected that you will need more than 10 treatments at
an alternative medicine practitioner next year? Yes No
b. Is it to be expected that you will need to buy a hearing aid, wig or
hairpiece next year? Yes No
c. Is it to be expected that you will purchase a pair of glasses next
year? Yes No
d. Is it to be expected that you will need more than 21 treatments at a
physiotherapist next year? Yes No
e. Is it to be expected that you will need a laser treatment for your
eyes or a lens implant next year? Yes No
5. Choose your dental insurance
If you choose Tandarts Extra, Uitgebreid of Optimaal, you have to fill in
health questions:
a. Did you visit the dentist for periodic preventive examination (checkup) at least once a year in the past 2 years?
b. Did you receive periodontal (gums) treatment in the past year? Or
does your dentist expect you to need periodontal (gums) treatment
within a year?
c. Do you have any extracted or missing teeth and/or molars which
will be replaced by crowns and bridges, implants or a partial plate
prosthesis or frame prosthesis within a year?
d. Does your dentist expect you to need treatment involving crowns,
bridges and/or implants within a year?
6. Do you want to add another person?
a. Volwassene (adult)
b. Kind <18 jr (child under 18 years)
7. Choose your preferred term of premium payment
a. Maand 0% korting (monthly 0% discount)
(quarterly 0% discount)
b. Kwartaal 0% korting
c. Halfjaar 0% korting (half-yearly 0% discount)
d. Jaar 2% korting (annually 0% discount)
8. Reset
9. Print
10. Proceed
11. Change your current insurance
12. Information about your selected insurance
13. Coverage overview health insurance and terms and policy health insurance.
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b. Buitenland(Abroad)
c. Nederland&Buitenland(TheNetherlands&Abroad)
d. Nietvantoepassing(Doesnotapplytoyou)
Step 2:
1.
2.
3.
4.
Initials
Insertion
Surname
Sex
a. Man (Male)
b. Vrouw (Female)
5. Citizen service number (BSN)
6. Nationality (click at “Anders, namelijk” to select a different
nationality)
7. Country of residence
8. Postal code
9. House number and addition to house number
10. You receive salary or social benefits from (select one of the
following options):
a. Nederland (The Netherlands)
b. Buitenland (Abroad)
c. Nederland & Buitenland (The Netherlands & Abroad)
d. Niet van toepassing (Does not apply to you)
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Step 3:
1. How do you want to receive information?
a. Digitaal: in het postvak van Mijn Amersfoortse (Digitally: in the mailbox
of Mijn Amersfoortse)
b. Op papier: on paper
2. You can log on with your DigiD in the secured online environment of
De Amersfoortse: Mijn Amersfoortse. Here you can find all the
correspondence with De Amersfoortse and you can organize your insurance
matters. You will receive an e-mail if a new document is added in your
mailbox.
3. E-mail address
4. Confirm e-mail address
5. Phone number
6. Second phone number
7. Method of payment
a. Automatische incasso (automatic collection)
b. Betaalmail (e-mail payment)
c. Overboeking via uw bank (manual transfer by bank account)
8. Giro or bank account number for automatic collection (IBAN)
9. By signing this application form, you are authorising De Amersfoortse to
debit the owed premium (including costs) from your account on a regular
basis.
10. You can choose to pay your mandatory excess ( € 385,- in 2017) in advance by
spread payments in 10 equal terms paid monthly. The health care costs you
have made which are part of the excess will be settled subsequently with the
paid terms.
Do you want to participate in spread payment?
a. Ja (Yes)
b. Nee (No)
11. Select the persons who want to participate in spread payment
12. Based on your citizen service number (BSN) we can see where you have your
current health insurance. We can terminate your current health insurance.
You do not have to do anything.
Do you want to use the termination service?
a. Yes, terminate my basic and supplementary health insurance at my
current insurer
b. Yes, terminate only my basic health insurance at my current insurer
c. No, I will terminate my basic health insurance myself
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Step 4:
1. Hereyoucancheckifallyourinformationiscorrect
2. Youdeclarethatyoufilledinthedatacorrectlyandthatyouagreewiththetermsand
conditionsofthepolicy.
3. Ifyouclickon‘Indienen->’,yourinformationwillbesentandyourapplicationisfinished.
1. Here you can check if all your information is correct
2. You declare that you filled in the data correctly and that
you agree with the terms and conditions of the policy.
3. If you click on ‘Indienen ->’, your information will be
sent and your application is finished.
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