华泰财产保险有限公司华泰全球至尊健康团体保险计划.PDFVIP

华泰财产保险有限公司 华泰全球至尊健康团体保险计划 （核心、锦绣、增强、精英）—— Administered by 团体构成表 Aetna International 由Aetna International管理 Huatai Property Casualty Insurance Co., Ltd. Huatai Global Group Health Insurance Plan (Core, Essential, Plus, or Elite) - Group Formation Form 注明：本表应由授权接收报价并为投保人确认计划的团体保险单管理员填写。填写时请使用大写正楷字体，勾选适当的选项， 完成后请将此表交还给我们或您的经纪公司/代理公司。 Explanatory Notes: This form should be completed by the Group Administrator authorised to accept a quotation and set up a plan for the Plan Sponsor. Please use BLOCK CAPITALS, check boxes as appropriate, and return this completed form to Us or your broker/agent. 安态（上海）企业服务有限公司 电话：+400 881 1291 中国上海黄浦区西藏中路18号港陆广场1302室 传真：+8621 6326 8525 邮编：200001 邮箱：HuataiEnquiriesPSSShanghai@ Aetna (Shanghai) Enterprise Services Co., Ltd T: + 400 881 1291 Suite1302 F: + 8621 6326 8525 Harbour Ring Plaza E: HuataiEnquiriesPSSShanghai@ 18 Middle Xi Zang Rd HuangPu District, Shanghai, China, 200001 请配合华泰全球至尊健康团体医疗保险计划宣传册、报价概要及保单条款 （另附）一起阅读。中文表述与英文表述不一致的， 以中文表述为准。 This form should be read in conjunction with the HuaTai Global Group Health Insurance Plan Brochure, the Quotation Summary and Policy Wording. Should there be any discrepancy, Chinese shall prevail. 大写和字体加粗的单词和短语具有特定含义，详情请参见医疗计划宣传册 Words and phrases that are