Plan Administrator: USI Affinity Travel Insurance Services | AM Best Rating: A "Excellent" | Underwriter: Lloyd's

• Coverage Area: US & Non-US citizens (age 0 to 80+) traveling outside home country, excluding USA.
• Coverage Length: Min 5 days up to max 364 days.
• Acute Onset of Pre-existing Condition (excludes chronic and congenital conditions): Up to policy max for age under 60. $20,000 for age 60 to 79. $5,000 for age 80 & above.
• Co-Insurance: In-network: After deductible 100% up to policy max. Out-Network: URC up to policy max.
• PPO Network: United Health Network.
• ID Card: Link comes in email to download.

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• Doctor visit: Up to policy max. Deductible & co-insurance apply.
• Urgent Care: $50 co-pay if more than $0 deductible chosen. Co-insurance apply
• Hospital Room and Board: Up to policy max. Deductible & co-insurance apply. Average semi-private room rate, including nursing services.
• X-ray & laboratory: Up to policy max. Deductible & co-insurance apply.
• Prescription: Up to policy max. Deductible & co-insurance apply.

Complete details are given in certificate of insurance.

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• Pre-existing Conditions, except charges resulting directly from an Acute Onset of Pre-existing Condition, as herein defined, subject to the limits set forth in the Schedule of Benefits and Limits.
• Birth defects and congenital illnesses. Birth defects are deemed to include hereditary conditions.
• Mental health disorders.
• Pregnancy except as covered under Complications of Pregnancy, as herein defined, termination of pregnancy except in connection with covered Complications of Pregnancy, all charges related to pregnancy after the 26th week of pregnancy, routine prenatal care, child birth, postnatal care, and charges incurred by a child under the age of 14 days.
  
  

Complete details are given in certificate of insurance.

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Age 0-64,$10,000;formembers Age 65 and over, $2,500

The term “Acute Onset of a Pre-Existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.

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Non Renewable.

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Premiums may be refunded after the certificate effective date subject to the following provisions:

1. $25 cancellation fee will apply for administrative costs incurred by us; and
2. Only the unused portion of the plan cost will be refunded; and
3. You cannot have filed any claims to be eligible for a premium refund.

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This insurance policy has in it a Claims Procedure which tells you what steps you must take to file a claim, and explains our obligations to you. Beginning on the last day of your certificate period, you shall have 60 days to provide us proof of claim.

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