Health Insurance Overview for 2015

Transcription

1 2015 Whitaker Program Pre-Departure Orientation Comprehensive Worldwide Health Insurance & 24/7 Medical/Security Assistance for IIE Grantees Health Insurance Overview for 2015 Presented to: Presented by: 2015 Whitaker Program Grantees and IIE Colleagues on July 9, 2015 Margot Popowycz, Senior Account Executive, Cultural Insurance Services International (CISI)

2 Cultural Insurance Services International (CISI) and our Partners: Founded in 1992 Located in Stamford, CT Primary Focus Insuring Cultural Exchange Participants Claims processed by CISI s Benefit Analysts in Stamford, CT CISI Hours: Mon-Fri 9:00 to 5:00 pm Medical Assistance Partner AXA Assistance, Chicago, IL available 24/7 Security Assistance Partner i-jet, Annapolis, MD available 24/7 Dependent Insurance Option:

3 IIE Policy GLM N O Plan Benefits/Limits: Medical Expenses for Participants: $500,000 per Injury/Illness $50 Deductible per Injury/Illness Accidental Death & Dismemberment for Participants: $100,000 Home Health Care: covered following a 3-day hospitalization Physiotherapy inpatient up to $10,000; outpatient $50/visit, 10 visit/max., outpatient must be within 30 days of surgery or hospitalization Extension of Benefits 60 days from the coverage end date just for Injuries/Illnesses which began while covered overseas and require additional follow-up care after the reported coverage end date

4 IIE Policy GLM N O Plan Benefits/Limits (con t.): Mental and Nervous Coverage inpatient up to 45 days; outpatient 75% of covered expenses up to 40 visits then 60% thereafter Incidental Home Country Coverage up to $10,000 Accidental Dental up to $250 per tooth per accidental injury Palliative Dental or Routine Dental not covered Emergency Medical Reunion up to $2,500 after hospitalized for 3 days, reimburses roundtrip economy air and hotel/meals up to $75/day Return Ticket Benefit up to $2,500 for roundtrip economy airfare

5 IIE Policy GLM N O Plan Benefits/Limits (con t.): Emergency Medical Evacuation 100% of Covered Expenses Return of Mortal Remains or Cremation 100% of Covered Expenses 24/7/365 Medical/Travel/Technical Assistance Services Annual Mammogram and Pap Smear covered Colonoscopy covered for screening Maternity covered Infertility Treatments not covered Contraceptives not covered

6 IIE Policy GLM N O Plan Benefits/Limits (con t): Substance Abuse Treatment inpatient 28 days; outpatient 30 days Injuries/illnesses caused by Alcohol or Drugs not covered Termination of Pregnancy up to $500 Ambulance Ground up to $1,000; Air up to $10,000 Suicide or Self-inflicted Injuries/Illnesses covered Pre-existing Conditions covered up to $10,000 Security Evacuation 4 Basic triggers are covered up to $100,000

7 How to reach CISI: If you have any questions regarding your benefits or the claim submission process, do not hesitate to contact CISI. Please include your policy number (GLM N O) on all communications submitted to CISI by or mail. To reach a CISI Claims Representative: Phone: (800) ext (toll-free from within the US) (203) (from outside the US, collect calls accepted) claimhelp@culturalinsurance.com Mail: Cultural Insurance Services International (CISI) 1 High Ridge Park Stamford, CT 06905

8 Team Assist Plan (TAP)-24/7/365 Medical Assistance: Medical referrals Prescription medication availability/legality by country Assistance with protocol for shipping prescription drugs Coverage/payment verification to foreign providers Determining adequacy of foreign medical facility Medical monitoring by Team Assist Medical Department doctors Medical consultation between attending physician and U.S. doctor Medical translator services for insureds/parents

9 Team Assist Plan (TAP)-24/7/365 Travel Assistance: Pre-travel information including visa/passport requirements Currency conversion or purchase Up-to-the-minute travel delay reports Up-to-the-minute travel supplier strike information Worldwide public holiday information Traveler s check replacement help Lost/delayed luggage tracing Help in replacing lost/stolen airline ticket ATM locator

10 Team Assist Plan (TAP)-24/7/365 Technical Assistance: Emergency message transmittal Important document replacement Locating legal services (connection to free initial consultation by calling Team Assist immediately 24/7) Assistance in posting bond/bail Embassy or consulate referral Help in obtaining emergency cash Translator services

11 Medical Evacuation/Repatriation: Contact AXA Assistance to open a medical file Transport to nearest adequate medical facility or Transport back to the Home Country if unable to continue the program Must be deemed Medically Necessary by the local physician in conjunction with one of AXA Assistance s physicians Must be arranged and approved by AXA Assistance (our 24/7 assistance provider) in order for expenses to be covered

12 Return of Mortal Remains/Cremation: Contact AXA Assistance to report the death Transports an insured s remains back to their Home Country Expenses for embalming, cremation, and a minimally necessary container appropriate for transportation are covered Shipping expenses and necessary government authorizations are covered Must be arranged and approved by AXA Assistance (our 24/7 assistance provider) in order for expenses to be covered

13 Security Evacuation Potential Triggers: 1. expulsion from a Host Country or being declared persona non-grata on the written authority of the recognized government if a Host Country; 2. political or military events involving a Host Country, if the Appropriate Authorities issue an Advisory stating that citizens of the Insured Person s Home Country or Country of Residence or citizens of the Host Country should leave the Host Country (evacuation must be within 30 days of Advisory); 3. deliberate physical harm of the Insured Person confirmed by documentation or physical evidence or a threat against the Insured Person s health and safety as confirmed by documentation and/or physical evidence; 4. after the Insured Person had been deemed kidnapped or a Missing Person by local or international authorities and, when found, his or her safety and/or wellbeing are in question within seven days of his or her being found. **As with Medical Evacuations and Return of Mortal Remains, any of the above must be arranged and approved by AXA Assistance (24/7 assistance provider) in order for expenses to be covered **

14 In cases of medical or security related emergency please contact our 24/7/365 emergency assistance provider: Emergency Assistance Provider: AXA Assistance (generically known as Team Assist) Phone: (855) (calling toll-free from within the US) (312) (calling outside the US, collect calls accepted) ** This information is also on each grantee s ID card as well as in the coverage brochure just below the claim form. **

15 In cases of medical or security related emergency please contact our 24/7/365 emergency assistance provider: Worldwide Health Insurance & 24/7 Medical/Security Assistance Emergency Assistance Provider: AXA Assistance Phone: (877) (calling toll-free from within the US) (240) (calling outside the US, collect calls accepted) Assistanceance-usa.com

16 In cases of medical or security related emergency please contact our 24/7/365 emergency assistance provider: Emergency Assistance Provider: AXA Assistance Phone: (877) (calling toll-free from within the US) (240) (calling outside the US, collect calls accepted) Assistanceance-usa.com

17 In cases of medical or security related emergency please contact our 24/7/365 emergency assistance provider: Emergency Assistance Provider: AXA Assistance Phone: (877) (calling toll-free from within the US) (240) (calling outside the US, collect calls accepted) Assistanceance-usa.com

18 In cases of medical or security related emergency please contact our 24/7/365 emergency assistance provider: Emergency Assistance Provider: AXA Assistance Phone: (877) (calling toll-free from within the US) (240) (calling outside the US, collect calls accepted) Assistanceance-usa.com

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20 Margot Popowycz, Senior Account Executive, CISI (presenting today): (860) from overseas (M-F, 9-5pm EST) (800) from the U.S. toll-free (M-F, 9-5pm EST) Renata Marut, Medical Benefit Analyst (processes most IIE claims): (800) ext 5565 from the U.S. toll-free, from overseas (M-F, 9-5pm EST) address for claims: Mailing address for claims: Cultural Insurance Services International, 1 High Ridge Park, Stamford, CT Ellen Vetrano, Claims Operations Manager, CISI (oversees processing of all CISI claims): evetrano@culturalinsurance.com (203) from overseas (M-F, 9-5pm EST) (800) ext 5511 from the U.S. toll-free (M-F, 9-5pm EST) Thank you for the opportunity to review IIE s customized coverage with you questions?