Student Injury and Sickness Insurance Plan for International Community Service - Vantage Plan 2011-2012
International Community Service is pleased to offer an Injury and Sickness Insurance Plan This plan is underwritten byunderwritten by UnitedHealthcare Insurance Company. All regular, full time and part time
eligible students, scholars or other persons with a current passport who: 1) are engaged in
international educational activities; and 2) are temporarily located outside his/her home
country as a non resident alien; and 3) have not obtained permanent residency status areeligible to enroll in this Plan on a voluntary basis. Those enrolled in an Optional Practical
Training program (with a F-1 or J-1 visa) who were previously enrolled in this Plan are eligible.
Eligible Dependents of insured student may enroll concurrently on a voluntary basis. The
Named Insured must actively attend classes for at least the first 31 days after the date for
which coverage is purchased, with the exception of those with a J Visa or those in an Optional
Highlights of the Coverage and Services offered by UnitedHealthcare StudentResources are:
Up to $250,000 for each Injury or Sickness Maximum Benefit for Covered Medical
Covered Medical Expenses for Preferred Provider are payable at 80% of Preferred
Allowances and Out of Network benefits are payable at 70% of Usual and Customarycharges (all benefits are subject to satisfaction of the deductible, specific benefit
limitations, maximum and copays as described in the policy).
$100 Deductible for each Injury or Sickness. The maximum Deductible for any oneInsured will not exceed $500 Per Policy Year.
The Deductible will be waived if treatment is received at a Recognized Student HealthCenter.
The Preferred Provider for this plan is UnitedHealthcare Options PPO.
Prescription Drug Benefits: 80% of Usual and Customary Charges ($2,000 maximum per
Coverage available for eligible dependents.
Scholastic Emergency Services – International Students are covered worldwide except intheir home country.
MyAccount, available through www.firststudent.com, allows insured students access24/7 to check their claim status, search for network providers, print ID cards, enteraccident details, view EOBs and enter additional insurance information online.
Included with every policy, the UnitedHealth Allies® discount program provides 5% to 50% savings on dental and vision services, fitness clothing and equipment, andtextbooks from McGraw-Hill Professional. The UnitedHealth Allies program is not
insurance and is offered by UnitedHealth Allies, a UnitedHealth Group company.
UnitedHealthcare StudentResources School Benefit Summary 2011-201293-92-Benefit Summary Flyer
PRE-EXISTING CONDITION means any condition which is
Adopted Child Effective date under this policy.
diagnosed, treated or recommended for treatment within the 6
20. Prescription Drugs, services or supplies as follows:
months immediately prior to the Insured's Effective Date under the
a) Therapeutic devices or appliances, including: hypodermic
needles, syringes, support garments and other non-medical
substances, regardless of intended use except as specifically
No benefits will be paid for: a) loss or expense caused by,
contributed to, or resulting from; or b) treatment, services or
b) Birth control and/or contraceptives, oral or other, whether
medication or device, regardless of intended use;
c) Immunization agents, biological sera, blood or blood products
2. Addiction, such as: nicotine addiction and caffeine addiction;
non-chemical addiction, such as: gambling, sexual, spending,
d) Drugs labeled, “Caution – limited by federal law to
shopping, working and religious; codependency;
investigational use” or experimental drugs; except as
e) Products used for unapproved cosmetic indications;
5. Congenital conditions, except as specifically provided for
f) Drugs used to treat or cure baldness; anabolic steroids used
6. Cosmetic procedures, except cosmetic surgery required to
g) Anorectics - drugs used for the purpose of weight control;
correct an Injury for which benefits are otherwise payable under
h) Fertility agents or sexual enhancement drugs, such as
this policy or for newborn or adopted children; removal of warts,
Parlodel, Pergonal, Clomid, Profasi, Metrodin, Serophene, or
7. Custodial care; care provided in: rest homes, health resorts,
homes for the aged, halfway houses, college infirmaries or
j) Refills in excess of the number specified or dispensed after
places mainly for domiciliary or custodial care; extended care in
one (1) year of date of the prescription;
treatment or substance abuse facilities for domiciliary orcustodial care;
21. Reproductive/Infertility services including but not limited to:
family planning; fertility tests; infertility (male or female), including
8. Dental treatment, except for accidental Injury to Teeth;
any services or supplies rendered for the purpose or with the
9. Elective Surgery or Elective Treatment;
intent of inducing conception; premarital examinations;
10. Eye examinations, eye refractions, eyeglasses, contact lenses,
impotence, organic or otherwise; tubal ligation; vasectomy;
prescriptions or fitting of eyeglasses or contact lenses, vision
sexual reassignment surgery; reversal of sterilization
correction surgery, or other treatment for visual defects and
problems; except when due to a disease process;
22. Research or examinations relating to research studies, or any
11. Foot care including: care of corns, bunions (except capsular or
treatment for which the patient or the patient’s representative
must sign an informed consent document identifying the
12. Immunizations, except as specifically provided in the policy;
treatment in which the patient is to participate as a research
preventive medicines or vaccines, except where required for
treatment of a covered Injury or as specifically provided in the
23. Routine Newborn Infant Care, well-baby nursery and related
Physician charges in excess of 48 hours for vaginal delivery or
13. Injury or Sickness for which benefits are paid under any Workers'
Compensation or Occupational Disease Law or Act, or similar
24. Routine physical examinations and routine testing; preventive
testing or treatment; screening exams or testing in the absence
14. Injury sustained by reason of a motor vehicle accident to the
of Injury or Sickness; except as specifically provided in the policy;
extent that benefits are paid or payable by any other valid and
25. Services provided normally without charge by the Health Service
of the Policyholder; or services covered or provided by the
15. Injury sustained while (a) participating in any interscholastic,
club, intercollegiate, or professional sport, contest or
26. Deviated nasal septum, including submucous resection and/or
competition; (b) traveling to or from such sport, contest or
other surgical correction thereof; nasal and sinus surgery, except
competition as a participant; or (c) while participating in any
for treatment of chronic purulent sinusitis;
practice or conditioning program for such sport, contest or
27. Skydiving, parachuting, hang gliding, glider flying, parasailing, sail
planing, bungee jumping, or flight in any kind of aircraft, except
16. Organ transplants, including organ donation;
while riding as a passenger on a regularly scheduled flight of a
17. Outpatient Physiotherapy; except for a condition that required
surgery or Hospital Confinement: 1) within the 30 days
28. Suicide or attempted suicide while sane or insane (including
immediately preceding such Physiotherapy; or 2) within the 30
drug overdose); or intentionally self-inflicted Injury;
days immediately following the attending Physician's release for
29. Supplies, except as specifically provided in the policy;
30. Surgical breast reduction, breast augmentation, breast implants
18. Participation in a riot or civil disorder; commission of or attempt
or breast prosthetic devices, or gynecomastia; except as
31. Treatment in a Government hospital, unless there is a legal
19. Pre-existing Conditions, for a period of 6 months, except for
obligation for the Insured Person to pay for such treatment;
individuals who have been continuously insured under theInternational Community Service insurance policy for at least 6
32. War or any act of war, declared or undeclared; or while in the
consecutive months; Credit will be given for the time the Insured
armed forces of any country (a pro-rata premium will be
was covered under previous Creditable Coverage if the
refunded upon request for such period not covered); and
Creditable Coverage was continuous to a date not more than
33. Weight management, weight reduction, nutrition programs,
sixty-three (63) prior to the Insured’s Effective Date under this
treatment for obesity, surgery for removal of excess skin or fat,
Policy; or 2) a Newborn Infant or Adopted Child who has been
and treatment of eating disorders such as bulimia and anorexia.
continuously insured under previous Creditable Coverage since
Exception: benefits will be provided for the treatment of
birth or adoption if the Creditable Coverage was continuous to a
dehydration and electrolyte imbalance associated with eating
date not more than 63 days prior to the Insured Newborn or
Modulo " America " - Principali azioni quotate in Canada e Stati Uniti Lista aggiornata al 22/11/2013 (circa 1200 strumenti) AZIONI CANADA Nome CA AGNICO EAGLE MINES LTD CA AGRIUM INC CA ARC RESOURCES CA ATLANTIC POWER CA BANK NOVA SCOTIA (THE) CA BANK OF MONTREAL CA BARRICK GOLD CORP CA BCE INC CA BIOVAIL CORP CA BOMBARDIER CL B INC CA BROOKFIELD ASSET MANAGEMENT CL A INT CA