| Liaison International |
| Medical Maximum: |
$50,000; $100,000; $500,000; $1,000,000
(ages 80+, maximum limited to $15,000) |
| Deductible: |
$0; $100; $250; $500; $1000; $2500
Deductible is per person per policy period, maximum of 3 Policy Period deductibles
per family. The selected Deductible and Coinsurance amount must be met for
each 12-month period (see Continuing Coverage) |
| Coinsurance: |
Class 1: U.S. or Canadian citizen traveling outside the United States. After You pay the Deductible, the plan pays 100% to the selected Medical Maximum.
Class 2: Non U. S. citizens traveling to the United States.
- option 1: After You pay the Deductible, the plan pays 80% of the next $5,000 of eligible expenses, then 100% to the selected Medical Maximum
- option 2: After You pay the Deductible, the plan pays 100% of the next $2,500 of eligible expenses, then 80% to the selected Medical Maximum
Class 3: Non U.S. citizens traveling outside of their Home Country. After You pay the Deductible, the plan pays 100% to the selected Medical Maximum. |
| Hospital Indemnity*: class 1: |
$150 / night (traveling outside the
US and Canada) In addition to any other Covered Expense. |
| Dental (Emergency)*: class 1: |
$100 or ($500 for accidents) Only available
to programs purchased for 1 month or more. |
| Emergency Medical Evacuation / Repatriation: |
$300,000 (in addition to the Medical
Maximum) |
| Home Country Coverage : |
Incidental Trips to The Home Country: Up to $50,000; Extension of Benefits: Up to $5,000 |
| Return of Mortal Remains: |
$50,000 |
| Emergency Reunion: |
$50,000 |
| Return of Minor Child(ren): |
$50,000 |
| Interruption of Trip: |
$5,000 |
| Loss of Checked Luggage: |
$250 |
| Local Ambulance Expense: |
$5,000 |
| Accidental Death & Dismemberment: |
$25,000 Principal Sum for Insured or
Insured Spouse, $5,000 for Dependent Child. Note: In the event of a Common Carrier Accidental Death, this benefit will not be paid. |
| Common Carrier AD&D: |
$50,000 Principal Sum for Insured or Insured Spouse; $10,000 per Dependent child(ren) under age of eighteen (18); $250,000 Maximum per family. |
| Hospital Room & Board: |
Usual, reasonable and customary to the
selected Policy Maximum. |
| Intensive Care: |
Usual, reasonable and customary to the
selected Policy Maximum. |
| Outpatient Medical Expense: |
Usual, reasonable and customary to the
selected Policy Maximum. |
| Terrorism: |
Usual, reasonable and customary to the
selected Policy Maximum
(This benefit not available for states underwritten by Certain
Underwriters at Lloyd's of London) |
| Unexpected Recurrence of a Pre-Existing Condition*: class 1: |
Up to $20,000 for U.S. and Canadian citizens traveling outside the United States (Age 65+, up to $2,500, refer to exclusion #1 for details) |
| Benefit Period: |
Six months |
| * These benefits are only available to Class 1 individuals |
Atlas
