Sources of Dependent, Short Term and Supplemental Insurance Please note that this list is for informational purposes only, it does not represent any endorsement by the Fulbright Program or CIES. In some circumstances, grantees may wish to purchase supplemental insurance for themselves and/or their accompanying family members. Below is a list of some companies in the United States that offer dependent, short term and supplemental insurance. Some plans offer online enrollment and payment. The main coverage points listed are subject to change. Contact the insurance provider to determine if plans are available to meet your needs. HTH Worldwide Web site: http://www.hthworldwide.com One Radnor Corporate Center Suit 100 100 Matsonford Road Radnor, PA 19087 USA 1-610-254-8700 (Local); 1-6102933529 (Local Fax) E-mail: customerservice@hthworldwide.com TravelGap Voyager Maximum Benefits: $50,000, $100,000. $500,000, $1,000,000 Medical Evacuation up to $500,000 Repatriation coverage up to $25,000 Deductible $0, $100, $250, $500 Coverage up to six months Excludes pre-existing conditions Covers pregnancy Enroll online Associated Insurance Plans International, Inc. Web site: http://www.associatedinsuranceplans.com/ 28085 Ashley Circle, Suite 201 Libertyville, IL 60048 Phone: (800) 452-5772 fax: (847) 281-8813 Email: office@aipstudentinsurance.com. Atlas International (for 6 mos. or less)/Atlas Extra (coverage over 6 mos.) Coverage: 15 days to 12 months Ages: 14 days to 80+ years Provides $50,000, $250,000, $500,000 or $1,000,000 of coverage per incident Medical Evacuation covered to maximum limit Repatriation coverage covered to maximum limit Deductibles of $100, $250, or $500 Excludes pre-existing conditions and pregnancy Get quote online International Student Organization Web site: http://www.isoa.org 250 West 49th Street, Suite 806 New York, NY 10019 Toll Free: 1.800.244.1180 General: 212-262-8922 Fax: 212.262.8920 Email: mailbox@isoa.org Compass Gold/Compass Silver $250,000 maximum per injury or sickness with $500,000 lifetime maximum/&150,000 maximum per injury or sickness with $300,000 maximum overall coverage Medical evacuation $60,000/$50,000 Repatriation $60,000/50,000 $100 deductible Excludes pre-existing conditions Covers pregnancy Minimum: 3 months New England Benefits Services Web site: http://www.nebenefitservices.com P.O. Box 35220 Brighton, MA 02135-0004 Phone: (800) 335-0003 Fax: (617) 254-8184 Email: info@nebenefitservices.com Global Medical Insurance (Silver/Gold Plus/Platinum) $5,000,000/$5,000,000/$8,000,000 lifetime coverage $50,000/up to Maximum Limit (Gold Plus/Platinum) Medical evacuation Repatriation only available on Platinum $250 to $10,000 deductible Excludes pre-existing conditions Pregnancy: $50,000 lifetime maximum on an optional rider Worldwide coverage, including home country Get a quote/apply online International Medical Group Web site: http://www.gatewayplans.com/ 2960 North Meridian Street Indianapolis, IN 46208-4715 Phone: 1 (317) 655-4500 or 1 (877) 808-7434 Fax: 1 (317) 655-4505 Email: insurance@imglobal.com Choose From Five Gateway Plans: Gateway INTERNATIONAL—short-term coverage for 5 days to 24 months for travel anywhere except to the United States PATRIOT PLATINUM---Short-term coverage for 5 days to 36 months for travel anywhere except to the United States. Global Medical Insurance—longer term coverage for travel or work assignments abroad for 6 or more consecutive months for up to 5 years Patriot Executive—multiple short-term or extended trips abroad offering primary coverage for medical evacuation and repatriation with a variety of other options; Travel Insurance Services Web site: http://www.travelinsure.com 2950 Camino Diablo, Suite 300 Walnut Creek, CA 94596-3949 Phone: 1-800-937-1387 or (925) 932-1387 Fax: (484) 652-5394 Email: webinfo@travelinsure.com Study USA-Health Care Rated A++ Ages 65 and under Medical Expenses $250,000 Accidental Death and Dismemberment $5,000 Emergency Medical Evacuation $500,000 Mental/Nervous Disorders & Alcohol/Substance Abuse Benefits $10,000 Repatriation of Remains $100,000 Excludes Pre-existing conditions and pregnancy InterMedical Insurance (A/B) Maximum Stay 1Year Medical Exspenses/Incident ($25,000/$100,000) Deductible $50 Emergency Evacuation ($50,000/$75,000) Accidental Death ($10,000/$100,000) Repatriation of Remains $7,500 Excludes Pre-existing conditions and pregnancy Wallach & Company, Inc. Web site: http://www.wallach.com/ 107 West Federal Street P.O. Box 480 Middleburg, VA 20118 Phone: (540) 687-3166 or (800) 237-6615 Fax: (540) 687-3172 Email: info@wallach.com Health Care Global/Health Care Abroad $50,000-$500,000 or $250,000 medical expense benefit per accident/illness, which includes medical evacuation and repatriation. $100-$1,000 deductible $25,000 personal accident benefit. Ages 1-75 eligible (up to 84 for Health Care Abroad). Not available to residents of Washington State and New York State Seven Corners, Inc. Web site: https://www.sevencorners.com/insuranceplans/ 303 Congressional Boulevard Carmel, IN 46032 Phone: 0 (317) 575-2652 or 1 (800) 335-0611 Fax: (317) 575-2659 Email: policy@sevencorners.com Liaison International/Liaison Continent $50,000-$1,000,000 Medical Maximum $300,000 Emergency medical evacuation/repatriation benefit. $25,000/$50,000 Accidental death & dismemberment. Up to six months Liaison Majestic/Liaison Worldwide $1,000,000/$500,000 Medical Maximum $300,000 Emergency Medical evacuation/repatriation $25,000 Accidental death and dismemberment $50,000 Political evacuation and repatriation (Majestic) $5,000 Interruption of Trip (Worldwide) Waiver for pre-existing condition available – see website for details Up to 12 months Liaison Student $250,000 medical maximum $0-$100 deductible per illness/injury Maternity coverage $100,000 Emergency medical evacuation $10,000 Accidental death and dismemberment Up to 12 months Liaison Silver 50 years old and up $60,000, $125,000, $600,000, $1,000,000 medical maximum $300,000 Emergency medical evacuation/repatriation $50,000 Accidental death & dismemberment $50,000 political evacuation and repatriation Waiver for pre-existing conditions available – see website for details Up to 12 months Cultural Insurance Services International Web site: http://www.culturalinsurance.com River Plaza 9 West Broad Street Stamford, CT 06902-3788 Phone: (800) 303-8120 Fax: (203) 399-5596 Email: cisiwebadmin@culturalinsurance.com or enrollments@culturalinsurance.com Basic Plan/Comprehensive Plan $50,000/$250,000 maximum per accident or sickness $100/$0 deductible $10,000 accidental death and dismemberment $100,000 Medical Evacuation $50,000 Repatriation/Return of Mortal Remains All ages eligible Excludes pre-existing conditions Global Underwriters Web site: http://www.globalunderwriters.com/ 3195 Linwood Road, Suite 201 Cincinnati, Ohio 45208 Phone: 1 (800) 423-8496 or (513) 533 9800 Fax: (513) 533 1055 or (513) 533 1504 Email: diplomat@globalunderwriters.com Diplomat International Coverage up to $50,000-$1,000,000 Deductibles as low as $0-$5,000 $10,000 Emergency Reunion $20,000 Repatriation of Remains $10,000 Personal Security Evacuation $25,000 Accidental Death Coverage for 5 days to 12 months Diplomat LT Coverage from 3 months to 3 years $500,000-Plan A/$1,000,000-Plan B Deductibles vary from $50-$5,000 Policies from $500,000-$1,000,000 $300,000 Emergency Medical Evacuation $10,000 Emergency Reunion $20,000 Repatriation of Remains CMI Insurance Worldwide Web site: http://cmi-insurance.com/homepage.aspx 850 LaSalle Road, Suite 200 Baltimore, MD 21286 Phone: +1 (410) 583 2595 or 1 (800) 586-0753 Fax: +1 (410) 583 8244 Email: info@cmi-insurance.com Study Abroad (Plan A - Basic/Plan B – High Option) $100,000/$250,000 life time Maximum $50/$0 deductible $3,000/$5,000 Emergency Reunion Benefit Ages 1-60+/Ages 1-39 1 month- 12 months Excludes pre-existing conditions Global Medical International $100,000 - $500,000 Lifetime Maximum $50-$1,000 deductible 100% Emergency Medical Evacuation Benefit $12,500 Emergency Reunion Benefit $25,000 Accidental Death and Dismemberment Benefit 15 days to 12 months Excludes pre-existing conditions and pregnancy June 2011