RESIDE Prime Brochure 2007 SCHEDULE OF BENEFITS
WHO NEEDS THIS PLAN? US Citizens Foreign
Nationals ELIGIBILITY The Reside Prime program is available to persons of any country who are at least 15 days of age and who are not older then age 74. Non-US citizens may reside anywhere in the world, including their Home Country. US citizens must either reside outside the United States, or expect their departure from the United States within 30 days of the plan's effective date. In addition, insured persons must continue to reside outside the United States for at least 6 months during any given policy year in order to remain eligible. APPLYING FOR COVERAGE To apply, all you need to do is complete the application in full and pay the appropriate premium, given your age category and desired deductible amount. Be sure to answer all sections and questions as completely, accurately, and as legible as possible. The application you complete becomes part of your certificate of coverage should you be accepted. Once the underwriters have had an opportunity to review the application, SRI may request additional information from the applicant. If you are accepted, you will receive an ID Card confirming your effective date and conditions of acceptance, as well as a claim form and a certificate of coverage, which describes the program in complete detail and describes how the insurance can be utilized. If you are ultimately not accepted, SRI will return your premium without delay. WORLDWIDE COVERAGE RESIDE Prime is designed to cover Insured Persons 24 hours a day, seven days a week, regardless of where in the world they may be located. As an international citizen, you will no longer need to purchase multiple insurance programs in order to have seamless protection. Coverage in the United States is limited to 6 months during any 12 month Policy Period. RENEWABILITY The initial Period of Coverage cannot exceed twelve (12) months. The Insured Person, however, may apply for renewal of coverage at the Renewal Rates in force at the time of renewal. The renewal Period of Coverage may not total more than twelve (12) months. Renewal(s) will be contingent upon the Insured Person submitting the applicable renewal premiums for their class, as determined by the Company. Renewal(s) will also be contingent upon the Insured Person declaring that they continue to meet the Eligibility Requirements. The Company can not cancel an Insured Person, unless that Insured Person is included in a class that is canceled in its entirety by the Company. MATERNITY RESIDE Prime provides maternity and newborn child benefits to eligible Insured Persons, who are the Primary Insured or Spouse, up to $7500 per pregnancy. A pregnancy must be Pre-Notified during the first 90 days of the pregnancy. Failure to Pre-Notify a pregnancy will result in a 100% reduction in eligible benefits. The plan does not pay expenses related to a pregnancy within the first 12 months of coverage. INTERNATIONAL TRAVELER'S COVERAGE When the Insured Person travels outside of their home country, in addition to the standard benefit, they will be covered for Repatriation of Mortal Remains and Emergency Medical Reunion coverage. LIMITATIONS Pre-existing Conditions: If an existing condition is fully and accurately disclosed on the application, and the condition is not excluded or restricted by a rider, your preexisting condition will be covered up to a lifetime maximum of $50,000 ($5,000 limit per year) after you have been continuously insured for 24 months. Preexisting conditions are any Injury or Illness which meets the following criteria: 1) A condition that would have caused a person to seek medical advice, diagnosis, care or treatment prior to the Effective Date of coverage under this Certificate; 2) A condition for which manifestation, medical advice, diagnosis, care or treatment (including medication) was recommended or received prior to the Effective Date of coverage under this Certificate; 3) Expenses for Pregnancy within twelve (12) months of the Effective Date of coverage under this Certificate. The following
conditions, treatments, supplies, services, and/or expenses are not
covered:
This brochure is only a brief description of RESIDE Prime. A complete description of the Master Policy Provisions and Benefits is contained in the Certificate of Insurance, which will be mailed to you once your application and premium have been received and approved by SRI. PRE-NOTIFICATION PROGRAM So that you receive the best care possible, RESIDE Prime requires that the Insured Person (or someone on the Insured Person's behalf) contact SRI Assist for notification prior to all hospital admissions worldwide and any medical expenses incurred within the United States. The methods of contacting SRI Assist will appear on the back of your ID Card. SRI Assist will also be able to assist you in locating the approved SRI medical care providers in the United States. If the Pre-Notification Program is not followed, there will be a 50% reduction in eligible benefits. THE ADMINISTRATOR Since 1993, Specialty Risk International, Inc. (SRI) has provided international insurance plans to private citizens, governments, missionaries, students, and corporations of various nations around the globe. As a premier underwriter, SRI has had the opportunity to provide innovative solutions to unique and challenging situations. Our claims professionals are experienced in the complexity of processing international medical expenses. As an insured of SRI, you can feel confident that there is someone ready to assist you with a medical situation 24 hours a day, 365 days a year. Other services including proficient administration, responsive underwriting, and access to secure and stable insurance carriers and medical care providers worldwide. SECURITY Reside Prime is underwritten by Certain Underwriters at Lloyd's, London and is rated A "Excellent" by A.M. Best. In addition to being one of the largest insurance entities in the world, Lloyd's has over 300 years of experience in the international insurance business. IMPORTANT INFORMATION It is important to note that Reside Prime is a program for international citizens and Lloyd's is an international entity. Thus, Lloyd's operates as an unauthorized insurer in most US states. Coverage and benefits under Reside Prime are not regulated by any US state insurance department. The information concerning Reside Prime is not intended to be an offer to sell Reside Prime or a solicitation by Specialty Risk International, Inc or Lloyd's, London in any jurisdiction where such an action would be unlawful or in which SRI or Lloyd's, London is not qualified to do so. Reside Prime may not be available in all situations or jurisdictions. For US citizens, Reside Prime is intended for persons living or traveling outside the United States. Copyright 1998 - 2007
by Specialty Risk International, Inc. |
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