Global Medical Insurance - International Health Insurance - Annually renewable major medical insurance

Plan Options: Bronze, Silver, Gold, Gold Plus & Platinum

Global Medical Insurance^®

Worldwide Coverage. World-Class Services.

Being a global citizen can be an exciting experience, but it also comes with potential complications. Your health care while traveling should not be one of those concerns. With Global Medical Insurance, a revolutionary program, you will receive the worldwide medical coverage you need, backed by the world-class services you expect.

Global Medical Insurance allows you to choose from several plan options, customize your length and area of coverage and select from multiple deductibles and modes of payment. With your medical history in mind, the program provides different underwriting methods to extend medical coverage to you that may be declined by other companies.

With us, you will rest assured knowing that we have a dedicated department working to keep your insurance as affordable as possible. The costs of health care are rising, but we are committed to controlling those costs. As part of that commitment, we offer a Medical Concierge program, an unparalleled service that saves you on out-of-pocket medical expenses. We also offer a cash incentive and to waive 50% of your deductible for choosing to receive treatment from some of the best medical facilities outside the U.S.

You need the proper worldwide coverage, provided by a company that's there for you when you need us most. When you select Global Medical Insurance, you receive our promise to deliver exceptional medical benefits, medical assistance and service - all designed to give you Global Peace of Mind^®.

Why Us?

We have provided global benefits and assistance services to millions of members in almost every country. We're committed to being there with our members wherever they may be in the world, helping to deliver Global Peace of Mind. With 24/7 medical management services, multilingual claims administrators and highly trained customer service professionals, we are confident in its ability to provide the products international members need, backed by the services they want.

Global Support. With offices and partners across the globe, we provide the support you need, when you need it. In fact, it is our corporate mission to be there to protect and enhance your health and well-being.
Service Without Obstacles. With a team of international, multilingual specialists, we are accustomed to working in multiple time zones, languages and currencies. Our global reach means we can work without barriers.
International Provider Access^SM (IPA). In addition to the expansive UnitedHealthcare PPO network available for treatment received within the U.S., our proprietary IPA network of more than 17,000 accomplished physicians and facilities allows you to access quality care worldwide. Our direct billing arrangements can also ease the time and upfront expense at select providers.
Financial Stability. Owned by Sirius International Insurance Group — an A- rated, $2.6 billion global enterprise — we offer the financial security and reputation demanded by international consumers.
Accessible Technology. Log on to the secure, 24-hour online portal to submit and view your claims, manage your account, search for providers, and more.
International Emergency Care. When you're away from home and a medical emergency occurs, you may not be able to wait for regular business hours. With our on-site medical staff, you have 24-hour access to highly qualified coordinators of emergency medical services and international treatment.

Why Global Medical Insurance?

Five plan options - Bronze, Silver, Gold, Gold Plus and Platinum - and additional, optional coverages
Choice of coverage area - Worldwide or Worldwide Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore and Taiwan - to reflect your desired geographic area
Flexible underwriting that fits your needs
Emergency benefits backed by the services of an accredited, on-site clinical staff
Premium modes - Monthly, Quarterly, Semi-Annual, and Annual - to schedule the frequency of payment that meets your needs.
Multiple deductible options - $100 (Platinum plan option), $250, $500, $1,000, $2,500, $5,000, $10,000, $25,000 (Gold, Gold Plus, and Platinum plan options) -to accommodate your financial resources.
Freedom to choose your own health care provider, no matter where you are in the world

Summary Schedule of Benefits

The following is a summary schedule of benefits for eligible medical expenses.

Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Charges are Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary ("Eligible Medical Expenses").

Benefit	Bronze	Silver	Gold (1^st 36 months of continuous coverage)	Gold (Beginning the 1^st day of the 37^th month)	Gold Plus	Platinum
Lifetime Maximum Limit	$1,000,000 per individual	$5,000,000 per individual	$5,000,000 per individual	$5,000,000 per individual	$5,000,000 per individual	$8,000,000 per individual
Deductible (Per Period of Coverage)	$250 to $10,000	$250 to $10,000	$250 to $25,000	$250 to $25,000	$250 to $25,000	$100 to $25,000
Deductible Carry Forward	Included	Included	Included	Included	Included	Included
Treatment outside the U.S.	50% of deductible waived, up to a maximum of $2,500. No coinsurance	50% of deductible waived, up to a maximum of $2,500. No coinsurance	50% of deductible waived, up to a maximum of $2,500. No coinsurance	50% of deductible waived, up to a maximum of $2,500. No coinsurance	50% of deductible waived, up to a maximum of $2,500. No coinsurance	50% of deductible waived, up to a maximum of $2,500. No coinsurance
Treatment inside the U.S. using Medical Concierge	50% of deductible waived, up to a maximum of $2,500. No coinsurance.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.	50% of deductible waived, up to a maximum of $2,500. No coinsurance.
Treatment inside the U.S. - PPO Network	Subject to deductible. No coinsurance	Subject to deductible. No coinsurance	Subject to deductible. No coinsurance	Subject to deductible. No coinsurance	Subject to deductible. No coinsurance	Subject to deductible. No coinsurance
Treatment inside the U.S. - Non-PPO Network	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage	Subject to deductible. Plan pays 80% of the next $5,000 of eligible expenses, then 100% to the overall maximum per period of coverage
Coinsurance	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%	International - 100% U.S. in-network - 100% U.S. out-of-network - 80%
Outpatient	$500 maximum limit - specialists/ physician charges (pre-inpatient / post-inpatient) $300 maximum per visit - lab tests; $250 maximum per visit - diagnostic x-rays	$70 maximum limit; 25 visit limit - specialists/physician charges $50 maximum limit - chiropractor charges $500 maximum limit - surgery intervention consultation charges $300 maximum per visit - lab tests; $250 maximum per visit -diagnostic x-rays	Subject to deductible and coinsurance	Physician charges - $150 per visit; Hospital charge - $100 co-pay unless admitted; urgent care facility - $25 co-pay $5,000 maximum per period of coverage for diagnostic lab and x-rays	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Mental/Nervous	NA	Subject to deductible and coinsurance. Outpatient after 12 months of continuous coverage	Subject to deductible and coinsurance. $10,000 maximum. Available after 12 months of continuous coverage.	Inpatient: Subject to deductible and coinsurance Outpatient: International - 70% U.S. in-network - 70% U.S. Out-of-network - 70% Additional Outpatient Sub-limit: $75 maximum limit per visit $2,500 maximum per period of coverage	Subject to deductible and coinsurance. $10,000 maximum per period of coverage with a $50,000 lifetime maximum. Available after 12 months of continuous coverage	Subject to deductible and coinsurance. $50,000 lifetime maximum. Available after 12 months of continuous coverage
Hospital Emergency Room Injury	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Hospital Emergency Room Illness	Subject to deductible and coinsurance. Covered only if admitted as inpatient	Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient	Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient	Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient	Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient	Subject to deductible and coinsurance. Additional $250 deductible if not admitted as an inpatient
Hospitalization/Room & Board	Subject to deductible and coinsurance for average semi-private room rate	Subject to deductible and coinsurance for average semi-private room rate. All subject to $600 per day /240 day maximum	Subject to deductible and coinsurance for average semi-private room rate	Subject to deductible and coinsurance for average semi-private room rate $2,250 limit per day	Subject to deductible and coinsurance for average semi-private room rate	Subject to deductible and coinsurance for average semi-private room rate
Intensive Care Unit	Subject to deductible and coinsurance	Subject to deductible and coinsurance. $1,500 limit per day - 180 days of coverage per event	Subject to deductible and coinsurance	Subject to deductible and coinsurance. $4,500 limit per day	Subject to deductible and coinsurance	Subject to deductible and coinsurance
CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy, Cystoscopy	Subject to deductible and coinsurance $600 maximum limit per examination	Subject to deductible and coinsurance $600 maximum limit per examination	Subject to deductible and coinsurance	Subject to deductible and coinsurance $5,000 maximum limit for outpatient labs	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Surgery	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Assistant Surgeon	20% of primary surgeon's charge	20% of primary surgeon's charge	20% of primary surgeon's charge	20% of primary surgeon's charge	20% of primary surgeon's charge	20% of primary surgeon's charge
Chemotherapy or Radiation Therapy	Subject to deductible and coinsurance	Subject to deductible and coinsurance	Subject to deductible and coinsurance	$10,000 maximum per period of coverage, $50,000 lifetime maximum	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Maternity Delivery, preventative care, newborn care & congenital disorders, Family Matters Maternity Program (available after 10 months of coverage)	NA	NA	NA	NA	NA	$2,500 additional deductible per pregnancy. $50,000 lifetime maximum. $200 newborn preventative care benefit for the first 31 days -12 months after birth. $250,000 maximum for newborn care & congenital disorders for the first 31 days after birth
Podiatry Care	NA	NA	$750 maximum limit	$750 maximum limit	$750 maximum limit	$750 maximum limit
Physical Therapy	Subject to deductible and coinsurance. $40 maximum per visit - 10 visit limit per event. Available for 90 days following inpatient treatment or outpatient surgery	Subject to deductible and coinsurance. $40 maximum per visit - 30 visit limit	Subject to deductible and coinsurance. $50 maximum per visit	Subject to deductible and coinsurance. $50 maximum per visit - $1,000 maximum per period of coverage $10,000 lifetime maximum	Subject to deductible and coinsurance. $50 maximum per visit	Subject to deductible and coinsurance. $50 maximum per visit
Transplants	$250,000 lifetime maximum	$250,000 lifetime maximum	$1,000,000 lifetime maximum	$500,000 lifetime maximum	$1,000,000 lifetime maximum	$2,000,000 lifetime maximum
Prescription Coverage	Subject to deductible and coinsurance. Available for 90 days following related inpatient treatment or outpatient surgery. $600 outpatient maximum limit per event	Subject to deductible and coinsurance. 90-day supply per prescription following related covered event	Subject to deductible and coinsurance. 90-day supply per prescription Outpatient only	Subject to deductible and coinsurance. $5,000 per period of coverage - outpatient only. 90-day supply per prescription	Subject to deductible and coinsurance. 90-day supply per prescription	International - 100% Inside U.S. - Prescription drug card co-pay: $20 for generic / $40 for brand name where generic is not available. 90-day supply per prescription
Adult Preventative Care (Age 19 or older)	NA	NA	$250 per period of coverage. Not subject to deductible or coinsurance. Available after 12 months of continuous coverage	$250 per period of coverage. Not subject to deductible or coinsurance	$250 per period of coverage. Not subject to deductible or coinsurance. Available after 12 months of continuous coverage	$500 per period of coverage. Not subject to deductible or coinsurance. Available after 6 months of continuous coverage
Child Preventative Care (Through age 18)	NA	$70 maximum per visit, 3 visit limit per period of coverage. Not subject to deductible or coinsurance. Available after 12 months of continuous coverage	$200 maximum per period of coverage. Not subject to deductible or coinsurance. Available after 12 months of continuous coverage	$200 maximum per period of coverage. Not subject to deductible or coinsurance	$200 maximum per period of coverage. Not subject to deductible or coinsurance. Available after 12 months of continuous coverage	$400 maximum per period of coverage. Not subject to deductible or coinsurance. Available after 6 months of continuous coverage
Vision	Optional Rider	Optional Rider	Optional Rider	Optional Rider	Optional Rider	$100 maximum per 24 months for exams. $150 per 24 months for materials
Local Ambulance due to Injury or Illness resulting in Hospitalization	$1,500 maximum limit per event. Not subject to deductible or coinsurance	$1,500 maximum limit per event. Not subject to deductible or coinsurance	Subject to deductible and coinsurance	$100 maximum limit per event. Not subject to deductible or coinsurance	Subject to deductible and coinsurance	Not subject to deductible or coinsurance
Emergency Evacuation	$50,000 maximum per period of coverage. Not subject to deductible or coinsurance	$50,000 maximum per period of coverage. Not subject to deductible or coinsurance	Up to lifetime maximum limit. Not subject to deductible or coinsurance	$250,000 maximum per period of coverage. Not subject to deductible or coinsurance	Up to maximum limit. Not subject to deductible or coinsurance	Up to maximum limit. Not subject to deductible or coinsurance
Emergency Reunion	$10,000 lifetime maximum. Not subject to deductible or coinsurance	NA	$10,000 lifetime maximum. Not subject to deductible or coinsurance	$10,000 lifetime maximum. Not subject to deductible or coinsurance	$10,000 lifetime maximum. Not subject to deductible or coinsurance	$10,000 lifetime maximum. Not subject to deductible or coinsurance
Interfacility Ambulance Transfer (Transfer from one licensed health care Facility to another licensed health care Facility)	$1,500 maximum limit per event. Not subject to deductible or coinsurance. U.S. only	$1,500 maximum limit per event. Not subject to deductible or coinsurance. U.S. only	Subject to deductible and coinsurance. U.S. only	$1,000 maximum limit per event. Not subject to deductible or coinsurance. U.S. only	Not subject to deductible or coinsurance. U.S. only	Subject to maximums, deductible and coinsurance. Not subject to deductible or coinsurance. U.S. only
Political Evacuation and Repatriation	NA	NA	NA	NA	NA	$10,000 lifetime maximum
Remote Transportation	NA	NA	NA	NA	NA	$5,000 per period of coverage up to $20,000 lifetime maximum. Not subject to deductible or coinsurance
Return of Mortal Remains	$10,000 lifetime maximum. Not subject to deductible or coinsurance	$25,000 lifetime maximum. Not subject to deductible or coinsurance	$25,000 lifetime maximum. Not subject to deductible or coinsurance	$15,000 lifetime maximum. Not subject to deductible or coinsurance	$25,000 lifetime maximum. Not subject to deductible or coinsurance	$50,000 lifetime maximum. Not subject to deductible or coinsurance
Complementary Medicine	NA	NA	$500 maximum limit per period of coverage	$500 maximum limit per period of coverage	$500 maximum limit per period of coverage	$500 maximum limit per period of coverage
Traumatic Dental Injury Treatment at a hospital facility	$1,000 per period of coverage	$1,000 per period of coverage	Up to the lifetime maximum limit	$5,000 per period of coverage	Up to the lifetime maximum limit	Up to the lifetime maximum limit
Treatment Due to Unexpected Pain to Sound, Natural Teeth	NA	NA	$100 per period of coverage	$100 per period of coverage	$100 per period of coverage	100%
Non-Emergency Treatment at a Dental Provider due to an Accident	NA	NA	$500 per period of coverage	$500 per period of coverage	$500 per period of coverage	See Non-Emergency Dental benefit
Non-Emergency Dental	Optional Rider	Optional Rider	Optional Rider	Optional Rider	Optional Rider	$750 maximum per period of coverage; $50 individual deductible, applies to minor restorative and major restorative services
Hospital Indemnity (Outside the U.S. only)	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance	Private Hospitals: $400 per overnight and $4,000 maximum limit per period of coverage Public Hospitals: $500 per overnight and $5,000 maximum limit per period of coverage. Not subject to deductible or coinsurance
Supplemental Accident	NA	NA	$300 of eligible medical expenses following an accident . Not subject to deductible or coinsurance	$300 of eligible medical expenses following an accident . Not subject to deductible or coinsurance	$300 of eligible medical expenses following an accident . Not subject to deductible or coinsurance	$500 maximum limit per accident. Not subject to deductible and coinsurance
Pre-Existing Conditions Limitation	Excluded	$50,000 lifetime maximum; $5,000 per period of coverage for unknown conditions. Available after 24 months of continuous coverage	$50,000 lifetime maximum; $5,000 per period of coverage for unknown conditions. Available after 24 months of continuous coverage	$50,000 lifetime maximum; $5,000 per period of coverage	$50,000 lifetime maximum; $5,000 per period of coverage for unknown conditions. Available after 24 months of continuous coverage	NA

DISCLAIMER: Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way the Certificate of Insurance and governing policy documents (together the "Insurance Contract"). The Insurance Contract is the only source of the actual benefits provided.

Optional Coverage

Global Medical Insurance is designed to help protect individuals and families from the high cost of medical expenses. In addition to tailored benefits packages, the program offers several optional coverages. You may review and choose the options that meet your needs.

Rider	Description
Global Term Life Insurance (Amounts shown are the Principal Sums per unit)	Age 31 days - 18 years: $5,000 Age 19 - 29 years: $75,000 Age 30 - 39 years: $50,000 Age 40 - 44 years: $35,000 Age 45 - 49 years: $25,000 Age 50 - 54 years: $20,000 Age 55 - 59 years: $15,000 Age 60 - 64 years: $10,000 Age 65 - 69 years: $7,500
Accidental Death & Dismemberment (AD&D) - included with Global Term Life Insurance	Accidental Loss of Life: Principal Sum* Accidental Total Loss of 2 Members*: Principal Sum Accidental Total Loss of 1 Member*: 50% of Principal Sum (* Benefit based on age at time of death ** "Member" means hand, foot or eye)
Terrorism(Platinum plan option)	$50,000 lifetime maximum for Eligible Medical Expenses arising out of injury or illness incurred by the Insured as a result of or in connection with an act of terrorism (Refer to rider for more details)
Sports (Gold Plus and Platinum plan options) (Refer to rider for a comprehensive list of sports excluded)	$10,000 lifetime maximum for amateur athletics Adventure Sports: Through age 49 years: $50,000 lifetime maximum Age 50 years through age 59 years: $30,000 lifetime maximum Age 60 years through age 64 years: $15,000 lifetime maximum
Dental & Vision (Bronze, Silver, Gold, Gold Plus plan options)	Dental $750 calendar maximum $50 deductible (max. 2 per family) Routine services - 90% (deductible is waived), Minor restorative - 70%, Major restorative- 50% 6 month waiting period	Vision Exams - up to $100 per 24 months Materials - up to $150 per 24 months

Comprehensive World-Class Services

Medical Concierge
Whether you are seeking care at a local facility or in an unfamiliar location, quality of care is a primary concern. The Medical Concierge program is designed to provide you with critical information and to assist you in making the right decision for treatment. Your personal Medical Concierge will review your specific non-emergency medical condition and provide you with information on provider ratings, past outcomes and general costs — all in the area where you are planning treatment.
You will be entitled to receive a reduction in your deductible for utilizing this unique medical service while in the United States. This level of individualized service is unmatched in the international arena.
Online Services
Proprietary online services located in MyAccount member/login that allows you to manage your accounts, 24 hours a day, seven days a week, from anywhere in the world. Some features include:
- Submission and management of claims
- Access to Explanations of Benefits (EOBs)
- Initiate precertification
- Access Customer Care via email or telephone
- Locate and recommend a provider/facility
- Obtain ID cards and other important documents
Teladoc
Teladoc provides access to a national network of board-certified doctors and pediatricians in the U.S. who are available 24 hours a day, seven days a week, 365 days a year to help diagnose, treat and prescribe medication (when necessary and available) for many non-emergent medical issues via phone or online video consultations. Teladoc does not replace existing primary care physician relationships, but supplements them as a convenient, affordable alternative for non-emergency medical care. The use of Teladoc will be considered as treatment inside the U.S. - PPO Network. (Available only when Worldwide coverage is purchased)
Universal Rx Pharmacy Discount Savings
This discount savings program allows you to purchase prescriptions at one of over 35,000 participating pharmacies in the U.S. and receive the lower of 1) Universal Rx contract price or 2) the pharmacy regular retail price. This program is not insurance coverage. It is purely a discount program.
eDocAmerica
The Platinum plan option offers you direct access to eDocAmerica, a worldwide medical information service, which allows you to communicate with licensed physicians, psychologists, pharmacists, dentists, dieticians and fitness trainers free of charge 24 hours a day. eDocAmerica's services result in saved office visits, peace of mind, confidence to act, and ultimately an informed, empowered member.
The Family Matters^® Maternity Program
This program is designed to provide you with educational information on your pregnancy, and suggestions for a healthy lifestyle for the expecting mom and family. A complimentary copy of the book "What to Expect When You're Expecting" is provided to help answer the day-to-day questions faced by all expectant families. This program can also assist you in early detection of potential pregnancy complications, and encourage proper prenatal medical treatment. (Available on the Platinum plan option only)
Global Concierge and Assistance Services
The Platinum plan option provides you with more than just insurance protection. You also have exclusive access to a list of additional emergency travel assistance services handled by a dedicated service team available 24/7. Some of the assistance services provided include:
- Emergency travel arrangements
- Lost passport/travel documents assistance
- Lost luggage assistance
- Embassy or consulate referrals
- Emergency message relay
- Emergency prescription replacement
- Medical referrals
- 24-hour medical monitoring
- Emergency cash transfer and emergency translations
- Legal referrals

Eligibility

Global Medical Insurance is available to individuals and families of all nationalities. U.S. citizens must plan to be residing outside U.S. on or before their effective date and renewal dates, and for at least six (6) out of the next 12 months. Additional eligibility restrictions apply to non-U.S. citizens residing in the U.S. Persons from the ages of 14 days to 74 years old may apply for coverage, and coverage ends at age 75. Persons 75 years of age and older are not eligible for coverage. Please see a sample contract for details.

Lifetime Coverage

Lifetime medical coverage is available if you are enrolled in the Global Medical Insurance program by your 65th birthday and maintain continuous coverage to age 75. Prior to your 75th birthday you will receive a summary of benefits for the Global Senior Plan^®, and an enrollment form for coverage. There is no additional medical underwriting. You simply need to review the benefits, and promptly complete and return the enrollment form with your premium.

Enrollment

To apply for Global Medical Insurance, simply apply online or complete and return the Application. If you are applying as a family, you may include yourself, your spouse and dependents on one application. If you have dependents who are 19 and older, you must complete a separate application for those individuals. You must accurately complete all questions outlined in the application in order to be considered for coverage.

If approved, you will receive a fulfillment kit, which includes an identification card, declaration of insurance and a Certificate Wording containing a complete description of benefits, exclusions and terms of the plan. You are required to notify the administrator, as required by the terms of the plan, if you or any family member suffers from or is treated for any illness, injury or other medical condition between the time of your application and the issuance of the certificate. If your application is not approved, you will receive a full refund of any premium received by the administrator. For additional information, please contact us.

Quality Guarantee

To ensure your satisfaction, once you are accepted in the plan, we provide a 15-day free look period to review the coverage. If during that 15-day period you find that you are not satisfied with the plan for any reason, you may submit a written request for cancellation and full refund of your premium received by the administrator. See the Certificate Wording for full details.

IMPORTANT NOTICE REGARDING PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA): This insurance is not subject to, and does not provide benefits required by PPACA. Since January 1, 2014, PPACA requires U.S. citizens, U.S. nationals and certain U.S. residents to obtain PPACA compliant insurance coverage unless they are exempt from PPACA. Penalties may be imposed on persons who are required to maintain PPACA compliant coverage but do not do so. Eligibility to purchase, extend or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including PPACA. Please note that it is an insured person's sole and exclusive responsibility to determine the insurance requirements applicable to them, and the Company and the administrator shall have no liability whatsoever, including for any penalties a person may incur, for failure to obtain coverage required by any applicable law including without limitation PPACA. For information on whether PPACA applies to you or whether you are eligible to purchase Global Medical Insurance.

Global Medical Insurance^® - Bronze

Worldwide Coverage

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	343		298		232		204		186		166
10 to 18**	351		313		258		239		225		199
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	794	990	688	975	536	748	466	651	367	522	325	450
25 to 29	838	1,128	731	1,096	569	844	497	733	389	610	346	480
30 to 34	938	1,248	807	1,175	626	910	549	794	430	637	382	542
35 to 39	1,072	1,503	868	1,333	673	1,035	589	895	460	745	411	582
40 to 44	1,356	1,650	1,101	1,435	730	1,125	639	984	612	762	543	679
45 to 49	1,510	1,820	1,239	1,548	958	1,197	836	1,043	682	823	607	733
50 to 54	1,843	2,025	1,563	1,746	1,208	1,355	1,053	1,205	896	998	796	890
55 to 59	2,271	2,271	1,975	1,975	1,528	1,527	1,333	1,333	1,122	1,130	997	1,007
60 to 64	3,344	3,146	3,046	2,851	2,569	2,162	2,325	2,087	1,944	1,726	1,730	1,536
65 to 69	6,983	6,058	6,683	5,794	6,251	5,276	4,806	3,922	4,202	3,763	3,740	3,349
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $570 annual premium						*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

**Except for Global Group, the administrator will not accept checks, money orders or wire transfers for semi-annual, quarterly, or monthly payment modes. These alternative payment modes are only accepted with pre-authorization to debit your credit card on the due date(s) of your future premium installment(s) prior to the expiration date.

Note: Choosing the semi-annual payment option (modal payment factor .55) results in total payments of 110% of the annual premium, choosing the quarterly payment option (modal payment factor .28) results in total payments of 112% of the annual premium, and choosing the monthly payment option (modal payment factor .10) results in total payments of 120% of the annual premium.

Global Medical Insurance^® - Bronze

Worldwide Coverage Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	256		224		175		153		141		123
10 to 18**	263		235		194		181		169		148
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	597	742	515	730	401	560	351	488	275	392	244	338
25 to 29	629	846	550	823	427	633	371	551	292	457	259	361
30 to 34	704	936	606	882	468	683	411	596	322	478	286	408
35 to 39	806	1,128	652	1,002	504	777	443	672	346	560	308	436
40 to 44	1,015	1,239	825	1,076	547	844	480	738	459	575	408	508
45 to 49	1,132	1,365	928	1,162	720	899	627	783	511	618	455	549
50 to 54	1,382	1,519	1,173	1,309	905	1,015	791	903	672	750	598	668
55 to 59	1,703	1,703	1,480	1,480	1,147	1,145	998	998	841	848	749	754
60 to 64	2,508	2,361	2,285	2,138	1,926	1,701	1,745	1,566	1,457	1,296	1,298	1,152
65 to 69	5,236	4,544	5,013	4,346	4,690	3,957	3,604	2,942	3,152	2,822	2,805	2,512
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $460 annual premium						*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Silver

Worldwide Coverage

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	396		345		268		236		215		192
10 to 18**	405		361		298		277		261		231
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	918	1,144	795	1,127	619	864	539	752	423	604	376	520
25 to 29	969	1,304	846	1,267	658	976	574	848	450	705	400	554
30 to 34	1,084	1,443	934	1,359	723	1,052	635	918	498	737	442	627
35 to 39	1,239	1,738	1,004	1,541	777	1,197	681	1,034	531	861	475	673
40 to 44	1,567	1,908	1,272	1,659	844	1,300	739	1,139	707	881	628	784
45 to 49	1,746	2,105	1,432	1,791	1,109	1,383	966	1,206	789	951	702	848
50 to 54	2,131	2,341	1,807	2,018	1,396	1,565	1,218	1,393	1,035	1,155	920	1,029
55 to 59	2,627	2,627	2,283	2,283	1,768	1,765	1,541	1,541	1,297	1,308	1,153	1,165
60 to 64	3,866	3,637	3,522	3,296	2,969	2,621	2,689	2,413	2,246	1,995	2,000	1,777
65 to 69	8,073	7,004	7,726	6,698	7,227	6,100	5,556	4,534	4,858	4,349	4,323	3,872
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $570 annual premium						*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Silver

Worldwide Coverage Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, And Taiwan

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	297		260		201		177		163		143
10 to 18**	305		270		224		208		196		171
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	690	858	596	844	463	646	405	565	317	454	282	391
25 to 29	727	979	636	951	492	730	430	637	337	528	300	417
30 to 34	813	1,082	700	1,020	542	790	475	688	373	553	331	472
35 to 39	932	1,304	753	1,158	583	899	512	776	400	646	357	504
40 to 44	1,174	1,432	952	1,244	633	975	554	853	530	665	472	588
45 to 49	1,309	1,578	1,073	1,342	833	1,040	725	905	590	714	527	635
50 to 54	1,599	1,756	1,356	1,513	1,047	1,174	915	1,044	776	867	691	772
55 to 59	1,969	1,969	1,711	1,711	1,325	1,324	1,155	1,155	972	980	865	873
60 to 64	2,899	2,729	2,642	2,471	2,228	1,967	2,017	1,811	1,685	1,498	1,501	1,333
65 to 69	6,054	5,252	5,795	5,024	5,421	4,576	4,166	3,401	3,644	3,263	3,243	2,903
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $460 annual premium						*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

*Except for Global Group, we will not accept checks, money orders or wire transfers for semi-annual, quarterly, or monthly payment modes. These alternative payment modes are only accepted with pre-authorization to debit your credit card on the due date(s) of your future premium installment(s) prior to the expiration date.

Global Medical Insurance^®- Gold (For enhanced, long-term benefits, see Gold Plus plan option)

Worldwide Coverage

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	551		470		352		320		282		255		230
10 to 18**	610		497		389		352		315		282		254
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	1,272	1,674	1,095	1,587	875	1,173	757	1,014	590	818	466	618	420	557
25 to 29	1,301	1,848	1,119	1,724	895	1,271	775	1,099	604	858	477	633	430	569
30 to 34	1,381	1,988	1,187	1,829	950	1,388	826	1,208	650	980	513	734	461	660
35 to 39	1,434	2,205	1,234	1,937	987	1,440	859	1,254	674	1,018	532	761	480	684
40 to 44	1,884	2,463	1,724	2,241	1,379	1,655	1,186	1,565	925	1,194	730	935	658	758
45 to 49	2,182	2,638	1,984	2,420	1,528	1,834	1,375	1,651	1,120	1,289	886	1,018	797	917
50 to 54	2,593	2,796	2,335	2,544	1,866	2,034	1,727	1,883	1,381	1,505	1,091	1,189	982	1,071
55 to 59	3,441	3,344	3,062	2,970	2,496	2,422	2,109	2,046	1,771	1,718	1,401	1,357	1,260	1,221
60 to 64	4,832	4,557	4,518	4,234	3,616	3,343	3,398	3,143	2,854	2,525	2,340	2,084	2,107	1,875
65 to 69	9,667	8,691	9,376	8,129	8,720	7,455	6,757	6,217	5,947	5,472	4,876	4,486	4,388	4,038
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $570 annual premium							*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Gold (For enhanced, long-term benefits, see Gold Plus plan option)

Worldwide Coverage Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	406		347		260		237		209		190		170
10 to 18**	450		367		288		261		233		209		189
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	942	1,240	810	1,174	649	867	560	751	437	605	345	458	311	412
25 to 29	963	1,367	828	1,277	664	942	573	813	447	635	353	468	319	421
30 to 34	1,021	1,472	879	1,354	703	1,027	612	892	480	725	380	543	342	489
35 to 39	1,061	1,631	913	1,433	729	1,066	636	928	499	753	393	562	354	506
40 to 44	1,394	1,822	1,277	1,658	1,020	1,225	877	1,158	684	882	541	692	486	623
45 to 49	1,615	1,953	1,469	1,791	1,130	1,357	1,018	1,221	830	953	656	753	590	679
50 to 54	1,919	2,069	1,727	1,883	1,381	1,505	1,278	1,393	1,022	1,114	807	880	727	792
55 to 59	2,547	2,475	2,267	2,199	1,848	1,792	1,561	1,515	1,311	1,272	1,035	1,005	932	905
60 to 64	3,577	3,372	3,343	3,133	2,675	2,475	2,515	2,325	2,113	1,869	1,732	1,542	1,559	1,388
65 to 69	7,154	6,432	6,938	6,016	6,453	5,517	5,001	4,600	4,401	4,049	3,609	3,320	3,248	2,989
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $460 annual premium							*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Gold Plus

Worldwide Coverage

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	737		621		473		429		384		332		299
10 to 18**	799		652		505		460		408		371		334
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	1,448	2,032	1,204	1,689	934	1,311	821	1,153	673	944	514	721	462	649
25 to 29	1,458	2,186	1,254	1,880	972	1,458	854	1,282	699	1,049	534	803	481	722
30 to 34	1,685	2,606	1,403	2,169	1,087	1,681	957	1,479	782	1,211	598	923	538	831
35 to 39	1,880	2,930	1,564	2,439	1,212	1,891	1,067	1,663	874	1,362	667	1,041	600	936
40 to 44	2,424	3,233	2,018	2,691	1,564	2,086	1,377	1,835	1,127	1,502	860	1,147	774	1,033
45 to 49	3,031	3,486	2,522	2,900	1,955	2,248	1,722	1,979	1,408	1,619	1,075	1,237	968	1,113
50 to 54	5,338	5,766	5,137	5,541	4,563	4,928	4,015	4,336	3,286	3,549	2,509	2,711	2,259	2,439
55 to 59	7,175	7,043	6,976	6,843	6,245	6,179	5,496	5,437	4,497	4,448	3,435	3,398	3,091	3,058
60 to 64	8,949	8,224	8,687	7,979	7,706	7,175	6,782	6,314	5,549	5,166	4,238	3,946	3,815	3,551
65 to 69	20,064	17,406	19,266	16,728	18,602	15,945	15,440	13,234	11,533	9,885	10,232	8,770	9,208	7,892
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $570 annual premium								*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Gold Plus

Worldwide Coverage Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	551		466		359		320		289		255		230
10 to 18**	599		490		381		344		309		277		250
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	1,086	1,524	904	1,268	700	983	616	866	505	708	385	541	346	486
25 to 29	1,093	1,641	941	1,410	728	1,093	642	961	524	788	401	600	361	541
30 to 34	1,265	1,954	1,052	1,626	817	1,262	716	1,110	587	907	449	693	404	623
35 to 39	1,410	2,199	1,173	1,830	910	1,419	802	1,249	656	1,021	500	780	450	702
40 to 44	1,819	2,424	1,513	2,018	1,173	1,564	1,033	1,377	845	1,127	645	860	581	774
45 to 49	2,274	2,617	1,892	2,177	1,466	1,688	1,291	1,486	1,056	1,216	807	929	727	836
50 to 54	4,545	4,739	4,003	4,176	3,422	3,695	3,011	3,253	2,464	2,661	1,883	2,033	1,694	1,830
55 to 59	5,381	5,282	5,233	5,134	4,684	4,635	4,122	4,079	3,372	3,337	2,576	2,550	2,318	2,294
60 to 64	6,711	6,169	6,516	5,985	5,780	5,381	5,086	4,736	4,162	3,874	3,179	2,959	2,861	2,663
65 to 69	15,048	13,055	14,451	12,548	13,952	11,959	11,579	9,926	8,650	7,414	7,674	6,577	6,907	5,919
70 to 74	Please contact us or click Quotes & Purchase for premium information
Optional Dental & Vision Rider $460 annual premium							*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Platinum

Worldwide Coverage

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$100		$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	2,357		2,145		1,923		1,638		1,550		1,466		1,394		1,255
10 to 18**	2,493		2,266		1,985		1,704		1,611		1,521		1,442		1,298
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	3,908	5,947	3,569	5,373	3,152	5,142	2,605	3,837	2,371	3,453	2,058	2,762	1,745	2,418	1,571	2,176
25 to 29	4021	7,324	3,672	6,615	3,244	6,332	2,680	4,725	2,439	4,253	2,118	3,733	1,796	2,788	1,617	2,509
30 to 34	4,386	8,299	4,006	7,496	3,538	6,961	2,924	5,354	2,661	4,819	2,310	4,230	1,959	3,267	1,763	2,940
35 to 39	4,630	9,216	4,229	8,324	3,735	7,552	3,087	5,946	2,809	5,351	2,438	4,697	2,068	3,389	1,861	3,050
40 to 44	5,687	10,080	5,194	9,105	4,587	8,195	3,791	6,503	3,450	5,853	2,994	5,138	2,464	3,902	2,218	3,512
45 to 49	6,956	8,028	6,354	7,251	5,751	6,008	4,638	5,180	4,220	4,662	3,663	4,092	2,968	3,108	2,671	2,797
50 to 54	14,707	16,712	13,342	15,253	13,131	14,020	10,505	11,216	9,559	10,094	8,299	8,861	6,723	7,066	6,051	6,360
55 to 59	20,921	20,621	19,109	18,684	17,435	17,299	13,948	13,840	12,693	12,455	11,019	10,933	8,648	8,580	7,783	7,722
60 to 64	23,227	22,058	21,070	20,194	19,576	18,486	16,591	15,535	15,098	13,981	13,106	12,272	10,783	9,787	9,705	8,808
65 to 69	47,212	41,347	42,990	37,709	41,454	36,055	38,383	33,078	29,939	27,455	26,101	23,817	21,878	19,847	19,691	17,862
70 to 74	Please contact us or click Quotes & Purchase for premium information
*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

Global Medical Insurance^® - Platinum

Worldwide Coverage Excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan

(New Business Rates Effective 01/01/2018. The administrator reserves the right to issue the most current rates online in the event these expire, are modified or replaced with a newer version.)

Annual Premiums

All amounts shown are in U.S. dollars. Please select your deductible carefully, as you will be unable to select a lower deductible when you renew your coverage.

Deductibles	$100		$250		$500		$1,000		$2,500		$5,000		$10,000		$25,000
Age	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female	Male	Female
14 days to 9 years**	1,971		1,790		1,625		1,414		1,344		1,281		1,230		1,107
10 to 18**	2,068		1,880		1,673		1,462		1,392		1,324		1,265		1,139
*Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Female 19 to 24 rates.
19 to 24	3,169	4,825	2,894	4,358	2,556	4,171	2,112	3,113	1,923	2,801	1,669	2,241	1,415	1,961	1,273	1,765
25 to 29	3257	5,935	2,975	5,440	2,627	4,516	2,171	3,726	1,976	3,353	1,716	2,910	1,455	2,474	1,310	2,227
30 to 34	3,531	6,682	3,224	6,034	2,848	5,604	2,353	4,311	2,142	3,879	1,860	3,405	1,577	2,629	1,420	2,366
35 to 39	3,704	7,373	3,382	6,659	2,988	6,041	2,469	4,757	2,246	4,280	1,950	3,757	1,655	2,711	1,489	2,440
40 to 44	4,493	7,964	4,103	7,193	3,624	6,474	2,995	5,137	2,725	4,624	2,366	4,058	1,947	3,083	1,752	2,774
45 to 49	5,496	6,343	5,019	5,729	4,543	4,747	3,663	4,092	3,334	3,683	2,894	3,233	2,345	2,456	2,110	2,210
50 to 54	11,471	13,034	10,406	11,897	10,242	10,935	8,194	8,748	7,457	7,873	6,474	6,911	5,244	5,511	4,720	4,960
55 to 59	16,256	16,022	14,848	14,517	13,548	13,442	10,838	10,753	9,862	9,678	8,562	8,495	6,720	6,668	6,048	6,001
60 to 64	17,884	16,985	16,224	15,550	15,074	14,234	12,774	11,962	11,625	10,766	10,091	9,450	8,304	7,536	7,473	6,783
65 to 69	35,881	31,424	32,672	28,658	31,505	27,402	29,172	25,139	22,754	20,866	19,837	18,101	16,628	15,083	14,965	13,575
70 to 74	Please contact us or click Quotes & Purchase for premium information
*Modal Payment Factors Annual 1.00 Semi Annual .55 Quarterly .28 Monthly .10**

*Except for Global Group, IMG will not accept checks, money orders or wire transfers for semi-annual, quarterly, or monthly payment modes. These alternative payment modes are only accepted with pre-authorization to debit your credit card on the due date(s) of your future premium installment(s) prior to the expiration date.

管理商

IMG
9200 Keystone Crossing
Suite 800
Indianapolis, IN 46240

联系我们

选择语言

Global Medical Insurance®

Plan Options: Bronze, Silver, Gold, Gold Plus & Platinum