Rotary Youth Exchange Sample Plan

Rotary Youth Exchange requires that all students have comprehensive accident and sickness insurance.

Accidental Death & Dismemberment

Principal Sum:	$20,000
Time Period for Accident:	365 days from the date of a Covered Accident

Medical Expense Benefits

Maximum per Injury or Sickness:	$500,000
Maximum Benefit Period:	52 weeks after the date of a Covered Accident or Sickness

For Covered Services incurred due to Injury:

Deductible:

For the first $5,000 of Covered Services:	$25 per Injury
For charges in excess of $5,000:	$100 per Policy Term

Co-insurance Rate:

For the first $5,000 of Covered Services:	100% of the Usual and Customary  Charges
For charges in excess of $5,000:	80%* of the Usual and Customary Charges

For Covered Services incurred due to Sickness:

Deductible per Policy Term:	$100 per Policy Term
Co-insurance Rate:	80%* of the Usual and Customary Charges

*  For All Covered Services due to Injury or Sickness, All Covered Medical
Expenses will be paid at 100% when the Insured's out-of-pocket expenses
exceed $2,500.

For Hospital Room and Board Services, Maximum Benefit:  the average semi-private
room rate.

For Chiropractic Services:

Co-Insurance Rate:	80% of the Usual and Customary Charges
Maximum per visit:	$35
Maximum number of visits:	10 visits

For Mental and Nervous Disorder Services: $300 outpatient, 50% to 30 days inpatient

 

Emergency Medical Evacuation Benefit

Benefit Maximum:  100% of the Usual and Customary Charges.

 

Repatriation of Remains Benefit

Benefit Maximum:  100% of the Usual and Customary Charges.

 

Emergency Reunion Benefit

Total Benefit Maximum:	$12,500
Daily Benefit Maximum:	$300
Maximum Number of days:	10 days
Family Travel Arrangements Benefit:	$2,500 for one round trip travel to accompany  remains home

Emergency Assistance

In addition to this accident and sickness insurance program is the availability of the 24-hour assistance network for emergency assistance anywhere in the world.  The assistance provider must be involved in any events that require Emergency Medical Evacuation, Emergency Reunion, Repatriation or Trip Interruption.

 

Personal Liability Rider Plan Highlights

The Personal Liability Rider is available to add on a group basis to the Accident & Sickness plan.

A.  Personal Liability Insurance Coverage :

Maximum Benefit per Claim:	$100,000
Deductible per Claim:	None
Aggregate Limit per Insured:	$200,000

B. Medical Payments Coverage:

Limited Per Coverage Period:  $5,000

C.  Additional Living Expense Coverage :

Limit per Coverage Period:  $5,000

D.  Payment of Deductible Under Homeowner's Insurance Coverage $1,000

For a complete description of this sample coverage, benefits and limitations see the 2010/2011 Coverage Description.