Health Insurance Designed for the Graduate Students employed by the THE TEXAS A&M UNIVERSITY SYSTEM...

Health Insurance Health Insurance Designed for the Graduate Students Designed for the Graduate Students

employed by theemployed by theTHE TEXAS A&M UNIVERSITY SYSTEMTHE TEXAS A&M UNIVERSITY SYSTEM

2011-20122011-2012

Underwritten By: Companion Life Insurance Underwritten By: Companion Life Insurance Company (A+)Company (A+)

Administered by: Associated Insurance Plans Administered by: Associated Insurance Plans International, Inc. (AIP)International, Inc. (AIP)

Serviced in College Station, Texas by: Dunlap Serviced in College Station, Texas by: Dunlap Financial ServicesFinancial Services

www.TAMUInsurance.comwww.TAMUInsurance.com

Preferred Provider Preferred Provider NetworkNetwork

100% reimbursement100% reimbursement for covered medical expenses for covered medical expenses incurred at the Student Health Center.incurred at the Student Health Center.

80% reimbursement80% reimbursement for in-network treatment, after for in-network treatment, after deductible and any co-payment – PHCS and Beech deductible and any co-payment – PHCS and Beech Street National ProvidersStreet National Providers

60% reimbursement60% reimbursement for out-of-network treatment, after for out-of-network treatment, after deductible and any co-paymentdeductible and any co-payment

Outside the United States benefits are reimbursed at 80%Outside the United States benefits are reimbursed at 80%

Out-of-pocket Maximum: Out-of-pocket Maximum: $3,000 per policy year$3,000 per policy year

www.TAMUInsurance.com

DeductibleDeductible $100 each plan year ($300 for family)$100 each plan year ($300 for family)

NOTE: NOTE: The deductible is The deductible is waivedwaived for medical for medical treatment received at your campus Student Health treatment received at your campus Student Health CenterCenter


Co-paymentsCo-payments

Outpatient Physician visit and Outpatient Physician visit and Urgent Care Treatment Center: Urgent Care Treatment Center: $25 plus 20%/40% of the remaining $25 plus 20%/40% of the remaining

chargescharges

Emergency Room visit: Emergency Room visit: $250 plus 20%/40% of the remaining $250 plus 20%/40% of the remaining

chargescharges


PharmacyPharmacyAt The Student Health CenterAt The Student Health Center $15 co-payment per 30 day supply (paid at 100% $15 co-payment per 30 day supply (paid at 100%

to $1,000 per policy year) – submit pharmacy to $1,000 per policy year) – submit pharmacy receipts and complete a claim for reimbursement.receipts and complete a claim for reimbursement.

Outside The Student Health CenterOutside The Student Health Center Prescription Drug CardPrescription Drug Card: cost of prescription : cost of prescription

medication to $5,000 per policy year, subject to a medication to $5,000 per policy year, subject to a co-payment per 30 day supply. co-payment per 30 day supply.

Co-payments: Co-payments: $$15 co-payment for generic15 co-payment for generic$25 co-payment for brand$25 co-payment for brand$35 co-payment for single source$35 co-payment for single source

(Contraceptives are included.)(Contraceptives are included.)


Provided “as any other illness”Provided “as any other illness”

Newborn care for 3 days (normal Newborn care for 3 days (normal delivery) and 4 days (caesarean delivery)delivery) and 4 days (caesarean delivery)

Maternity BenefitsMaternity Benefits


Additional BenefitsAdditional Benefits Accidental Death & Dismemberment: Accidental Death & Dismemberment:

$10,000$10,000 Repatriation of mortal remains: Repatriation of mortal remains:

$25,000 for International students$25,000 for International students

$15,000 for U.S. students$15,000 for U.S. students Medical Evacuation: Medical Evacuation: up to $50,000 up to $50,000 (advance (advance

approval required)approval required) Family Visit:Family Visit: for International travelers & for International travelers &

study abroad students - $2,500 for cost of study abroad students - $2,500 for cost of round trip airfare for family member when round trip airfare for family member when insured is hospitalized 7 daysinsured is hospitalized 7 days


Pre-existing conditions:Pre-existing conditions: Pre-existing conditions are covered if you have been Pre-existing conditions are covered if you have been

continuously insured for 18 consecutive months prior to continuously insured for 18 consecutive months prior to enrolling in the plan, or enrolling in the plan, or you have been continuously you have been continuously insured for 12 months under any TAMUS student plan, insured for 12 months under any TAMUS student plan, or you are 12 months treatment free for your pre-or you are 12 months treatment free for your pre-existiexisting conditionng condition

Exception to pre-existing condition limitationException to pre-existing condition limitation: : If you have not been continuously insured for 12 months under If you have not been continuously insured for 12 months under any of the TAMUS insurance plans, or 18 months under any any of the TAMUS insurance plans, or 18 months under any other insurance plan, there is a $1,000 maximum benefit for other insurance plan, there is a $1,000 maximum benefit for your pre-existing condition until you are continuously insured your pre-existing condition until you are continuously insured for 12 months under the TAMUS student insurance plan – once for 12 months under the TAMUS student insurance plan – once you are continuously insured, benefits would be paid for your you are continuously insured, benefits would be paid for your pre-existing condition on the same basis as for any new pre-existing condition on the same basis as for any new medical condition. medical condition.

Creditable coverage: Creditable coverage: Applies towards the pre-existing condition limitation. This is Applies towards the pre-existing condition limitation. This is

health insurance coverage you have had in place for 18 health insurance coverage you have had in place for 18 continuous months prior to enrolling in this insurance plan continuous months prior to enrolling in this insurance plan (this would include a foreign country who provides health (this would include a foreign country who provides health coverage). coverage).


Continuation PlanContinuation Plan If you graduate or leave school prior to the policy If you graduate or leave school prior to the policy

termination date, you may remain on the insurance plan for termination date, you may remain on the insurance plan for the balance of the policy year – as well as for one additional the balance of the policy year – as well as for one additional year. You must contact AIP within 31 days of your change year. You must contact AIP within 31 days of your change in status, complete an application, and pay your premiums in status, complete an application, and pay your premiums directly to AIP.directly to AIP.

If your employment terminates, but you remain a registered If your employment terminates, but you remain a registered student of the TAMU System, you must contact AIP within student of the TAMU System, you must contact AIP within 31 days of your change in status, and you may continue this 31 days of your change in status, and you may continue this plan, or change to any of the other TAMUS student plan, or change to any of the other TAMUS student insurance plans, by completing an application and paying insurance plans, by completing an application and paying your premium directly to AIP. your premium directly to AIP.

Request for continuation must be received within 31 days Request for continuation must be received within 31 days of your employment termination date. of your employment termination date.

Contact Associated Insurance Plans International, Inc. (AIP) Contact Associated Insurance Plans International, Inc. (AIP) for details and premiums. for details and premiums.


Optional - Dental & Vision Optional - Dental & Vision Insurance Plan and Insurance Plan and

Dental, Vision & Pharmacy Discount Dental, Vision & Pharmacy Discount CardCard

Discount Card Option:Discount Card Option:

low annual premium for low annual premium for pharmacy, dental, and pharmacy, dental, and vision discountsvision discounts

Participating providers Participating providers include all major vision and include all major vision and pharmacy chainspharmacy chains

No claim forms to completeNo claim forms to complete Discount is immediate at the Discount is immediate at the

time of servicetime of service

Dental & Vision Insurance Dental & Vision Insurance Option:Option:

Choice of 3 plans with Choice of 3 plans with different different

co-insurance optionsco-insurance options Choice of $1,000, $1,500 or Choice of $1,000, $1,500 or

$2,000 annual maximum $2,000 annual maximum benefitbenefit

No waiting periodNo waiting period Optional Vision coverageOptional Vision coverage Premium as low as $20 per Premium as low as $20 per

month for annual coveragemonth for annual coverage


Information Available At:Information Available At: www.TAMUInsurance.comwww.TAMUInsurance.com

Description of CoverageDescription of Coverage Identification Card Identification Card Preferred Provider Network Look-upPreferred Provider Network Look-up Claim ProceduresClaim Procedures Claim FormsClaim Forms Claim Status InquiryClaim Status Inquiry Student Insurance SurveyStudent Insurance Survey Dental and Vision discount and insurance Dental and Vision discount and insurance

optionsoptions

Questions and Questions and Assistance?Assistance?

Contact Associated Insurance Plans Contact Associated Insurance Plans International, Inc. (AIP)International, Inc. (AIP)

Monday through Friday, Monday through Friday, 8:00 a.m. to 7:00 p.m.8:00 a.m. to 7:00 p.m. (CST)(CST)

(800) 452-5772(800) 452-5772

www.TAMUInsurance.comwww.TAMUInsurance.com

or contact our Representative in College Station:or contact our Representative in College Station:Dunlap Financial ServicesDunlap Financial Services

111 E. University Drive, Suite 110111 E. University Drive, Suite 110

College Station, Texas 77840College Station, Texas 77840

(979) 260-9632(979) 260-9632

Health Insurance Designed for the Graduate Students employed by the THE TEXAS A&M UNIVERSITY SYSTEM...

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