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SPECIAL NOTE: This plan is renewable. This plan provides long-term medical coverage for non-U.S. citizens around the globe including the U.S.A. For U.S. citizen, you must live or travel outside of the United States for at least 6 months of any given 12 months of policy period in order to qualify for this plan. If you are a non-U.S. citizen and a permanent resident of the United States, a green card holders, please contact us for eligibility requirement.
For U.S. Citizens: Applicants / Insured Persons must either be outside the United States at the time of application, or must depart the United States within 30 days of the Certificate's Effective Date. In addition, the Insured Person must reside outside the United States at least 6 months during any given 12-month period to meet the Eligibility Requirements of an Insured Person. Should any Insured Person reside in the United States longer than 6 months during any given 12-month period, their Coverage shall immediately terminate. For Non-U.S. Citizens: Applicants / Insured Persons must be outside the United States at the time of application or must depart the United States within 30 days of the Certificate's Effective Date . In addition, the Insured Person must reside outside the United States at least 6 months during any given 12-month period to meet the Eligibility Requirements of an Insured Person. Should any Insured Person reside in the United States longer than 6 months during any given 12-month period, their Coverage shall immediately terminate.
For those who apply for coverage prior to their 65th birthday and remain continuously insured for ten consecutive years, you will automatically be converted to Reside Prime Senior Provider at age 75 as long as you continue your eligibility status. * A "Class" is a group of people defined by a common characteristic, including but not limited to demographic group and geographic region.
In order to continue coverage beyond the first thirty one (31) days and be accepted as any other new Insured Person subject to the Insurance Provisions, Scope of Coverage and Exclusions sections of this Certificate or other sections relating to a Newborn Child up to the maximum amount of this Certificate the following conditions must be met: (1) An Application and any applicable premium is submitted and Approved by the Company within thirty one (31) days of the birth of a Newborn Child(ren); (2) The Pregnancy which led to the birth of a Newborn Child was an eligible pregnancy covered under this Certificate; (3) That the mother of the Newborn Child remain covered under this Certificate; (4) The mother and Newborn Child meets and will continue to meet the Eligibility Requirements of this Certificate.
Pre-existing 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. Charges for treatment of the following illnesses or surgeries, which manifest themselves or are recommended, or symptoms occur during the first 180 days of coverage hereunder beginning on the initial effective date: any condition of the breast, any condition of the prostate, disorders of the reproductive system, gall stones or kidney stones, any acne diagnosis or acne related condition, or any surgery that is not emergency in nature, as emergency is defined hereunder. Note: coverage for such illnesses or surgeries may be further limited under the pre-existing condition exclusion and definition contained herein, or other exclusions contained herein; and 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 the Plan Administrator.
Utilize an approved PPO Service Provider within
the United States If Services and Treatment eligible for coverage under this Certificate are received directly from an approved PPO Service Provider while the Insured Person is in the United States: (a) the Company will reduce by 50% any part of the Deductible applicable to such Eligible Benefits, and (b) the Company will waive any and all Coinsurance applicable to such Eligible Benefits. Failure to follow the Pre-Notification Program and to utilize an approved PPO Service Provider will result in a 25% reduction of the Eligible Benefits stated in the Schedule of Benefits.
If Services and Treatment eligible for coverage under this Certificate are received directly from an approved PPO Service Provider while the Insured Person is in the United States: (a) the Company will reduce by 50% any part of the Deductible applicable to such Eligible Benefits, and (b) the Company will waive any and all Coinsurance applicable to such Eligible Benefits. Failure to follow the Pre-Notification Program and to utilize an approved PPO Service Provider will result in a 25% reduction of the Eligible Benefits stated in the Schedule of Benefits. IMPORTANT INFORMATION THE UNDERWRITER 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 the Plan Administrator.
Bon Voyage! ˇTenga un viaje seguro! Ayez un voyage sűr! Have a safe trip! |
HERE IS THE FINE
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Copyright © 1999-2012 by Sunburst Worldwide Insurance Services. CA Insurance License #0B65721Warning: All of the pages on this site are protected under U.S. and International copyright laws. Reproduction by any means or for any purpose, except as specified on certain pages, is not allowed without the express written permission of the copyright owner.
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