Cultural Insurance Services International
Clayton State University
Policy Number
GLM N10892880
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World Class Coverage Plan Designed For
Clayton State University
This plan is provided by Cultural Insurance Services International and underwritten by Ace American Insurance Company, a member of the Chubb Group of Companies
Coverage Summary for Policy #
GLM N10892880
SCHEDULE OF BENEFITS
| Coverages and Services | Maximum Limits |
|---|---|
| TRAVEL ACCIDENT INDEMNITY INSURANCE | |
| Accidental Death and Dismemberment Per Insured Person: | |
| Faculty/Student | $25,000 |
| Spouse | $10,000 |
| Per Child | $5,000 |
| ACCIDENT AND SICKNESS INSURANCE | |
| Medical expenses (per Accident or Sickness) | |
| Deductible | zero |
| Benefit Maximum for Spain participants (90+days Visa Requirement) | $500,000 at 100% |
| Benefit Maximum | Unlimited |
| Extension of Benefits | 30 days |
| Home Country Coverage Limit | $10,000 |
| TRAVEL ASSISTANCE INSURANCE | |
| Emergency Medical Reunion | (incl. hotel/meals, max $150/day) $10,000 |
| Program Fee Refund (Student Only) | $5,000 |
| Quarantine | $2,000 |
| Return of Minor Child(ren) | $2,500 |
| Trip Delay | $500 ($100/day) |
| Return Ticket (Trip Interruption) | $1,000 |
| Chaperone Replacement Benefit | $5,000 |
| PERSONAL PROPERTY INSURANCE | |
| Lost Checked Baggage | (deduct. $50, $100/item) $250max |
| EVACUATION AND REPATRIATION INSURANCE | |
| Emergency Medical Evacuation | 100% of Covered Expenses Participants in Antarctica $250,000 max |
| Repatriation of Mortal Remains | $100% of Covered Expenses Participants in Antarctica $250,000 max |
| Security Evacuation (Comprehensive) | $100,000 ($2.5M Aggregate) |
| NON-INSURANCE SERVICES | |
| Team Assist Plan (TAP): 24/7 medical, travel, technical assistance | |
Please contact the Team Assist line by phone at +1 312-935-1703 (collect calls accepted) or email medassist-usa@axa-assistance.us. The TeamAssist Emergency Assistance Provider is AXA Assistance.
Non-Emergency questions may be directed to CISI at 203-399-5132 (toll free 800-303-8120).