rotary-international - Welcome Cultural Insurance Service International

PLAN DESIGNED FOR ROTARY INTERNATIONAL

Including:

● Peace Fellow
● Global Grant Scholar
● Global Grant Vocational Training Team (VTT)

● Global Grant Humanitarian Traveler
● District Grant Traveler
● New Generation Short Term Exchange

PURCHASE YOUR POLICY

Option 1

● $500,000 medical max per illness or injury
● Coverage provided worldwide
● 24/7/365 emergency assistance
● Payment guarantees to hospitals worldwide
● Ability to reimburse in foreign currencies
● Round trip tickets for a family member to join you if you are hospitalized
● Emergency Medical Evacuation and Repatriation
● Security Evacuation
● Quick & easy enrollment online

Age	Weekly Rate (Up to 3 weeks)	Monthly Rate
Up to Age 59	$23.00	$85.17
Age 60 to 75	$125.21	$502.95
If over age 75, please call CISI.

View Policy

Enroll Now

Option 2

All of the benefits provided with Option 1 PLUS:

● $1,000 Trip Cancellation benefit if cancellation is prior to the scheduled departure date
● $1,000 Trip Interruption coverage
● $500 Personal effects coverage from theft or damage

Age	Weekly Rate (Up to 3 weeks)	Monthly Rate
Up to Age 59	$24.13	$90.85
Age 60 to 75	$126.26	$504.00
If over age 75, please call CISI.

View Policy

Enroll Now

In Case of Emergency

Please contact the Team Assist line by phone at +1 312-935-1703 (outside the U.S., collect calls accepted) or 855-327-1411 (toll-free from within the U.S.), or email medassist-usa@axa-assistance.us.

The TeamAssist Emergency Assistance Provider is AXA Assistance.

Non-Emergency questions may be directed to CISI at 203-399-5130 (toll free 800-303-8120).

Need a Doctor?

To seek recommendations for doctors or hospitals outside of the U.S., please contact Team Assist at +1 312-935-1703 or email medassist-usa@axa-assistance.us. *We can make appointments for you.

To seek recommendations for doctors or hospitals inside the U.S., please visit our website www.mycisi.com and click on Services, then select U.S. Provider Search to access the First Health Network.

Who Pays for Services?

CISI will make every effort to pay invoices directly to medical providers. Please notify CISI by contacting TeamAssist and we will make every effort to arrange to pay the doctor or hospital directly. If you prefer to pay yourself, then we will reimburse you (you may scan/email or fax the claim information to CISI and we will process it while you are still abroad, OR you may file the claim information after your trip). The average claim processing time at CISI is 2 weeks from receipt of claim information.

Group Enrollment

Schedule of Benefits
Benefits	Limits
Medical Expenses Limits:
Lifetime/Annual Maximum	Unlimited
Per Accident or Sickness	$250,000
Per Occurrence Deductibles:
Emergency Room Deductible (waived if admitted)	$250
Call-A-Doc	$0
Physician/Outpatient/Dr. Visit	$100
Urgent Care	$50
Walk in Clinic	$25
MRI/CAT Scan	$0
Rx Copay	$0
Pre-Existing Conditions-12 Month Look Back; thereafter up to policy max	Up to $500
Coinsurance Percentage (%)	100% Coinsurance
Prescription Drugs (inpatient/outpatient)	Inpatient: 100% of Covered Expenses Outpatient: 100% of Covered Expenses
Mental Health	Inpatient up to 30 days/Outpatient 30 visits
Pregnancy (conception must occur while covered under this plan)	Treated as any other illness
Physiotherapy	Covered
Chiropractic Care & Therapeutic Services	Up to $500 max, $50 per visit
Emergency Reunion	$15,000 (hospitalized 3 days)
Home Country (Incidental Trips)	$1,000
Trip Delay (applies mid trip as well) 24-hour time	Up $1,500/daily limit $100
Political Evacuation	$10,000
Dental Injury Only	Up to policy max
Palliative Dental	$1,000max/$200 per tooth
24/7 Assistant Services & In-house Crisis Team	Included
Medical Evacuation	$50,000
Repatriation of Remains	$25,000
Accidental Death & Dismemberment	$15,000 ($1M aggregate limit)

Schedule of Benefits
Benefits	Limits
Medical Expenses Limits:
Lifetime/Annual Maximum	Unlimited
Per Accident or Sickness	$2,000,000
Per Occurrence Deductibles:
Emergency Room (waived if admitted)	$250
Call-A-Doc	$0
Physician/Outpatient/Dr. Visit	$50
Urgent Care	$50
Walk in Clinic	$25
MRI/CAT Scan	$0
Rx Copay	$0
Pre-Existing Conditions-12 Month Look Back; thereafter up to policy max	Up to $500
Coinsurance Percentage (%)	100% Coinsurance
Prescription Drugs (inpatient/outpatient)	Inpatient: 100% of Covered Expenses Outpatient: 100% of Covered Expenses
Mental Health	Inpatient up to 30 days/Outpatient 30 visits
Pregnancy (conception must occur while covered under this plan)	Treated as any other illness
Emergency Reunion	$15,000 (hospitalized 3 days)
Physiotherapy	Covered
Chiropractic Care & Therapeutic Services	Up to $500 max, $50 per visit
Home Country (Incidental Trips)	$1,000
Trip Delay (applies mid trip as well) 24-hour time	Up $1,500/daily limit $100
Political Evacuation	$10,000
Dental Injury Only	Up to policy max
Palliative Dental	$1,000max/$200 per tooth
24/7 Assistant Services & In-house Crisis Team	Included
Medical Evacuation	$50,000
Repatriation of Remains	$25,000
Accidental Death & Dismemberment	$15,000 ($1M aggregate limit)
Trip Interruption	$1,000
Personal Liability
Personal Liability Limit	$2,000,000
Liability deductible	$100
Medical Payments to Others	$25,000
Additional Living Expenses	$10,000
Payment of Homeowners Deductible	$1,000
Personal Property	$1,500