Cultural Insurance Services International
University of Houston - Clear Lake Education Abroad and Scholar Services
Policy Number
#GLM N14301628
Questions?
24/7 Emergency
Assistance – Team Assist
Phone:
(inside the U.S.)
+1 855-327-1411
(call collect from outside the U.S.)
+001 312-935-1703
Benefit or Claim
Questions?
Contact CISI
(9AM-5PM EST Mon-Fri)
Phone: 1 203-399-5130
(toll-free) 800-303-8120
Email: Claimhelp@mycisi.com
World Class Coverage Plan Designed for University of Houston - Clear Lake Education Abroad and Scholar Services
This plan is underwritten by ACE American Insurance Company.
Participant rates
| Rates | Participant(Student/Faculty/Staff) |
| 1-Week | $10.20 |
| 2-Week | $20.40 |
| 3-Week | $30.60 |
| Thereafter, Monthly* (*longer than 21 days, monthly rate applies) |
$40.65 |
| Coverage Summary for Policy # GLM N14301628 | |
|---|---|
| Coverages & Services | Maximum Limits |
| Accidental Death and Dismemberment Per Insured | |
| Per Insured Person | $15,000 |
| Aggregate | $1,000,000 |
| Medical expenses (per Covered Accident or Sickness): | |
| Deductible | zero |
| Benefit Maximum | $250,000 at 100% |
| Physiotherapy(if recommended by a physician & administered by licensed physiotherapist) | 100% of covered expenses |
| Chiropractic Care/Therapeutic Services | $500 overall ($50 per visit, up to 10 visits) |
| Dental Treatment (Injury Only): | |
| Accidental Dental | 100% of covered expenses |
| Emergency (Palliative Dental) | $500 ($250 per tooth) |
| Prescription Drugs (Inpatient/Outpatient) | 100% of covered expenses |
| Mental and Nervous: | |
| Outpatient | $10,000 |
| Inpatient | $20,000 |
| Pre-existing Conditions | $10,000 on primary basis, thereafter up to $100,000 on a secondary basis |
| Maternity | 100% of covered expenses |
| Alcohol/drug-related Injuries | 100% of covered expenses |
| Motor Vehicle Accident | 100% of covered expenses |