Cultural Insurance Services International
The University of New Haven
World Class Coverage Plan Designed For The University of New Haven
This plan is provided by Cultural Insurance Services International
and underwritten by Ace American Insurance Company
Coverage Summary for Policy #
GLM N18157159
| Coverages and Services | Maximum Limits |
|---|---|
| Accidental Death & Dismemberment Per Insured: | $10,000 ($1,000,000 Aggregate limit Per Accident) |
| Medical Expense (per Accident or Sickness): | |
| Deductible | $-0- (zero) |
| Basic Medical | $150,000 @100% |
| Accidental Dental | 100% of Covered Expenses, up to policy limits |
| Dental Palliative | $50 max/$250 per tooth |
| Pre-existing Conditions Coverage Limit | Up to $2,500 |
| Mental and Nervous | Inpatient up to $5,000, Outpatient up to $2,500 |
| Pregnancy | Treated as any other illness |
| Newborn Nursery Care | $500 max |
| Therapeutic Termination of Pregnancy | $500 max |
| Prescription Drugs (Inpatient/Outpatient) | 100% |
| Extension of Benefits | 30 Days (secondary) |
| Physiotherapy | If recommended by a Physician and administered by a licensed physiotherapist |
| Outpatient Chiropractic Care | Max of $50/visit; maximum of 10 visits; $500 overall maximum |
| Emergency Medical Evacuation | $100,000 |
| Repatriation/Return of Mortal Remains | $50,000 |
| Security Evacuation Comprehensive | $100,000 ($1M aggregate limit) |
| Emergency Medical Reunion | $3,000 ($300/day,10 day max) Hospitalized after 5 days |
| Trip Delay | Up to $500, delayed for over 12 hours, 5 day max, $100 per day |
| Trip Interruption | Up to $1,000 |
| 24/7 Team Assist Package & CISI Crisis Team | Included |
Optional Coverage for Cancel for Any Reason and Trip Interruption for Any Reason
This plan is not mandatory and completely separate from the above CISI medical policy. The Cancel for Any Reason and Trip Interruption for Any Reason policy can be purchased by going to the following page.
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 203-399-5130 (toll free 800-303-8120).