World Class Coverage Plan Designed for Virginia Commonwealth University – Business Travel

Questions? 24/7 Emergency Assistance – Team Assist

Phone:
1-855-327-1411 (in the U.S.) or +001-(312)-935-1703 (call collect from outside the U.S.)

Emails:
mail@oncallinternational.com

Benefit or Claim Questions?

Contact CISI
(9AM-5PM EST Mon-Fri)
Phone:
1-203-399-5130
(toll-free)
1-800-303-8120

Email:
medassist-usa@axa-assistance.us

Blanket Coverage Policy

Policy #:

24 GLM N1900997A-BL-ENR

Eligibility: All business travelers, including faculty and staff who are abroad for conference, meetings, symposiums, or other categories that VCU has determined fall outside of the study abroad travel policy are automatically covered under the Blanket Coverage for travel outside of the United States.

This policy provides coverage for Medical Evacuation, Repatriation, Security Evacuation, and Emergency Medical Reunion.

Note: When registering, after you put in your coverage dates and go to the next screen, it will show up as $0.00 since this has already been paid by VCU.

Blanket Coverage Schedule of Benefits:

Coverages and Services	Maximum Limits
Emergency Medical Reunion	(incl. hotel/meals, max $300/day) $10,000
Emergency Medical Evacuation	$250,000
Repatriation/Return of Mortal Remains	$100,000
Security Evacuation (Comprehensive)	$250,000 ($1M Aggregate)

Medical Option Policy

Policy #: 24 GLM N1900997A-MED OPT

If you’d also like to purchase Accident/Sickness Coverage for your travel abroad, please use the following self-enrollment link:

Enroll Here

Daily Rate: $1.95

Medical Option Coverage Schedule of Benefits:

(for additional plan details, see the Medical Opt Brochure posted on the left sidebar)
Coverages and Services	Maximum Limits
Accidental Death and Dismemberment Per Insured Person	$20,000
Medical expenses (per Covered Accident or Sickness):
Deductible	zero
Benefit Maximum	$500,000 at 100%
Extension of Benefits	30 days
Home Country Coverage Limit	$10,000
Trip Delay	$5,000
Trip Interruption	$1,000

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