The University of Rhode Island

Policy Number
GLM N14285581

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World Class Coverage Plan Designed For The University of Rhode Island

This plan is provided by Cultural Insurance Services International
and underwritten by Ace American Insurance Company

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Coverage Summary for Policy # GLM N14285581

Coverages and ServicesMaximum Limits
Accidental Death & Dismemberment:
Per Insured$10,000
Aggregate Limit Per Accident$1,000,000
Medical Expense (per Accident or Sickness):
Deductible$0 (zero)
Basic Medical$250,000 @100%
Accidental Dental 100% of Covered Expenses, up to policy limits
Pre-existing Conditions Coverage Limit Primary up to the first $10,000, thereafter Secondary up to policy max
Mental and Nervous Inpatient up to $5,000, Outpatient up to $2,500
Prescription Drugs (Inpatient/Outpatient) 100%
Physiotherapy If recommended by a Physician and administered by a licensed physiotherapist
Specified Therapies and Spinal Manipulation, including acupuncture and physiotherapy:
Outpatient LimitMax of $50/visit; maximum of 10 visits; $500 overall maximum
Emergency Medical Evacuation $100,000
Repatriation/Return of Mortal Remains $100,000
Security Evacuation Comprehensive $100,000 ($1M aggregate limit)
Emergency Medical Reunion $3,000 ($300/day,10 day max) Hospitalized after 5 days
24/7 Team Assist Package & CISI Crisis Team Included
Trip Delay Up to $1,000
Trip CancellationUp to $1,000
Personal Liability Up to $500,000 (Aggregate limit per insured $500,000)
Medical Payments to Others $25,000
Payment of Deductible under Homeowners Insurance $1,000
Personal Property Benefit Up to $3,000 max per trip, benefit max per item or set of items $1,500

Coverages and ServicesMaximum Limits
Accidental Death & Dismemberment:
Per Insured$10,000
Aggregate Limit Per Accident$1,000,000
Medical Expense (per Accident or Sickness):
Deductible$0 (zero)
Basic Medical$250,000 @100%
Accidental Dental 100% of Covered Expenses, up to policy limits
Pre-existing Conditions Coverage Limit Primary up to the first $10,000, thereafter Secondary up to policy max
Mental and Nervous Inpatient up to $5,000, Outpatient up to $2,500
Prescription Drugs (Inpatient/Outpatient) 100%
Physiotherapy If recommended by a Physician and administered by a licensed physiotherapist
Specified Therapies and Spinal Manipulation, including acupuncture and physiotherapy:
Outpatient LimitMax of $50/visit; maximum of 10 visits; $500 overall maximum
Emergency Medical Evacuation $100,000
Repatriation/Return of Mortal Remains $100,000
Security Evacuation Comprehensive $100,000 ($1M aggregate limit)
Emergency Medical Reunion $3,000 ($300/day,10 day max) Hospitalized after 5 days
24/7 Team Assist Package & CISI Crisis Team Included
Trip Delay Up to $1,000
Trip CancellationUp to $1,000
Personal Liability Up to $500,000 (Aggregate limit per insured $500,000)
Medical Payments to Others $25,000
Payment of Deductible under Homeowners Insurance $1,000
Personal Property Benefit Up to $3,000 max per trip, benefit max per item or set of items $1,500

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).