|
Atlas Group Travel
Health Coverage that Goes Far & Beyond
Group of 5 or more.
|
|
The Atlas Group Travel Series now automatically includes many new benefits, services and features that make it a leading option for student groups, missionary organizations and corporations who travel internationally. The policy now includes a benefit to be used in case of Natural Disasters and expanded coverage of Incidental Trips Home. This innovative product also includes coverage for Acts of Terrorism, Political Evacuation, and Complications of Pregnancy. Non-US citizens traveling outside of the US will benefit from our updated rating structure. State of the art travel and emergency medical assistance services are part of every Atlas Group Travel Series plan. These features are accompanied by the same astonishing service you have come to expect from MultiNational Underwriters®, the leader in international travel medical insurance.
The answer is easy. Whether your group is traveling for business or pleasure, international travel involves risk. You may arrive at your destination to find that a member of your group’s luggage with personal items has disappeared. A personal emergency may necessitate early return home for a member of your group. A medical emergency may require hospitalization or even air evacuation. In most cases, your existing insurance will not provide adequate protection for these and other risks. Without appropriate travel insurance, members of your group may be in jeopardy of significant financial liability. MultiNational Underwriters® can’t take the risk out of international travel, but if the unforeseen happens, we will be there to help you.
If your group consists of a minimum of five travelers who are at least 14 days old traveling internationally for at least 5 days, your group is eligible. If your group members are under age 70, you may select the Overall Maximum Limit, ranging from $50,000 to $1,000,000. The Overall Maximum Limit for members age 70 to 79 is $50,000. The Overall Maximum Limit for members age 80 and older is $10,000. The minimum coverage period is 5 days and the maximum coverage period is 12 months. The same Overall Maximum Limit must be purchased for every member of your group under the age of 70. The same Deductible must be purchased for every member of your group.
Coverage becomes effective on the latest of: the moment we receive your Application and correct premium (if Application and payment is made online or by fax), 12:01am* on the date we receive your Application and payment (if Application and payment is made by mail), the moment the member departs from his or her Home Country or 12:01am on the date you request on your Application. Coverage will end on the earliest of: 12:01am on the last day of the period for which you have paid a premium, 12:01am on the date requested on your Application, or the moment of the member’s return to his or her Home Country (unless the member has started a Benefit Period or is eligible for Home Country Coverage).
*Times expressed above are based on US Eastern Standard Time.
Call MNU for current passport, visa, inoculation and vaccine requirements as well as for up-to-date travel safety advisories.
Yes. Under certain circumstances, the Atlas Group Travel Series will provide limited Home Country Coverage
Incidental Home Country Medical Coverage - The Atlas Group Travel Series provides up to 15 days of incidental coverage for trips to the member’s Home Country for every 3 months of coverage purchased. Incidental visit time must be used within the three-month period earned, and the member must continue their international trip in order to be eligible for this benefit, which covers Medical expenses only. Return to the Home Country must not be taken for the purpose of obtaining treatment of an Illness or Injury that began while traveling.
Benefit Period Medical Coverage – A Benefit Period begins on the first date the member receives a diagnosis or treatment of a covered Illness or Injury while outside his or her Home Country and lasts for 180 days. If a member started a Benefit Period while this insurance was in effect, the member is covered only for Medical expenses for the duration of the Benefit Period, regardless of whether the member is at home or abroad.
End of Trip Home Country Medical Coverage – If your group is covered under the Atlas Group Travel Series and members are outside of their Home Countries continuously (except for covered Incidental Trips as described above) for six (6) months or more, you may purchase an additional 30 days of End of Trip Home Country Medical Coverage for the group.
Home Country Defined - If you are a US citizen, your Home Country is the United States, regardless of the location of your Principal Residence. If you are not a US citizen, your Home Country is the country where you principally reside and receive regular mail.
US citizens, as well as all non-US citizens traveling outside of the US, should purchase Atlas Group International, which provides coverage for outside of the United States. Non-US citizen traveling to the United States should purchase Atlas Group America.
All benefits, except Hospital Indemnity, Lost Checked Luggage, Natural Disaster, Accidental Death & Dismemberment and Common Carrier Accidental Death, are subject to the Deductible and Coinsurance. Limits apply to all benefits (See Schedule of Benefits and Limits):
Medical:
- Inpatient and Outpatient charges made by a Hospital
- Charges made by a Physician, surgeon, radiologist, anesthesiologist, and any other medical specialist to whom the Physician has referred the case
- Charges made for dressings, sutures, casts or other supplies prescribed by the attending Physician or specialist, but excluding nebulizers, oxygen tanks, diabetic supplies and all devices for repeat use at home
- Charges for diagnostic testing using radiology, ultrasonographic or laboratory services
- Charges for oxygen and other gases and anesthetics and their administration
- Charges for prescription drugs for treatment of a covered Injury or Illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs
- Charges made by a licensed Extended Care Facility upon direct transfer from an acute care Hospital
- Emergency local ambulance transport incurred in connection with Injury or Illness resulting in inpatient hospitalization
Let MNU help you when you need help most:
- Medical Referrals
- Assistance with Prescription Drug Replacement
- Dispatch of a Doctor or Specialist
- Up-to-the-minute travel medical advisories
Complications of Pregnancy:
Treatment of Complications of Pregnancy during the first 26 weeks of Pregnancy is covered under this insurance. Complications of Pregnancy is defined as: Illnesses whose diagnoses are distinct from Pregnancy, but are adversely affected by Pregnancy or caused by Pregnancy, and not associated with a normal Pregnancy. This includes: ectopic Pregnancy, spontaneous abortion, hyperemesis gravidarum, pre-eclampsia, eclampsia, missed abortion and conditions of comparable severity.
Hospital Indemnity:
If a member of your group is hospitalized as an Inpatient for treatment of a covered Illness or Injury, the Atlas Group Travel Series will provide $100 for each night the member spends in the hospital. This benefit is in addition to payments for other covered expenses and is not subject to Deductible or Coinsurance.
Acute Onset of a Pre-Existing Condition:
Group members under age 70 are covered for an Acute Onset of a Pre-existing Condition. Coverage is available up to $15,000 Maximum for Eligible Medical Expenses and up to $25,000 for Emergency Medical Evacuation. An Acute Onset of a Pre-existing Condition is a sudden and unexpected outbreak or recurrence of a Pre-existing Condition, which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.
Emergency Dental:
The following Emergency Dental expenses are covered: Emergency Dental treatment and Dental surgery necessary to restore or replace sound natural teeth lost or damaged in an Accident that is covered under this insurance subject to the Overall Maximum Limit; and Emergency Dental treatment necessary to resolve acute, spontaneous and unexpected onset of pain subject to a maximum benefit of $100.
Political Evacuation:
If the United States government issues a travel warning that becomes effective on or after your date of arrival in your destination country, the plan will provide for transportation to the nearest place of safety or for return to your Home Country. You must contact MultiNational Underwriters ® within 10 days of the date the travel warning is issued and the evacuation must be approved in advance and coordinated by MultiNational Underwriters ®.
Emergency Medical Evacuation:
If recommended by your attending Physician, who certifies that Evacuation is necessary to safeguard your life and that Medically Necessary treatment is not available locally, and if approved in advance and coordinated by MultiNational Underwriters ®, the Atlas Group Travel Series will provide the following benefits: Emergency air and/or ground transportation to the nearest Hospital that is qualified to provide the Medically Necessary treatment.
Emergency Message Relay:
MNU will relay messages to your family, friends and co-workers, helping you to maintain contact during an emergency.
Emergency Reunion:
In the event of a covered Emergency Medical Evacuation, the Atlas Group Travel Series will provide the following benefits: The cost of an economy round-trip air and/or ground transportation ticket for one of the member’s relatives (parent, spouse, sibling or child age 18 or older) for travel to the area where the member is hospitalized following Emergency Medical Evacuation and reasonable expenses for lodging and meals for the relative for a period not to exceed 15 days.
Return of Minor Children:
If a member of your group is the only person age 18 or older, traveling with one or more children under the age of 18, who are also covered by the Atlas Group Travel Series, and the member is Hospitalized for treatment of a covered Illness or Injury, resulting in the children being left unattended for a period of time expected to exceed 36 hours, the Atlas Group Travel Series will provide the following benefit: The cost of a one-way economy air and/or ground transportation ticket for each covered child to the terminal serving the area of Principal Residence of each covered child.
Emergency Travel Arrangements:
When family members need to join you in an emergency, MNU can make the arrangements for you.
Terrorism:
The Atlas Group Travel Series provides Medical coverage for Injuries and Illnesses resulting from an Act of Terrorism, subject to a $50,000 lifetime maximum, provided all of the following conditions are met:
- The Injury or Illness does not result from chemical, nuclear or biological weapons or events.
- The member has no direct or indirect involvement in the Act of Terrorism.
- The Act of Terrorism is not in a country or location where the United States government has issued a travel warning that has been in effect within the 6 months prior to your date of arrival.
- The member has not unreasonably failed or refused to depart a country or location following the date a warning to leave that country or location is issued by the United States government.
An Act of Terrorism is defined as: an act, including but not limited to, the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s) committed for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.
For additional benefits covering Acts of Terrorism, including high limit AD&D and Permanent Total Disability coverage, review the
MultiNational Accident Plan (MAP).
Contact us for additional information about this exciting new product offered by MultiNational Underwriters ®.
Accidental Death and Dismemberment:
In the event of your Accidental Death (except while traveling on a common carrier) or Dismemberment resulting from a covered Injury, the Atlas Group Travel Series will provide the following benefit:
- Accidental Death – Principal Sum to the Beneficiary
- Loss of 2 eyes or 2 or more limbs – Principal Sum to the member
- Loss of 1 eye or 1 limb – One-half of the Principal Sum to the member
|
|
|
|
14 days to 17 years
|
$5,000
|
|
18 to 69
|
$25,000
|
|
70 to 74
|
$12,500
|
|
75+
|
$6,250
|
The Accidental Death and Dismemberment benefit is not available for losses incurred during participation in a Hazardous Sport or in respect to losses resulting from an Act of Terrorism.
The Beneficiary for members age 18 or older will be as follows:
1. Spouse (if any) 2. Children (if any) 3. Estate of the member.
The Beneficiary for members under age 18 will be as follows:
1. Custodial Parent(s) 2. Siblings (if any) 3. Estate of the member.
Common Carrier Accidental Death:
In the event of Accidental Death while traveling on board a commercial Common Carrier, the Atlas Group Travel Series will provide the following benefit: Principal Sum of $50,000 ($25,000 for children under age 18) subject to a maximum of $250,000 per group to the Beneficiary, as described above. This benefit is not available in respect to losses resulting from an Act of Terrorism.
Repatriation of Remains:
In the event of a covered Injury or Illness resulting in a member’s death, the Atlas Group Travel Series will provide the following benefit: Air and/or ground transportation of bodily remains or ashes to the area of the member’s Principal Residence, and reasonable costs of preparation of remains necessary for transportation.
Natural Disaster:
In the event of natural disaster (hurricane, flood, tornado, tsunami, etc) the Atlas Group Travel Series will provide up to $100 a day for 5 days if you are displaced from your planned, paid accommodations due to evacuation from forecasted disaster or following a disaster strike. Displaced is defined as required to depart your destination due to an evacuation ordered by prevailing authorities. Proof of paid accommodations must be submitted at time of claim.
Emergency Cash Transfers:
MNU will assist you in arranging and obtaining cash transfers anywhere in the world.
Lost Passport or Travel Documents Assistance:
Losing important documents is extremely troublesome. MNU can help you notify the appropriate authorities for assistance with replacement of documents.
Trip Interruption:
- If, after you have departed, a member of your group learns of the death of a parent, spouse, sibling or child, or learns of the substantial destruction of his or her Principal Residence by fire or weather, the Atlas Group Travel Series will provide the following benefit: The cost of an economy one way air and/or ground transportation ticket for the member to travel to the area of his or her Principal Residence; or
- If, following a covered Emergency Medical Evacuation, the attending Physician states that it is Medically Necessary for the member to return to his or her Home Country or to the area from which he or she was initially evacuated for continuing treatment, recuperation and recovery, the Atlas Group Travel Series will provide the following benefit: The cost of an economy, one-way air and/or ground transportation ticket for the member’s travel from the area where he or she was hospitalized following the Emergency Medical Evacuation to the area where he or she was initially evacuated from, or to the terminal serving the area of the member’s Principal Residence.
Livetravel Services:
MNU will make emergency travel and itinerary changes for you including rebooking flights, hotel reservations and ground transportation arrangements.
Lost Checked Luggage:
In the event a member’s checked luggage is permanently lost by the transportation provider, the Atlas Group Travel Series will provide the following benefit: Up to $250 for replacement of clothes and personal hygiene items, not to exceed $50 for any one item. The member must file a formal claim with the transportation provider and submit copies of all claim forms and proof that the transportation provider has paid its normal reimbursement for the lost checked luggage.
BagTrak:
TravelGuard is the industry leader in tracking lost, checked baggage. TravelGuard will help you locate your lost checked baggage and deliver it to you anywhere in the world.
Travel Assistance
Travel Assistance Services are available to you 24 hours a day, 7 days a week while your Atlas Group Travel plan is in effect. In addition to the services already described, the following services are included:
- Embassy and consulate referrals
- Legal and accounting referrals
- Bail bond assistance
- Translation and interpretation assistance
Atlas Group Travel Assistance Services are not insurance benefits, and provision of any Assistance Service is not a guarantee of any other benefit under the Atlas Group Travel Series.
Deductibles: | $0, $100, $250, $500, $1,000 or $2,500 per Certificate Period |
Coinsurance – Claims incurred in US or Canada: | For the Certificate Period, Underwriters will pay 80% of the next $5,000 of Eligible Expenses after the Deductible, then 100% to the Overall Maximum Limit. Coinsurance will be waived if expenses are incurred within the PPO and expenses are submitted to Underwriters for review and payment directly to the provider. |
Coinsurance – Claims incurred outside US or Canada: | For the Certificate Period, Underwriters will pay 100% of Eligible Expenses after the Deductible up to the Overall Maximum Limit |
Hospital Room and Board: | Average Semi-private room rate, including nursing services |
Local Ambulance: | Usual, Reasonable and Customary charges |
Hospital Indemnity: | $100 per day (not subject to Deductible or Coinsurance) |
Intensive Care Unit: | Usual, Reasonable and Customary charges |
Outpatient Treatment: | Usual, Reasonable and Customary charges |
Acute Onset of Pre-existing Condition: | $15,000 limit per Certificate Period for Eligible Medical Expenses
$25,000 limit per Certificate Period for Emergency Medical Evacuation
(Only available to Members under age 70) |
Physical Therapy: | $50 per visit |
All Other Eligible Medical Expenses: | Usual, Reasonable and Customary charges |
Emergency Dental: | Accident – Overall Maximum Limit Acute Onset of Pain - $100 limit per Certificate Period |
Emergency Medical Evacuation: | $500,000 Maximum Lifetime Limit |
Emergency Reunion: | $15,000 limit per Certificate Period |
Return of Minor Children: | $5,000 limit per Certificate Period |
Political Evacuation: | $10,000 Maximum Lifetime Limit |
Terrorism: | $50,000 Maximum Lifetime Limit, Medical Expenses only |
Accidental Death and Dismemberment: | Prinicipal Sum $25,000 Adults age 18-69
$12,500 Adults age 70-74
$6,250 Adults age 75 and above $5,000 Children age 17 and below |
Common Carrier Accidental Death: | $50,000 per adult, $25,000 children under age 18; $250,000 per group |
Repatriation of Remains: | Overall Maximum Limit |
Natural Disaster Benefit: | Up to $100 a day for 5 days |
Trip Interruption: | $5,000 limit per Certificate Period |
Lost Checked Luggage: | $250 limit per Certificate Period (not subject to Deductible or Coinsurance) |
Hospital Pre-Notification Penalty: | 50% of Eligible Medical Expenses |
Optional Hazardous Sports Rider: | Overall Maximum Limit |
Overall Maximum Limit per Certificate Period (includes all benefits except Accidental Death and Dismemberment and Common Carrier Accidental Death): | Age 14 days to 69 - $50,000, $100,000, $250,000, $500,000 or $1,000,000; Age 70 to 79 - $50,000; Age 80 or older - $10,000 |
The following charges, treatments, surgeries, medications, conditions and circumstances are excluded:
- Pre-existing Conditions – Charges resulting directly or indirectly from any Pre-existing Condition are excluded from this insurance. Members under age 70 are covered for Medical and Emergency Evacuation charges resulting from an Acute Onset of a Pre-existing Condition, up to the limit set forth in the Schedule of Benefits and Limits. A Pre-existing Condition is any Illness, Injury or medical condition or chronic or recurring Illness or Injury or medical condition, including any associated complications or consequences, which existed at or during the 2 years immediately preceding your Effective Date. An Acute Onset is a sudden and unexpected outbreak or recurrence of a Pre-existing Condition, that occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence
- Treatment for or related to any congenital condition
- Routine pre-natal care, childbirth, care of newborns, post-natal care, birth control, artificial insemination, infertility, impotency or sexual dysfunction, sterilization or reversal thereof
- False labor, edema, prolonged labor, prescribed rest during the period of Pregnancy, morning sickness and conditions of comparable severity associated with management of a difficult Pregnancy, and not constituting a medically distinct Complication of Pregnancy, and all charges related to Pregnancy after the 26th week of Pregnancy
- Mental Health Disorders or Substance Abuse
- Charges which are not Incurred during the Certificate Period or the applicable Benefit Period, and charges which are not presented to Underwriters for payment within 60 days from the end of the Certificate Period or the applicable Benefit Period
- Charges for use of Emergency Room within the US for treatment of Illness unless the patient is directly admitted to the Hospital as Inpatient for further treatment of that Illness
- Not Medically Necessary and administered or ordered by a Physician
- Provided at no cost, by a family member, or by a person who ordinarily resides with you, or which are attributable to or recoverable from any other party including government-sponsored plans
- Charges which exceed Usual, Reasonable and Customary
- Investigational, Experimental or for Research Purposes
- While confined primarily to receive Custodial Care, Educational or Rehabilitative care.
- Venereal disease, and treatment of individuals who are HIV+ or have AIDS or ARC
- Treatment by a Chiropractor
- Diseases of the skin
- Dental treatment, including treatment of the temporomandibular joint, except for Emergency Dental treatment necessary to replace sound natural teeth lost or damaged in an Accident covered hereunder or for the relief of acute, spontaneous and unexpected onset of pain
- Eyeglasses, vision exams, contact lenses, hearing tests, hearing aids, hearing implants, eye refraction, visual therapy, orthoptics or visual eye training or eye surgery (including cataract surgery and radial keratotomy) or for any examination or fitting related to these devices or procedures
- Injury due to participation in while taking part in the following activities: Amateur Athletics, Contact Sports, and professional sports or athletic activities. Non-contact and non-organized/non-sanctioned amateur sports or athletic activities engaged in by the Member solely for leisure, recreational, entertainment or fitness purposes are not excluded exept the following which are excluded: Mountaineering where ropes or guides are normally used or at elevations of 4,500 meters or higher; Aviation, except when traveling solely as a passenger in a commercial aircraft; Hang gliding, sky diving, parachuting or bungee jumping; Snow skiing or snowboarding, except for recreational downhill and/or cross-country snow skiing or snowboarding (no cover provided whilst skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body); Racing by any animal or motorized vehicle; spelunking; subaqua pursuits involving underwater breathing apparatus unless NAUI/PADI certified, accompanied by a certified instructor, and at depths of less than 10 meters; jet skiing; and any other sport or athletic activity which is undertaken for thrill seeking and exposes you to abnormal or extreme risk of injury
- Injury sustained while under the influence of or due wholly or partly to the effects of intoxicating liquor or drugs other than drugs taken in accordance with treatment prescribed and directed by a Physician but not for the treatment of Substance Abuse
- Willfully self-inflicted Injury or Illness and immunizations and Routine Physical Exams
- The Deductible, Coinsurance and charges which are not included as Eligible Expenses as described in the Master Policy, and charges which exceed the limits set forth in the Schedule of Benefits and Limits
- Treatment required as a result of complications or consequences of a treatment or condition not covered hereunder
- Charges for travel or accommodations, except as provided for in the Local Ambulance, Emergency Medical or Political Evacuation, Repatriation of Remains, Emergency Reunion, Natural Disaster and Trip Interruption sections of this insurance
- Treatment incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s)
- Organ or tissue transplants or related services
- Acts of Terrorism, except as provided for herein, war, insurrection, riot or any variation thereof
This is a summary of exclusions. For more details, or for a complete copy of the Master Policy, contact us.
The Optional Hazardous Sports Rider is available for the adventurous groups. This Rider adds coverage for the Amateur sports listed in exclusion #18. The maximum coverage under this Rider is the Overall Maximum Limit you select. The Accidental Death and Dismemberment benefit is deleted during the course of the activity. The Rider must be purchased for all members of your group.
Hospitalizations, Surgeries, Emergency and Political Evacuations, Emergency Reunions, Trip Interruptions, Repatriation of Remains, Computerized Tomography (CAT Scan) and Magnetic Resonance Imaging (MRI) must be Pre-certified. Simply call, or have your Physician call, MultiNational Underwriters® with the information relative to your claim. You may also pre-certify by submitting details through Client Zone. Be sure to have your ID number available. If you do not Pre-certify, medical expenses will be reduced by 50% and all other expenses will be forfeited.
MultiNational Underwriters® (MNU), headquartered in Indianapolis, Indiana, is a full service organization offering a comprehensive portfolio of insurance products designed specifically to address the insurance needs of consumers worldwide. MNU's international claims specialists, medical professionals and client relations specialists are available 24 hours a day, 7 days a week to answer your questions and respond to your needs. Whether you have lost your luggage or are in need of Emergency Medical Evacuation, you will find their service team to be prompt, compassionate, and highly professional. MNU is a subsidiary of HCC Insurance Holdings, Inc. (HCC), which is a leading international specialty insurance group headquartered in Houston, Texas. HCC has assets of more than $8.0 billion, shareholders’ equity in excess of $2.3 billion and is rated AA (Very Strong) by Standard & Poor’s, AA (Very Strong) by Fitch Ratings and A+ (Superior) by A.M. Best Company.
Lloyd’s, the largest and oldest insurance market in the world, is the insurer of the Atlas Series. Rated 'A' (Superior) by AM Best Company and 'A' (Strong) by Standard and Poor’s, Lloyd’s provides financial strength and security that is unparalleled in the worldwide insurance market. Lloyd’s is recognized as a market leader in the accident and health insurance arena and is well-known for its innovative products and services. Presently, Lloyd’s provides accident and health insurance to millions of individuals in almost every country of the world.
Whether you have misplaced your ID card or benefit booklet, need assistance with a claim, or have a question about benefits, MNU is ready to respond. Frequently, these and other issues can be addressed with a short visit to Client Zone. Client Zone is an online account management and resource tool that allows you to:
- Change personal information
- Renew coverage and reprint ID cards
- Obtain details about claim filing, including downloading necessary forms
- Pre-certify for certain medical procedures and hospitalizations
- Locate providers within the PPO Network
- Study destination, weather and travel security information using our Travel Intelligence and Planning System (TIPS)
- Access health and wellness information
- View and download brochures, obtain policy information, or get quotes for other products offered by MultiNational Underwriters®
You may access Client Zone at http://www.buyamericaninsurance.com/clients/
If you prefer to speak to one of the professional representatives, you may contact our World Service Center by calling toll-free from various countries around the world or by calling collect. MNU's World Service Center can provide you with service in many different languages.
You can either apply online on this web site or you can send the paper application using the links towards
the top of this web page.
MultiNational Underwriters® respects individual privacy and values the confidence of its customers, employees, consumers, business associates, and others. Please contact us to obtain a full version of our Privacy Policy.
|
|
|
|
|
|
|
|
AGE
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
|
18-29
|
26.00
|
0.85
|
30.00
|
1.00
|
34.00
|
1.10
|
36.00
|
1.20
|
41.00
|
1.35
|
|
30-39
|
30.00
|
1.00
|
36.00
|
1.20
|
44.00
|
1.45
|
47.00
|
1.55
|
55.00
|
1.80
|
|
40-49
|
52.00
|
1.70
|
58.00
|
1.90
|
62.00
|
2.10
|
65.00
|
2.20
|
71.00
|
2.30
|
|
50-59
|
85.00
|
2.80
|
97.00
|
3.20
|
104.00
|
3.40
|
108.00
|
3.60
|
114.00
|
3.80
|
|
60-64
|
109.00 |
3.60
|
128.00
|
4.20
|
137.00
|
4.50
|
143.00
|
4.80
|
170.00
|
5.70
|
|
65-69
|
126.00
|
4.10
|
139.00
|
4.60
|
148.00
|
4.90
|
153.00
|
5.00
|
178.00
|
6.00
|
|
70-79
|
198.00
|
6.60
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
|
80+*
|
450.00
|
14.90
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
|
Dep. Child
|
15.00
|
0.50
|
20.00
|
0.65
|
22.00
|
0.80
|
23.00
|
0.80
|
24.00
|
0.85
|
|
Child Alone
|
27.00
|
0.90
|
32.00
|
1.05
|
33.00
|
1.10
|
35.00
|
1.20
|
39.00
|
1.30
|
* $10,000 Maximum Limit
|
|
|
|
|
|
|
|
AGE
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
Monthly
|
Daily
|
|
18-29
|
38.00
|
1.25
|
44.00
|
1.50
|
55.00
|
1.80
|
57.00
|
1.90
|
67.00
|
2.20
|
|
30-39
|
49.00
|
1.60
|
59.00
|
1.95
|
72.00
|
2.40
|
75.00
|
2.50
|
86.00
|
2.85
|
|
40-49
|
75.00
|
2.50
|
85.00
|
2.80
|
106.00
|
3.50
|
112.00
|
3.75
|
126.00
|
4.20
|
|
50-59
|
107.00
|
3.55
|
131.00
|
4.40
|
156.00
|
5.20
|
160.00
|
5.30
|
184.00
|
6.10
|
|
60-64
|
141.00
|
4.70
|
193.00
|
6.40
|
206.00
|
6.80
|
207.00
|
6.90
|
230.00
|
7.70
|
|
65-69
|
179.00
|
6.00
|
223.00
|
7.40
|
249.00
|
8.30
|
250.00
|
8.40
|
270.00
|
9.00
|
|
70-79
|
227.00
|
7.60
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
|
80+*
|
450.00
|
14.90
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
N/A
|
|
Dep. Child
|
22.00
|
0.70
|
24.00
|
0.85
|
29.00
|
1.00
|
30.00
|
1.00
|
34.00
|
1.15
|
|
Child Alone
|
35.00
|
1.20
|
40.00
|
1.35
|
47.00
|
1.60
|
49.00
|
1.60
|
58.00
|
1.95
|
* $10,000 Maximum Limit
|
|
|
|
$0
|
1.25
|
|
$100
|
1.1
|
|
$250
|
1.0
|
|
$500
|
0.9
|
|
$1,000
|
0.8
|
|
$2,500
|
0.7
|
If, for any reason, you wish to cancel your policy, you must submit your cancellation request in writing to
MultiNational Underwriters ® to receive a refund of premium. To be eligible for a full refund, the request
for cancellation must be received prior to your effective date. Cancellation requests received after the effective
date will be subject to the following conditions:
- a $25 cancellation fee will apply; and
- only the unused portion of the plan cost will be refunded; and
- only members who have no claims are eligible for cancellation.
|