What is Emergency Medical travel insurance?

Emergency Medical is a popular travel insurance benefit that can reimburse the costs to treat a medical emergency during a trip.

Getting sick or injured while abroad is a major concern among travelers and can to lead to costly out-of-pocket medical expenses if not covered. Emergency Medical can provide peace of mind by offering reimbursement for unforeseen medical emergency services and medical transportation.

The majority of travel insurance companies include medical benefits, such as Emergency Medical and Medical Evacuation, in their policies. However, coverage limits and exclusions can vary from one plan to the next.

If a medical emergency does occur during a trip, a policyholder may be required to pay for medical care out-of-pocket, and then file a claim for reimbursement when they return home. In certain situations, a provider may pre-authorize payment of medical bills under the Emergency Medical benefit, but it is not guaranteed.

What is Covered by Emergency Medical Travel Insurance?

In short, the Emergency Medical benefit will typically cover unforeseen emergency medical care expenses that may occur during a trip.

Examples of medical expenses typically covered by travel insurance include:

  • Ambulance services
  • Emergency room and doctor visits
  • X-rays and lab work
  • Emergency dental expenses
  • Prescription drug medications

Common Emergency Medical Exclusions

Travel medical insurance covers a wide-range of unforeseen medical costs. However, Emergency Medical insurance is not all-encompassing.

While exclusions and limitations may vary from one travel insurance provider to the next, most Emergency Medical plans do not offer coverage for the following:

  • Pre-existing medical conditions (unless stated otherwise)
  • Injuries sustained while participating in an excluded activity
  • Routine physicals or checkups
  • Normal pregnancy or childbirth
  • Intentional self-harm

Is Emergency Medical Travel Insurance Required for International Travel?

While rare, certain countries may require proof of Emergency Medical travel insurance upon entry. A list of those countries can be found in our Destination Center. Regardless of your destination, Emergency Medical coverage is always strongly recommended.

Most primary health insurance plans, such as Medicare, Medicaid, or an employer-based plan, don’t offer coverage overseas. This can often lead to costly out-of-pocket medical expenses if not covered by insurance.

Purchasing an insurance policy with the Emergency Medical benefit can save individuals thousands of dollars in unexpected healthcare costs while traveling abroad.

Recommended Emergency Medical Coverage Limits

For those traveling internationally, Squaremouth recommends a minimum of $50,000 in Emergency Medical coverage and at least $100,000 in Medical Evacuation coverage.

For travelers going on a cruise or traveling to remote destinations, Squaremouth recommends $100,000 in Emergency Medical coverage and $250,000 in Medical Evacuation coverage due to the potential for high medical costs while traveling.

How Much Does Emergency Medical Travel Insurance Cost?

The cost of travel insurance will vary and are determined by various factors, including a traveler’s age, destination, trip cost, policy type, and trip length.

Comprehensive travel insurance policies, which also include Trip Cancellation, Trip Interruption, and other important benefits, average roughly $375 – $450. Travelers not concerned with cancellations can opt for “medical-only” plans, which can range from $75-$125.

When purchasing any form of travel insurance, it’s strongly recommended to compare plans and prices to find the best coverage for the lowest price.

Types of Emergency Medical Travel Insurance Plans

Travelers have two primary coverage options to pick from when comparing travel health insurance plans; Primary and Secondary.

Both types of medical plans provide travelers with health insurance coverage. The main difference, however, is the order in which a claim is paid.

Primary Travel Medical Insurance

With Primary coverage, it is the travel insurance company that will pay a claim first up to the limit outlined in the policy. Once the policy limit has been reached, the remaining balance will be passed on to the policyholder or their primary insurance provider.

Keep in mind that Primary travel medical insurance doesn’t necessarily mean better coverage, but claims typically settle faster.

Secondary Travel Medical Insurance

Secondary coverage means that an insurance company will pay a claim only after a traveler has filed with their primary health insurance provider. This typically doesn’t impact international travelers, but may be a concern for those taking a domestic trip.

Travelers who opt for secondary Emergency Medical benefits are usually just as satisfied with the level of service and coverage provided by their travel insurance.

Do Emergency Medical Travel Insurance Plans Include Deductibles?

Some travel insurance plans may include a medical deductible, which is an amount you must pay out of pocket before the insurance coverage kicks in. The deductible is typically applied per covered incident or per person, and it helps insurers manage costs and discourage small or frequent claims.

The presence and amount of a medical deductible can vary depending on the travel insurance policy and the insurance provider. Some plans may have a separate deductible for medical expenses, while others may have a combined deductible that applies to both medical and non-medical claims.

When reviewing travel insurance plans, it’s essential to carefully read the policy documents and understand the terms, conditions, and any deductibles that may apply.

Please be aware that coverage and eligibility requirements for this benefit differ by policy. The tables below show the providers that offer Emergency Medical coverage.

Looking for a policy with Emergency Medical coverage?

Enter your trip information on our custom quote form. Once you receive your results, select the Emergency Medical filter to find the best policy for your trip with the coverage that you need.

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Emergency Medical by Provider

Last Updated: 02/15/2024
Aegis Aegis
Policy Name and Summary of Coverage
1

Go Ready Trip Cancellation

No coverage

There is no Emergency Medical coverage with this plan.

2

Go Ready Choice

$50,000 per person
Secondary coverage

C. EMERGENCY MEDICAL EXPENSE PLAN

1. EMERGENCY MEDICAL EXPENSE BENEFIT

Subject to SECTION II – EFFECTIVE AND TERMINATION DATES OF INSURANCE, A. EFFECTIVE DATE, the Insured’s coverage under the Emergency Medical Expense Benefit will take effect on the Scheduled Date of Departure.

We will pay the Insured an Emergency Medical Expense Benefit, for the Covered Expenses described below in this Emergency Medical Expense Benefit section, up to the corresponding Maximum Covered Amount per Insured shown in the Schedule for the following Covered Expenses incurred by the Insured, subject to the following: (i) Covered Expenses will only be payable at the Usual and Customary level of payment; (ii) benefits will be payable only for Covered Expenses resulting from a Sickness that first manifests itself or a Covered Injury that occurs while on a Covered Trip; (iii) the Insured must first receive treatment by a Physician, in person during his/her Covered Trip; and (iv) benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any In Force Policy in effect for the Insured or in accordance with a Coordination of Benefits provision in jurisdictions where excess coverage provisions are not permitted.

The following are Covered Expenses under this Emergency Medical Expense Benefit:

(1) expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services incurred by the Insured that occurred during a Covered Trip; and

(2) expenses for a Hospital Admission Guarantee Charge or a Medical Expense Guarantee Charge if while traveling outside of the Insured’s country of Primary Residence on a Covered Trip, the Insured suffers a medical emergency. We or Our Assistance Provider will pay on the Insured’s behalf or reimburse up to the Hospital Admission Guarantee Charge or Medical Expense Guarantee Charge Benefit, up to the corresponding Maximum Covered Amount per Insured shown in the Schedule, for actual expenses incurred for guarantee of payment to the Hospital or the medical provider.

The Insured’s duties in the event of a Medical Expense:

(i) The Insured must provide Us with all bills and reports for medical expenses claimed.

(ii) The Insured must provide any requested information, including but not limited to, an explanation of benefits from any other applicable insurance.

(iii) The Insured must sign a patient authorization to release any information required by Us to investigate his/her claim.

2. EMERGENCY DENTAL EXPENSE BENEFIT – Maximum Covered Amount per Insured $1,000

Subject to SECTION II – EFFECTIVE AND TERMINATION DATES OF INSURANCE, A. EFFECTIVE DATE, the Insured’s coverage under the Emergency Dental Expense Benefit will take effect on the Scheduled Date of Departure.

We will pay the Insured an Emergency Dental Expense Benefit, up to the corresponding Maximum Covered Amount per Insured shown in the Schedule, for the following Covered Expenses incurred by the Insured, subject to the following: (i) Covered Expenses will only be payable at the Usual and Customary level of payment; (ii) benefits will be payable only for Covered Expenses resulting from a Covered Injury that occurs while on a Covered Trip; (iii) the Insured must first receive treatment during his her Covered Trip by a Dentist; and (iv) benefits payable as a result of incurred Covered Expenses will only be paid after benefits have been paid under any Other Valid and Collectible Insurance in effect for the Insured or in accordance
with a Coordination of Benefits provision in jurisdictions where excess coverage provisions are not permitted.

The following are Covered Expenses under this Emergency Dental Expense Benefit:

a. expenses for emergency dental treatment incurred by the Insured during his/her Covered Trip.

The Insured’s duties in the event of a Dental Expense:

(1) The Insured must provide Us with all bills and reports for dental expenses claimed.

(2) The Insured must provide any requested information, including but not limited to, an explanation of benefits from any other applicable insurance.

(3) The Insured must sign a patient authorization to release any information required by Us to investigate his/her claim.

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3

Go Ready Pandemic Plus

$50,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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Arch RoamRight Arch RoamRight
Policy Name and Summary of Coverage
4

Pro

$25,000 per person
Primary coverage

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; and 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

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5

Pro Plus

$50,000 per person
Primary coverage

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for covered Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following: 1) covered Medical Expenses will only be payable at the Usual and Customary level of charges; 2) benefits will be payable only for covered Medical Expenses resulting from an Emergency Condition that first manifests itself or occurs while on Your Trip; and 3) only Medical Expenses incurred during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

Benefits will include up to $750 for expenses incurred during Your Trip for emergency dental treatment. Dental expenses incurred after Your Trip is completed are not covered.

“Emergency Condition” means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

“Medical Expenses” means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip), if recommended by Your attending Physician and approved by Us or Our Program Assistance Provider as a substitute for a hospital room for recovery from Your Emergency Condition;

3. local Transportation Expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

We will advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Emergency Condition.

Optional Benefits

Medical Coverage Upgrade – Additional $25,000

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AXA Assistance USA AXA Assistance USA
Policy Name and Summary of Coverage
6

Silver

$25,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits , subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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7

Gold

$100,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits , subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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8

Platinum

$250,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits , subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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battleface battleface
Policy Name and Summary of Coverage
9

Discovery Plan

Optional coverage

TRAVEL MEDICAL EXPENSE

We will pay a benefit to reimburse you for the reasonable and customary charges, up to the maximum limit shown in the schedule of benefits (and after satisfaction of the deductible) if you suffer an injury or sickness during the covered trip that requirestreatment by a physician. The injury must occur or the sickness must first begin while on a covered trip. The initial documented treatment must be given by a physician during the covered trip.

Travel Medical Covered Expenses:

We will pay a benefit to reimburse you the medically necessary expenses incurred for:

a. Services of a physician or nurse, and related tests or treatment;

b. Hospital charges or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or hotel room, not already included in the cost of your covered trip, if recommended as a substitute for a hospital room for recovery from an injury or sickness;

c. Prescription medication to treat the injury or sickness;

d. Charges for anesthesia (including administration), x-ray examinations or treatments, and laboratory tests;

e. Local ambulance services to and from a hospital;

f. Hospital room and board

g. Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices; and

h. The cost of emergency dental treatment for accidental injury to sound natural teeth that occurs during a covered trip limited to the Maximum Limit shown in the schedule of benefits.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after you have reached your return destination, regardless of the reason. The treatment must be given by a physician or dentist.

We will pay a benefit to reimburse you for these expenses for all treatment related to the initial injury or sickness for thirty (30) days from the date of the first treatment during the covered trip, or until the return date, whichever is later. Otherwise, we will not pay for any expenses incurred after the Coverage Termination Date as shown in the Effective and Termination Dates section of this policy, regardless of the reason.

We will not pay benefits in excess of the reasonable and customary charges. We will not cover any expenses incurred by another party at no cost to you or already included within the cost of the covered trip.

Adventure Sports Coverage: Benefits will be paid up to the limit shown in the schedule of benefits, if you suffer an injury while participating adventure activities.

Extreme Sports Coverage: Benefits will be paid up to the limit shown in the schedule of benefits, if you suffer an injury while participating in extreme activities

Winter Sports Coverage: Benefits will be paid up to the limit shown in the schedule of benefits, if you suffer an injury while participating in winter activities.

Advance Payment: If you require admission to a hospital during a covered trip for an injury or sickness, we or our designated representative will arrange advance payment, if required by the hospital, directly to the hospital. Hospital confinement must be certified as medically necessary by the onsite attending physician.

This amount will be deducted from the Travel Medical Expense benefit limit shown in the schedule of benefits. You agree to reimburse this payment to us if:

a. You do not complete the claims process as outlined in the Payment of Claims section; or

b. It is determined that your Travel Medical Expense claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment if we confirm that your claim is not covered under the Policy; and

b. An advance payment made by us is not a guarantee of claim approval.

Benefits for Advance Payment will not duplicate any other benefits payable under the policy.

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Berkshire Hathaway Travel Protection Berkshire Hathaway Travel Protection
Policy Name and Summary of Coverage
10

ExactCare

$25,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre‐existing medical conditions will be covered if the Pre‐ existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:
● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X‐rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Berkshire Hathaway Specialty Concierge will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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11

ExactCare

$25,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician.

The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip.

Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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12

ExactCare Value

$15,000 per person
Secondary coverage

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Berkshire Hathaway Specialty Concierge will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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13

ExactCare Value

$15,000 per person
Secondary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:
The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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14

LuxuryCare

$100,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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15

LuxuryCare

$100,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip.

Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.Covered Expenses:

The Company will reimburse the Insured for:
● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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16

ExactCare Lite

$10,000 per person
Secondary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason.

The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Berkshire Hathaway Specialty Insurance will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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17

ExactCare Lite

$10,000 per person
Secondary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:
The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● Local ambulance services to and/or from a Hospital; and

● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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Cat 70 Cat 70
Policy Name and Summary of Coverage
18

Travel Plan

$500,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or

Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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Detour Insurance Detour Insurance
Policy Name and Summary of Coverage
19

@the edge

$100,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center
services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

NOTICE OF SPORTS COVERAGEEXTREME SPORTS BENEFITS

If You suffer a Loss due to an Accidental Injury while participating in Extreme Sports as defined, such activities will not be excluded under LIMITATIONS AND EXCLUSIONS, and You have access to benefits outlined in this Policy up to the Maximum Benefit subject to any applicable sub-limit shown on the Schedule of Benefits for Extreme Sports.

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20

@the edge plus

$100,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center
services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

NOTICE OF SPORTS COVERAGEEXTREME SPORTS BENEFITS

If You suffer a Loss due to an Accidental Injury while participating in Extreme Sports as defined, such activities will not be excluded under LIMITATIONS AND EXCLUSIONS, and You have access to benefits outlined in this Policy up to the Maximum Benefit subject to any applicable sub-limit shown on the Schedule of Benefits for Extreme Sports.

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Generali Global Assistance Generali Global Assistance
Policy Name and Summary of Coverage
21

Standard

$50,000 per person
Secondary coverage

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

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22

Preferred

$150,000 per person
Secondary coverage

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

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23

Premium

$250,000 per person
Secondary coverage

MEDICAL AND DENTAL COVERAGE

We will pay this benefit, up to the amount on the Schedule, for the following covered expenses incurred by you, subject to the following:

1. Covered expenses will only be payable at the Usual and Customary level of payment; and

2. Benefits will be payable only for covered expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on a Trip; and

3. Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for you. This coverage is in excess to any other health insurance you have available to you at the time of the loss. You must submit your claim to that provider first. Any benefits you receive from your primary or supplementary insurance providers will be deducted from your claim with us.

Covered Expenses:

1. Expenses for the following Physician-ordered medical services: services of legally qualified Physicians and graduate nurses, charges for Hospital confinement and services, local ambulance services, prescription drugs and medicines, and therapeutic services, incurred by you within one year from the date of your Sickness or Injury during a Trip; and

2. Expenses for emergency dental treatment incurred by you during a Trip up to the amount in the Schedule.

Your duties in the event of a Medical or Dental Expense:

1. You must provide us with all bills and reports for medical and/or dental expenses claimed.

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance.

3. You must sign a patient authorization to release any information required by us, to investigate your claim.

Please refer to the Definitions, for an explanation of Pre- Existing Conditions, which are excluded under the Medical or Dental Expense Benefits.

Coordination of Benefits

If you reside in CT, ID, IL, and excess coverage for Medical and Dental Expense Benefits is not permitted, then coordination of benefit provisions in accordance with the laws and regulations in your state will apply in lieu of the excess coverage provisions.

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GeoBlue GeoBlue
Policy Name and Summary of Coverage
24

Voyager Choice excl US

$50,000 per person
Secondary coverage

Note: For existing and/or prospective members, injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person has not unreasonably failed or refused to depart a country or location or is traveling to a country or location following the date a warning to leave or avoid travel to that country or location is issued by the United States government.

Coronavirus disease (COVID-19) and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) are not subject to the above exception and are covered as any other Injury or Illness. Medical Expenses associated with asymptomatic testing are not covered under this Plan.

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate including for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person 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 State government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture

Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Choice of Hospital and Physician: Nothing contained in this Plan restricts or interferes with the Eligible Participant’s right to select the Hospital or Physician of the Eligible Participant’s choice. Also, nothing in this Plan restricts the Eligible Participant’s right to receive, at his/her expense, any treatment not covered in this Plan.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving at a depth of 20 meters or less, provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

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25

Voyager Essential excl US

$50,000 per person
Secondary coverage

Note: For existing and/or prospective members, injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person has not unreasonably failed or refused to depart a country or location or is traveling to a country or location following the date a warning to leave or avoid travel to that country or location is issued by the United States government.

Coronavirus disease (COVID-19) and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) are not subject to the above exception and are covered as any other Injury or Illness. Medical Expenses associated with asymptomatic testing are not covered under this Plan.

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate including for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person 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 State government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture

Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Choice of Hospital and Physician: Nothing contained in this Plan restricts or interferes with the Eligible Participant’s right to select the Hospital or Physician of the Eligible Participant’s choice. Also, nothing in this Plan restricts the Eligible Participant’s right to receive, at his/her expense, any treatment not covered in this Plan

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving at a depth of 20 meters or less, provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

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26

Trekker Choice excl US

$1,000,000 per person
Secondary coverage

Note: For existing and/or prospective members, injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person has not unreasonably failed or refused to depart a country or location or is traveling to a country or location following the date a warning to leave or avoid travel to that country or location is issued by the United States government.

*Coronavirus disease (COVID-19) and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) are not subject to the above exception and are covered as any other Injury or Illness. Medical Expenses associated with asymptomatic testing or expenses for quarantining(confinement outside of a hospital setting) are not covered under this Plan

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate other than for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture
Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Note: For existing and/or perspective members, injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person has not unreasonably failed or refused to depart a country or location or is traveling to a country or location following the date a warning to leave or travel to that country or location is issued by the United State government.

Choice of Hospital and Physician:

Nothing contained in this Plan restricts or interferes with the Eligible Participant’s right to select the Hospital or Physician of the Eligible Participant’s choice. Also, nothing in this Plan restricts the Eligible Participant’s right to receive, at his/her expense, any treatment not covered in this Plan.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving at a depth of 20 meters or less, provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

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27

Trekker Essential excl US

$500,000 per person
Secondary coverage

Note: For existing and/or prospective members, injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person has not unreasonably failed or refused to depart a country or location or is traveling to a country or location following the date a warning to leave or avoid travel to that country or location is issued by the United States government.

*Coronavirus disease (COVID-19) and Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) are not subject to the above exception and are covered as any other Injury or Illness. Medical Expenses associated with asymptomatic testing or expenses for quarantining (confinement outside of a hospital setting) are not covered under this Plan.

Services and Supplies Provided by a Hospital

For any eligible condition not excluded under this Certificate other than for Mental, Emotional or Functional Nervous Conditions or Disorders, and Substance Abuse, the Insurer will pay indicated benefits on Covered Expenses for:

1. Inpatient services and supplies provided by the Hospital except private room charges above the prevailing two-bed room rate of the facility.

Note: When outside the United States, this benefit will provide coverage for private rooms if that is all that is available or if the choice is between a ward or a more than two person room and a private room.

2. Outpatient services and supplies including those in connection with outpatient surgery performed at an Ambulatory Surgical Center.

3. Emergency Hospitalization and Emergency Medical Care provided in a Hospital emergency room, including professional air and ground ambulance services for transport to and from the Hospital for such Emergency Hospitalization and Emergency Medical Care.

Payment of Inpatient Covered Expenses are subject to these conditions:

1. Services must be those which are regularly provided and billed by the Hospital.

2. Services are provided only for the number of days required to treat the Covered Person’s Illness or Injury

Note: No benefits will be provided for personal items, such as TV, radio, guest trays, etc.

Note: Injuries and Illnesses resulting from Terrorism and pandemics are covered as any other Injury or Illness provided all of the following conditions are met:

1. The Covered Person had no direct or indirect involvement in the Terrorist Activity;

2. The Covered Person 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 State government.

Professional and Other Services

The Insurer will pay Covered Expenses not excluded under this Certificate for:

1. Services of a Physician.

2. Services of an anesthesiologist or an anesthetist.

3. Outpatient diagnostic radiology and laboratory services.

4. Surgical implants.

5. The first pair of contact lenses or the first pair of eyeglasses when required as a result of a covered eye surgery.

6. Self-Administered injectable drugs.

7. Syringes when dispensed with self-administered injectable drugs (except insulin).

8. Blood transfusions, including blood processing and the cost of un-replaced blood and blood products.

9. Rental or purchase of Durable Medical Equipment and/or supplies that are all of the following:

a) ordered by a Physician;

b) of no further use when medical need ends;

c) usable only by the patient;

d) not primarily for the Covered Person’s comfort or hygiene;

e) not for environmental control;

f) not for exercise; and

g) manufactured specifically for medical use.

Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Certificate of Coverage. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. The Insurer determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.

Ambulance Services

The following ambulance services are covered under this Certificate of Coverage:

1. Base charge, mileage and non-reusable supplies of a licensed ambulance company for ground or air service for transportation to and from a Hospital.

2. Monitoring, electrocardiograms (EKGs or ECGs), cardiac defibrillation, cardiopulmonary resuscitation (CPR) and administration of oxygen and intravenous (IV) solutions in connection with ambulance service. An appropriate licensed person must render the services.

The Insurer pays as stated in the Benefit Overview Matrix.

Complications of Pregnancy

Complications of Pregnancy are covered under this Certificate of Coverage as any other medical condition. Benefits for complications of pregnancy shall be provided for all Covered Persons.

Dental Care for an Accidental Injury

Benefits are payable for dental care for an Accidental Injury to natural teeth that occurs while the Covered Person is covered under this Plan, subject to the following:

1. services must be received during the six months following the date of Injury;

2. no benefits are available to replace or repair existing dental prostheses even if damaged in an eligible Accidental Injury; and

3. damage to natural teeth due to chewing or biting is not considered an Accidental Injury under this Certificate of Coverage.

In addition, the Certificate of Coverage provides benefits for up to three days of Inpatient Hospital services when a Hospital stay is ordered by a Physician and a Dentist for dental treatment required due to an unrelated medical condition. The Insurer determines whether the dental treatment could have been safely provided in another setting. Hospital stays for the purpose of administering general anesthesia are not considered Medically Necessary. The Insurer pays as stated in the Benefit Overview Matrix.

Dental Care for Relief of Pain

Benefits are payable for dental care for Relief of Pain to the teeth that occurs while the Covered Person is covered under this Certificate of Coverage. Services must be received while covered during the Trip Coverage Period. The Insurer pays as stated in the Benefit Overview Matrix.

Physical and/or Occupational Therapy/Medicine, Including spinal manipulations and other specified therapies including acupuncture
Charges incurred for the following rehabilitative therapies, if prescribed by a Physician to restore function loss due to an illness or injury covered under this Certificate of Coverage: physical, occupational, chelation, massage, hearing and cardiac/pulmonary therapy. Additionally, coverage shall also be provided for chiropractic care delivered by a currently licensed chiropractor acting within the scope of his or her practice. The coverage shall include initial diagnosis and clinically appropriate and Medically Necessary services and supplies required to treat the diagnosed disorder, subject to the terms and conditions of the Certificate of Coverage; Acupuncture that treats a covered illness or injury provided by Doctor of Acupuncture.

Therapies excluded under this coverage include, but are not limited to: speech therapy, vocational rehabilitation, behavioral training, gym or swim therapy, dance therapy, marital counseling, legal or financial counseling, biofeedback, neuro-feedback, hypnosis, sleep therapy, employment counseling, back to school, return to work services, work hardening programs, driving safety, and services, training, educational therapy or other non-medical ancillary services for learning disabilities, developmental delays or intellectual disabilities.

These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

Choice of Hospital and Physician: Nothing contained in this Plan restricts or interferes with the Eligible Participant’s right to select the Hospital or Physician of the Eligible Participant’s choice. Also, nothing in this Plan restricts the Eligible Participant’s right to receive, at his/her expense, any treatment not covered in this Plan.

Benefits for Claims resulting from downhill skiing and scuba diving

The Insurer will pay Covered Expenses for claims resulting from downhill (alpine) skiing. It will also pay Covered Expenses resulting from scuba diving at a depth of 20 meters or less, provided that the diver is certified by the Professional Association of Diving Instructors (PADI) or the National Association of Underwater Instructors (NAUI), or equivalent governing body, or provided that he/she is diving under the supervision of a certified instructor. These Covered Expenses are Limited as stated in the Benefit Overview Matrix.

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Global Underwriters Global Underwriters
Policy Name and Summary of Coverage
28

Diplomat America

$50,000 per person
Secondary coverage

ACCIDENT and SICKNESS MEDICAL EXPENSE BENEFIT

We will pay Usual Reasonable and Customary charges for Eligible Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum (age 60-69, medical maximum limited to $250,000 unless reduced maximum amount selected; age 70-79, medical maximum limited to $100,000 unless reduced maximum amount selected; age 80+ medical maximum limited to $20,000), incurred by You due to an accidental Injury or Sickness which occurred during the period of coverage inside the USA except as provided under the Incidental Trips benefit. All bodily disorders existing simultaneously which are due to the same or related causes will be considered one Disablement. If a Disablement is due to causes which are the same or related to the cause of a prior Disablement, the Disablement will be considered a continuation of the prior Disablement and not a separate Disablement. The initial treatment of an Injury or Sickness must occur within 30 days of the date of Injury or onset of Sickness. For a covered disablement, after you pay the per person deductible, the plan pays 80% up to $5,000 of eligible costs, then 100% to the Medical Maximum. There will be an additional $250 deductible for each emergency room visit as a result of an Illness. The emergency room deductible will be waived if hospital admittance is within 12 hours of the incident.

We will pay Accident and Sickness Medical Expense Benefits for Eligible Expenses. These benefits are subject to the Deductibles, Coinsurance Factors, Benefit Maximums and other terms or limits shown below and in the Schedule of Benefits. Only such Expenses that are specifically enumerated in the following list of charges that are incurred for the medical care and supplies which are incurred within: 26 weeks from the date of the disablement will be considered.

Accident and Sickness Medical Expense Benefits are only payable:

1) for Usual, Reasonable and Customary Charges incurred after the Deductible has been met;

2) for those Medically Necessary Eligible Expenses incurred by or on behalf of the Plan Participant; No benefits will be paid for any expenses incurred that are in excess of Usual, Reasonable and Customary Charges.

Eligible Expenses include:

1) Hospital Admission Expenses: Charges for each hospital admission.

2) Outpatient Pre-Surgical Testing benefit – charges for Pre-surgical testing. A scheduled surgical procedure must occur within 7 days of the testing.

3) Nursing Services – Outpatient Charges for nursing services by a Registered Nurse or Licensed Professional.

4) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

5) Charges made for artificial limbs, eyes, larynx, and orthotic appliances, but not for replacement of such items.

6) In-Patient Hospital Room & Board Benefit, Intensive Care Unit Benefit, Hospital Miscellaneous Expense Benefit, Day Surgery Miscellaneous, Surgeon (In or Outpatient) Benefits, Assistant Surgeon Benefit (In or Outpatient).

7) Pre-Admission Testing Benefit, Anesthesia Benefit, Diagnostic X-Ray and Laboratory Benefit

8) Ambulance Benefit

9) Physician Visit Benefit (Inpatient or Outpatient), Consultant Physician Benefit.

10) Emergency Room Benefit, Physiotherapy Expense Benefit (In / URC) or (Outpatient / Chiropractic Care subject to $50 per visit 10 visits maximum), Durable Medical Equipment Expense Benefit

11) Out-Patient Prescription Drug Benefit; 30-day supply per prescription.

ADDITIONAL BENEFITS

Emergency Dental Treatment (Accident) – We will pay benefits as described in the Schedule of Benefits for expenses incurred during the Plan Participant’s Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during the Trip will be reimbursed. Expenses incurred after the Trip are not cover.

Emergency Dental Treatment (Palliative) – We will pay benefits as described in the Schedule of Benefits for eligible expenses for Palliative Dental; an eligible Dental condition will mean emergency pain relief treatment to natural teeth.

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29

Diplomat LT excl US

$500,000 per person
Secondary coverage

ACCIDENT and SICKNESS MEDICAL EXPENSE BENEFIT:

We will pay Usual Reasonable and Customary charges for Eligible Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum (age 70-79, medical maximum limited to $100,000 unless reduced maximum amount selected; age 80+ medical maximum limited to $20,000), incurred by You due to an accidental Injury or Sickness which occurred during the period of coverage outside your Home Country (except as provided under the Home Country Coverage). All bodily disorders existing simultaneously which are due to the same or related causes will be considered one Disablement. If a Disablement is due to causes which are the same or related to the cause of a prior Disablement, the Disablement will be considered a continuation of the prior Disablement and not a separate Disablement. The initial treatment of an Injury or Sickness must occur within 30 days of the date of Injury or onset of Sickness.

We will pay Accident and Sickness Medical Expense Benefits for Eligible Expenses. These benefits are subject to the Deductibles, Coinsurance Factors, Benefit Maximums and other terms or limits shown below and in the Schedule of Benefits. Only such Expenses that are specifically enumerated in the following list of charges that are incurred for the medical care and supplies which are incurred within: i) 52 weeks for US Citizens; or ii) 26 weeks for Non US Citizens from the date of the disablement will be considered.

Accident and Sickness Medical Expense Benefits are only payable:

1) for Usual, Reasonable and Customary Charges incurred after the Deductible has been met;
2) for those Medically Necessary Eligible Expenses incurred by or on behalf of the Plan Participant;

No benefits will be paid for any expenses incurred that are in excess of Usual, Reasonable and Customary Charges.

Eligible Expenses include:

1) Hospital Admission Expenses: Charges for each hospital admission.

2) Outpatient Pre-Surgical Testing benefit – charges for Pre-surgical testing. A scheduled surgical procedure must occur within 7 days of the testing.

3) Nursing Services – Outpatient Charges for nursing services by a Registered Nurse or Licensed Professional.

4) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

5) Charges made for artificial limbs, eyes, larynx, and orthotic appliances, but not for replacement of such items.

6) In-Patient Hospital Room & Board Benefit, Intensive Care Unit Benefit, Hospital Miscellaneous Expense Benefit, Day Surgery Miscellaneous, Surgeon (In or Outpatient) Benefits, Assistant Surgeon Benefit (In or Outpatient).

7) Pre-Admission Testing Benefit, Anesthesia Benefit, Diagnostic X-Ray and Laboratory Benefit

8) Ambulance Benefit

9) Physician Visit Benefit (Inpatient or Outpatient), Consultant Physician Benefit.

10) Emergency Room Benefit, Physiotherapy Expense Benefit (In / URC) or (Outpatient / Physiotherapy Care subject to $50 per visit 10 visits maximum), Durable Medical Equipment Expense Benefit

11) Out-Patient Prescription Drug Benefit; 30-day supply per prescription.

Emergency Dental Treatment (Accident) -We will pay benefits as described in the Schedule of Benefits for expenses incurred during the Plan Participant’s Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during the Trip will be reimbursed. Expenses incurred after the Trip are not cover.

Emergency Dental Treatment (Palliative) – We will pay benefits as described in the Schedule of Benefits for eligible expenses for Palliative Dental; an eligible Dental condition will mean emergency pain relief treatment to natural teeth.

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30

Diplomat LT incl US

$500,000 per person
Secondary coverage

ACCIDENT and SICKNESS MEDICAL EXPENSE BENEFIT:

We will pay Usual Reasonable and Customary charges for Eligible Expenses, excess of the chosen Deductible and Coinsurance up to the selected Medical Maximum (age 70-79, medical maximum limited to $100,000 unless reduced maximum amount selected; age 80+ medical maximum limited to $20,000), incurred by You due to an accidental Injury or Sickness which occurred during the period of coverage outside your Home Country (except as provided under the Home Country Coverage). All bodily disorders existing simultaneously which are due to the same or related causes will be considered one Disablement. If a Disablement is due to causes which are the same or related to the cause of a prior Disablement, the Disablement will be considered a continuation of the prior Disablement and not a separate Disablement. The initial treatment of an Injury or Sickness must occur within 30 days of the date of Injury or onset of Sickness.

We will pay Accident and Sickness Medical Expense Benefits for Eligible Expenses. These benefits are subject to the Deductibles, Coinsurance Factors, Benefit Maximums and other terms or limits shown below and in the Schedule of Benefits. Only such Expenses that are specifically enumerated in the following list of charges that are incurred for the medical care and supplies which are incurred within: i) 52 weeks for US Citizens; or ii) 26 weeks for Non US Citizens from the date of the disablement will be considered.

Accident and Sickness Medical Expense Benefits are only payable:

1) for Usual, Reasonable and Customary Charges incurred after the Deductible has been met;
2) for those Medically Necessary Eligible Expenses incurred by or on behalf of the Plan Participant;

No benefits will be paid for any expenses incurred that are in excess of Usual, Reasonable and Customary Charges.

Eligible Expenses include:

1) Hospital Admission Expenses: Charges for each hospital admission.

2) Outpatient Pre-Surgical Testing benefit – charges for Pre-surgical testing. A scheduled surgical procedure must occur within 7 days of the testing.

3) Nursing Services – Outpatient Charges for nursing services by a Registered Nurse or Licensed Professional.

4) Dressings, drugs, and medicines that can only be obtained upon a written prescription of a Physician or Surgeon.

5) Charges made for artificial limbs, eyes, larynx, and orthotic appliances, but not for replacement of such items.

6) In-Patient Hospital Room & Board Benefit, Intensive Care Unit Benefit, Hospital Miscellaneous Expense Benefit, Day Surgery Miscellaneous, Surgeon (In or Outpatient) Benefits, Assistant Surgeon Benefit (In or Outpatient).

7) Pre-Admission Testing Benefit, Anesthesia Benefit, Diagnostic X-Ray and Laboratory Benefit

8) Ambulance Benefit

9) Physician Visit Benefit (Inpatient or Outpatient), Consultant Physician Benefit.

10) Emergency Room Benefit, Physiotherapy Expense Benefit (In / URC) or (Outpatient / Physiotherapy Care subject to $50 per visit 10 visits maximum), Durable Medical Equipment Expense Benefit

11) Out-Patient Prescription Drug Benefit; 30-day supply per prescription.

Emergency Dental Treatment (Accident) -We will pay benefits as described in the Schedule of Benefits for expenses incurred during the Plan Participant’s Trip for emergency dental treatment. Only expenses for emergency dental treatment to natural teeth incurred during the Trip will be reimbursed. Expenses incurred after the Trip are not cover.

Emergency Dental Treatment (Palliative) – We will pay benefits as described in the Schedule of Benefits for eligible expenses for Palliative Dental; an eligible Dental condition will mean emergency pain relief treatment to natural teeth.

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HTH Travel Insurance HTH Travel Insurance
Policy Name and Summary of Coverage
31

TravelGap Voyager excl US

$50,000 per person accident
$50,000 per person sickness
Secondary coverage

ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, subject to any Deductible shown on the Schedule of Benefits if You incur Covered Medical Expenses for Necessary Treatment as a result of an Accidental Injury or Sickness that occurs during the Trip. You must receive initial treatment for Accidental Injuries within thirty (30) days of the Accident that caused them or the onset of the Sickness and while on the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms;
c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services; and
f) emergency and palliative dental treatment (limited to expenses incurred while on Your Trip).

The Company will not reimburse benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or Sickness which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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32

TripProtector Preferred

$500,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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33

TravelGap Excursion excl US

$50,000 per person accident
$50,000 per person sickness
Secondary coverage

ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, subject to any Deductible shown on the Schedule of Benefits if You incur Covered Medical Expenses for Necessary Treatment as a result of an Accidental Injury or Sickness that occurs during the Trip. You must receive initial treatment for Accidental Injuries within thirty (30) days of the Accident that caused them or the onset of the Sickness and while on the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms;
c) charge for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services; and
f) emergency and palliative dental treatment (limited to expenses incurred while on Your Trip).

The Company will not reimburse benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or Sickness which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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34

TripProtector Economy

$75,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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35

TripProtector Classic

$250,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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IMG IMG
Policy Name and Summary of Coverage
36

iTravelInsured Travel Lite

$100,000 per person
Secondary coverage

ACCIDENT & SICKNESS MEDICAL AND DENTAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a) benefits will be payable only for Medical Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on Your Trip (of a duration of one hundred eighty (180) days or less for Sickness) and requires treatment in person by a Physician;

b) only Medical Expenses incurred by You during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

If You suffer one or more Injury or Sickness while on the same Trip, the maximum amount payable for all Injuries or Sicknesses will not exceed the Maximum Benefit Amount shown in the Schedule of Benefits.

Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury or Sickness;

3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to sound natural teeth. Dental expenses incurred after Your Trip is completed are not covered;

4. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Advance Payment: If You require admission to a Hospital or treatment at a clinic, Our designated Travel Assistance Services Provider will arrange advance payment (directly to the provider) necessary for Your admission to a Hospital because of a covered Injury or Sickness, up to the Maximum Benefit Amount shown in the Schedule of Benefits, provided You agree to reimburse Us if it is determined that Your Medical Expense claim is not covered.

We reserve the right to deny a request for advance payment if We confirm that Your claim is not covered under the policy. An advance payment made by Us is not a guarantee that Your Medical Expense claims are covered.

Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

Emergency Dental Expenses means expenses incurred only for the following:

1. dental services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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37

iTravelInsured Travel SE

$250,000 per person
Primary coverage

ACCIDENT & SICKNESS MEDICAL AND DENTAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a) benefits will be payable only for Medical Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on Your Trip (of a duration of one hundred eighty (180) days or less for Sickness) and requires treatment in person by a Physician;

b) only Medical Expenses incurred by You during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

If You suffer one or more Injury or Sickness while on the same Trip, the maximum amount payable for all Injuries or Sicknesses will not exceed the Maximum Benefit Amount shown in the Schedule of Benefits. Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury or Sickness;

3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to sound natural teeth. Dental expenses incurred after Your Trip is completed are not covered;

4. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Advance Payment: If You require admission to a Hospital or treatment at a clinic, Our designated Travel Assistance Services Provider will arrange advance payment (directly to the provider) necessary for Your admission to a Hospital because of a covered Injury or Sickness, up to the Maximum Benefit Amount shown in the Schedule of Benefits, provided You agree to reimburse Us if it is determined that Your Medical Expense claim is not covered. We reserve the right to deny a request for advance payment if We confirm that Your claim is not covered under the policy. An advance payment made by Us is not a guarantee that Your Medical Expense claims are covered. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

Emergency Dental Expenses means expenses incurred only for the following:

1. dental services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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38

Patriot America Plus

$50,000 policy limit
Secondary coverage

G. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary, and Charges are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies that are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies that are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery that was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs that require a prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one (1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

i) an Injury

ii) an Illness resulting in Hospital confinement as an Inpatient

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

r) a Telehealth, Teleconsultation or Virtual Physician Visit

(5) Charges incurred for Treatment at an Urgent Care Clinic

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder (10) Charges for an Emergency eye examination performed by a licensed optometrist or ophthalmologist to obtain a Medically Necessary prescription for corrective lenses that were lost or damaged due to an Accident covered hereunder, but not for the replacement of prescription corrective lenses or contact lenses

(11) Charges for Treatment resulting from COVID-19/SARS-CoV-2

(12) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses..

N. HOSPITAL INDEMNITY:

• Overnight limit: $250
• Maximum nights: 10
• Outside Insured Person’s Country of Residence and the United States
• Inpatient Hospitalization only

Subject to the Terms of this insurance and in the event the Insured Person has been Hospitalized in a Facility outside the Country of Residence and the United States, during the Period of Coverage, the Company will pay the Insured Person the amount shown in the BENEFIT SUMMARY for each overnight Hospitalization as an Inpatient, so long as the Treatment received during the overnight Hospitalization is considered to be an Eligible Medical Expense.

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39

iTravelInsured Travel LX Basic

$500,000 per person
Primary coverage

ACCIDENT & SICKNESS MEDICAL AND DENTAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a) benefits will be payable only for Medical Expenses resulting from a Sickness that first manifests itself or an Injury that occurs while on Your Trip (of a duration of one hundred eighty (180) days or less for Sickness) and requires treatment in person by a Physician;
b) only Medical Expenses incurred by You during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

If You suffer one or more Injury or Sickness while on the same Trip, the maximum amount payable for all Injuries or Sicknesses will not exceed the Maximum Benefit Amount shown in the Schedule of Benefits. Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;
2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury or Sickness;
3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to sound natural teeth. Dental expenses incurred after Your Trip is completed are not covered;
4. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Advance Payment: If You require admission to a Hospital or treatment at a clinic, Our designated Travel Assistance Services Provider will arrange advance payment (directly to the provider) necessary for Your admission to a Hospital because of a covered Injury or Sickness, up to the Maximum Benefit Amount shown in the Schedule of Benefits, provided You agree to reimburse Us if it is determined that Your Medical Expense claim is not covered.

We reserve the right to deny a request for advance payment if We confirm that Your claim is not covered under the policy.

An advance payment made by Us is not a guarantee that Your Medical Expense claims are covered.

Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

Emergency Dental Expenses means expenses incurred only for the following:

1. dental services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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40

iTravelInsured Travel Sport

$250,000 per person
Secondary coverage

ACCIDENT AND SICKNESS MEDICAL EXPENSE

Benefits will be paid for Your covered reasonable and necessary Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:
1. covered Medical Expenses will only be payable at the Usual and Customary level of charges;
2. benefits will be payable only for covered Medical Expenses resulting from a Sickness or an Injury that occurs while on Your Trip; and
3. Medical Expenses to be considered are only those incurred by You during Your Trip. Medical Expenses incurred after You return from Your Trip are not covered.

We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

The Plan Assistance Provider will coordinate advance payment to a Hospital, up to the Maximum Benefit Amount shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital because of a covered Injury or Sickness.

Sickness or Injury due to Adventure Sports, Extreme Sports, Hazardous Sports or Organized Sports are subject to the sub-limit listed in the Schedule of Benefits.

Maximum Benefit $250,000
Dental Expenses $1,000
Hazardous Sports $5,000
Extreme Sports $5,000
Adventure Sports $50,000
Organized Sports $50,000

Medical Expenses means the reasonable and necessary expenses incurred only for the following:

(1) Medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prosthetics, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for examination and treatment;

(2) Hospital or ambulatory medical-surgical center services (including expenses for cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Our Plan Assistance Provider as a substitute for a hospital room for recovery from Your Injury or Sickness); or

(3) Local Transportation Expense to and/or from a Hospital; or

(4) Emergency dental treatment.

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41

iTravelInsured Travel Essential

No coverage

There is no Emergency Medical coverage with this plan.

42

Patriot America Platinum

$2,000,000 policy limit
Secondary coverage

G. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary, and Charges are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies that are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness (2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies (3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies that are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery that was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs that require a prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one

(1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

i) an Injury

ii) an Illness resulting in Hospital confinement as an Inpatient

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

r) a Telehealth, Teleconsultation or Virtual Physician Visit

5) Charges incurred for a Teladoc Consultation subject to the limitations set forth in the BENEFIT SUMMARY

6) Charges incurred for Treatment at an Urgent Care Clinic

7) Charges incurred for Treatment at a Walk-in Clinic

8) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

9) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(10) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(11) Charges for an Emergency eye examination performed by a licensed optometrist or ophthalmologist to obtain a Medically Necessary prescription for corrective lenses that were lost or damaged due to an Accident covered hereunder, but not for the replacement of prescription corrective lenses or contact lenses

(12) Charges for Treatment resulting from COVID-19/SARS-CoV-2

(13) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses.

N. HOSPITAL INDEMNITY:

• Overnight limit: $250
• Maximum nights: 10
• Outside Insured Person’s Country of Residence and the United States
• Inpatient Hospitalization only

Subject to the Terms of this insurance and in the event the Insured Person has been Hospitalized in a Facility outside the Country of Residence and the United States, during the Period of Coverage, the Company will pay the Insured Person the amount shown in the BENEFIT SUMMARY for each overnight Hospitalization as an Inpatient, so long as the Treatment received during the overnight Hospitalization is considered to be an Eligible Medical Expense.

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43

Patriot America Lite

$50,000 policy limit
Secondary coverage

G. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary, and Charges are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies that are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury, even if Hospital confinement is not required

f) Emergency Treatment of an Illness; however, an additional Deductible (as shown in the BENEFIT SUMMARY) will be required unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies that are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery that was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs that require a prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one (1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

i) an Injury
ii) an Illness resulting in Hospital confinement as an Inpatient

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

r) a Telehealth, Teleconsultation or Virtual Physician Visit

(5) Charges incurred for Treatment at an Urgent Care Clinic

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(10) Charges for an Emergency eye examination performed by a licensed optometrist or ophthalmologist to obtain a Medically Necessary prescription for corrective lenses that were lost or damaged due to an Accident covered hereunder, but not for the replacement of prescription corrective lenses or contact lenses

(11) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses.

M. HOSPITAL INDEMNITY:

-Overnight limit: $250
-Maximum nights: 10
-Outside Insured Person’s Country of Residence and the United States
-Inpatient Hospitalization only

Subject to the Terms of this insurance and in the event the Insured Person has been Hospitalized in a Facility outside the Country of Residence and the United States, during the Period of Coverage, the Company will pay the Insured Person the amount shown in the BENEFIT SUMMARY for each overnight Hospitalization as an Inpatient, so long as the Treatment received during the overnight Hospitalization is considered to be an Eligible Medical Expense.

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44

Patriot International Lite

$50,000 policy limit
Secondary coverage

F. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage or any applicable Benefit Period, with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary, and Charges are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies that are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury or Illness, even if Hospital confinement is not required (2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies (3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies that are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery that was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs that require a prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one (1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

(i) an Injury

(ii) an Illness resulting in Hospital confinement as an Inpatient

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

r) a Telehealth, Teleconsultation or Virtual Physician Visit

(5) Charges incurred for Treatment at an Urgent Care Clinic

(6) Charges incurred for Treatment at a Walk-in Clinic

(7) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(8) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(9) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(10) Charges for an Emergency eye examination performed by a licensed optometrist or ophthalmologist to obtain a Medically Necessary prescription for corrective lenses that were lost or damaged due to an Accident covered hereunder, but not for the replacement of prescription corrective lenses or contact lenses

(11) Charges for Treatment resulting from COVID-19/SARS-CoV-2

(12) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses.

Q. HOSPITAL INDEMNITY: Overnight limit: $250, Maximum nights: 10

Subject to the Terms of this insurance and in the event the Insured Person has been Hospitalized in a Facility outside the Country of Residence and the United States, during the Period of Coverage, the Company will pay the Insured Person the amount shown in the BENEFIT SUMMARY for each overnight Hospitalization as an Inpatient, so long as the Treatment received during the overnight Hospitalization is considered to be an Eligible Medical Expense.

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45

Patriot International Platinum

$2,000,000 per person
Secondary coverage

F. ELIGIBLE MEDICAL EXPENSES:

Subject to the Terms of this insurance, and the insurance plan shown in the Declaration, the Company will reimburse the Insured Person up to the amount shown in the BENEFIT SUMMARY for the following costs, Charges and expenses incurred by the Insured Person during the Period of Coverage or any applicable Benefit Period with respect to an Illness or Injury suffered or sustained by the Insured Person during the Period of Coverage and while this Certificate is in effect, so long as the Illness or Injury is covered under this Certificate, Charges are Usual, Reasonable and Customary, and Charges are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”):

(1) Charges incurred at a Hospital for:

a) daily room and board, nursing services, and Ancillary Services not to exceed the average semi-private room rate. A private room will be considered when no semi-private room is available or if medical necessity warrants this type of room. The private room rate is not to exceed the average private room rate.

b) daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

c) use of operating, Treatment or recovery room

d) services and supplies that are routinely provided by the Hospital to persons for use while an Inpatient

e) Emergency Treatment of an Injury or Illness, even if Hospital confinement is not required

(2) Charges incurred for Surgery at an Outpatient Surgical Facility, including services and supplies

(3) Charges by a Physician for professional services rendered, including Surgery; provided, however, that Charges by or for an assistant surgeon will be limited and covered at the rate of up to twenty percent (20%) of the Usual, Reasonable and Customary charge of the primary surgeon; and provided, further, that the standby availability of a Physician or surgeon will not be deemed to be a professional service and is not eligible for coverage

(4) Charges incurred for:

a) dressings, sutures, casts or other supplies that are Medically Necessary

b) diagnostic testing using Radiology, ultrasonography or laboratory services. Laboratory services billed for professional component fees are covered if the pathologist has direct involvement in providing a written report or verbal consultation for specimen-specific pathology services

c) Implant devices that are Medically Necessary; however, any Implants provided outside the PPO network are limited to a payment of no more than one hundred fifty percent (150%) of the established invoice price and/or list price for that item

d) basic functional artificial limbs, eye or larynx or breast prostheses, but not the replacement or repair thereof

e) reconstructive Surgery when the Surgery is incidental to and follows Surgery that was covered hereunder

f) radiation therapy or Treatment, and chemotherapy

g) hemodialysis for the Treatment of acute renal failure only and the Charges by a Hospital for processing and administration of blood or blood components

h) oxygen and other gases and their administration

i) anesthetics and their administration by a Physician

j) drugs that require a prescription by a Physician for Treatment of Illness or Injury, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of ninety (90) days of any one (1) prescription

k) care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital

l) Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

m) Emergency Local Ambulance Transport necessarily incurred in connection with:

i) an Injury

ii) an Illness resulting in Hospital confinement as an Inpatient

n) Interfacility Ambulance Transfer must be a result of an Inpatient Hospital Admission, Medically Necessary and from one licensed health care Facility to another licensed health care Facility via air or land ambulance

o) chiropractic services prescribed by a Physician and performed by a professional chiropractor and necessarily incurred to continue recovery from a covered Injury or covered Illness; services include manipulations, x-rays and laboratory tests ordered by the chiropractor

p) physical therapy prescribed by a Physician and performed by a professional physical therapist and necessarily incurred to continue recovery from a covered Injury or covered Illness

q) Durable Medical Equipment, as defined herein, deemed to be Medically Necessary

r) a Telehealth, Teleconsultation or Virtual Physician Visit

(5) Charges incurred for a CareClix Consultation subject to the limitations set forth in the BENEFIT SUMMARY

(6) Charges incurred for Treatment at an Urgent Care Clinic

(7) Charges incurred for Treatment at a Walk-in Clinic

(8) Charges for Treatment of an Injury to the foot due to an Accident covered hereunder

(9) Charges for Treatment of an Illness for which foot Surgery is Medically Necessary and determined to be the only appropriate method of Treatment

(10) Charges for Dental Treatment as follows up to the amount shown in the BENEFIT SUMMARY:

a) Charges for Treatment following Traumatic Dental Injury from a covered Accident that resulted in physical Injury to the Insured Person

b) Charges for necessary Dental Treatment of Unexpected pain to sound natural teeth

c) Charges incurred for non-emergency Dental Treatment necessary due to an Accident covered hereunder

(11) Charges for an Emergency eye examination performed by a licensed optometrist or ophthalmologist to obtain a Medically Necessary prescription for corrective lenses that were lost or damaged due to an Accident covered hereunder, but not for the replacement of prescription corrective lenses or contact lenses

(12) Charges for Treatment resulting from COVID-19/SARS-CoV-2

(13) Charges for value-added tax (VAT) or like tax incurred on Eligible Medical Expenses.

Q. HOSPITAL INDEMNITY: Overnight limit: $250, Maximum nights: 10

Subject to the Terms of this insurance and in the event the Insured Person has been Hospitalized in a Facility outside the Country of Residence and the United States, during the Period of Coverage, the Company will pay the Insured Person the amount shown in the BENEFIT SUMMARY for each overnight Hospitalization as an Inpatient, so long as the Treatment received during the overnight Hospitalization is considered to be an Eligible Medical Expense.

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John Hancock Insurance Agency, Inc. John Hancock Insurance Agency, Inc.
Policy Name and Summary of Coverage
46

Bronze

$50,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip

Covered Expenses for this benefit include but are not limited to:
a) The services of a Physician

b) Charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel/Motel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) Charges for anesthetics (including administration);

e) X-ray examinations or treatments, and laboratory tests;

f) Ambulance service;

g) Drugs; medicines; prosthetics; and therapeutic services and supplies; and

h) Emergency dental treatment for the relief of pain

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on your trip

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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47

Silver

$100,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on Your Trip.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

Advance Payment: If You require admission to a Hospital during a Covered Trip for an Injury or Sickness, We or Our designated representative will arrange advance payment, if required by the Hospital, directly to the Hospital. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

This amount will be deducted from the Travel Medical Expense benefit limit shown in the Schedule of Benefits. You agree to reimburse this payment to Us if:

a. You do not complete the claims process as outlined in the Payment of Claims section; or

b. It is determined that Your Travel Medical Expense claim is not covered.

We will provide advance payment when required and requested by You. However:

a. We reserve the right to deny a request for advance payment if We confirm that Your claim is not covered under the Policy; and

b. An advance payment made by Us is not a guarantee of claim approval.

Benefits for Advance Payment will not duplicate any other benefits payable under the Policy.

Dental Covered Expenses

If You suffer an Injury or a Sickness that requires emergency dental treatment by a Dentist, We will reimburse You, up to the amount shown in the Schedule of Benefits, for the following emergency dental expenses:

a. Services and supplies for the relief of dental pain; and

b. The repair or replacement of teeth or dental implants.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after You have reached Your Return Destination, regardless of the reason.

Your duties in the event of a Loss:

1. You must provide Us with all bills and reports for medical and/or dental expenses claimed;

2. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance;

3. You must sign a patient authorization to release any information required by Us, to investigate Your claim.

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48

Gold

$250,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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MedjetAssist MedjetAssist
Policy Name and Summary of Coverage
49

Annual Membership

No coverage

There is no Emergency Medical coverage with this plan.

50

MedjetAssist Extended Stay

No coverage

There is no Emergency Medical coverage with this plan.

51

MedjetAssist Short Term Plan

No coverage

There is no Emergency Medical coverage with this plan.

Nationwide Mutual Insurance Company Nationwide Mutual Insurance Company
Policy Name and Summary of Coverage
52

Essential

$75,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services; This will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury or a Sickness.

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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53

Prime

$150,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services; This will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury or a Sickness.

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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54

Cruise Universal

$75,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services; This will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury or a Sickness.

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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55

Cruise Choice

$100,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services; This will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury or a Sickness.

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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56

Cruise Luxury

$150,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services; This will also include expenses for a Cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended as a substitute for a Hospital room for recovery from an Accidental Injury or a Sickness.
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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Seven Corners Seven Corners
Policy Name and Summary of Coverage
57

Trip Protection Choice

$500,000 per person
Primary coverage

EMERGENCY ACCIDENT & SICKNESS MEDICAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a. Sickness must first commence or manifest itself and Injury must first occur while on Your Trip;
b. only Medical Expenses incurred by You during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered;

If You suffer one or more Injury or Sickness while on the same Trip, the maximum amount payable for all Injuries or Sicknesses will not exceed the Maximum Benefit Amount shown in the Schedule of Benefits.

Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury, Sickness or Emergency Condition;

3. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Emergency Condition means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

Emergency Dental Expense Benefit

Benefits will be paid for Emergency Dental Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

1. benefits will be payable only for Emergency Dental Expenses resulting from an Injury to sound natural teeth that occurs while on Your Trip and requires treatment in person by a Physician;

2. only Emergency Dental Expenses incurred by You during Your Trip will be reimbursed. Dental Expenses incurred after You return from Your Trip are not covered;

3. benefits payable as a result of incurred Emergency Dental Expenses will only be paid after benefits have been paid under any other valid and collectible insurance in effect for You or in accordance with a provision in jurisdictions where excess coverage provisions are not permitted.

Emergency Dental Expenses means expenses incurred only for the following:

a. dental services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

b. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury;

c. emergency dental treatment incurred during Your Trip due to an Accidental Injury to sound natural teeth. Dental Expenses incurred after Your Trip are not covered.

We will not pay benefits in excess of the Usual and Customary level of charges.

We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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58

Trip Protection Economy

$10,000 per person
Secondary coverage

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 for expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

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59

Trip Protection Elite

$250,000 per person
Secondary coverage

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

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60

Trip Protection Basic

$100,000 per person
Secondary coverage

EMERGENCY ACCIDENT & SICKNESS
MEDICAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a. Sickness must first commence or manifest itself and Injury must first occur while on Your Trip;
b. only Medical Expenses incurred by You during Your Trip will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered;
c. benefits payable as a result of incurred Medical Expenses will only be paid after benefits have been paid under any other valid and collectible insurance in effect for You or in accordance with a provision in jurisdictions where excess coverage provisions are not permitted.

If You suffer one or more Injury or Sickness while on the same Trip, the maximum amount payable for all Injuries or Sicknesses will not exceed the Maximum Benefit Amount shown in the Schedule of Benefits.

Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us
or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury, Sickness or Emergency Condition;

3. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Emergency Condition means an Injury or Sickness diagnosed by a Physician for which You have sudden and unexpected severe or acute symptoms requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of Your condition or place Your life in jeopardy. The severe or acute symptoms must occur while on Your Trip.

Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

Emergency Dental Expense Benefit – up to $750

Benefits will be paid for Emergency Dental Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

1. benefits will be payable only for Emergency Dental Expenses resulting from an Injury to sound natural teeth that occurs while on Your Trip and requires treatment in person by a Physician;

2. only Emergency Dental Expenses incurred by You during Your Trip will be reimbursed. Dental Expenses incurred after You return from Your Trip are not covered;

3. benefits payable as a result of incurred Emergency Dental Expenses will only be paid after benefits have been paid under any other valid and collectible insurance in effect for You or in accordance with a provision in jurisdictions where excess coverage provisions are not permitted.

Emergency Dental Expenses means expenses incurred only for the following:

1. dental services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury;

3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to sound natural teeth. Dental Expenses incurred after Your Trip are not covered.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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61

Travel Medical Basic incl US

$50,000 per person
Secondary coverage

3.2 Medical Covered Expenses

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum set forth in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a) Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi-private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b) Outpatient Treatment or Surgery;

c) Administration of anesthetics;

d) Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes,oxygen, and blood transfusions;

e) Dressings, sutures, casts, splints, drugs, and medicines that can only be administered by a Physician or Surgeon or obtained through a written prescription;

f) Medically Necessary rental of a non-motorized wheelchair, crutches, or a basic hospital bed upto the purchase price;

g) Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance;

h) Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

i) Home Health Care in bed if recommended by the attending Physician, provided by a Home HealthCare agency upon direct transfer from an acute care Hospital and only in lieu of Medically Necessary Inpatient hospitalization; and

j.)Telehealth Consultation or Care

The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.

The Deductible, Copay and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

3.3 Local Ambulance – Inside the United States: $5,000, Outside the United States: Up to Medical Maximum

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Other than in an emergency, licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance. The exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The Deductible and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

Section 4. Dental

4.1 Dental Emergency — Sudden Relief of Pain $100

if the Period of Coverage is greater than thirty (30) days, the Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment for the relief of pain to Sound Natural Teeth.

The Deductible and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

4.2 Dental Emergency — Accident $250

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of an Accidental Injury caused by external contact with a foreign object. Coverage does not apply if You break a Sound Natural Tooth while eating or biting into a foreign object

The Deductible and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

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62

Travel Medical Basic excl US

$50,000 per person
Secondary coverage

3.2 Medical Covered Expenses. Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum set forth in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a. Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi- private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b. Outpatient Treatment or Surgery;

c. Administration of anesthetics;

d. Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, and blood transfusions;

e. Dressings, sutures, casts, splints, drugs, and medicines that can only be administered by a Physician or Surgeon or obtained through a written prescription;

f. Medically Necessary rental of a non-motorized wheelchair, crutches, or a basic hospital bed up to the purchase price;

g. Physiotherapy and Chiropractic Care if recommended by a Physician for the Treatment of a specific Occurrence and if administered by a licensed physical therapist;

h. Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance;

i. Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

j. Home Health Care in bed if recommended by the attending Physician, provided by a Home Health Care agency upon direct transfer from an acute care Hospital and only in lieu of Medically Necessary Inpatient hospitalization;

k. Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

l. Telehealth Consultation or Care.

The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

3.3 Local Ambulance. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Other than in an emergency, licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

Section 4. Dental

4.1 Dental Emergency — Sudden Relief of Pain

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment for the relief of pain to Sound Natural Teeth

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by this Certificate under this section.

4.2 Dental Emergency — Accident

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of an Accidental Injury caused by external contact with a foreign object. Coverage does not apply if You break a Sound Natural Tooth while eating or biting into a foreign object.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

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63

Travel Medical Choice excl US

$50,000 per person
Secondary coverage

3.2 Medical Covered Expenses. Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum set forth in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a. Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi- private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b. Outpatient Treatment or Surgery;

c. Administration of anesthetics;

d. Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes, oxygen, and blood transfusions;

e. Dressings, sutures, casts, splints, drugs, and medicines that can only be administered by a Physician or Surgeon or obtained through a written prescription;

f. Medically Necessary rental of a non-motorized wheelchair, crutches, or a basic hospital bed up to the purchase price;

g. Physiotherapy and Chiropractic Care if recommended by a Physician for the Treatment of a specific Occurrence and if administered by a licensed physical therapist;

h. Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance;

i. Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

j. Home Health Care in bed if recommended by the attending Physician, provided by a Home Health Care agency upon direct transfer from an acute care Hospital and only in lieu of Medically Necessary Inpatient hospitalization;

k. Care in a licensed Extended Care Facility upon direct transfer from an acute care Hospital; and

l. Telehealth Consultation or Care.

The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

3.3 Local Ambulance. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Other than in an emergency, licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

3.4 Hospital Daily Indemnity. The Company will pay You the amount set forth in the Schedule of Benefits for the Period of Coverage if You are an Inpatient in a Hospital while traveling outside of Your Home Country. Payment will be for each day for which You were an Inpatient up to a maximum of thirty (30) days. This payment is not related to the actual Hospital charges and is paid directly to You. You may use these funds for incidentals or as you like. This benefit applies regardless of whether Your Hospital stay is related to an exclusion from the plan. However, Your Hospital stay cannot be known or scheduled prior to the purchase of Your Plan.

3.5 Extension of Benefits in Home Country. The Company will reimburse You for Covered Expenses incurred in Your Home Country, including those incurred in Your Home Country following an Emergency Medical Evacuation or an Emergency Medical Repatriation, up to the amount set forth in the Schedule of Benefits for one hundred eighty days (180) from the onset of a new, covered Injury or Illness that begins while You are traveling and is first diagnosed and treated outside Your Home Country. This coverage does not apply for Pre-Existing Conditions.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The limit for this coverage is the amount shown on the Schedule of Benefits under “Extension of Benefits in Home Country,” not the amount shown for “Medical Maximum Options.”

3.6 Incidental Trips to Home Country. If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre-Existing Conditions.

Under this section, You will receive five (5) days of coverage per month of coverage purchased up to a maximum of sixty (60) days per three hundred sixty-four (364) days of purchased coverage.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The limit for this coverage is that amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not the amount shown for “Medical Maximum Options.”

Section 4. Dental and Vision

4.1 Dental Emergency — Sudden Relief of Pain. If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment for the relief of pain to Sound Natural Teeth.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by this Certificate under this section.

4.2 Dental Emergency — Accident. The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of an Accidental Injury caused by external contact with a foreign object. Coverage does not apply if You break a Sound Natural Tooth while eating or biting into a foreign object.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

4.3 Emergency Eye Exam. If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses if Your Medically Necessary prescription corrective lenses are lost or damaged due to a covered Accident and the replacement will require an Emergency Eye Exam to establish the proper prescription. This benefit is for the Emergency Eye Exam only and does not provide reimbursement for the replacement cost of prescription corrective lenses or contact lenses.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

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64

Travel Medical Choice incl US

$50,000 per person
Secondary coverage

3.2 Medical Covered Expenses.

Subject to the terms of the Certificate, the Company will reimburse You for Covered Expenses up to the Medical Maximum set forth in the Schedule of Benefits for the following medical Expenses that are incurred as the result of and within the Benefit Period:

a. Hospital Expenses for room and board that do not exceed the Hospital’s average charge for semi-private accommodations, Inpatient Treatment, Surgery, operating room, Intensive Care, nursing services, and services and supplies routinely provided by the Hospital to Inpatients;

b. Outpatient Treatment or Surgery;

c. Administration of anesthetics;

d. Medication, x-ray services, laboratory tests and services, use of radium and radioactive isotopes,oxygen, and blood transfusions;

e. Dressings, sutures, casts, splints, drugs, and medicines that can only be administered by a Physician or Surgeon or obtained through a written prescription;

f. Medically Necessary rental of a non-motorized wheelchair, crutches, or a basic hospital bed upto the purchase price;

g. Physiotherapy and Chiropractic Care if recommended by a Physician for the Treatment of a specific Occurrence and if administered by a licensed physical therapist;

h. Hotel room when the Insured Person, otherwise necessarily confined in a Hospital, is under the care of a duly qualified Physician in a hotel room due to unavailability of a Hospital room due to capacity or distance;

i. Artificial limbs, eyes, larynx, and orthotic appliances other than for replacement of such items;

j. Home Health Care in bed if recommended by the attending Physician, provided by a Home HealthCare agency upon direct transfer from an acute care Hospital and only in lieu of Medically Necessary Inpatient hospitalization; and

k. Telehealth Consultation or Care

The initial Treatment of an Injury or Illness must occur within thirty (30) days of the date of Injury or onset of Illness.

The Deductible, Copay and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

3.3 Local Ambulance. Inside the United States: $10,000, Outside the United States: Up to Medical Maximum.

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for the Period of Coverage for local ambulance service from within the metropolitan area to the nearest Hospital having facilities required for Medically Necessary Treatment. Other than in an emergency, licensed air ambulance transportation may be substituted for a ground ambulance if You are in a rural area and unreachable by ground ambulance.

The Deductible, Copay and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

4.1 Dental Emergency — Sudden Relief of Pain. $200

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment for the relief of pain to Sound Natural Teeth.

The Deductible and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

4.2 Dental Emergency — Accident. $500

The Company will reimburse You up to the amount set forth in the Schedule of Benefits for Covered Expenses for emergency Treatment to repair or replace Sound Natural Teeth damaged as the result of an Accidental Injury caused by external contact with a foreign object. Coverage does not apply if You break a Sound Natural Tooth while eating or biting into a foreign object

The Deductible and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

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Tin Leg Tin Leg
Policy Name and Summary of Coverage
65

Economy

$20,000 per person
Secondary coverage

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Covered Expenses:

The Company will reimburse the Insured for:

- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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66

Economy

$20,000 per person
Secondary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip.

Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:
● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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67

Standard

$30,000 per person
Secondary coverage

ACCIDENT SICKNESS MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for reasonable and customary charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses: The Company will reimburse the Insured for:

- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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68

Standard

$30,000 per person
Secondary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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69

Luxury

$100,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, Tin Leg will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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70

Luxury

$100,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:
The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● Local ambulance services to and/or from a Hospital; and

● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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71

Adventure

$100,000 per person if purchased within 15 days of trip deposit
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● local ambulance services to or from a Hospital;
● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

EXCESS INSURANCE LIMITATION

The insurance provided by this Policy for all coverages except Baggage Delay, shall be in excess of all other valid and collectible insurance or indemnity. If at the time of the occurrence of any Loss payable under this Policy there is other valid and collectible insurance or indemnity in place, the Company shall be liable only for the excess of the amount of Loss, over the amount of such other insurance or indemnity, and applicable deductible. Medical Expense will become Primary if this plan is purchased within 15 days of Initial Trip Payment.

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72

Adventure

$100,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip.

Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:
● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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73

Gold

$500,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or

Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges.

We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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74

Basic

$50,000 per person
Secondary coverage

TRAVEL MEDICAL EXPENSE

We will pay a benefit to reimburse you for the reasonable and customary charges, up to the maximum limit shown in the schedule of benefits if you suffer an injury or sickness during the covered trip that requires treatment by a physician. The injury must occur or the sickness must first begin while on a covered trip. The initial documented treatment must be given by a physician during the covered trip.

Travel Medical Covered Expenses:

We will pay a benefit to reimburse you the medically necessary expenses incurred for:

a. Services of a physician or registered nurse (R.N.), and related tests or treatment;

b. Hospital charges or ambulatory medical-surgical centerservices (this may also include expenses for a cruise ship cabin or hotel room, not already included in the cost of your covered trip, if recommended as a substitute for a hospital room for recovery from an injury or sickness;

c. Prescription medication to treat the injury or sickness;

d. Charges for anesthesia (including administration), x-ray examinations or treatments, and laboratory tests;

e. Local ambulance services to and from a hospital;

f. Hospital room and board;

g. Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices; and

h. The cost of emergency dental treatment for accidental injury to sound natural teeth that occurs during a covered trip limited to the Maximum Limit shown in the schedule of benefits. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after you have reached your return destination, regardless of the reason. The treatment must be given by a physician or dentist.

We will not pay for any expenses incurred after the Coverage Termination Date as shown in the Effective and Termination Dates section of this policy, regardless of the reason.

We will not pay benefits in excess of the reasonable and customary charges. We will not cover any expenses incurred by another party at no cost to you or already included within the cost of the covered trip.

Advance Payment: If you require admission to a hospital during a covered trip for an injury or sickness, we or our designated representative will arrange advance payment, if required by the hospital, directly to the hospital. Hospital confinement must be certified as medically necessary by the onsite attending physician.

This amount will be deducted from the Travel Medical Expense benefit limit shown in the schedule of benefits. You agree to reimburse this payment to us if:

a. You do not complete the claims process as outlined in the Payment of Claims section; or

b. It is determined that your Travel Medical Expense claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment if we confirm that your claim is not covered under the policy; and

b. An advance payment made by us is not a guarantee of claim approval.

Benefits for Advance Payment will not duplicate any other benefits payable under the policy.

Travel Medical Expense Exclusions:

In addition to the General Limitations and Exclusions, the following exclusions apply to the Travel Medical Expense Benefit. No benefits will be paid for any loss for, caused by, or resulting from:

a. Any service provided by you, a family member, or your traveling companion;

b. Alcohol orsubstance abuse or treatment for the same;

c. Experimental or investigative treatment or procedures;

d. Expenses incurred by any child born during the covered trip;

e. Care or treatment which is not medically necessary, except for related reconstructive surgery resulting from trauma,infection or disease;

f. Mental health care; or

g. Physical therapy or occupational therapy.

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75

Platinum

$100,000 per person
Secondary coverage

TRAVEL MEDICAL EXPENSE

We will pay a benefit to reimburse you for the reasonable and customary charges, up to the maximum limit shown in the schedule of benefits if you suffer an injury or sickness during the covered trip that requires treatment by a physician. The injury must occur or the sickness must first begin while on a covered trip. The initial documented treatment must be given by a physician during the covered trip.

Travel Medical Covered Expenses:

We will pay a benefit to reimburse you the medically necessary expenses incurred for:

a. Services of a physician or registered nurse (R.N.), and related tests or treatment;

b. Hospital charges or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or hotel room, not already included in the cost of your covered trip, if recommended as a substitute for a hospital room for recovery from an injury or sickness;

c. Prescription medication to treat the injury or sickness;

d. Charges for anesthesia (including administration), x-ray examinations or treatments, and laboratory tests;

e. Local ambulance services to and from a hospital;

f. Hospital room and board;

g. Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices; and

h. The cost of emergency dental treatmentfor accidental injury to sound natural teeth that occurs during a covered trip limited to the Maximum Limit shown in the schedule of benefits.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after you have reached your return destination, regardless of the reason. The treatment must be given by a physician or dentist.

We will not pay for any expenses incurred after the Coverage Termination Date as shown in the Effective and Termination Dates section of this policy, regardless of the reason.

We will not pay benefits in excess of the reasonable and customary charges. We will not cover any expenses incurred by another party at no cost to you or already included within the cost of the covered trip.

Advance Payment: If you require admission to a hospital during a covered trip for an injury or sickness, we or our designated representative will arrange advance payment, if required by the hospital, directly to the hospital. Hospital confinement must be certified as medically necessary by the onsite attending physician.

This amount will be deducted from the Travel Medical Expense benefit limit shown in the schedule of benefits. You agree to reimburse this payment to us if:

a. You do not complete the claims process as outlined in the Payment of Claims section; or

b. It is determined that your Travel Medical Expense claim is not covered.

We will provide advance payment when required and requested by you. However:

a. We reserve the right to deny a request for advance payment if we confirm that your claim is not covered under the policy; and

b. An advance payment made by us is not a guarantee of claim approval.

Benefits for Advance Payment will not duplicate any other benefits payable under the policy.

Travel Medical Expense Exclusions:

In addition to the General Limitations and Exclusions, the following exclusions apply to the Travel Medical Expense Benefit. No benefits will be paid for any loss for, caused by, or resulting from:

a. Any service provided by you, a family member, or your traveling companion;

b. Alcohol or substance abuse or treatment for the same;

c. Experimental or investigative treatment or procedures;

d. Expenses incurred by any child born during the covered trip;

e. Care or treatment which is not medically necessary, except for related reconstructive surgery resulting from trauma, infection or disease;

f. Mental health care; or

g. Physical therapy or occupational therapy.

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76

Silver

$250,000 per person
Secondary coverage

TRAVEL MEDICAL AND DENTAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits if You incur necessary Covered Expenses while on Your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip and the initial documented treatment is given by a Physician during this Trip.

Benefits payable as a result of incurred covered expenses will only be paid after benefits have been paid under any Other Valid and Collectible Health Insurance in effect for You. This coverage is in excess of any other health insurance You have available to You at the time of the loss. You must submit Your claim to that provider first. Any benefits You receive from Your primary or supplementary insurance providers will be deducted from Your claim with Us.

Covered Expenses for this benefit include but are not limited to:
a. The services of a Physician or registered nurse (R.N), and related test or treatment;
b. Charges for Hospital confinement and use of operating rooms;
c. Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel/Motel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);
d. Charges for anesthetics (including administration);
e. X-ray examinations or treatments, and laboratory tests;
f. Ambulance service;
g. Drugs, medicines, prosthetics and therapeutic services and supplies; and
h. Emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on Your Trip.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

Dental Covered Expenses

If You suffer an Injury or a Sickness that requires emergency dental treatment by a Dentist, We will reimburse You, up to the amount shown in the Schedule of Benefits, for the following emergency dental expenses:

a. Services and supplies for the relief of dental pain; and
b. The repair or replacement of teeth or dental implants.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after You have reached Your Return Destination, regardless of the reason.

Your duties in the event of a Loss:

a. You must provide Us with all bills and reports for medical and/or dental expenses claimed;
b. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance;
c. You must sign a patient authorization to release any information required by Us, to investigate Your claim.

Travel Medical and Dental Expense Exclusions:

In addition to the General Limitations and Exclusions, the following exclusions apply to the Travel Medical and Dental Expense Benefit. No benefits will be paid for any loss for, caused by, or resulting from:

1. Any service provided by You, a Family Member, or Your Traveling Companion;
2. Alcohol or substance abuse or treatment for the same;
3. Experimental or Investigative treatment or procedures;
4. Expenses incurred by any Child born during the Covered Trip;
5. Care or treatment which is not Medically Necessary, except for related reconstructive surgery resulting from trauma, infection or disease;
6. Routine physical examinations;
7. Repair or replacement of hearing aids, any type of eye glasses, contact lenses, or sunglasses;
8. Mental health care; or
9. Physical therapy or occupational therapy.

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Travel Insured International Travel Insured International
Policy Name and Summary of Coverage
77

Worldwide Trip Protector Plus

$100,000 per person
Primary coverage

ACCIDENT & SICKNESS MEDICAL EXPENSE

Benefits will be paid for the Covered Expense incurred, up to the Maximum Benefit Amount shown in the Confirmation of Benefits as a result of a Covered Accidental Injury or covered Sickness, which first occurs during Your Trip (of a duration of 90 days or less for Sickness). Only Covered Expenses incurred during Your Trip (of duration of 90 days or less for Sickness) will be reimbursed. Expenses incurred after Your Trip are not covered.

Benefits will include up to $750 expenses for emergency dental treatment due to Injury to natural teeth.

Benefits will not be paid in excess of the Usual and Customary Charges.

Advance payment will be made to a Hospital, up to the Maximum Benefit Amount, if needed to secure Your admission to a Hospital, because of a Covered Accidental Injury or covered Sickness. The authorized travel assistance company will coordinate advance payment to the Hospital.

For the purpose of this benefit:

“Covered Expense” means expense incurred only for the following:

1. The medical services, prescription drugs, prosthetics, and therapeutic services and supplies ordered or prescribed by a Legally Qualified Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services (including expenses for a cruise ship cabin or hotel room, not already included in the cost of the Your Trip, if recommended as a substitute for a hospital room for recovery from a Covered Accidental Injury or covered Sickness);

3. Transportation furnished by a professional ambulance company to and/or from a Hospital.

These benefits will not duplicate any benefits payable under the Policy or any coverage(s) attached to the Policy.

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78

Worldwide Trip Protector

$100,000 per person
Primary coverage

ACCIDENT & SICKNESS
MEDICAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a. Sickness must first commence or manifest itself and Injury must first occur while on Your Trip (of a duration of 180 days or less for Sickness);

b. only Medical Expenses incurred by You during Your Trip (of a duration of 180 days or less for Sickness) will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered.

Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury or Sickness;

3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to natural teeth. Dental expenses incurred after Your Trip is completed are not covered;

4. local transportation expense to and/or from a Hospital. We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Advance Payment: If You require admission to a Hospital or treatment at a clinic, Our designated Travel Assistance Services Provider will arrange advance payment (directly to the provider) necessary for Your admission to a Hospital because of a covered Injury or Sickness, up to the Maximum Benefit Amount shown in the Schedule of Benefits, provided You agree to reimburse Us if it is determined that Your Medical Expense claim is not covered.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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79

Worldwide Trip Protector Edge

$10,000 per person
Primary coverage

ACCIDENT & SICKNESS MEDICAL EXPENSE BENEFIT

Benefits will be paid for Medical Expenses incurred by You, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

a. Sickness must first commence or manifest itself and Injury must first occur while on Your Trip (of a duration of 180 days or less for Sickness);
b. only Medical Expenses incurred by You during Your Trip (of a duration of 180 days or less for Sickness) will be reimbursed. Medical Expenses incurred after You return from Your Trip are not covered;

Medical Expenses means expenses incurred only for the following:

1. medical services (including charges for anesthetics, x-ray examinations or treatments, and laboratory tests) and supplies, prescription drugs, and therapeutic services ordered or prescribed by a Physician as Medically Necessary for treatment;

2. Hospital or ambulatory medical-surgical center services, including expenses for a cruise ship cabin or hotel room, not already included in the cost of Your Trip, if recommended by Your attending Physician and approved by Us or Our designated Travel Assistance Services Provider as a substitute for a hospital room for recovery from Your Injury or Sickness;

3. emergency dental treatment incurred during Your Trip due to an Accidental Injury to natural teeth. Dental expenses incurred after Your Trip is completed are not covered;

4. local transportation expense to and/or from a Hospital.

We will not pay benefits in excess of the Usual and Customary level of charges. We will not cover any expenses provided by another party at no cost to You or already included within the cost of Your Trip.

Advance Payment: If You require admission to a Hospital or treatment at a clinic, Our designated Travel Assistance Services Provider will arrange advance payment (directly to the provider) necessary for Your admission to a Hospital because of a covered Injury or Sickness, up to the Maximum Benefit Amount shown in the Schedule of Benefits, provided You agree to reimburse Us if it is determined that Your Medical Expense claim is not covered.

These benefit(s) will not duplicate any other benefits payable under the policy or any coverage(s) attached to the policy.

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Travelex Insurance Services Travelex Insurance Services
Policy Name and Summary of Coverage
80

Travel Basic

$15,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● local ambulance services to or from a Hospital;

● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;

● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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81

Travel Basic

$15,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● Local ambulance services to and/or from a Hospital; and

● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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82

Travel Select

$50,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Preexisting Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:
- services of a Physician or registered nurse (R.N.);
- Hospital charges;
- X-rays;
- local ambulance services to or from a Hospital;
- artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;
- the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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83

Travel Select

$50,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule ,if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:

The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);
● Hospital charges;
● X-rays;
● Local ambulance services to and/or from a Hospital; and
● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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84

Flight Insure Plus

$10,000 per person
Primary coverage

MEDICAL EXPENSE BENEFIT

If, while on a Trip, You suffer an Injury or Sickness that requires You to be treated by a Physician, the Company will pay a benefit for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule. The Company will reimburse You for Medically Necessary covered expenses incurred to treat such Injury or Sickness during the course of the Trip provided the initial documented treatment was received from a Physician during the Trip. The Injury must first occur or the Sickness must first begin while on an overnight Trip with a Destination of at least 100 miles from Your Primary Residence, while covered under this Policy. Pre-existing medical conditions will be covered if the Pre-existing Medical Condition Waiver is in effect.

Covered Expenses:

The Company will reimburse the Insured for:

● services of a Physician or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● local ambulance services to or from a Hospital;

● artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices;

● the cost of emergency dental treatment only during a Trip limited to the Maximum Limit shown in the Schedule. Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after the Insured has reached his/her Return Destination, regardless of the reason. The treatment must be given by a Physician or dentist.

Advance Payment: If You require admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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85

Flight Insure Plus

$10,000 per person
Primary coverage

EMERGENCY MEDICAL EXPENSE

The Company will reimburse for Reasonable and Customary Charges, up to the Maximum Limit shown in the Schedule, if the Insured suffers an Injury or Sickness that requires them to be treated by a Physician. The Injury must first occur or the Sickness must first begin while on the Trip. The Company will reimburse Medically Necessary covered expenses determined by the treating Physician which are incurred to treat such Injury or Sickness during the course of the Trip. Coverage for Emergency Medical Expenses does not apply if treatment or expenses are incurred after the Insured has reached their Return Destination, regardless of the reason.

Covered Expenses:
The Company will reimburse the Insured for:

● Services of a Physician, Dentist, or registered nurse (R.N.);

● Hospital charges;

● X-rays;

● Local ambulance services to and/or from a Hospital; and

● Artificial limbs, artificial eyes, artificial teeth, or other prosthetic devices.T

The Company will also reimburse the Insured for the cost of emergency dental treatment during a Trip, up to the Dental coverage Limit shown in the Schedule.

Advance Payment: If the Insured requires admission to a Hospital, the Travel Insurance Administrator will arrange advance payment, if required. Hospital confinement must be certified as Medically Necessary by the onsite attending Physician.

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Trawick International Trawick International
Policy Name and Summary of Coverage
86

Safe Travels International excl US

$50,000 per person
Secondary coverage

MEDICAL EXPENSE BENEFIT

If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses that are incurred during the Benefit Period. The first covered expenses must be incurred within 90 days after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi-private room when a Covered Person is Hospital Confined, and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.

2. Hospital Emergency Room Visits: Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional Deductible as outlined in the schedule of benefits.

3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by the Policy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges) , laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration of blood products. This does not include personal services of a non-medical nature.

4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

5. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.

6. Physician’s Surgical Expenses.

7. Assistant Physician Surgical Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.

9. Outpatient Medical Expenses.

10. Physician Visits.

11. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.

12. X-rays.

13. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.

14. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.

15. Emergency medical treatment of pregnancy.

16. Mental or nervous disorders. Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis. A Physician or a licensed clinical psychologist must provide all mental health care services. Services of a clinical psychologist must be rendered in the provider’s office or in the outpatient department of a Hospital. Services Include treatment for Bulimia; Anorexia; Non-medical causes of insomnia. The following services are excluded: Aptitude testing, educational testing and services; Services for conditions not determined by Us as to be emotional or personality Sicknesses; Psychiatric services extending beyond the period necessary for evaluation and Diagnosis of mental deficiency or retardation; Services for mental disorders or Sickness which are not amenable to favorable modification; Bereavement; Family counseling of any kind; Marriage counseling of any kind.

17. Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.

18. Medically Necessary treatment for COVID-19, SARS-CoV-2, and any mutation or variation of SARS-CoV-2.

TRANSPORTATION BENEFITS

AMBULANCE SERVICE BENEFITS

Ambulance Service Benefits are provided for medically necessary emergency ground or air ambulance transportation as required from the emergency site to the nearest Hospital able to provide the required level of care.

ADDITIONAL BENEFITS

HOSPITAL CONFINEMENT – $150 per night up to a maximum of 15 nights per Policy Period

Benefits are payable, if the Covered Person is confined to a Hospital provided;

1. The Hospital stay is the direct result, from no other causes, of Injuries sustained in a Covered Accident or Sickness that occurs while the Policy is in effect; and

2. The Hospital say begins within 3 days of a Covered Accident or Sickness and lasts for at least 3 days. The benefit will be paid retroactive to the first day of the Hospital stay. Benefit payments will end on the first of the
following:

1. The date the Hospital Stay ends;

2. The date the Covered Person dies;

3. The 15th day of hospitalization; or

4. The date the coverage terminates.

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87

Safe Travels International Cost Saver excl US

$50,000 per person
Secondary coverage

MEDICAL EXPENSE BENEFIT

If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses that are incurred during the Benefit Period. The first covered expenses must be incurred within 90 days after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi-private room when a Covered Person is Hospital Confined, and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.

2. Hospital Emergency Room Visits: Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional Deductible as outlined in the schedule of benefits.

3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by thePolicy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges), laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration of blood products. This does not include personal services of a non-medical nature.

4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a CoveredPerson is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

5. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.

6. Physician’s Surgical Expenses.

7. Assistant Physician Surgical Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.

9. Outpatient Medical Expenses.

10. Physician Visits.

11. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.

12. X-rays.

13. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.

14. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.

15. Emergency medical treatment of pregnancy.

16. Mental or nervous disorders. Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis. A Physician or a licensed clinical psychologist must provide all mental health care services. Services of a clinical psychologist must be rendered in the provider’s office or in the outpatient department of a Hospital. Services Include treatment for Bulimia; Anorexia; Non-medical causes of insomnia. The following services are excluded: Aptitude testing, educational testing and services; Services for conditions not determined by Us as to be emotional or personality Sicknesses; Psychiatric services extending beyond the period necessary for evaluation and Diagnosis of mental deficiency or retardation; Services for mental disorders or Sickness which are not amenable to favorable modification; Bereavement; Family counseling of any kind; Marriage counseling of any kind.

17. Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.

TRANSPORTATION BENEFITS

AMBULANCE SERVICE BENEFITS

Ambulance Service Benefits are provided for medically necessary emergency ground or air ambulance transportation as required from the emergency site to the nearest Hospital able to provide the required level of care.

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88

Safe Travels USA Cost Saver

$50,000 per person
Secondary coverage

MEDICAL EXPENSE BENEFIT

If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses that are incurred during the Benefit Period. The first covered expenses must be incurred within 90 days after the date of the covered Sickness or Injury. No benefits will be paid for any expenses incurred which are in excess of usual and customary charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi-private room when a Covered Person is Hospital Confined, and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.

2. Hospital Emergency Room Visits: Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional deductible as outlined in the schedule of benefits.

3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by the Policy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges) , laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration of blood products. This does not include personal services of a non-medical nature.

4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

5. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.

6. Physician’s Surgical Expenses.

7. Assistant Physician Surgical Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.

9. Outpatient Medical Expenses.

10. Physician Visits.

11. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.

12. X-rays.

13. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.

14. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.

15. Emergency medical treatment of pregnancy.

16. Mental or nervous disorders: Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis. A Physician or a licensed clinical psychologist must provide all mental health care services. Services of a clinical psychologist must be rendered in the provider’s office or in the outpatient department of a Hospital. Services Include treatment for Bulimia; Anorexia; Non-medical causes of insomnia. The following services are excluded: Aptitude testing, educational testing and services; Services for conditions not determined by Us as to be emotional or personality Sicknesses; Psychiatric services extending beyond the period necessary for evaluation and Diagnosis of mental deficiency or retardation; Services for mental disorders or Sickness which are not amenable to favorable modification; Bereavement; Family counseling of any kind; Marriage counseling of any kind.

17. Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.

CARDIAC CONDITIONS up to $25,000 per Policy Period for ages up to 69, or $15,000 per Policy Period for ages 70 and over per Policy Period.

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89

Safe Travels USA Comprehensive

$50,000 per person
Secondary coverage

MEDICAL EXPENSE BENEFIT

If a covered Sickness or Injury occurs during the Policy Period, and the Covered Person requires medical or surgical treatment, benefits are payable for the following covered expenses that are incurred during the Benefit Period. The first covered expenses must be incurred within 90 days after the date of the Covered Accident or Sickness. No benefits will be paid for any expenses incurred which are in excess of Usual and Customary Charges.

1. Hospital Room and Board Expenses: the average daily rate for a semi-private room when a Covered Person is Hospital Confined, and general nursing care is provided and charged for by the Hospital. In computing the number of days payable under this benefit, the date of admission will be counted but not the date of discharge. All charges in excess of the allowable semiprivate rate are the responsibility of the Covered Person.

2. Hospital Emergency Room Visits: Emergency Room Visit for an Illness with no direct Hospital Admittance will be subject to an additional deductible as outlined in the schedule of benefits.

3. Ancillary Hospital Expenses: Services and supplies as Medically Necessary and approved and covered by the Policy including meals and special diets (only for the Covered Person), use of operating room and related facilities, use of intensive care and related services to include x-ray (including reading charges) , laboratory and other diagnostic tests, drugs, medications, biological anesthesia and oxygen services, and administration
of blood products. This does not include personal services of a non-medical nature.

4. Intensive Care Unit Expenses: Room and Board: 3 times the average semiprivate room rate when a Covered Person is Hospital Confined in a bed in the Intensive Care Unit and nursing services other than private duty nursing services.

5. Physician non-surgical treatment and examination expenses including the Physician’s initial visit, each Medically Necessary follow-up visit and consultation visits when referred by the attending Physician.

6. Physician’s Surgical Expenses.

7. Assistant Physician Surgical Expenses when Medically Necessary.

8. Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure on an outpatient basis.

9. Outpatient Medical Expenses.

10. Physician Visits.

11. Physiotherapy Physical Medicine/Chiropractic Expenses on an Inpatient or outpatient basis including treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, heat treatments, adjustments, manipulation, or any form of physical therapy.

12. X-rays.

13. Emergency dental treatment and restoration of sound natural teeth, including x-rays, required as a result of an Accident or to relieve pain.

14. Prescription Drug Expenses including dressings, drugs and medicines prescribed by a Physician.

15. Emergency medical treatment of pregnancy.

16. Mental or nervous disorders: Benefits are provided for psychotherapeutic treatment and psychiatric counseling and treatment for an approved psychiatric diagnosis. A Physician or a licensed clinical psychologist must provide all mental health care services. Services of a clinical psychologist must be rendered in the provider’s office or in the outpatient department of a Hospital. Services Include treatment for Bulimia; Anorexia; Non-medical causes of insomnia. The following services are excluded: Aptitude testing, educational testing and services; Services for conditions not determined by Us as to be emotional or personality Sicknesses; Psychiatric services extending beyond the period necessary for evaluation and Diagnosis of mental deficiency or retardation; Services for mental disorders or Sickness which are not amenable to favorable modification; Bereavement; Family counseling of any kind; Marriage counseling of any kind.

17. Treatment for Cardiac Conditions up to the maximum as stated in the Schedule of Benefits.

18. Medically Necessary treatment for COVID-19, SARS-CoV-2, and any mutation or variation of SARS-CoV-2.

ADDITIONAL MEDICAL EXPENSE BENEFITS

ACUTE ONSET OF PRE-EXISTING CONDITION Benefits are payable for an Acute Onset of a Pre-Existing Condition up to the maximum as stated in the Schedule of Benefits provided the condition or event: 1. occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care; 2. occurs a minimum of 48 hours after the Effective Date of the Policy; and 3. treatment is obtained within 24 hours of the sudden and unexpected outbreak or recurrence.

Any repeat/reoccurrence within the same Policy Period will no longer be considered Acute Onset of a Pre-Existing Condition and will not be eligible for additional coverage. This benefit covers only one (1) Acute Onset episode of a Pre-Existing Condition . Sudden and Acute Onset of a Pre-Existing Condition Coverage expires upon medical advice that the condition and onset is no longer acute, or the Covered Person is discharged from a medical facility.

WELL DOCTOR VISIT

Benefits will be payable for a Well Doctor Visit per person during the Policy Period. The Covered Person may use any Physician. Telemedicine is not eligible. To be covered:

1. the visit must occur within the first 21 days from the effective date of coverage: and

2. the Covered Person must purchase at least 30 days of coverage initially; and

3. the Physician must use specific ICD10 codes for the Well Visit which are the following three Diagnosis Codes only a) V70.0-Routine medical exam; b) Z00.00-Encounter for general adult medical examination without abnormal findings c) Z00.129-Encounter for routine child health examination without abnormal findings. Visits with ICD10 Codes not listed here are not considered Well Doctor Visits and are not covered as such but may be covered under another Policy benefit. Please register for this benefit with the Plan Administrator.

Visits with ICD10 Codes not listed here are not considered Well Doctor Visits and are not covered as such but may be covered under another Policy benefit. Please register for this benefit at: https://trawickinternational.com/wellness/register

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90

Safe Travels Single Trip

$75,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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91

Safe Travels First Class

$150,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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92

Safe Travels Explorer

$50,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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93

Safe Travels Journey

$150,000 per person
Secondary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;
b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;
c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;
d) ambulance service;
e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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94

Safe Travels Voyager

$250,000 per person
Primary coverage

EMERGENCY ACCIDENT AND SICKNESS MEDICAL EXPENSE

The Company will reimburse benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, if You incur Covered Medical Expenses for Necessary Treatment of an Accidental Injury or a Sickness that occurs during the Trip.

Covered Medical Expenses are limited to the list below:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms; Hospital or ambulatory medical-surgical center services;

c) charges for anesthetics (including administration); x-ray examinations or treatments, and laboratory tests;

d) ambulance service;

e) drugs, medicines and therapeutic services.

The Company will pay benefits up to the Maximum Benefit shown on the Schedule of Benefits, subject to any applicable sub-limits, for dental Necessary Treatment for Accidental Injury to Sound Natural Teeth. Both the Accidental Injury and the dental Necessary Treatment must occur during the Trip.

The Company will not pay benefits in excess of reasonable and customary charges. The Company will not cover any expenses provided by another party at no cost to You, or already included within the cost of the Trip.

If You are hospitalized due to an Accidental Injury or a Sickness, which first occurs during the Trip, beyond the Scheduled Return Date, coverage will be extended for up to ninety (90) days, or until You are released from the Hospital or until You have exhausted the Maximum Benefits payable under this coverage, whichever occurs first.

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95

Safe Travels Protect

$25,000 per person
Primary coverage

TRAVEL MEDICAL AND DENTAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on Your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip and the initial documented treatment is given by a Physician during this Trip.

This coverage can be considered Primary up to the amount listed in the Schedule of Benefits.

Covered Expenses for this benefit include but are not limited to:

a) The services of a Physician or registered nurse (R.N), and related test or treatment;
b) Charges for Hospital confinement and use of operating rooms;
c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel/Motel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);
d) Charges for anesthetics (including administration);
e) X-ray examinations or treatments, and laboratory tests;
f) Ambulance service;
g) Drugs, medicines, prosthetics and therapeutic services and supplies; and
h) Emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on Your Trip.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

Dental Covered Expenses

If You suffer an Injury or a Sickness that requires emergency dental treatment by a Dentist, We will reimburse You, up to the amount shown in the Schedule of Benefits, for the following emergency dental expenses:

a) Services and supplies for the relief of dental pain; and
b) The repair or replacement of teeth or dental implants.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after You have reached Your Return Destination, regardless of the reason.

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96

Safe Travels Defend

$50,000 per person
Primary coverage

TRAVEL MEDICAL AND DENTAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on Your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip and the initial documented treatment is given by a Physician during this Trip.

This coverage can be considered Primary up to the amount listed in the Schedule of Benefits.

Covered Expenses for this benefit include but are not limited to:

a. The services of a Physician or registered nurse (R.N), and related test or treatment;
b. Charges for Hospital confinement and use of operating rooms;
c. Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel/Motel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);
d. Charges for anesthetics (including administration);
e. X-ray examinations or treatments, and laboratory tests;
f. Ambulance service;
g. Drugs, medicines, prosthetics and therapeutic services and supplies; and
h. Emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on Your Trip.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

Dental Covered Expenses

If You suffer an Injury or a Sickness that requires emergency dental treatment by a Dentist, We will reimburse You, up to the amount shown in the Schedule of Benefits, for the following emergency dental expenses:

a. Services and supplies for the relief of dental pain; and
b. The repair or replacement of teeth or dental implants.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after You have reached Your Return Destination, regardless of the reason.

Your duties in the event of a Loss:

a. You must provide Us with all bills and reports for medical and/or dental expenses claimed;
b. You must provide any requested information related to the claimed expense(s), including but not limited to, an explanation of benefits from any other applicable insurance;
c. You must sign a patient authorization to release any information required by Us, to investigate Your claim.

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97

Safe Travels Armor

$100,000 per person
Primary coverage

TRAVEL MEDICAL AND DENTAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on Your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip and the initial documented treatment is given by a Physician during this Trip.

This coverage can be considered Primary up to the amount listed in the Schedule of Benefits.

Covered Expenses for this benefit include but are not limited to:

a) The services of a Physician or registered nurse (R.N), and related test or treatment;

b) Charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel/Motel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) Charges for anesthetics (including administration);

e) X-ray examinations or treatments, and laboratory tests;

f) Ambulance service;

g) Drugs, medicines, prosthetics and therapeutic services and supplies; and

h) Emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth while on Your Trip.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

Dental Covered Expenses

If You suffer an Injury or a Sickness that requires emergency dental treatment by a Dentist, We will reimburse You, up to the amount shown in the Schedule of Benefits, for the following emergency dental expenses:

a) Services and supplies for the relief of dental pain; and

b) The repair or replacement of teeth or dental implants.

Coverage for emergency dental treatment does not apply if treatment or expenses are incurred after You have reached Your Return Destination, regardless of the reason.

Your duties in the event of a Loss:

a) You must provide Us with all bills and reports for medical and/or dental expenses claimed;

b) You must provide any requested information related to the claimed expense(s), including but not limited to, an
explanation of benefits from any other applicable insurance;

c) You must sign a patient authorization to release any information required by Us, to investigate Your claim.

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USI Affinity Travel Insurance Services USI Affinity Travel Insurance Services
Policy Name and Summary of Coverage
98

Ruby

$250,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;

g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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99

Diamond

$500,000 per person
Primary coverage

EMERGENCY ACCIDENT AND EMERGENCY SICKNESS MEDICAL EXPENSE

We will pay Reasonable and Customary Charges up to the maximum limit shown on the Schedule of Benefits, subject to the Deductible, if You incur necessary Covered Expenses while on your Covered Trip and as a result of an Accidental Injury or Emergency Sickness that first manifests itself during the Covered Trip.

Covered Expenses for this benefit include but are not limited to:

a) the services of a Physician;

b) charges for Hospital confinement and use of operating rooms;

c) Hospital or ambulatory medical-surgical center services (this may also include expenses for a cruise ship cabin or Hotel room, not already included in the cost of Your Covered Trip, if recommended as a substitute for a Hospital room for recovery from an Emergency Sickness);

d) charges for anesthetics (including administration);

e) x-ray examinations or treatments, and laboratory tests;

f) ambulance service;(g) drugs, medicines, prosthetics and therapeutic services and supplies; and

h) emergency dental treatment for the relief of pain.

We will pay benefits, up to the amount shown on the Schedule of Benefits, for emergency dental treatment for Accidental Injury to natural teeth.

We will not pay benefits in excess of the Reasonable and Customary Charges. We will not cover any expenses incurred by another party at no cost to You or already included within the cost of the Covered Trip.

We will advance payment to a Hospital, up to the maximum shown on the Schedule of Benefits, if needed to secure Your admission to a Hospital during the Covered Trip because of Accidental Injury or Emergency Sickness.

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WorldTrips WorldTrips
Policy Name and Summary of Coverage
100

Atlas International excl US

$50,000 per person
Secondary coverage

Subject to the limits set forth in the Schedule of Benefits and Limits, and subject to the conditions and restrictions contained in this provision, we will pay the following expenses incurred while this insurance is in effect.

MEDICAL EXPENSES

YOU ARE COVERED FOR:

1. Charges made by a hospital for:

a. Daily room and board and nursing services not to exceed the average semi-private room rate; and

b. Daily room and board and nursing services in Intensive Care Unit; and

c. Use of operating, treatment or recovery room; and

d. Services and supplies which are routinely provided by the hospital to persons for use while inpatients; and

e. Emergency treatment of an injury, even if hospital confinement is not required; and

f. Emergency treatment of an illness; subject to emergency room co-pay as outlined in the Schedule of Benefits and Limits. ER co-payment is waived when you are directly admitted to the hospital as inpatient for further treatment of that illness.

2. Surgery at an outpatient surgical facility, including services and supplies.

3.Charges made by a physician for professional services, including virtual physician visits and surgery. Charges for an assistant surgeon are covered up to 20% of the usual, reasonable and customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

4. Dressings, sutures, casts or other supplies which are medically necessary and administered by or under the supervision of a physician, but excluding nebulizers, oxygen tanks, diabetic supplies, other supplies for use or application at home, and all devices or supplies for repeat use at home, except durable medical equipment.

5. Diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, intelligence, behavioral and educational testing are not included).

6. Artificial limbs, eyes or larynx, breast prosthesis or basic functional artificial limbs, but not the replacement or repair thereof.

7. Reconstructive surgery when the reconstructive surgery is directly related to a surgery which is covered hereunder.

8. Hemodialysis and the charges by the hospital for processing and administration of blood or blood components but not the cost of the actual blood or blood components.

9. Oxygen and other gasses and their administration by or under the supervision of a physician.

10. Anesthetics and their administration by a physician.

11. Drugs which require prescription by a physician for treatment of a covered injury or illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of 60 days per prescription.

12. Care in a licensed extended care facility upon direct transfer from an acute care hospital.

13. Home nursing care in bed by a qualified licensed professional, provided by a home health care agency upon direct transfer from an acute care hospital and only in lieu of medically necessary inpatient hospitalization.

14. Emergency local ambulance transport necessarily incurred in connection with injury or illness resulting in inpatient hospitalization.

15. Emergency dental treatment and dental surgery necessary to restore or replace natural teeth lost or damaged in an accident which was covered under this insurance.

16. Emergency dental treatment necessary to resolve acute onset of pain, provided that initial treatment is obtained within 72 hours of the acute onset of pain.

17. Emergency Eye Exam if your prescription corrective lenses are lost or damaged due to a covered loss and an exam is required to obtain a lens prescription for medically necessary correction lenses, but not for the replacement cost of prescription corrective lenses or contact lenses.

18. Medically necessary rental of durable medical equipment (consisting of a standard basic hospital bed and or a standard basic wheelchair) up to the purchase prices.

19. Outpatient physical therapy or chiropractic care if prescribed by a physician who is not affiliated with the physical therapy or chiropractic practice, necessarily incurred to continue recovery from a covered injury or illness.

20. Injury or illness resulting from participation in sports or athletic activities not otherwise excluded under this insurance.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

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101

Atlas America incl US

$50,000 per person
Secondary coverage

Subject to the limits set forth in the Schedule of Benefits and Limits, and subject to the conditions and restrictions contained in this provision, we will pay the following expenses incurred while this insurance is in effect.

MEDICAL EXPENSES

YOU ARE COVERED FOR:

1. Charges made by a hospital for:

a. Daily room and board and nursing services not to exceed the average semi-private room rate; and

b. Daily room and board and nursing services in Intensive Care Unit; and

c. Use of operating, treatment or recovery room; and

d. Services and supplies which are routinely provided by the hospital to persons for use while inpatients; and

e. Emergency treatment of an injury, even if hospital confinement is not required; and

f. Emergency treatment of an illness; subject to emergency room co-pay as outlined in the Schedule of Benefits and Limits. ER co-payment is waived when you are directly admitted to the hospital as inpatient for further treatment of that illness.

2. Surgery at an outpatient surgical facility, including services and supplies.

3.Charges made by a physician for professional services, including virtual physician visits and surgery. Charges for an assistant surgeon are covered up to 20% of the usual, reasonable and customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

4. Dressings, sutures, casts or other supplies which are medically necessary and administered by or under the supervision of a physician, but excluding nebulizers, oxygen tanks, diabetic supplies, other supplies for use or application at home, and all devices or supplies for repeat use at home, except durable medical equipment.

5. Diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, intelligence, behavioral and educational testing are not included).

6. Artificial limbs, eyes or larynx, breast prosthesis or basic functional artificial limbs, but not the replacement or repair thereof.

7. Reconstructive surgery when the reconstructive surgery is directly related to a surgery which is covered hereunder.

8. Hemodialysis and the charges by the hospital for processing and administration of blood or blood components but not the cost of the actual blood or blood components.

9. Oxygen and other gasses and their administration by or under the supervision of a physician.

10. Anesthetics and their administration by a physician.

11. Drugs which require prescription by a physician for treatment of a covered injury or illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of 60 days per prescription.

12. Care in a licensed extended care facility upon direct transfer from an acute care hospital.

13. Home nursing care in bed by a qualified licensed professional, provided by a home health care agency upon direct transfer from an acute care hospital and only in lieu of medically necessary inpatient hospitalization.

14. Emergency local ambulance transport necessarily incurred in connection with injury or illness resulting in inpatient hospitalization.

15. Emergency dental treatment and dental surgery necessary to restore or replace natural teeth lost or damaged in an accident which was covered under this insurance.

16. Emergency dental treatment necessary to resolve acute onset of pain, provided that initial treatment is obtained within seventy-two (72) hours of the acute onset of pain.

17. Emergency Eye Exam if your prescription corrective lenses are lost or damaged due to a covered loss and an exam is required to obtain a lens prescription for medically necessary correction lenses, but not for the replacement cost of prescription corrective lenses or contact lenses.

18. Medically necessary rental of durable medical equipment (consisting of a standard basic hospital bed and or a standard basic wheelchair) up to the purchase prices.

19. Outpatient physical therapy or chiropractic care if prescribed by a physician who is not affiliated with the physical therapy or chiropractic practice, necessarily incurred to continue recovery from a covered injury or illness.

20. Injury or illness resulting from participation in sports or athletic activities not otherwise excluded under this insurance.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

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102

Atlas Premium International excl US

$50,000 per person
Secondary coverage

Subject to the limits set forth in the Schedule of Benefits and Limits, and subject to the conditions and restrictions contained in this provision, we will pay the following expenses incurred while this insurance is in effect.

MEDICAL EXPENSES

YOU ARE COVERED FOR:

1. Charges made by a hospital for:

a. Daily room and board and nursing services not to exceed the average semi-private room rate; and

b. Daily room and board and nursing services in Intensive Care Unit; and

c. Use of operating, treatment or recovery room; and

d. Services and supplies which are routinely provided by the hospital to persons for use while inpatients; and

e. Emergency treatment of an injury, even if hospital confinement is not required; and

f. Emergency treatment of an illness; subject to emergency room co-pay as outlined in the Schedule of Benefits and Limits. ER co-payment is waived when you are directly admitted to the hospital as inpatient for further treatment of that illness.

2. Surgery at an outpatient surgical facility, including services and supplies.

3. Charges made by a physician for professional services, including virtual physician visits and surgery. Charges for an assistant surgeon are covered up to 20% of the usual, reasonable and customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

4. Dressings, sutures, casts or other supplies which are medically necessary and administered by or under the supervision of a physician, but excluding nebulizers, oxygen tanks, diabetic supplies, other supplies for use or application at home, and all devices or supplies for repeat use at home, except durable medical equipment.

5. Diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, intelligence, behavioral and educational testing are not included).

6. Artificial limbs, eyes or larynx, breast prosthesis or basic functional artificial limbs, but not the replacement or repair thereof.

7. Reconstructive surgery when the reconstructive surgery is directly related to a surgery which is covered hereunder.

8. Hemodialysis and the charges by the hospital for processing and administration of blood or blood components but not the cost of the actual blood or blood components.

9. Oxygen and other gasses and their administration by or under the supervision of a physician.

10. Anesthetics and their administration by a physician.

11. Drugs which require prescription by a physician for treatment of a covered injury or illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of 60 days per prescription.

12. Care in a licensed extended care facility upon direct transfer from an acute care hospital.

13. Home nursing care in bed by a qualified licensed professional, provided by a home health care agency upon direct transfer from an acute care hospital and only in lieu of medically necessary inpatient hospitalization.

14. Emergency local ambulance transport necessarily incurred in connection with injury or illness resulting in inpatient hospitalization.

15. Emergency dental treatment and dental surgery necessary to restore or replace sound natural teeth lost or damaged in an accident which was covered under this insurance.

16. Emergency dental treatment necessary to resolve acute onset of pain, provided that initial treatment is obtained within seventy-two (72) hours of the acute onset of pain.

17. Emergency Eye Exam if your prescription corrective lenses are lost or damaged due to a covered loss and an exam is required to obtain a lens prescription for medically necessary correction lenses, but not for the replacement cost of prescription corrective lenses or contact lenses.

18. Medically necessary rental of durable medical equipment (consisting of a standard basic hospital bed and or a standard basic wheelchair) up to the purchase prices.

19. Outpatient physical therapy or chiropractic care if prescribed by a physician who is not affiliated with the physical therapy or chiropractic practice, necessarily incurred to continue recovery from a covered injury or illness.

20. Injury or illness resulting from participation in sports or athletic activities not otherwise excluded under this insurance.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

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103

Atlas Premium America incl US

$50,000 per person
Secondary coverage

Subject to the limits set forth in the Schedule of Benefits and Limits, and subject to the conditions and restrictions contained in this provision, we will pay the following expenses incurred while this insurance is in effect.

MEDICAL EXPENSES

YOU ARE COVERED FOR:

1. Charges made by a hospital for:

a. Daily room and board and nursing services not to exceed the average semi-private room rate; and

b. Daily room and board and nursing services in Intensive Care Unit; and

c. Use of operating, treatment or recovery room; and

d. Services and supplies which are routinely provided by the hospital to persons for use while inpatients; and

e. Emergency treatment of an injury, even if hospital confinement is not required; and

f. Emergency treatment of an illness; subject to emergency room co-pay as outlined in the Schedule of Benefits and Limits. ER co-payment is waived when you are directly admitted to the hospital as inpatient for further treatment of that illness.

2. Surgery at an outpatient surgical facility, including services and supplies.

3. Charges made by a physician for professional services, including virtual physician visits and surgery. Charges for an assistant surgeon are covered up to 20% of the usual, reasonable and customary charge of the primary surgeon, but standby availability will not be deemed to be a professional service and therefore is not covered hereunder.

4. Dressings, sutures, casts or other supplies which are medically necessary and administered by or under the supervision of a physician, but excluding nebulizers, oxygen tanks, diabetic supplies, other supplies for use or application at home, and all devices or supplies for repeat use at home, except durable medical equipment.

5. Diagnostic testing using radiology, ultrasonographic or laboratory services (psychometric, intelligence, behavioral and educational testing are not included).

6. Artificial limbs, eyes or larynx, breast prosthesis or basic functional artificial limbs, but not the replacement or repair thereof.

7. Reconstructive surgery when the reconstructive surgery is directly related to a surgery which is covered hereunder.

8. Hemodialysis and the charges by the hospital for processing and administration of blood or blood components but not the cost of the actual blood or blood components.

9. Oxygen and other gasses and their administration by or under the supervision of a physician.

10. Anesthetics and their administration by a physician.

11. Drugs which require prescription by a physician for treatment of a covered injury or illness, but not for the replacement of lost, stolen, damaged, expired or otherwise compromised drugs, and for a maximum supply of 60 days per prescription.

12. Care in a licensed extended care facility upon direct transfer from an acute care hospital.

13. Home nursing care in bed by a qualified licensed professional, provided by a home health care agency upon direct transfer from an acute care hospital and only in lieu of medically necessary inpatient hospitalization.

14. Emergency local ambulance transport necessarily incurred in connection with injury or illness resulting in inpatient hospitalization.

15. Emergency dental treatment and dental surgery necessary to restore or replace sound natural teeth lost or damaged in an accident which was covered under this insurance.

16. Emergency dental treatment necessary to resolve acute onset of pain, provided that initial treatment is obtained within seventy-two (72) hours of the acute onset of pain.

17. Emergency Eye Exam if your prescription corrective lenses are lost or damaged due to a covered loss and an exam is required to obtain a lens prescription for medically necessary correction lenses, but not for the replacement cost of prescription corrective lenses or contact lenses.

18. Medically necessary rental of durable medical equipment (consisting of a standard basic hospital bed and or a standard basic wheelchair) up to the purchase prices.

19. Outpatient physical therapy or chiropractic care if prescribed by a physician who is not affiliated with the physical therapy or chiropractic practice, necessarily incurred to continue recovery from a covered injury or illness.

20. Injury or illness resulting from participation in sports or athletic activities not otherwise excluded under this insurance.

YOU ARE NOT COVERED IF:

1. Expenses arise directly or indirectly from anything in the General Exclusions.

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104

Atlas Journey Economy

$10,000 per person
Secondary coverage

Emergency Accident and Sickness Medical Expense

Please note: this coverage is in excess of any other coverage available to You. Please see Excess Insurance under the GENERAL PROVISIONS section for details.

Benefits will be paid for Your covered reasonable and necessary Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

1. covered Medical Expenses will only be payable at the Usual and Customary level of charges;

2. benefits will be payable only for covered Medical Expenses resulting from a Sickness or an Injury that occurs while on Your Trip; and

3. Medical Expenses to be considered are only those incurred by You during Your Trip. Medical Expenses incurred after You return from Your Trip are not covered.

We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

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105

Atlas Journey Preferred

$100,000 per person
Secondary coverage

Emergency Accident and Sickness Medical Expense

Please note: this coverage is in excess of any other coverage available to You. Please see Excess Insurance under the GENERAL PROVISIONS section for details.

Benefits will be paid for Your covered reasonable and necessary Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

1. covered Medical Expenses will only be payable at the Usual and Customary level of charges;

2. benefits will be payable only for covered Medical Expenses resulting from a Sickness or an Injury that occurs while on Your Trip; and

3. Medical Expenses to be considered are only those incurred by You during Your Trip. Medical Expenses incurred after You return from Your Trip are not covered.

We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

Excess Insurance: Insurance provided by this Policy shall be in excess of all Other Insurance. If, at the time of the occurrence of any other loss, there is Other Insurance in place, We shall be liable only for the excess of any amount paid or payable under Other Insurance. Recover of losses from other parties does not result in a refund of premium paid.

Upgrade – Primary Coverage: Emergency Accident and Sickness Medical Expense

If you purchase this optional upgrade, the following changes apply:

Under the heading “GENERAL PROVISIONS”, “Emergency Accident and Sickness Medical Expense” is removed from the “Excess Insurance” provision, and added to the “Primary Insurance” provision:

Primary Insurance: Benefits provided under Emergency Accident and Sickness Medical Expense coverage shall be considered primary. This is subject to recovery, as We may pay a claim first and then seek recovery from any responsible third party.

Excess Insurance: Insurance provided by this Policy shall be in excess of all Other Insurance (except for Emergency Accident and Sickness Medical Expense). If, at the time of the occurrence of any other loss, there is Other Insurance in place, We shall be liable only for the excess of any amount paid or payable under Other Insurance. Recover of losses from other parties does not result in a refund of premium paid.

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106

Atlas Journey Premier

$150,000 per person
Primary coverage

Emergency Accident and Sickness Medical Expense

Please note: this coverage is primary. Please see Primary Insurance under the GENERAL PROVISIONS section for details.

Benefits will be paid for Your covered reasonable and necessary Medical Expenses incurred, up to the Maximum Benefit Amount shown in the Schedule of Benefits, subject to the following:

1. covered Medical Expenses will only be payable at the Usual and Customary level of charges;

2. benefits will be payable only for covered Medical Expenses resulting from a Sickness or an Injury that occurs while on Your Trip; and

3. Medical Expenses to be considered are only those incurred by You during Your Trip. Medical Expenses incurred after You return from Your Trip are not covered.

We will not cover any expenses provided by another party at no cost to You or already included within the cost of the Trip.

Primary Insurance: Benefits provided under Emergency Accident and Sickness Medical Expense coverage shall be considered primary. This is subject to recovery, as We may pay a claim first and then seek recovery from any responsible third party.

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