International Student Insurance, OPT Insurance, AT Health Insurance, Visiting Faculty Insurance, Scholar Insurance

VISIT^® Travel & Medical Insurance Program
for International Students, Scholars, Spouses, Families and Visitors

Call Us Today 1-800-247-5575 or 1-703-660-9062 or

The Trusted Name in International Travel and Medical Insurance for over 30 Years!

Student Insurance Plans

VISIT^® International Student Plans Are Ideal For:

International students
OPT/AT students

ESL
Visiting faculty

Scholars & researchers
High school foreign students

Choose from 9 different International Student Insurance Plans:

Choose $100K or $250K Medical
Maternity included up to $10,000
$100 deductible per illness/injury
(reduced to $50 if Student Health)
80/20 co-insurance to $10,000
Medical Lifetime Maximum -
$1 million
As low as $39 per month

Choose $100K or $250K Medical
Maternity included up to $10,000
$100 deductible per illness/injury
(reduced to $50 if Student Health)
80/20 co-insurance to $5000
Medical Lifetime Maximum -
$1 million
As low as $43 per month

Choose $100K or $250K Medical
Maternity covered to policy max
$100 deductible per illness/injury
(reduced to $50 if Student Health)
80/20 co-insurance to $5000
Medical Lifetime Maximum -
$1 million
As low as $48 per month

Choose $100K or $250K Medical
Maternity covered as any other illness
Unlimited Medical Evacuation
$100 deductible per illness/injury
(reduced to $50 if Student Health)
80/20 co-insurance to $5000
Pre-existing conditions covered after 6 months
Medical Lifetime Maximum -
$1 million
As low as $53 per month

Choose $100K Medical
No maternity coverage
$100 deductible per policy period
80/20 co-insurance to $5000
As low as $43 per month

Economy, Standard, Super & Platinum Plan Benefits
Underwritten by Virginia Surety Company, Inc. (VSC), rated A- “Excellent” by A.M. Best. The VSC Master Policies are filed under form numbers IN/OUT-EOC (01/2004) and Liability AIFS LIAB (IL 09/98R)

Economy, Standard and Super plans meet or exceed U.S. State Department DS2019 requirements
Choose your own doctor or hospital; you are not required to use doctors within a specific network
Deductible reduced to $50 per occurrence if the university student health center is used first
Maternity coverage included - limits vary by plan
Pre-existing conditions covered after 12 months of continuous coverage (6 months for Platinum)
Sports & hazardous sports coverage included

ECONOMY International Student Insurance Plans
Choose $100K or $250K (maternity included)

ECONOMY Plan Monthly Rates

Rates as of July 1, 2010

Age	Economy $100K	Economy $250K
12-18	$39	$42
19-23	$42	$44
24-30	$83	$89
31-40	$129	$137
41-49	$209	$221
50-64	$285	$302

ECONOMY Plan Coverages
Coverage	Economy $100K	Economy $250K
Accident & Sickness Medical	$100,000 per injury or illness maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $10,000, 100% thereafter to policy maximum	80% to $10,000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000	up to $10,000
Home Country Coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

STANDARD International Student Insurance Plans
Choose $100K or $250K (maternity included)

STANDARD Plan Monthly Rates

Rates as of July 1, 2010

Age	Standard $100K	Standard $250K
12-18	$43	$45
19-23	$46	$48
24-30	$92	$96
31-40	$142	$150
41-49	$230	$242
50-64	$314	$330

STANDARD Plan Coverages

Coverage	Standard $100K	Standard $250K
Accident & Sickness Medical	$100,000 per injury or illness maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity Coverage	up to $10,000	up to $10,000
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

SUPER International Student Insurance Plans
Choose $100K or $250K (maternity included)

SUPER Plan Monthly Rates

Rates as of July 1, 2010

Age	Super $100K	Super $250K
12-18	$48	$51
19-23	$50	$56
24-30	$102	$112
31-40	$158	$173
41-49	$257	$279
50-64	$349	$380

SUPER Plan Coverages

Coverages	Super $100K	Super $250K
Accident & Sickness Medical	$100,000 per injury or illness medical maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	$100,000	$100,000
Repatriation of mortal remains	$25,000	$25,000
Pre-existing condition coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage	Pre-existing Conditions 12 months prior to Effective Date, waived after 12 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	up to policy maximum	up to policy maximum
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

PLATINUM International Student Insurance Plans
Choose $100K or $250K (maternity included)

PLATINUM Plan Monthly Rates

Age	Platinum $100K	Platinum $250K
12-18	$53	$56
19-23	$55	$62
24-30	$113	$124
31-40	$174	$191
41-49	$283	$307
50-64	$384	$418

PLATINUM Plan Coverages

Coverages	Platinum $100K	Platinum $250K
Accident & Sickness Medical	$100,000 per injury or illness medical maximum Student - $50,000 (Age 50-64)	$250,000 per injury or illness maximum Student - $100,000 (Age 50-64)
Deductible	$50 Student Health / $100 non-Student Health per injury or illness	$50 Student Health / $100 non-Student Health per injury or illness
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$1,000,000	$1,000,000
Emergency Medical Evacuation	Unlimited	Unlimited
Repatriation of mortal remains	unlimited	unlimited
Pre-existing condition coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage	6 months prior to Effective Date, waived after 6 consecutive months of coverage
AD&D - Accidental Death & Dismemberment	$10,000	$10,000
Maternity coverage	Covered as any other Illness	Covered as any other Illness
Home Country coverage	30 days of coverage up to a max. of $25,000 per policy period	30 days of coverage up to a max. of $25,000 per policy period
Sports Coverage (non-interscholastic sports)	$10,000 per policy period	$10,000 per policy period
Hazardous sports coverage	$10,000 per policy period	$10,000 per policy period
View Policy Details

Plan E^PLUS
Underwritten by Virginia Surety Company, Inc. (VSC), rated A- “Excellent” by A.M. Best. The VSC Master Policies are filed under form numbers IN/OUT-EOC (01/2004) and Liability AIFS LIAB (IL 09/98R)

Plan E^PLUS Monthly Rates

Age	Plan E^PLUS	Plan E^PLUSHazardous Sports
0-29	$43	$50
30-39	$57	$66
40-49	$90	$95
50-59	$135	$155
60-64	$169	$195
65-69	$210	$242
70-79	$265	$305

Plan E^PLUS Coverages

Coverages	E^PLUS	E^PLUS Hazardous Sport Coverage
Accident & Sickness Medical	$100,000 per injury or illness medical maximum	$100,000 per injury or illness medical maximum
Deductible	$100 per policy period	$100 per policy period
Co-insurance	80% to $5000, 100% thereafter to policy maximum	80% to $5000, 100% thereafter to policy maximum
Medical Lifetime Maximum	$100,000 Age 0-69 / $50,000 Age 70-79	$100,000 Age 0-69 / $50,000 Age 70-79
Emergency Medical Evacuation	up to $100,000	up to $100,000
Repatriation of mortal remains	up to $25,000	up to $25,000
Pre-existing condition coverage	no coverage	no coverage
AD&D - Accidental Death & Dismemberment	$25,000 per Insured/Spouse $5000 per Dependent Child	$25,000 per Insured/Spouse $5000 per Dependent Child
Maternity coverage	no coverage	no coverage
Home Country coverage	60 days per 12 months of coverage up to $50,000	60 days per 12 months of coverage up to $50,000
Sports Coverage (non-interscholastic sports)	up to policy maximum	up to policy maximum
Hazardous Sports coverage	no coverage	included
Trip Interruption	up to $5000	up to $5000
Return of minor child	up to $10,000	up to $10,000
Lost baggage	up to $250	up to $250
View Policy Details

Cancellation Policy
All premiums are fully earned upon Application, and are Non-Refundable. Please apply only for the term of coverage you need, and re-apply as necessary as your plans may change.

VISIT Travel & Medical Insurance Program, an Insurance program of PENTECO, LLC
www.visitinsurance.com
Correspondence: P.O. Box 210, Mount Vernon, VA 22121 (703) 660-9062/ (800) 247-5575/ (703) 991-9164 fax
email: info@visitinsurance.com